CNOR Professional Accountability and Ethics 4 — Questions and Answers
Question 1: Under which circumstance is it ethically permissible for a perioperative nurse to share a patient's health information without consent?
- When the patient's family specifically requests it
- When required by mandatory reporting laws such as gunshot wounds or communicable diseases (Correct answer)
- When the nurse believes it is in the patient's best interest
- When the surgeon instructs the nurse to inform next of kin
Correct answer: When required by mandatory reporting laws such as gunshot wounds or communicable diseases
Mandatory reporting laws legally require disclosure of specific conditions (e.g., gunshot wounds, reportable diseases) without patient consent.
Question 2: A perioperative nurse identifies a gap between current practice and AORN evidence-based guidelines. The BEST professional response is to:
- Adapt the guideline informally to match current unit practice
- Bring the gap to the attention of the manager and recommend a practice improvement plan (Correct answer)
- Follow the existing practice until a new policy is officially published
- Apply the guideline only to patients at highest risk
Correct answer: Bring the gap to the attention of the manager and recommend a practice improvement plan
Professional accountability includes identifying practice gaps and advocating for evidence-based improvements through formal channels.
Question 3: The ethical principle of JUSTICE in perioperative nursing MOST directly relates to:
- Ensuring all patients receive equal, fair access to care and resources (Correct answer)
- Providing the greatest benefit to each individual patient
- Avoiding actions that could harm the patient
- Respecting patients' rights to make their own decisions
Correct answer: Ensuring all patients receive equal, fair access to care and resources
Justice requires fair distribution of care and resources without discrimination based on personal characteristics.
Question 4: A nurse is asked to circulate a procedure they have not been trained to perform. The nurse's ethical obligation is to:
- Attempt the procedure and seek help if difficulties arise
- Decline and inform the charge nurse, stating the lack of training (Correct answer)
- Proceed if a senior surgeon is present to guide them
- Accept the assignment to avoid delaying the surgical schedule
Correct answer: Decline and inform the charge nurse, stating the lack of training
Nurses are professionally and legally accountable for practicing within their competence level and must decline assignments beyond their training.
Question 5: Which action is an example of the perioperative nurse fulfilling the advocacy role?
- Performing procedures exactly as the surgeon directs without questioning
- Speaking up when the patient's surgical site mark does not match the consent form (Correct answer)
- Expediting the surgical schedule to reduce the OR's overtime costs
- Delegating patient education to the pre-admission unit
Correct answer: Speaking up when the patient's surgical site mark does not match the consent form
Patient advocacy requires the nurse to halt proceedings and clarify discrepancies that could result in wrong-site surgery.
Question 6: What does the term 'scope of practice' define for the perioperative RN?
- The specific surgical specialties a nurse may assist with
- The range of activities, skills, and responsibilities a nurse is legally and professionally authorized to perform (Correct answer)
- The number of patients a nurse can safely care for in one shift
- The geographic region where a nurse's license is valid
Correct answer: The range of activities, skills, and responsibilities a nurse is legally and professionally authorized to perform
Scope of practice is defined by state nursing practice acts and outlines the legal boundaries of a nurse's professional role.
Question 7: A surgeon asks the perioperative nurse to sign off on a surgical count that the nurse did not personally perform. The nurse should:
- Sign the form because the surgeon was present during the count
- Refuse to sign and explain that falsifying records is an ethical and legal violation (Correct answer)
- Ask another nurse to sign in their place
- Sign only if the count results appear correct upon visual inspection
Correct answer: Refuse to sign and explain that falsifying records is an ethical and legal violation
Signing documentation you did not perform is falsification of records, which is both an ethical breach and a legal violation.
CNOR Professional Accountability and Ethics 4
Under which circumstance is it ethically permissible for a perioperative nurse to share a patient's health information without consent?