Preparing for the CCRN (Critical Care Registered Nurse) exam? Ethics is one of the areas our deck drills hardest: 30 of its 1000 flashcards focus on ethics, covering topics like Advanced Directive. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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A 58-year-old patient with capacity refuses a life-saving blood transfusion due to personal beliefs. The nurse ensures the patient understands the risks and supports the decision despite personal disagreement. Which ethical principle is primarily being upheld?
Show answer →The primary principle is Autonomy. Autonomy refers to the patient's right to self-determination and to make decisions about their own medical care without influence or coercion, provided they have the decision-making capacity. Key Exam Points: 1. Even if the decision leads to death, a competent adult has the right to refuse treatment. 2. Beneficence (acting in the patient's best interest) and Non-maleficence (do no harm) often conflict with autonomy in critical care. 3. The nurse's role is to ensure informed consent/refusal and advocate for the patient's stated wishes. Strategy Tip: AACN emphasizes that autonomy takes precedence over beneficence when a patient has capacity. Common distractor: Paternalism (where the provider makes decisions for the patient), which is the opposite of autonomy.
The nurse uses the AACN 4A's framework to address a recurring ethical conflict regarding end-of-life care on the unit. What are the four stages of this framework used to mitigate moral distress?
Show answer →The 4A's are: Ask, Affirm, Assess, and Act. Framework Breakdown: 1. Ask: Recognize signs of distress (physical or emotional) and ask Am I feeling moral distress? 2. Affirm: Acknowledge the distress and validate it with others; commit to addressing it. 3. Assess: Identify the source of the distress (e.g., communication breakdown, policy, family conflict) and determine your readiness to act. 4. Act: Implement a plan to initiate change, such as requesting an ethics committee consultation or a family meeting. Clinical Pearl: This framework is a core component of AACN’s healthy work environment initiatives and is highly testable as a tool for Moral Resilience.
An unconscious patient has no Advanced Directive or DPOA. Who is the legally recognized surrogate decision-maker according to the standard hierarchy used in most jurisdictions?
Show answer →The hierarchy typically follows: 1. Legal Guardian, 2. Designated DPOA-HC (Healthcare Proxy), 3. Spouse, 4. Adult Children, 5. Parents, 6. Adult Siblings. Exam Tip: CCRN often tests the distinction between a Living Will (written instructions) and a DPOA (the person designated to make decisions). If both exist and conflict, the DPOA generally has the power to interpret the patient's wishes in the current clinical context. Laws vary by state, but this hierarchy is the national standard.
During the withdrawal of mechanical ventilation for a patient moving to comfort care, the nurse notes significant tachypnea and use of accessory muscles. What is the priority nursing intervention?
Show answer →Immediate titration of analgesics and sedatives (e.g., Morphine and Midazolam) to alleviate respiratory distress. Priority: Symptom management is the primary goal of Comfort Measures Only (CMO). Exam Tip: AACN focuses on the nurse's role in ensuring a good death, which includes managing the death rattle with anticholinergics (Scopolamine or Glycopyrrolate) and ensuring the patient does not appear to be gasping or in pain, which is traumatic for the family.
A competent 82-year-old patient with a STEMI refuses a life-saving cardiac catheterization, stating, I've lived long enough. The family demands the nurse talk him into it. What is the nurse's priority action in patient advocacy?
Show answer →Support the patient's right to self-determination (autonomy). The nurse must ensure the patient is fully informed of the consequences (death/disability) and that the decision is not due to a reversible condition like clinical depression or delirium. Once competence and understanding are confirmed, the nurse advocates for the patient's choice, even if it contradicts family wishes or medical goals. Exam Tip: Autonomy usually trumps Beneficence (doing good) in competent adults in the ICU setting.
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Try 30 free CCRN cards firstThe full CCRN deck contains 1000 flashcards, and 30 of them focus on ethics. This page shows 5 free samples.
Our CCRN deck dedicates 30 of 1000 cards (3%) to ethics — always cross-check the official AACN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CCRN preview page has 30 more free cards. Full access to all 1000 cards is a one-time $7.
Assessment
40 cards
Diagnostics
40 cards
Management
230 cards
Pathology
370 cards
Pharmacology
50 cards
Procedures
170 cards
Professional
10 cards
Toxicology
30 cards
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