CARN - Certified Addictions Registered Nurse Professional and Ethical Responsibilities Questions and Answers

Question 1

A nurse is caring for a 17-year-old client seeking treatment for an opioid use disorder. The client's parents call the unit demanding to know their child's diagnosis and treatment plan. According to the federal regulation 42 CFR Part 2, what is the nurse's most appropriate response?

Accepted Answer

Inform the parents that without the client's specific written consent, no information can be disclosed.

Answer

Federal regulation 42 CFR Part 2 provides stringent confidentiality protections for patients receiving treatment for substance use disorders in federally assisted programs. These protections are often more strict than HIPAA. For a minor who has the legal capacity to apply for and obtain substance use disorder treatment on their own under state law, consent for disclosure must be given by the minor patient. Disclosing any information without the client's express written consent would be a violation of this federal law.

Question 2

An addictions nurse, Mark, has been working closely with a client, Sarah, for several months. Sarah is now stable in her recovery and is preparing for discharge. Sarah suggests they connect on social media to stay in touch. Which of the following actions by Mark best upholds professional boundaries?

Accepted Answer

Gently declining the request, explaining that the nurse-client relationship must remain professional to support her long-term recovery.

Answer

Maintaining professional boundaries is crucial for protecting the patient and the therapeutic nature of the nurse-client relationship. Connecting on personal social media blurs these lines and can create a dual relationship, which is a boundary violation. The most ethical and professional response is to clearly and kindly decline while reinforcing the therapeutic reason for the boundary, which is to protect the client's ongoing recovery.

Question 3

A nurse on an inpatient detoxification unit has a strong suspicion that a colleague is diverting opioid medications intended for patients. The nurse observes the colleague frequently taking breaks after medication administration and notes several documentation discrepancies. What is the nurse's primary ethical and professional responsibility in this situation?

Accepted Answer

Report the suspicions immediately to the nursing supervisor or through the facility's established reporting channels.

Answer

According to the American Nurses Association (ANA) Code of Ethics, the nurse's primary commitment is to the patient's safety. When impaired practice is suspected, especially involving drug diversion which endangers patients, the nurse has an obligation to report these concerns to the appropriate authority (e.g., a manager or supervisor) to protect patients from harm. Waiting to gather more evidence or confronting the colleague directly could place patients at further risk.

Question 4

A client with a severe alcohol use disorder is denied a spot on a liver transplant list, with a committee member privately stating it's a 'waste of an organ.' Which of the following actions by the addictions nurse best exemplifies the role of a patient advocate?

Accepted Answer

Helping the client file a formal grievance with the hospital's patient advocacy department and transplant ethics committee.

Answer

Patient advocacy involves actively working to protect a patient's rights and ensuring they receive equitable, unbiased care. Substance use disorders are recognized medical conditions, and denying care based on stigma is unethical. The most effective advocacy action is to use the established systems to challenge the decision by helping the client navigate the formal grievance process, which empowers the patient and directly addresses the potential discrimination within the system.

Question 5

A nurse is obtaining informed consent from a client for medication-assisted treatment (MAT) with buprenorphine. The client is showing mild signs of opioid withdrawal, including restlessness and anxiety. To ensure the client's consent is ethically valid, what is the MOST important action for the nurse to take?

Accepted Answer

Use simplified language and ask the client to explain the risks and benefits in their own words.

Answer

Valid informed consent requires that the patient has the capacity to understand the information provided and make a voluntary decision. While mild withdrawal can affect concentration, it does not automatically mean a client lacks decision-making capacity. The best way to assess and ensure comprehension is to use the 'teach-back' method, where the client articulates their understanding of the treatment, its alternatives, and its potential risks and benefits. This confirms their capacity to consent at that moment.

(CARN) Certified Addictions Registered Nurse Practice Test

(CARN) Certified Addictions Registered Nurse Practice Test

CARN - Certified Addictions Registered Nurse Professional and Ethical Responsibilities Questions and Answers