VABC Ethical Considerations 3 — Questions and Answers
Question 1: Which scenario BEST represents an ethical breach of patient confidentiality in vascular access practice?
- Reporting a catheter-related bloodstream infection to infection control
- Discussing a patient's PICC site status in a crowded elevator (Correct answer)
- Documenting catheter placement in the electronic health record
- Communicating line status during a structured handoff report
Correct answer: Discussing a patient's PICC site status in a crowded elevator
Discussing identifiable patient information in public spaces violates HIPAA and the ethical principle of confidentiality.
Question 2: A nurse suspects a patient's PICC was inserted without proper informed consent. The nurse's first step should be to:
- Remove the catheter immediately
- Review the medical record for consent documentation (Correct answer)
- Assume consent was obtained verbally and do nothing
- Notify the media about the potential violation
Correct answer: Review the medical record for consent documentation
Reviewing the medical record is the appropriate first step to determine whether proper consent was documented before escalating concerns.
Question 3: The ethical principle of justice in vascular access care requires that:
- Nurses always agree with physician orders
- Patients receive equitable access to appropriate vascular devices regardless of ability to pay (Correct answer)
- High-cost devices are reserved for insured patients
- Clinicians prioritize efficiency over individual patient needs
Correct answer: Patients receive equitable access to appropriate vascular devices regardless of ability to pay
Justice demands fair distribution of healthcare resources and equal treatment of all patients without discrimination.
Question 4: A patient asks a vascular access nurse not to share their HIV status with family members visiting. The nurse should:
- Inform family members because they may be at risk
- Honor the patient's request and maintain confidentiality (Correct answer)
- Document it but inform the attending physician to decide
- Ask the family to leave the room and reveal the status anyway
Correct answer: Honor the patient's request and maintain confidentiality
Patient confidentiality is a legal and ethical obligation; HIV status is protected health information that cannot be shared without patient consent.
Question 5: When a patient lacks English proficiency, ethically obtaining informed consent for vascular access requires:
- Proceeding based on the physician's verbal approval
- Using a qualified medical interpreter before the procedure (Correct answer)
- Having a family member translate to save time
- Obtaining written consent in English only
Correct answer: Using a qualified medical interpreter before the procedure
True informed consent requires the patient to understand the information, which necessitates a qualified interpreter, not a family member who may filter or distort information.
Question 6: A pediatric patient's parents refuse a medically necessary central line. Which ethical framework best guides the next step?
- Override the parents immediately and proceed
- Engage ethics consultation to balance parental rights against the child's best interests (Correct answer)
- Discharge the child at parental request
- Accept the refusal without further discussion
Correct answer: Engage ethics consultation to balance parental rights against the child's best interests
When parental refusal conflicts with a child's medical welfare, an ethics consultation helps navigate competing values within legal and institutional frameworks.
Question 7: A nurse is aware that a colleague is impaired by substances while performing vascular access procedures. The ethical duty is to:
- Cover for the colleague until their shift ends
- Immediately remove the colleague from patient care and report to a supervisor (Correct answer)
- Warn the colleague privately and monitor the situation
- Document concerns but take no immediate action
Correct answer: Immediately remove the colleague from patient care and report to a supervisor
An impaired clinician poses an immediate patient safety risk, requiring immediate removal from care duties and reporting per institutional policy.
VABC Ethical Considerations 3
Which scenario BEST represents an ethical breach of patient confidentiality in vascular access practice?