RPN Professional and Ethical Practice 2 — Questions and Answers
Question 1: A client refuses a recommended blood transfusion due to religious beliefs. What is the RPN's primary ethical obligation?
- Administer the transfusion because it is life-saving
- Document the refusal and respect the client's autonomous decision (Correct answer)
- Notify the ethics board before taking any action
- Contact the client's family to override the refusal
Correct answer: Document the refusal and respect the client's autonomous decision
Respecting client autonomy means honoring informed refusals even when the RPN disagrees with the decision.
Question 2: An RPN suspects a colleague is diverting controlled substances. What is the most appropriate first action?
- Confront the colleague privately and warn them to stop
- Report the suspicion to the nurse manager or appropriate authority (Correct answer)
- Document observations over several weeks before acting
- Ignore it unless there is direct patient harm
Correct answer: Report the suspicion to the nurse manager or appropriate authority
RPN professional standards require reporting concerns about colleague conduct that may endanger patients to the appropriate authority promptly.
Question 3: Which principle is violated when an RPN shares a client's HIV status with the client's employer without consent?
- Beneficence
- Fidelity
- Confidentiality (Correct answer)
- Veracity
Correct answer: Confidentiality
Disclosing protected health information without authorization violates the client's right to confidentiality.
Question 4: An RPN documents an intervention that was not performed. This action is best described as:
- A documentation error
- Falsification of records (Correct answer)
- An acceptable workaround in busy settings
- Anticipatory charting
Correct answer: Falsification of records
Charting care that was not given constitutes falsification of records, a serious breach of professional and legal standards.
Question 5: A client with dementia is unable to provide informed consent for a procedure. Who has the legal authority to consent on the client's behalf in most US states?
- The attending physician
- The most available family member
- A legally designated surrogate decision-maker or healthcare proxy (Correct answer)
- The RPN caring for the client
Correct answer: A legally designated surrogate decision-maker or healthcare proxy
When a client lacks decision-making capacity, a legally designated surrogate or healthcare proxy provides substitute consent.
Question 6: The ethical principle of 'justice' in nursing practice primarily refers to:
- Telling the truth to clients at all times
- Doing no harm to clients
- Fair and equitable distribution of care and resources (Correct answer)
- Keeping promises made to clients
Correct answer: Fair and equitable distribution of care and resources
Justice requires that nursing care be provided fairly without discrimination based on personal characteristics.
Question 7: An RPN receives a gift of significant monetary value from a grateful client's family. The most appropriate response is to:
- Accept it graciously to avoid offending the family
- Accept it and report it to management
- Politely decline and explain professional boundaries around gifts (Correct answer)
- Accept it but donate it to charity
Correct answer: Politely decline and explain professional boundaries around gifts
Accepting significant gifts can compromise professional boundaries and the therapeutic relationship; declining is the ethically appropriate action.
RPN Professional and Ethical Practice 2
A client refuses a recommended blood transfusion due to religious beliefs.
What is the RPN's primary ethical obligation?