RPN Professional and Ethical Practice 4 — Questions and Answers
Question 1: A client confides thoughts of self-harm to an RPN and asks the RPN not to tell anyone. The RPN's obligation is to:
- Keep the confidence as promised to maintain trust
- Report the disclosure to the care team to ensure the client's safety (Correct answer)
- Document it but take no further action
- Consult with a peer before deciding
Correct answer: Report the disclosure to the care team to ensure the client's safety
Safety supersedes confidentiality when there is risk of self-harm; the RPN must report to the interdisciplinary team immediately.
Question 2: Which behavior best demonstrates the RPN's professional accountability?
- Completing tasks without questioning orders from supervisors
- Acknowledging a clinical error, reporting it, and identifying steps to prevent recurrence (Correct answer)
- Referring all clinical decisions to the RN or physician
- Avoiding complex clients to reduce risk of error
Correct answer: Acknowledging a clinical error, reporting it, and identifying steps to prevent recurrence
Accountability involves owning one's actions, including errors, and actively contributing to improvements in practice.
Question 3: An RPN is caring for a client from a culture with different health beliefs. The ethical approach is to:
- Prioritize evidence-based practices over cultural preferences
- Incorporate the client's cultural beliefs into the care plan after mutual discussion (Correct answer)
- Refer the client to a nurse from the same culture
- Educate the client on why Western medicine is superior
Correct answer: Incorporate the client's cultural beliefs into the care plan after mutual discussion
Culturally competent, ethical care integrates the client's beliefs and values while ensuring safe, evidence-based treatment.
Question 4: A client with decision-making capacity requests discharge against medical advice (AMA). The RPN's role includes:
- Refusing to facilitate discharge to prevent liability
- Ensuring the client is informed of risks and documenting the AMA appropriately (Correct answer)
- Calling the client's family to intervene
- Withholding the client's belongings until a physician arrives
Correct answer: Ensuring the client is informed of risks and documenting the AMA appropriately
A capacitated client has the right to leave AMA; the RPN ensures informed refusal is documented and risks are communicated.
Question 5: What does 'duty of care' mean for an RPN in the context of professional ethics?
- The obligation to care for any client regardless of personal risk
- The legal and ethical obligation to provide competent care to clients under the RPN's responsibility (Correct answer)
- The requirement to report all ethical concerns to the ethics board
- The duty to follow all physician orders without question
Correct answer: The legal and ethical obligation to provide competent care to clients under the RPN's responsibility
Duty of care is the legal and ethical standard requiring RPNs to act competently and reasonably toward clients in their care.
Question 6: An RPN notices a colleague making derogatory comments about a client's weight. The most appropriate action is to:
- Ignore it since it does not directly affect client care
- Laugh along to maintain collegial relations
- Address the behavior with the colleague and report it if it continues (Correct answer)
- Immediately file a formal complaint with the state board
Correct answer: Address the behavior with the colleague and report it if it continues
Professional standards require addressing unprofessional conduct, first directly when safe, and escalating through reporting channels if the behavior continues.
Question 7: A DNR (Do Not Resuscitate) order is in place for a client. During a shift, a family member demands that the RPN 'do everything' if the client stops breathing. The RPN should:
- Follow the family member's wishes since family knows best
- Explain the DNR order calmly and involve the care team in a family discussion (Correct answer)
- Suspend the DNR until the physician is consulted
- Document the family request and ignore it
Correct answer: Explain the DNR order calmly and involve the care team in a family discussion
The RPN should explain the valid DNR order respectfully and facilitate a care conference to address the family's concerns through appropriate channels.
RPN Professional and Ethical Practice 4
A client confides thoughts of self-harm to an RPN and asks the RPN not to tell anyone.
The RPN's obligation is to: