CNOR Professional Accountability and Ethics 3 — Questions and Answers
Question 1: Which organization sets the primary scope and standards of perioperative nursing practice in the United States?
- The Joint Commission (TJC)
- AORN (Association of periOperative Registered Nurses) (Correct answer)
- The American Nurses Association (ANA)
- The National Council of State Boards of Nursing (NCSBN)
Correct answer: AORN (Association of periOperative Registered Nurses)
AORN establishes the guidelines, standards, and recommended practices specific to perioperative nursing practice.
Question 2: A patient's family member demands to know details of the surgery performed on the patient. The nurse's BEST response is to:
- Provide a full summary to maintain family trust
- Share only what the patient has authorized to be disclosed (Correct answer)
- Direct the family to the hospital administrator
- Decline all discussion until the surgeon is present
Correct answer: Share only what the patient has authorized to be disclosed
HIPAA requires that patient health information only be shared with individuals the patient has authorized to receive it.
Question 3: In the context of the CNOR exam, 'professional boundaries' PRIMARILY refer to:
- Physical barriers separating sterile and non-sterile zones
- Limits that define appropriate nurse-patient relationships and interactions (Correct answer)
- Credentialing requirements for advanced practice nurses
- Policies restricting personal device use in the OR
Correct answer: Limits that define appropriate nurse-patient relationships and interactions
Professional boundaries define the therapeutic relationship between nurse and patient, preventing exploitation or inappropriate personal involvement.
Question 4: A perioperative nurse discovers that a sponge count is incorrect before wound closure. The surgeon wants to close anyway, stating it is 'probably a count error.' The nurse should:
- Defer to the surgeon's clinical judgment and proceed
- Perform an X-ray and refuse to close until the discrepancy is resolved (Correct answer)
- Document the discrepancy and allow closure
- Repeat the count once more and then proceed if still inconsistent
Correct answer: Perform an X-ray and refuse to close until the discrepancy is resolved
An unresolved incorrect count mandates radiographic investigation before closure to protect the patient from a retained surgical item.
Question 5: The concept of 'moral distress' in perioperative nursing occurs when a nurse:
- Lacks sufficient training to complete a complex procedure
- Knows the right action but is prevented from taking it by institutional constraints (Correct answer)
- Disagrees with a colleague's clinical technique
- Feels physically exhausted after a long surgical case
Correct answer: Knows the right action but is prevented from taking it by institutional constraints
Moral distress arises when ethical constraints prevent the nurse from acting on their moral judgment, leading to psychological distress.
Question 6: Which element is ESSENTIAL for a valid surgical informed consent?
- The signature must be witnessed by two licensed nurses
- The patient must be informed of alternatives, risks, benefits, and the right to refuse (Correct answer)
- Consent must be obtained on the day of surgery
- The anesthesia provider must co-sign the consent form
Correct answer: The patient must be informed of alternatives, risks, benefits, and the right to refuse
Valid informed consent requires disclosure of the procedure, its risks, benefits, alternatives, and the patient's right to refuse or withdraw consent.
Question 7: A nurse notes a colleague is impaired during a surgical procedure. The PRIORITY action is to:
- Cover for the colleague until the case ends to avoid disrupting care
- Immediately notify the charge nurse or supervisor and ensure patient safety (Correct answer)
- Discuss the concern privately with the colleague after the case
- Document the observations and submit an incident report the next day
Correct answer: Immediately notify the charge nurse or supervisor and ensure patient safety
Impairment in the OR poses an immediate threat to patient safety requiring immediate supervisory notification and removal of the impaired provider.
CNOR Professional Accountability and Ethics 3
Which organization sets the primary scope and standards of perioperative nursing practice in the United States?