VABC Ethical Considerations 4 — Questions and Answers
Question 1: Which statement BEST describes the ethical concept of veracity as applied to vascular access nursing?
- Always agree with patients to reduce anxiety
- Provide truthful, accurate information to patients about procedures and risks (Correct answer)
- Withhold negative outcomes to protect patient morale
- Share only information that the physician has approved
Correct answer: Provide truthful, accurate information to patients about procedures and risks
Veracity obligates clinicians to be truthful with patients about procedures, risks, and outcomes to support genuine informed consent.
Question 2: A nurse discovers during catheter care that a PICC was placed in a patient who later stated they did not consent to the procedure. This situation should be:
- Dismissed if no immediate complication is evident
- Reported as a potential ethical and legal violation through proper incident reporting channels (Correct answer)
- Kept confidential to protect the inserting clinician
- Handled by removing the line without documentation
Correct answer: Reported as a potential ethical and legal violation through proper incident reporting channels
Performing a procedure without informed consent is both an ethical violation and potential battery; it must be reported through incident reporting systems.
Question 3: In resource-limited settings, which ethical framework guides the allocation of scarce vascular access devices such as implanted ports?
- First-come, first-served regardless of clinical need
- Utilitarianism — maximize benefit for the greatest number of patients (Correct answer)
- Deontology — always provide the most expensive device available
- Beneficence alone — insert devices in all patients who request them
Correct answer: Utilitarianism — maximize benefit for the greatest number of patients
Utilitarian ethics prioritizes allocation decisions that produce the greatest overall patient benefit when resources are scarce.
Question 4: A patient signs consent for a midline catheter but during insertion the nurse realizes a PICC is clinically indicated. The nurse should:
- Insert the PICC since it is a better device
- Stop, explain the clinical situation, and obtain new consent for the PICC before proceeding (Correct answer)
- Complete the midline as consented and document the deviation later
- Ask the physician to change the order retrospectively
Correct answer: Stop, explain the clinical situation, and obtain new consent for the PICC before proceeding
Consent is procedure-specific; inserting a different device than the one consented to requires new informed consent.
Question 5: Which action by a vascular access nurse BEST demonstrates the ethical principle of fidelity?
- Completing charting at the end of the week to save time
- Returning to the patient after a PICC insertion to assess and address any concerns as promised (Correct answer)
- Delegating follow-up care to unlicensed personnel
- Reporting only favorable outcomes in the medical record
Correct answer: Returning to the patient after a PICC insertion to assess and address any concerns as promised
Fidelity means keeping promises and being reliable; following through on commitments made to patients exemplifies this principle.
Question 6: A nurse is pressured by a supervisor to insert a vascular access device in a patient who has clearly withdrawn consent. The nurse should:
- Comply because the supervisor has authority
- Refuse and document that the patient has withdrawn consent (Correct answer)
- Proceed if the physician also supports the insertion
- Ask the patient's family to re-consent the patient
Correct answer: Refuse and document that the patient has withdrawn consent
No authority—supervisory or otherwise—can override a competent patient's withdrawal of consent; proceeding would constitute assault.
Question 7: Which documentation practice most strongly supports ethical accountability in vascular access care?
- Recording only successful insertions to maintain positive statistics
- Accurate, timely, and complete documentation of all procedures, complications, and patient communications (Correct answer)
- Omitting minor complications to avoid disciplinary review
- Delaying documentation until the end of the shift for efficiency
Correct answer: Accurate, timely, and complete documentation of all procedures, complications, and patient communications
Accurate and complete documentation creates an ethical and legal record that protects both patients and clinicians.
VABC Ethical Considerations 4
Which statement BEST describes the ethical concept of veracity as applied to vascular access nursing?