1. A client expresses a wish to die at home. The nurse discusses the client’s expectations and negotiates a plan of
care involving all relevant parties. According to the CNO Practice Standard: Therapeutic nurse-client
relationship, Revised 2006, which Standard Statement does this demonstrate?
– Client – Centered Care
2. A client has been deemed incapable of making her own decisions and has no family. Whom should the nurse
contact for decision-making and consent for treatment?
– the office of the public guardian and trustee.
3. A client has frequent visitors in his room. A regular practice on the unit is to do bedside reports. Based on the
content of the CNO Practice Standard: Confidentiality and Privacy – Personal Health Information, what does the
nurse need to do prior to the report?
– Ask the client’s visitors to leave the room during the report unless the client requests that they stay.
4. A client is transferred to palliative care. The client asks for the nurse’s personal cellphone number in case he
has questions regarding pain management. Based on the content of the CNO practice Standard:Therapeutic
nurse-client relationship, Revised 2006, what should the nurse do?
– explore the client’s concerns regarding pain management.
5. A client requires chemotherapy and radiation. The client agrees to the treatment on the condition that he
receives constant nursing support due to his anxiety. What should the nurse do?
– advocate for effective care for the client.
6. A client situation arises that may present an ethical issue. What is the first thing the nurse must do?
- Determine the client’s wishes
7. According to CNO, nurses must obtain explicit consent for which one of the following actions?
– assessing a person’s capacity to make decisions about treatment.
8. According to the CNO Practice Standard: Confidentiality and Privacy – Personal Health information, what is the
‘lockbox provision’?
– a client instructs that a part of his or her personal health information is not shared with other providers.
9. According to the CNO Practice Standard: Decisions about Procedures and Authority, Revised 2006, what is one
of the four standards a nurse must consider before performing any procedure?
– Appropriate care provider.
10. According to the CNO Practice Standard: Documentation, Revised 2008, which one of the following statements
best demonstrates appropriate documentation?
– “Client states his pain is a ‘1 out of 10’.”
11. According to the CNO Practice Standard:Ethics, how is ‘’ defined?
- Allocating health care resources on the basis of objective health related factors.
12. According to the CNO Practice standard: Ethics, what is a component of the definition of the ethical value of
‘Truthfulness’? – speaking or acting without intending to deceive.
13. According to the CNO Practice Standard: Ethics, what is one of the ‘Ethical Values’?
– Maintaining commitments
14. According to the CNO Practice standard:Ethics, which one of the following statements best describes the Ethical
value related to ‘Privacy and Confidentiality’?
– Clients need to be informed that their relevant health information will be shared with the health care team.
15. According to the CNO Practice Standard: Ethics, which one of the following terms represents an Ethical Value
related to client choice? – Self-respect
16. According to the CNO Practice Standard: Professional Standards, Revised 2002, what is one element of
accountability? -Nurses are accountable for their actions and their consequences.
17. According to the CNO Practice Standard: Professional Standards, Revised 2002, what is the purpose of the seven
Standard Statements? – They list the specific knowledge, skills, judgment, and attitudes that nurses must
demonstrate at all times.
18. According to the CNO Practice Standard: Professional Standards, Revised 2002, which actions by a nurse best
describe the Standard Statement ‘Knowledge Application’?
– recognizing that a client is exhibiting the symptoms of a stroke and taking appropriate action.
19. According to the CNO Practice Standard: Professional Standards, Revised 2002, which one of the following
descriptions best reflects the Standard Statement related to ‘Accountability’?
– Each nurse is accountable to the public and responsible for meeting legislative requirements and the
standards of the profession.
20. According to the CNO Practice Standard: Professional Standards, Revised 2002, which one of the following
options best reflects the Standard Statement of ‘Knowledge Application’?
– incorporates evidence-informed practice into clinical performance.
21. According to the CNO Practice Standard: Therapeutic nurse-client relationship, Revised 2006, which one of the
following Standard Statements best describes the nurse’s accountability? – self disclosure
22. A 14-year old girl presents at a birth control center requesting the oral contraceptive pill. She has a boyfriend,
but has not yet had sex. How can the RN provide client-centered care?
– explore sexuality and birth control methods with the client.
23. An 80-year old nursing home resident with advanced Alzheimer’s disease requires minor surgery. Which of the
following individuals should sign the consent for his operation?
– The person named as his power of attorney for personal care.
24. An emergency department nurse is providing care to a 5- year old with a fractured humerus. Upon review of
the health record, the nurse notes that the child has presented to the emergency department on several
occasions with unexplained injuries over the previous 8 months. What should the nurse do?
– Inform the attending physician.
25. An NP has written an order for an influenza immunization at a local clinic. What should the RPN do?
– implement the order.
26. An occupational Health nurse reveals to a manager that one of their probationary employees is pregnant. What,
if anything, is wrong with this action? – The nurse has breached confidentiality.
27. An RN is precepting a nursing student. The student is performing many aspects of care. In this situation, what
is the role of the RN? – Supervising
28. An RN writes an order for daily irrigation of a wound for a home care client. The next day, a different nurse
comes to the client’s home. How should the second nurse proceed? – call the physician for an order.
29. A RN case manager visits a client in the community whose needs are becoming more complex. According to the
CNO Practice Guideline: RN and RPN Practice: the client, the nurse and the environment, what is one factor that
the case manager must consider when determining the appropriate category of care provider?
– Environment
30. An RPN and an NP practice collaboratively. The NP has written an order for acetaminophen (Tylenol) for pain.
What is the RPN’s responsibility? – Administer the medication as ordered.
31. An RPN assesses that a client in the home requires routine urinary catheterization. What must be considered
prior to initiation? – identifying the risks and benefits of the procedure.
32. An RPN employed as an unregulated care provider (UCP) administers a medication and an error is identified. To
what level of accountability will CNO hold this staff member? – As an RPN.
33. A nurse disagrees with a client’s decision to terminate a pregnancy for genetic reasons and wishes to
discontinue nursing care. What should the nurse do first?
– Discuss changing the client’s plan of care with the health care team.
34. A nurse documents all the care provided during the workday at the end of the shift. Which documentation
standard has the nurse breached? – Care must be documented in a timely manner.
35. A nurse has recently relocated and changed employers. What is the nurse’s responsibility to CNO?
– Immediately update any changes to the nurse’s employer or home address with CNO.
36. A nurse has relocated to Ontario from Florida, USA. Which one of the following facts is the nurse obligated to
report to CNO? – The nurse has been disciplined by the Florida state nursing regulatory body.
37. A nurse is advocating for a group of clients to obtain government subsidies for adequate nutrition. According
to the CNO Practice Standard: Professional Standards, Revised 2002, which one of the following standard
statements best describes the nurse’s actions? – accountability
38. A nurse is asked by a client’s employer for information on the client’s prognosis. What information, if any, can
the nurse disclose? – No information without consent from the client.
39. A nurse is assigned to a client with complications following a therapeutic abortion, which is in direct conflict
with the nurse’s values and religious beliefs. What action should the nurse take in this situation?
– Find another nurse to care for the client.
40. A nurse is caring for a client on life support. The client’s estranged spouse, who is the client’s power of attorney
for personal care, visits on a regular basis. The nurse has become attracted to the client’s spouse and has been
invited to the spouse’s home for dinner. What demonstrates protecting the client from abuse?
– declining the invitation to the spouse’s home.
41. A nurse is caring for an 87-year old male resident of a long-term care facility. The client has a history of
Parkinson’s Disease, requiring assistance with all activities of daily living. He has now developed aspiration
pneumonia. Transfer to acute care has been ordered; however, the client does not wish to go. How should
consent for treatment be obtained? – from the client.
42. A nurse is obtaining consent from a client for treatment. The nurse describes the information about the
treatment required to make a decision. What else must a nurse do to provide
?
– respond to the client’s question regarding the treatment.
43. A nurse is overheard saying “your breast look great in that shirt” to a client. The client smiles and walks away.
Is this sexual abuse? – yes, because the comment was of a sexual nature.
44. A nurse is required to create and implement a Learning Plan. Why must a nurse do this?
– It is a requirement of CNO’s QA Program.
45. A nurse may disclose personal health information without consent in which of the following situations?
– the client poses a serious risk of injuring others.
46. A nurse wants to ‘initiate’ cleansing and dressing of a client’s wound. In which practice setting is there a
restriction for the nurse to initiate this procedure? -A client’s home.
47. A nurse, who works with street youth, intentionally reveals her breast tattoo to a group of clients. Another
nursing colleague witnesses this action. Is the colleague required to report this behavior to CNO? – Yes, sexual
abuse must be reported.
48. A nurse wishes to control a client’s violent behavior. What should the nurse do?
– Consider the use of restraints only as a last resort.
49. A nurse witnesses another nurse taking a client’s personal items from the client’s room. What is the first action
the nurse should take? – Speak to the nurse regarding the matter.
50. A nurse witnesses another regulated health professional making a sexual comment to a client. To whom does
the nurse have a ‘legal responsibility’ to report this individual?
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
– The manager of the health care team member.
A nurse working in a Cancer Care Center encounters many competent clients who refuse further treatment. The
nurse disagrees with the clients’ decisions and believes she cannot continue to provide care. What should the
nurse consider? – Resigning from her place of employment to adhere to her personal values.
A physician calls in a telephone order for pain medication. The physician is not in the facility. Should the nurse
accept the order? – yes, if the physician will return to sign the order within 48 hours.
A physician gives a nurse a telephone directive to catheterize the physician’s admitted clients. Why should the
nurse refuse to follow this directive? – Directives must always be written and signed by the physician or NP.
Are nurse administrators accountable to practice in accordance with all CNO standards of practice?
– Yes, because all nurses are accountable to the standards of practice regardless of role
A 7-year old boy is admitted to the emergency department with a compound fracture of the arm. His parents
are not reachable. Is consent required to initiate treatment? – No, because this is an emergency situation.
A 79-year old mentally competent client is at risk for falls. The nurse recommends the use of a cane or a walker,
but the client refuses. What should the nurse do first? – Explore other options with the client that may be
acceptable.
As part of his end of life care, a client decides he wants only palliative measures to maintain his quality of life.
The nurse does not support the client’s decision and does not feel he can provide care to the client. How should
the nurse proceed? – Arrange for another health care provider.
A teacher asks the school nurse to see a 9-year old boy, who regularly comes to school “unkempt, dirty, and
hungry”. Today, the child presents with several bruises on his arms at different stages of healing, and tells the
nurse he “fell down”. What action must the nurse take? –Make a report to the local Children’s Aid Society.
A visiting nurse is providing foot care to an 85-year old client. Which one of the following behaviors may be
considered abusive in the context of the therapeutic nurse-client relationship?
– agreeing to have financial trusteeship with respect to the client.
Consistent with the Health Care Consent Act, 1996, when is a nurse required to obtain consent to treatment? –
Providing nursing services to an ill 8-year old in a community health center.
Consistent with the nursing act, 1991, which one of the following examples involves a nurse correctly exercising
the right to refuse assignments or discontinue nursing services?
– A homecare nurse is assigned a new client. Upon arrival at home, the nurse discovers that the client smokes.
The nurse refuses to visit the client because of the risks associated with the second hand smoke.
During lunch break, a nurse observes a colleague drinking several alcoholic beverages. Later in the day, the
colleague is observed loudly laughing and slurring words when interacting with clients. How would CNO most
likely assess this type of behavior? – Negligence
Erica, an RN, is working in the role of an unregulated care provider(UCP) at a long-term care home. Is Erica
accountable to practice in accordance with the CNO Standards? – Yes, because Erica is registered as an RN.
Every time the nurse begins work on the afternoon shift, she finds that most of the clients’ incontinence briefs
are saturated. After providing care for the clients, what should the nurse do?
– Communicate her concerns to the day staff.
Gladys has decided to resume nursing practice after resigning from the profession to raise a family. After an
interview, she was successful in obtaining a position at a local long-term care facility. Can Gladys begin working
as a nurse? – No, because Gladys requires current registration with CNO
How are ‘peer assessors’ assigned in CNO’s QA program?
– The college assigns a peer to assist in the process.
How does professional misconduct relate to CNO’s practice standards?
– Professional misconduct is only addressed in the CNO Practice Standard: Professional Standards, Revised
2002.
68. In which of the following situations can a nurse accept and perform a delegated task? – When an authorizing
mechanism is in place.
69. In which one of the following situations can a nurse perform a controlled act?
–A dentist writes an order for the nurse to start a pre-procedural IV.
70. Mrs. Johnson, a frail elderly client with multiple co-morbidities, has recently developed pneumonia requiring
admission to an acute care facility. Suzanne, a RPN, is assigned to care for Mrs. Johnson in collaboration with a
RN. The family approaches the RN and demands that only RNs care for their mother. How should the RN
respond? – Respect the family’s wishes and ask the charge nurse to adjust the nursing assignment.
71. Sue, a nurse, has arrived home at the end of a long shift and realizes that she forgot to sign for a medication.
Sue calls the unit and asks a colleague to “sign my name on the record”. The colleague refuses. What is the
rationale for his refusal to sign? – It is Sue’s responsibility to return to work immediately and sign the record.
72. Ted introduces himself to a newly admitted client with his designation. According to the CNO Practice Standard:
Therapeutic Nurse-client Relationship, Revised 2006, what standard statement is Ted meeting?
– Therapeutic Communication.
73. The Consent and Capacity Board has found Mr. Silva incapable of making decisions. His nephew, who is his
substitute decision-maker, has given consent to start the application for placement in long-term care. Mr. Silva
wishes to stay in his home. According to the Health Care Consent Act, 1996, which one of the following
statements is true? – Mr. Silva’s nephew has the authority to make the placement decision.
74. The nurse encounters a confused, combative client. Which one of the following actions would represent abuse?
– assuming a defensive stance in response to the client trying to hit the nurse.
75. The nurse has a client who does not speak or understand English or French. Family members, acting as
interpreters, have stated that the client would not want to know his prognosis. What is the nurse’s
responsibility in this situation? – Respect the wishes of the family and do not disclose this information.
76. The physician asks a nurse to perform a wound dressing change for a 15-year old client under the nurse’s care.
Is consent needed? – No, because routine treatment does not require consent.
77. Under the Regulated Health Professions Act, 1991, which one of the following activities is prohibited if
performed by an unauthorized person?
– male circumcision performed outside of a religious tradition or ceremony.
78. Under which of the following conditions can all nurses perform controlled acts according to the Nursing Act,
1991?- when delegated or ordered by an NP
79. Under which of the following conditions can a nurse accept ‘verbal orders’ from a physician?
– when the client’s condition is rapidly deteriorating.
80. Under which of the following conditions may nurses perform a controlled act?
– If ordered by a physician, dentist, chiropodist, or nurse practitioner.
81. What are the components of the therapeutic nurse-client relationship?
– Respect, trust, professional intimacy, empathy and power.
82. What CNO statutory Committee would act upon a finding of ‘professional misconduct’? – Discipline.
83. What controlled act is a nurse authorized to perform, when ordered, as found in the Nursing Act, 1991?
– Putting an instrument beyond the external ear canal.
84. What differentiates RPN from l? – RPNs do not study from the same body of nursing knowledge
85. What federal legislation relates to narcotics?- Controlled drugs and substances act.
86. What information from each member is required to be made public on the CNO Register?
– Full name, business address, and business telephone number.
87. What is a condition associated with the appropriate delegation of controlled acts to unregulated care
providers(UCP’s)? – It is part of their scope of practice COMPETENCE HAS BEEN DETERMINED
88. What is a difference between ‘initiating’ and ‘performing’ a controlled act? – When initiating, the nurse accepts
accountability for determining that the client’s condition warrants performance of the controlled act.
89. What is a warning sign that a nurse may not be effectively maintaining the boundaries of the therapeutic nurseclient relationship?
– Engaging in a sexual relationship with a client after termination of the therapeutic nurse-client relationship.
90. What is an example of abusive behavior in the context of the therapeutic nurse-client relationship?
– A nurse addresses a client in a demeaning manner.
91. What is CNO’s mandate? – To protect the public interest.
92. What is every member’s responsibility in a self-regulated profession?
– practicing in accordance with the standards of the profession.
93. What is included in the mandatory requirements for nurses who are randomly selected to participate in CNO’s
QA Program? – Peer Assessment
94. What is one nursing responsibility when deciding whether to use restraints? – following the physician’s order.
95. What is one of the four key regulatory functions of CNO? - Establish requirements for entry to practice
96. What is one part of the definition of ‘professional misconduct’ as defined by the Health Professions Procedural
code? – Guilty of an offense relevant to the member’s suitability tom practice.
97. What is one part of the self- assessment component of CNO’s QA Program?- Practice Reflection.
98. What is one purpose of documentation? – to monitor the client’s progress
99. What is the definition of ‘self regulation’ as it applies to CNO? – Every member is responsible for practicing in
accordance with the standards of the profession and keeping current and competent throughout their career.
100.
What is the key element of informed consent?
– The client receives responses to requests for additional information about treatment.
101.
What is the legislation related to the CNO Practice Standard: Restraints?
– Patient Restraints Minimization Act, 2001.
102.
