CPNRE Professional and Ethical Practice 4 — Questions and Answers
Question 1: A client refuses a blood transfusion based on religious beliefs despite risk of death. What is the PN's priority action?
- Administer the transfusion to save the client's life
- Document the refusal and notify the physician (Correct answer)
- Contact the client's family to override the decision
- Seek a court order to mandate treatment
Correct answer: Document the refusal and notify the physician
Competent adults have the right to refuse treatment; the PN must document the refusal, inform the physician, and respect client autonomy.
Question 2: A PN notices a colleague accessing a former client's health record without a current care relationship. This is best described as:
- A minor documentation issue
- A breach of privacy and confidentiality (Correct answer)
- Acceptable if the colleague previously cared for the client
- Required for quality assurance purposes
Correct answer: A breach of privacy and confidentiality
Accessing health records without a current therapeutic relationship violates PIPEDA and provincial privacy legislation.
Question 3: When delegating a task to an unregulated care provider (UCP), the PN must first confirm:
- The UCP has performed the task before
- The task is within the UCP's competence and the situation is appropriate for delegation (Correct answer)
- The charge nurse has approved the delegation
- The client has no objections to the UCP
Correct answer: The task is within the UCP's competence and the situation is appropriate for delegation
Safe delegation requires the PN to assess both the UCP's competence and the specific client situation before delegating.
Question 4: A PN is asked by a physician to perform a procedure the PN has never done before. The most appropriate response is to:
- Perform the procedure following the physician's verbal instructions
- Refuse the procedure and explain lack of competence (Correct answer)
- Ask a coworker to observe and guide during the procedure
- Complete the procedure and document any uncertainty
Correct answer: Refuse the procedure and explain lack of competence
PNs must only perform procedures within their competence; practicing outside competence violates professional standards and endangers clients.
Question 5: A PN receives a gift of significant value from a grateful client upon discharge. The most professional response is to:
- Accept it graciously to avoid offending the client
- Accept it and share it with the care team
- Decline politely and explain professional boundaries regarding gifts (Correct answer)
- Accept it but report it to the manager afterward
Correct answer: Decline politely and explain professional boundaries regarding gifts
Accepting gifts of significant value can compromise professional boundaries and create real or perceived conflicts of interest.
Question 6: Under the principle of justice in nursing ethics, a PN should:
- Give priority care to clients who are most compliant
- Provide equal and fair treatment to all clients regardless of background (Correct answer)
- Focus resources on clients most likely to recover
- Prioritize clients based on the physician's preference
Correct answer: Provide equal and fair treatment to all clients regardless of background
Justice requires fair allocation of resources and non-discriminatory care for all clients.
Question 7: A PN suspects that a client's injury is inconsistent with the reported mechanism. The PN's first responsibility is to:
- Confront the family member present at the bedside
- Document objective findings and report concerns to the physician and appropriate authority (Correct answer)
- Wait for more evidence before taking any action
- Discuss suspicions only with colleagues on the unit
Correct answer: Document objective findings and report concerns to the physician and appropriate authority
Mandatory reporting obligations require the PN to document observations and report suspected abuse to the physician and appropriate authority without delay.
CPNRE Professional and Ethical Practice 4
A client refuses a blood transfusion based on religious beliefs despite risk of death.
What is the PN's priority action?