CNOR Professional Accountability and Ethics 5 — Questions and Answers
Question 1: A patient with decision-making capacity refuses a blood transfusion for religious reasons despite a life-threatening hemorrhage. The perioperative nurse should:
- Administer the transfusion under the surgeon's orders to save the patient's life
- Respect the patient's decision and document it, notifying the care team (Correct answer)
- Request emergency guardianship to override the patient's wishes
- Consult the ethics committee before acknowledging the refusal
Correct answer: Respect the patient's decision and document it, notifying the care team
A competent adult's informed refusal of treatment must be respected even if the decision may result in death; overriding it is a violation of autonomy.
Question 2: Which behavior BEST demonstrates that a perioperative nurse is fulfilling lifelong learning obligations?
- Completing only the CE hours required for CNOR recertification
- Actively pursuing continuing education, reading current literature, and applying new evidence to practice (Correct answer)
- Attending mandatory annual competency reviews
- Relying on experienced colleagues to update them on new guidelines
Correct answer: Actively pursuing continuing education, reading current literature, and applying new evidence to practice
Professional accountability includes proactively seeking knowledge beyond minimum requirements to deliver the highest standard of care.
Question 3: When caring for a pediatric patient requiring emergency surgery without a guardian present, the perioperative nurse should:
- Delay surgery until consent can be obtained from a legal guardian
- Proceed with surgery under the doctrine of implied emergency consent and document thoroughly (Correct answer)
- Have the charge nurse sign consent on behalf of the child
- Transfer the patient to another facility where a guardian can be reached
Correct answer: Proceed with surgery under the doctrine of implied emergency consent and document thoroughly
In a life-threatening emergency involving a minor without a guardian, implied consent allows immediate treatment to prevent death or serious harm.
Question 4: Which statement BEST describes the perioperative nurse's responsibility regarding cultural competence?
- Cultural practices should be accommodated only if they do not inconvenience the OR team
- The nurse should recognize and respect cultural, religious, and individual differences that may affect perioperative care (Correct answer)
- Cultural competence is the responsibility of the patient educator, not the OR nurse
- Standardized care protocols eliminate the need for cultural accommodation in the OR
Correct answer: The nurse should recognize and respect cultural, religious, and individual differences that may affect perioperative care
Cultural competence requires acknowledging and integrating patients' cultural backgrounds into individualized perioperative care planning.
Question 5: A perioperative nurse receives a gift from a grateful patient's family after a complex surgery. The MOST ethical action is to:
- Accept it graciously since the procedure is already complete
- Decline the gift or follow institutional policy regarding acceptance of gifts (Correct answer)
- Accept the gift but disclose it to the manager
- Share the gift equally with the entire surgical team
Correct answer: Decline the gift or follow institutional policy regarding acceptance of gifts
Most professional codes of ethics and institutional policies prohibit or restrict acceptance of gifts to prevent conflicts of interest and maintain professional boundaries.
Question 6: What is the PRIMARY purpose of the perioperative nursing documentation?
- To justify billing for services rendered to the patient
- To provide a legal, professional, and communication record of patient care delivered (Correct answer)
- To satisfy accreditation requirements for the institution
- To create a timeline for evaluating OR efficiency
Correct answer: To provide a legal, professional, and communication record of patient care delivered
Perioperative documentation serves as a legal record, a communication tool among providers, and evidence of care delivered to protect both patient and nurse.
Question 7: A nurse practitioner colleague asks a perioperative RN to co-sign an order the RN did not assess or verify. The appropriate response is to:
- Co-sign if the colleague is licensed and trusted
- Decline, as co-signing implies personal verification of the assessment and order (Correct answer)
- Agree only if the patient is stable
- Ask the charge nurse to co-sign instead
Correct answer: Decline, as co-signing implies personal verification of the assessment and order
Co-signing documentation implies you have personally reviewed and verified the information; signing what you have not assessed is professional misconduct.
CNOR Professional Accountability and Ethics 5
A patient with decision-making capacity refuses a blood transfusion for religious reasons despite a life-threatening hemorrhage.
The perioperative nurse should: