CARN Professional and Ethical Responsibilities 2 — Questions and Answers
Question 1: A CARN discovers a colleague is diverting controlled substances for personal use. What is the nurse's primary ethical obligation?
- Confront the colleague privately and allow them to self-report
- Report the behavior to the appropriate authority or supervisor immediately (Correct answer)
- Document observations over several weeks before taking action
- Discuss the situation with other staff to gather more evidence
Correct answer: Report the behavior to the appropriate authority or supervisor immediately
The CARN has an ethical and legal obligation to report suspected diversion immediately to protect patient safety and uphold professional standards.
Question 2: Which ethical principle is most directly applied when a CARN ensures a patient with substance use disorder fully understands all treatment options before consenting?
- Beneficence
- Non-maleficence
- Autonomy (Correct answer)
- Justice
Correct answer: Autonomy
Autonomy requires that patients receive complete information and voluntarily make decisions free from coercion.
Question 3: A patient in a methadone maintenance program requests that their treatment information not be shared with their employer. Under 42 CFR Part 2, the nurse should:
- Share information if the employer has a legitimate need to know
- Obtain written consent from the patient before any disclosure (Correct answer)
- Disclose only general status without specific details
- Refer the employer to the medical director for information
Correct answer: Obtain written consent from the patient before any disclosure
42 CFR Part 2 requires patient-specific written consent before disclosing substance use disorder treatment records to any third party.
Question 4: A CARN is asked by law enforcement to confirm whether a specific individual is enrolled in the clinic's treatment program. The appropriate response is to:
- Confirm enrollment but provide no clinical details
- Neither confirm nor deny enrollment without a court order or patient consent (Correct answer)
- Provide enrollment information since law enforcement has authority
- Consult with the medical director before responding
Correct answer: Neither confirm nor deny enrollment without a court order or patient consent
Under 42 CFR Part 2, the existence of a patient's treatment record is itself protected and cannot be confirmed without consent or court order.
Question 5: When a CARN identifies a conflict between a patient's treatment goals and the facility's standard protocol, the ethical course of action is to:
- Always follow facility protocol to avoid liability
- Advocate for individualized patient care within ethical and legal boundaries (Correct answer)
- Allow the patient to refuse treatment without further discussion
- Transfer the patient to another provider
Correct answer: Advocate for individualized patient care within ethical and legal boundaries
Ethical nursing practice requires advocating for patient-centered care while operating within professional and legal boundaries.
Question 6: A patient with opioid use disorder discloses they have been drinking heavily while on buprenorphine. The nurse's priority ethical and clinical obligation is to:
- Immediately discontinue buprenorphine to prevent harm
- Document the disclosure and assess safety risk without punitive response (Correct answer)
- Notify family members about the concurrent alcohol use
- Report the patient to the prescribing physician and discontinue treatment
Correct answer: Document the disclosure and assess safety risk without punitive response
The nurse should document, assess safety, and respond therapeutically rather than punitively, as non-judgmental care is foundational in addiction nursing.
Question 7: Which action best exemplifies the CARN maintaining professional boundaries with a patient in long-term recovery?
- Accepting a small gift as a token of the patient's gratitude
- Providing personal phone number for after-hours support
- Attending the patient's community recovery celebration with supervisor approval
- Declining a social media connection request from a current patient (Correct answer)
Correct answer: Declining a social media connection request from a current patient
Declining social media connections from current patients maintains appropriate professional boundaries and protects therapeutic relationships.
CARN Professional and Ethical Responsibilities 2
A CARN discovers a colleague is diverting controlled substances for personal use.
What is the nurse's primary ethical obligation?