PCCN Professional Caring & Ethics — Questions and Answers
Question 1: A nurse notices that a colleague is documenting vital signs without actually taking them. What is the most appropriate first step?
- Ignore the situation
- Confront the colleague in front of others
- Report the behavior to the nurse manager (Correct answer)
- Document your own vital signs over theirs
Correct answer: Report the behavior to the nurse manager
Falsifying documentation is a serious breach of professional ethics and patient safety. The most appropriate first step is to report the behavior to the nurse manager, who has the authority and responsibility to address such misconduct. This ensures patient safety is maintained and professional standards are upheld, without directly confronting the colleague in a potentially unprofessional manner.
Question 2: What principle of ethical practice is demonstrated by respecting a patient’s right to refuse treatment?
- Nonmaleficence
- Justice
- Autonomy (Correct answer)
- Fidelity
Correct answer: Autonomy
Autonomy is the ethical principle that respects an individual's right to make their own decisions about their healthcare, free from coercion. Allowing a patient to refuse treatment, even if it goes against medical advice, upholds their right to self-determination and their personal values. This principle is fundamental to patient-centered care.
Question 3: Which action by the nurse demonstrates advocacy for a critically ill patient?
- Administering medications on time
- Reassuring the patient’s family that everything is fine
- Communicating the patient’s wishes to the care team (Correct answer)
- Avoiding conflict with the healthcare provider
Correct answer: Communicating the patient’s wishes to the care team
Patient advocacy involves speaking up for the patient, ensuring their rights are respected, and their needs and wishes are communicated effectively to the healthcare team. This empowers the patient, especially when they are critically ill and may not be able to advocate for themselves. Administering medications or reassuring family are important but do not solely define advocacy.
Question 4: A nurse assigned to care for a former romantic partner should:
- Continue with care as assigned
- Request reassignment to avoid potential conflict (Correct answer)
- Ask a co-worker to do all treatments
- Inform the patient not to disclose their past relationship
Correct answer: Request reassignment to avoid potential conflict
To maintain professional boundaries, avoid potential conflicts of interest, and ensure objective care, a nurse should request reassignment if a patient is a former romantic partner. This protects both the patient's privacy and the nurse's professional integrity, preventing any emotional or personal biases from affecting care. Continuing care could compromise the therapeutic relationship.
Question 5: A nurse forgets to document a dose of medication but gave it. What is the appropriate action?
- Ignore it to avoid getting in trouble
- Create a new entry with the current time
- Chart a late entry with the correct time and explanation (Correct answer)
- Alter the MAR to show it was given earlier
Correct answer: Chart a late entry with the correct time and explanation
If a medication was given but not documented, the nurse must make a late entry in the patient's chart. This entry should accurately reflect the time the medication was administered and include an concise explanation for the delay in documentation. This ensures the medical record is accurate and complete, reflecting the actual care provided and maintaining legal integrity.
Question 6: Which ethical principle involves doing no harm to the patient?
- Veracity
- Nonmaleficence (Correct answer)
- Justice
- Autonomy
Correct answer: Nonmaleficence
Nonmaleficence is the ethical principle that means "do no harm." In nursing, this involves avoiding actions that could intentionally or unintentionally cause harm to a patient. It is a fundamental principle guiding all healthcare interventions and decisions, ensuring patient safety is prioritized.
Question 7: Confidentiality is best maintained in the progressive care setting by:
- Discussing patient cases during breaks in the lounge
- Using only initials on whiteboards
- Speaking quietly during handoff at the nurses' station (Correct answer)
- Sharing information only with friends or family
Correct answer: Speaking quietly during handoff at the nurses' station
Maintaining patient confidentiality is paramount in healthcare. Speaking quietly during handoff reports at the nurses' station minimizes the risk of unauthorized individuals overhearing sensitive patient information. Discussing cases in public areas, using only initials, or sharing information with friends/family are breaches of confidentiality and HIPAA violations.
Question 8: Which action best reflects the ethical principle of justice in nursing?
- Spending more time with the most agreeable patient
- Prioritizing care based on who arrives first
- Providing equal care and resources to all patients (Correct answer)
- Choosing to help the family of a VIP patient first
Correct answer: Providing equal care and resources to all patients
The ethical principle of justice in nursing dictates that all patients should receive fair and equitable care, regardless of their background, socioeconomic status, or personal characteristics. This means distributing resources and care impartially and without discrimination. Prioritizing based on personal preference or arrival time does not align with justice.
Question 9: When a nurse admits a terminally ill patient who requests no life-prolonging treatment, the nurse should:
- Inform the patient they must be resuscitated in all situations
- Call the physician to clarify advance directives (Correct answer)
- Provide life-sustaining treatments until the DNR is written
- Respect the verbal request as legal and stop all interventions
Correct answer: Call the physician to clarify advance directives
A verbal request for no life-prolonging treatment is important, but it must be legally documented as an advance directive (e.g., DNR/DNI) to be actionable. The nurse's role is to ensure the patient's wishes are formally recognized and ordered by the physician, protecting both the patient's autonomy and the healthcare team legally. Calling the physician clarifies the patient's wishes and initiates the proper documentation process.
PCCN Professional Caring & Ethics
A nurse notices that a colleague is documenting vital signs without actually taking them.
What is the most appropriate first step?