OCC Professional Practice & Ethical Considerations 2 — Questions and Answers
Question 1: A patient refuses a recommended chemotherapy regimen after being fully informed of the risks and benefits. What is the nurse's ethical obligation?
- Administer the treatment anyway to preserve life
- Document the refusal and respect the patient's autonomous decision (Correct answer)
- Notify the ethics committee to override the patient's decision
- Discharge the patient for non-compliance
Correct answer: Document the refusal and respect the patient's autonomous decision
Respecting patient autonomy requires honoring informed refusal, even if the nurse disagrees with the decision.
Question 2: Which document establishes legal authority for a surrogate decision-maker when an oncology patient loses decision-making capacity?
- DNR order
- Durable power of attorney for healthcare (Correct answer)
- Advance directive living will
- Physician order for life-sustaining treatment (POLST)
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare legally designates a surrogate to make medical decisions when the patient lacks capacity.
Question 3: During an interdisciplinary team meeting, a nurse discovers that a colleague has been documenting chemotherapy administration without actually performing all required safety checks. The nurse should FIRST:
- Confront the colleague publicly during the meeting
- Report the behavior directly to the state licensing board
- Follow the facility's chain of command and report to the charge nurse or manager (Correct answer)
- Ignore the issue to avoid conflict with the colleague
Correct answer: Follow the facility's chain of command and report to the charge nurse or manager
The nurse should follow institutional reporting procedures by notifying the immediate supervisor as the first step in addressing unsafe practice.
Question 4: A pharmaceutical company representative offers a nurse an all-expenses-paid trip to a conference in exchange for promoting their new chemotherapy agent. This situation represents:
- An acceptable educational opportunity
- A conflict of interest that violates professional ethics (Correct answer)
- Standard industry practice permitted under ONS guidelines
- A legal requirement under the Sunshine Act
Correct answer: A conflict of interest that violates professional ethics
Accepting gifts or incentives from pharmaceutical companies in exchange for promotional activity constitutes a conflict of interest.
Question 5: Which principle of bioethics is MOST directly applied when a nurse advocates for a patient who cannot afford the prescribed oral chemotherapy agent?
- Autonomy
- Nonmaleficence
- Justice (Correct answer)
- Veracity
Correct answer: Justice
Justice concerns the fair distribution of healthcare resources and equal treatment regardless of a patient's financial status.
Question 6: A nurse is asked to participate in a clinical trial that requires randomizing patients between a proven chemotherapy regimen and an experimental arm. The ethical requirement for this is called:
- Therapeutic privilege
- Clinical equipoise (Correct answer)
- Beneficent paternalism
- Informed assent
Correct answer: Clinical equipoise
Clinical equipoise requires genuine uncertainty about which treatment arm is superior before randomizing patients in a trial.
Question 7: An oncology nurse who is nationally certified must meet continuing education requirements primarily to:
- Qualify for higher reimbursement rates
- Maintain competency and ensure patient safety (Correct answer)
- Satisfy hospital accreditation standards only
- Avoid malpractice litigation
Correct answer: Maintain competency and ensure patient safety
Continuing education requirements for certification maintenance exist to ensure nurses stay current and maintain competency in a rapidly evolving field.
OCC Professional Practice & Ethical Considerations 2
A patient refuses a recommended chemotherapy regimen after being fully informed of the risks and benefits.
What is the nurse's ethical obligation?