CMC Professional Standards & Ethics 5 — Questions and Answers
Question 1: A cardiac nurse notices that a patient's advance directive specifies no intubation, but the family demands the patient be intubated following a sudden decompensation. The nurse should:
- Follow the family's wishes since they know the patient best
- Honor the advance directive and advocate for the patient's documented wishes (Correct answer)
- Intubate the patient first and resolve the ethical conflict later
- Transfer the patient to a physician who agrees with the family
Correct answer: Honor the advance directive and advocate for the patient's documented wishes
An advance directive is the patient's legally binding expression of their wishes and takes precedence over family preferences.
Question 2: Which action by a CMC nurse BEST demonstrates the ethical principle of non-maleficence?
- Administering an experimental antiarrhythmic drug at the family's request without physician order
- Double-checking a high-alert cardiac medication dose with another nurse before administration (Correct answer)
- Withholding pain medication to avoid addiction risk in a post-MI patient
- Performing a procedure outside the nurse's scope to save time during a busy shift
Correct answer: Double-checking a high-alert cardiac medication dose with another nurse before administration
Double-checking high-alert medications is a standard safety practice that directly prevents medication harm, embodying non-maleficence.
Question 3: A nurse overhears colleagues making derogatory comments about a patient's lifestyle choices in the break room. The most professional response is to:
- Join the conversation to understand the context before intervening
- Immediately ask colleagues to stop and remind them of patient dignity and confidentiality (Correct answer)
- Report the incident anonymously to administration only if it continues
- Ignore the conversation since it is occurring in a private area
Correct answer: Immediately ask colleagues to stop and remind them of patient dignity and confidentiality
Professional standards require all healthcare workers to maintain patient dignity and confidentiality in all settings, including break rooms.
Question 4: A CMC nurse is asked to participate in an evidence-based practice committee. This activity BEST demonstrates which professional standard?
- Scope expansion beyond normal nursing duties
- Lifelong learning and commitment to improving patient care quality (Correct answer)
- Compliance with hospital administrative requirements
- Substituting for physician leadership in cardiac care decisions
Correct answer: Lifelong learning and commitment to improving patient care quality
Participation in evidence-based practice committees reflects the professional standard of continuous learning and quality improvement.
Question 5: A competent cardiac patient from a Jehovah's Witness background refuses a blood transfusion that the care team considers necessary. The ethically correct response is:
- Transfuse the patient when they are sedated to prevent death
- Respect the refusal, document thoroughly, explore bloodless alternatives, and involve ethics consultation if needed (Correct answer)
- Convince the patient to accept transfusion by emphasizing the mortality risk
- Obtain emergency legal authority to override the religious objection
Correct answer: Respect the refusal, document thoroughly, explore bloodless alternatives, and involve ethics consultation if needed
A competent adult's religiously motivated refusal of treatment must be respected; clinicians should explore alternatives and document the conversation.
Question 6: Which situation requires a cardiac nurse to make a mandatory report to a state or regulatory agency?
- A patient expresses dissatisfaction with their meal tray
- A nurse witnesses suspected elder abuse involving a cardiac patient (Correct answer)
- A cardiologist disagrees with a nurse's clinical assessment
- A patient requests a second opinion on their treatment plan
Correct answer: A nurse witnesses suspected elder abuse involving a cardiac patient
Nurses are mandated reporters and must report suspected elder abuse to the appropriate state protective services agency.
Question 7: A nurse manager assigns a culturally incompetent colleague to care for a patient whose religious customs require same-gender care providers. The nurse's advocacy role requires:
- Accepting the assignment since staffing constraints take priority
- Raising the concern with the manager and facilitating a culturally congruent care assignment (Correct answer)
- Asking the patient to waive their cultural preferences given staffing limitations
- Documenting the conflict in the patient's chart and taking no further action
Correct answer: Raising the concern with the manager and facilitating a culturally congruent care assignment
Patient advocacy requires nurses to proactively address cultural care needs and work with management to honor patient preferences.
CMC Professional Standards & Ethics 5
A cardiac nurse notices that a patient's advance directive specifies no intubation, but the family demands the patient be intubated following a sudden decompensation.
The nurse should: