VA-BC Ethical Considerations 5 — Questions and Answers
Question 1: A patient consented to a PICC insertion during a previous admission. During the current admission, the nurse should:
- Rely on the prior consent since the patient has had the procedure before
- Obtain new informed consent for the current procedure (Correct answer)
- Proceed if the physician's order is present without new consent
- Ask the patient if they remember the previous consent
Correct answer: Obtain new informed consent for the current procedure
Informed consent must be obtained for each procedure and each admission; prior consent does not carry over.
Question 2: Which behavior BEST reflects the ethical principle of fidelity in vascular access nursing?
- Completing all assigned procedures before the end of shift
- Following through on a promise to return and check on a patient's IV site pain (Correct answer)
- Accurately billing for services rendered
- Attending required continuing education courses
Correct answer: Following through on a promise to return and check on a patient's IV site pain
Fidelity means keeping promises and maintaining trust; following through on commitments made to patients exemplifies this principle.
Question 3: A nurse who is part of a vascular access team is offered participation in a clinical trial that would involve placing experimental catheters in patients. The nurse's ethical responsibility includes:
- Enrolling willing patients without additional oversight
- Ensuring patients provide fully informed consent specific to the experimental nature of the trial (Correct answer)
- Deferring all trial-related decisions entirely to the principal investigator
- Excluding patients who ask questions about the study
Correct answer: Ensuring patients provide fully informed consent specific to the experimental nature of the trial
Research participation requires an enhanced informed consent process that specifically addresses the experimental nature, risks, and right to withdraw.
Question 4: A patient discloses to the vascular access nurse that they are experiencing domestic abuse. The nurse's primary ethical obligation is to:
- Maintain confidentiality and take no action to avoid overstepping boundaries
- Provide information about resources and report according to applicable mandatory reporting laws (Correct answer)
- Document the disclosure only in personal notes
- Advise the patient to contact police independently
Correct answer: Provide information about resources and report according to applicable mandatory reporting laws
Nurses have ethical and legal obligations to provide support resources and follow mandatory reporting requirements for domestic abuse disclosures.
Question 5: Which practice BEST supports ethically sound documentation in vascular access nursing?
- Charting after verifying that outcomes were favorable
- Recording objective findings, patient responses, and complications accurately and promptly (Correct answer)
- Avoiding documentation of complications to protect the team from liability
- Charting procedures in advance to save time during busy shifts
Correct answer: Recording objective findings, patient responses, and complications accurately and promptly
Accurate, timely, and objective documentation is an ethical and professional requirement that supports patient safety and legal accountability.
Question 6: A nurse notices a pattern of unnecessary central line placements in a specific unit driven by physician preference rather than clinical indication. The MOST appropriate ethical response is to:
- Accept the pattern as a physician prerogative
- Raise the concern through quality improvement or ethics channels using evidence-based criteria (Correct answer)
- Refuse to place any central lines in that unit
- Discuss the pattern informally with patients
Correct answer: Raise the concern through quality improvement or ethics channels using evidence-based criteria
Systemic ethical concerns about unnecessary procedures should be escalated through formal quality improvement or ethics reporting structures using clinical evidence.
Question 7: When a patient's family asks the vascular access nurse to withhold a serious diagnosis from the patient before a procedure, the nurse should:
- Comply to maintain family harmony and reduce patient anxiety
- Explain that patients have the right to truthful information and redirect the family to speak with the physician (Correct answer)
- Withhold information only during the procedure itself
- Agree if the family provides a documented request
Correct answer: Explain that patients have the right to truthful information and redirect the family to speak with the physician
Patients have an ethical right to truthful information about their health; family requests to withhold diagnoses should be addressed by redirecting them to the treating physician.
VA-BC Ethical Considerations 5
A patient consented to a PICC insertion during a previous admission.
During the current admission, the nurse should: