Professional Ethics, Legal, and Regulatory Practice
Professional Ethics, Legal, and Regulatory Practice
This domain tests how you apply consent, capacity, confidentiality, duty of care, documentation, advocacy, and mandated reporting in real conflicts. The exam asks what the nurse must do, not what the family prefers.
Core rules
- Valid consent requires capacity, disclosure, understanding, and voluntariness. A competent adult may refuse even life-sustaining treatment.
- Capacity is decision-specific; a patient may have capacity for one decision and not another.
- Negligence requires duty, breach, causation, and damages. Documentation should be factual, timed, and objective.
- Confidentiality yields only for need-to-know care, legal requirement, or serious public-health risk; follow minimum-necessary rules.
- Mandatory reporting varies by jurisdiction (suspected abuse, communicable disease, impaired colleagues); know your policy.
- Restraints require a current order, least restrictive alternative, monitoring, and time-limited reassessment.
Worked example
A competent adult Jehovah’s Witness refuses blood before surgery. The surgeon asks the nurse to obtain the family’s consent instead. The nurse should not do so. The patient has capacity and has refused a specific intervention; the nurse documents the refusal, verifies the patient understands alternatives and consequences, and ensures the care team respects the decision. If the patient later loses capacity and has an advance directive refusing blood, that directive guides care within law and policy.
Traps
- Accepting a family member’s consent for a competent adult.
- Documenting patient was noncompliant instead of objective refusal and education.
- Sharing patient information on social media or in public areas.
- Applying restraints without an order or without reassessment.