OCC Professional Practice & Ethical Considerations 3 — Questions and Answers
Question 1: A patient with advanced cancer asks the nurse not to tell her family about her prognosis. A family member calls and demands the information. The nurse should:
- Share the information to relieve family distress
- Refer the family member to the social worker and say nothing
- Honor the patient's confidentiality and not disclose without consent (Correct answer)
- Disclose only if the family member is the healthcare proxy
Correct answer: Honor the patient's confidentiality and not disclose without consent
HIPAA and ethical principles of confidentiality protect patient information from disclosure without explicit patient consent.
Question 2: When obtaining informed consent for chemotherapy, which element is ESSENTIAL for the consent to be legally and ethically valid?
- The patient must sign the form in the presence of two witnesses
- The patient must demonstrate decision-making capacity at the time of consent (Correct answer)
- The oncologist must administer consent without nursing involvement
- Consent must be obtained at least 48 hours before treatment
Correct answer: The patient must demonstrate decision-making capacity at the time of consent
Valid informed consent requires that the patient possess decision-making capacity, receive adequate information, and consent voluntarily.
Question 3: A nurse overhears a physician give a patient incorrect information about a chemotherapy drug's side effect profile. The nurse's BEST action is to:
- Immediately correct the physician in front of the patient
- Say nothing; it is outside the nurse's scope to comment on physician communication
- Speak privately with the physician and clarify the correct information with the patient (Correct answer)
- File an incident report and take no further action
Correct answer: Speak privately with the physician and clarify the correct information with the patient
Patient advocacy requires the nurse to ensure accurate information reaches the patient while addressing the issue professionally with the physician.
Question 4: According to the Oncology Nursing Society (ONS) Code of Ethics, the nurse's PRIMARY commitment is to:
- The employing institution
- The patient and the public (Correct answer)
- The interdisciplinary healthcare team
- The physician directing care
Correct answer: The patient and the public
The ONS and ANA Codes of Ethics both identify the nurse's primary commitment as being to the patient and, by extension, the public.
Question 5: A hospice patient receiving comfort-focused care requests a chemotherapy agent they saw advertised online. The nurse's MOST ethical response is to:
- Arrange administration of the treatment to honor patient wishes
- Dismiss the request as unrealistic without further discussion
- Provide balanced information about the drug and explore the patient's goals of care (Correct answer)
- Contact the insurer to determine coverage before discussing with the patient
Correct answer: Provide balanced information about the drug and explore the patient's goals of care
Ethical practice requires honest communication about treatment options while aligning interventions with the patient's goals of care.
Question 6: Which situation BEST describes a breach of professional boundaries by an oncology nurse?
- Sitting with a distressed patient during a chemotherapy infusion
- Accepting a small gift basket from a patient's family after discharge
- Providing the personal phone number to a patient for after-hours contact (Correct answer)
- Attending a patient's memorial service with the family's permission
Correct answer: Providing the personal phone number to a patient for after-hours contact
Sharing personal contact information crosses professional boundaries by blurring the therapeutic relationship.
Question 7: A nurse suspects a coworker is diverting opioids prescribed for chemotherapy-related pain. The FIRST action should be to:
- Confront the coworker directly and demand an explanation
- Monitor the situation for several more weeks to gather more evidence
- Report suspicions to the nurse manager or charge nurse immediately (Correct answer)
- Notify law enforcement without involving hospital administration
Correct answer: Report suspicions to the nurse manager or charge nurse immediately
Suspected drug diversion must be reported immediately through institutional channels to protect patients and ensure a proper investigation.
OCC Professional Practice & Ethical Considerations 3
A patient with advanced cancer asks the nurse not to tell her family about her prognosis.
A family member calls and demands the information.
The nurse should: