CPAN Professional Ethics and Standards 3 — Questions and Answers
Question 1: A PACU nurse overhears a colleague making disparaging remarks about a patient's obesity in the hallway. The best response is to:
- Ignore the comment to avoid conflict with a coworker
- Address the colleague immediately and report it per facility policy if it continues (Correct answer)
- Report it directly to the patient so they can file a complaint
- Document the incident in the patient's medical record
Correct answer: Address the colleague immediately and report it per facility policy if it continues
Disrespectful behavior toward patients violates professional ethics and patient dignity; nurses have an obligation to address such conduct and report it through appropriate channels.
Question 2: Informed consent for a procedure was obtained before the patient received sedation in the PACU. Upon reflection, the nurse suspects the patient may not have been fully competent when signing. The nurse should:
- Trust that the provider obtained it appropriately
- Notify the surgeon and document the concern for clinical review (Correct answer)
- Ask the patient to sign a new consent form
- Proceed with the procedure and document observations
Correct answer: Notify the surgeon and document the concern for clinical review
Valid informed consent requires decision-making capacity; if the nurse suspects the patient lacked capacity when signing, this must be reported for clinical and ethical review.
Question 3: The ethical concept of 'fidelity' in nursing practice refers to:
- Equal treatment of all patients regardless of status
- Keeping promises and honoring commitments to patients (Correct answer)
- Telling the truth even when it is difficult
- Acting in the patient's best interest without their input
Correct answer: Keeping promises and honoring commitments to patients
Fidelity means keeping promises, fulfilling duties, and honoring commitments made to patients, which is foundational to the nurse-patient trust relationship.
Question 4: A post-anesthesia nurse is floated to a unit where they have no PACU experience. The safest and most ethical action is to:
- Accept the assignment and learn as situations arise
- Refuse the assignment entirely and leave the hospital
- Communicate concerns about competency to the charge nurse and request orientation or an appropriate assignment (Correct answer)
- Accept only if a buddy nurse is available
Correct answer: Communicate concerns about competency to the charge nurse and request orientation or an appropriate assignment
Nurses have an ethical and professional responsibility to practice only within their competency; communicating limitations while seeking support or reassignment protects patient safety.
Question 5: A DNR (Do Not Resuscitate) order exists for a patient arriving in the PACU following elective surgery. What is the standard ASPAN-guided approach to this order?
- Automatically suspend the DNR during the perioperative period
- Follow the DNR as written without any discussion
- Discuss the patient's wishes with the surgical team and document the agreed perioperative DNR policy (Correct answer)
- Ask family members to decide whether to honor the DNR
Correct answer: Discuss the patient's wishes with the surgical team and document the agreed perioperative DNR policy
ASPAN and anesthesia guidelines recommend required reconsideration of DNR orders in the perioperative period through informed discussion with the patient and surgical team, with clear documentation.
Question 6: Which behavior by a PACU nurse BEST demonstrates professional accountability?
- Blaming equipment failure for a medication error
- Reporting a near-miss event to the charge nurse and completing an incident report (Correct answer)
- Asking a colleague to document a procedure they performed
- Avoiding documentation of an error to prevent disciplinary action
Correct answer: Reporting a near-miss event to the charge nurse and completing an incident report
Professional accountability includes transparent reporting of near-misses and errors through proper channels, which supports a culture of safety and quality improvement.
Question 7: A CPAN nurse who witnesses unethical conduct but fears retaliation for reporting it should know that:
- Reporting is optional if the conduct does not directly harm a patient
- Most states have whistleblower protection laws for nurses who report in good faith (Correct answer)
- Only managers and supervisors are protected from retaliation
- Reporting to the state board of nursing is the only protected option
Correct answer: Most states have whistleblower protection laws for nurses who report in good faith
Federal and most state whistleblower protection laws protect healthcare workers who report unethical or illegal conduct in good faith from employer retaliation.
CPAN Professional Ethics and Standards 3
A PACU nurse overhears a colleague making disparaging remarks about a patient's obesity in the hallway.
The best response is to: