CNOR Professional Accountability and Ethics 2 — Questions and Answers
Question 1: A scrub technician notices the surgeon is about to use an instrument that was not properly sterilized. What is the perioperative nurse's FIRST action?
- Document the incident after the procedure
- Immediately inform the surgeon and remove the instrument from the field (Correct answer)
- Allow the procedure to continue and report to the charge nurse afterward
- Wait to see if any infection develops before acting
Correct answer: Immediately inform the surgeon and remove the instrument from the field
Patient safety requires immediate intervention to remove non-sterile items from the surgical field before use.
Question 2: Which ethical principle is MOST directly applied when a perioperative nurse ensures a patient fully understands the risks of a surgical procedure before signing consent?
- Beneficence
- Justice
- Autonomy (Correct answer)
- Nonmaleficence
Correct answer: Autonomy
Autonomy requires that patients receive adequate information to make voluntary, informed decisions about their own care.
Question 3: A nurse witnesses a colleague falsifying a count sheet to avoid delaying the surgeon. The nurse's ethical obligation is to:
- Ignore it if the patient has no visible harm
- Report the falsification through the proper chain of command (Correct answer)
- Confront the surgeon privately to resolve the issue
- Document personal concern in the nurse's own notes only
Correct answer: Report the falsification through the proper chain of command
Falsifying records is a safety and legal violation that must be reported to protect patients and uphold professional standards.
Question 4: The ANA Code of Ethics Provision 3 focuses on which core responsibility of the nurse?
- Maintaining personal health and fitness
- Promoting, advocating for, and protecting the rights and health of patients (Correct answer)
- Participating in professional nursing organizations
- Advancing nursing science through research
Correct answer: Promoting, advocating for, and protecting the rights and health of patients
Provision 3 establishes the nurse's duty to promote, advocate for, and protect the rights, health, and safety of patients.
Question 5: A patient scheduled for a laparoscopic cholecystectomy tells the perioperative nurse they have changed their mind and want to cancel the surgery. The nurse should:
- Reassure the patient and proceed as planned
- Notify the surgeon and support the patient's right to withdraw consent (Correct answer)
- Administer pre-medication to calm the patient before reconsidering
- Remind the patient of financial penalties for last-minute cancellations
Correct answer: Notify the surgeon and support the patient's right to withdraw consent
A competent patient retains the right to withdraw informed consent at any time, and the care team must be notified immediately.
Question 6: Which action BEST demonstrates professional accountability in the perioperative setting?
- Completing all tasks before the end of the shift regardless of accuracy
- Performing self-evaluation and seeking peer feedback to improve practice (Correct answer)
- Relying solely on hospital policy for all clinical decisions
- Deferring all ethical decisions to the attending physician
Correct answer: Performing self-evaluation and seeking peer feedback to improve practice
Professional accountability includes ongoing self-assessment and seeking feedback to continually improve the quality and safety of care.
Question 7: When a perioperative nurse disagrees with a physician's order on ethical grounds, the MOST appropriate course of action is to:
- Carry out the order to avoid conflict and report concerns later
- Refuse the order and leave the patient's bedside without further communication
- Use the chain of command and, if needed, invoke the conscience clause (Correct answer)
- Consult only with nursing peers before taking any action
Correct answer: Use the chain of command and, if needed, invoke the conscience clause
Nurses have a professional and ethical obligation to use the chain of command and may invoke conscientious objection when an order conflicts with their moral integrity.
CNOR Professional Accountability and Ethics 2
A scrub technician notices the surgeon is about to use an instrument that was not properly sterilized.
What is the perioperative nurse's FIRST action?