VA-BC Ethical Considerations 3 — Questions and Answers
Question 1: Which scenario BEST represents a conflict of interest for a vascular access nurse?
- Recommending a catheter type based on published clinical guidelines
- Recommending a specific device brand from a company that provides the nurse with gifts (Correct answer)
- Using institutional formulary devices for cost efficiency
- Documenting a procedure complication accurately
Correct answer: Recommending a specific device brand from a company that provides the nurse with gifts
Accepting gifts from vendors while recommending their products represents a conflict of interest that compromises professional integrity.
Question 2: A patient from a non-English-speaking background requires a PICC insertion. The nurse cannot find an interpreter and a family member offers to translate. The BEST ethical approach is to:
- Proceed using the family member to save time
- Delay the procedure until a qualified medical interpreter is available (Correct answer)
- Use a bilingual staff member from another department without interpreter training
- Proceed and document that an interpreter was unavailable
Correct answer: Delay the procedure until a qualified medical interpreter is available
Using a qualified medical interpreter ensures accurate communication and protects patient autonomy and informed consent validity.
Question 3: The ethical concept of 'double effect' is MOST relevant in vascular access when:
- A patient refuses a needed blood transfusion
- Placing a catheter for pain medication may hasten death in a palliative patient (Correct answer)
- A nurse makes a documentation error
- A device is back-ordered and an alternative must be used
Correct answer: Placing a catheter for pain medication may hasten death in a palliative patient
The doctrine of double effect addresses situations where an action intended to produce a good effect may also foreseeably cause harm.
Question 4: A nurse is pressured by a supervisor to insert an IV in a patient who has clearly refused the procedure. The nurse's BEST course of action is to:
- Comply because the supervisor has authority
- Refuse to perform the procedure and report the situation through appropriate channels (Correct answer)
- Perform the procedure and notify the ethics team afterward
- Ask another nurse to perform the procedure instead
Correct answer: Refuse to perform the procedure and report the situation through appropriate channels
Nurses have a professional and ethical duty to refuse participation in procedures that violate patient rights, regardless of institutional pressure.
Question 5: Which action BEST demonstrates the ethical principle of veracity in vascular access nursing?
- Inserting a catheter without telling the patient about potential complications to reduce anxiety
- Accurately informing the patient of all known risks, benefits, and alternatives before the procedure (Correct answer)
- Minimizing discussion of rare complications to maintain patient confidence
- Reassuring the patient the procedure is completely risk-free
Correct answer: Accurately informing the patient of all known risks, benefits, and alternatives before the procedure
Veracity requires truthfulness, meaning the nurse must fully and honestly disclose procedure-related information to the patient.
Question 6: When a nurse disagrees with a physician's vascular access plan on clinical grounds, the ethical and professional obligation is to:
- Follow orders without question to maintain scope boundaries
- Raise the concern using respectful professional communication and document it (Correct answer)
- Refuse to participate in the procedure without explanation
- Discuss the disagreement with the patient first
Correct answer: Raise the concern using respectful professional communication and document it
Professional advocacy requires the nurse to communicate clinical concerns through appropriate channels while maintaining respect and documentation.
Question 7: A pediatric patient undergoing a vascular access procedure is old enough to express fear and reluctance. Ethically, the nurse should:
- Proceed without addressing the child's concerns since parental consent is obtained
- Acknowledge the child's feelings, provide age-appropriate explanation, and seek assent when possible (Correct answer)
- Defer entirely to the parent's authority and ignore the child's response
- Sedate the child to avoid distress during the procedure
Correct answer: Acknowledge the child's feelings, provide age-appropriate explanation, and seek assent when possible
While parental consent is legally required for minors, seeking the child's assent and providing developmentally appropriate explanation respects the child's developing autonomy.
VA-BC Ethical Considerations 3
Which scenario BEST represents a conflict of interest for a vascular access nurse?