Professionalism
What you must know
Professionalism questions test ethical reasoning, scope, and role modeling. Know the ethical principles: autonomy (the patient's right to decide), beneficence (do good), nonmaleficence (avoid harm), justice (fair allocation), veracity (truthfulness), and fidelity (keeping promises). Know that the nurse's role in informed consent is to verify voluntariness and understanding and to witness the signature - not to obtain consent or to pressure a patient.
Know the ANA Code of Ethics themes: compassion and respect for inherent dignity, primacy of the patient's interests, protection of patient rights, authority for nursing judgment, self-regulation, and responsibility to advance the profession. Advocacy and mandatory reporting (impaired practice, abuse, unsafe conditions) recur. Peer review and chain-of-command escalation are the expected responses to a colleague's practice concern - not silence and not public criticism.
Distinguish quality improvement from research: QI improves local processes and generally does not require IRB review; research generates generalizable knowledge and does. Know evidence-based practice (PICO question, appraisal, integration with patient preference and expertise) and social media boundaries (no PHI, no patient images, no disparaging commentary).
Traps
Mixing up beneficence and nonmaleficence; interpreting autonomy as abandonment when a competent patient refuses care; assuming QI projects need IRB approval.
Worked example / rule of thumb
A colleague arrives smelling of alcohol. Correct sequence: protect patients immediately (remove from patient care), then report through the chain of command/employee assistance program. Rule of thumb: patient safety is never deferred to protect a coworker's feelings.