What is the purpose of mandatory reporting?
– To allow CNO to take action to protect the public and use innovative approaches to help rehabilitate the
nurse.
103.
What is the purpose of ‘mandatory reporting’ to CNO? – to notify CNO of unsafe nursing practice
104.
What is the purpose of nursing documentation?
– To communicate interventions in care to the health care team.
105.
What must a nurse consider when determining whether to discontinue nursing services?
– Whether there are conflicting obligations.
106.
What must be included for consent to be considered informed?
– Information the physician determines the client should know.
107.
What must nurses reflect upon when determining whether they are competent to provide safe nursing
care to clients? – knowledge, skills and judgment
108.
What organization regulates nurses in Ontario? – College of Nurses of Ontario
109.
What should a nurse do first when observing another nurse abusing a client?
– stop the colleague’s behavior.
110.
What statement best articulates the overall responsibility for all nurses to practice in accordance with
CNO’s Standards of Practice? – Nurses will practice in accordance with the standards of the profession and will
keep current and competent throughout their nursing career.
111.
When can a nurse discontinue nursing services for a cognitively impaired client without resulting in
professional misconduct? – If replacement services have been arranged.
112.
When is a nurse obligated to make a report to the Children’s Aid Society under the Child and Family
Services Act, 1990? – Only with evidence of child abuse.
113.
When sharing health information, in which one of the following scenarios is a nurse best demonstrating
confidentiality? – Discussion with the client’s employer, with client’s permission.
114.
Which one of the following actions by a nurse demonstrates unequal power in the nurse-client
relationship? – Administering an antibiotic as ordered
115.
Which one of the following actions is an example of a controlled act that all nurses are authorized to
perform as per the Nursing Act, 1991? – performing a client’s digital rectal examination.
116.
Which one of the following activities in CNO’s QA Program do all nurses have to complete?
– completing a Learning Plan.
117.
Which one of the following conditions must be met prior to a nurse ‘initiating’ a controlled act
authorized to nurses? – The nurse has determined the client’s condition warrants performance of the
procedure.
118.
Which one of the following examples always reflects establishing and maintaining appropriate
boundaries in the therapeutic nurse-client relationship?
– documenting consultation with a colleague about a questionable client interaction.
119.
Which one of the following examples demonstrates a nurse effectively maintaining the boundaries of
the therapeutic nurse-client relationship?
– Ensuring the nurse does not interfere with the client’s personal relationships.
120.
Which one of the following examples reflects one of the three controlled acts that all nurses are
authorized to perform according to the Nursing Act, 1991?
– Putting an instrument, hand or finger into an artificial opening in the body.
121.
Which of the following examples represents sexual abuse as defined by the Health professions
procedural Code? – A 12-year old client with suspected vaginal trauma.
122.
Which one of the following health care providers is appropriately using the authorizing mechanism of
‘initiation’? – An RN who establishes peripheral venous access in an emergency situation.
123.
Which one of the following nursing practices demonstrates a client choice?
– providing the client with the necessary information for informed decision-making.
124.
Which one of the following options is an example of an ‘authorizing mechanism’? – Advance directive.
125.
Which one of the following options is one of the four Standard Statements that a nurse must consider
prior to performing a procedure? – Care delivery process.
126.
Which one of the following statements about the Practice Assessment component of CNO’s QA Program
is true? – Selected nurses are required to submit their annual Learning Plan to CNO.
127.
Which one of the following statements best describes the ‘client’ in the context of the therapeutic
nurse-client relationship? –an individual, family, group or community
128.
Which one of the following statements best describes the purpose of CNO’s QA Program?
- to promote continuing competence.
129.
Which one of the following statements describes the Ethical Value related to ‘Privacy anddiscon’, as
outlined in the CNO Practice Standard:Ethics?
– Collecting the only information necessary for providing health care.
130.
Which one of the following statements is a key element of informed consent according to the CNO
Practice Guideline: Consent? – Power of Attorney for personal care.
131.
Which one of the following statements is considered to be a ‘directive’?
– a client specific order that is either written or oral.
132.
Which one of the following statements is true?
– The regulated health professions act, 1991 is applicable to all health care providers.
133.
Which one of the following statements represents a component of therapeutic communication used by
nurses? – Modifying their communication style for each client
134.
Which one of the following statutes is relevant to the practice of nursing in Ontario? – Medicine Act
135.
While off duty, a nurse is charged with impaired driving. Ultimately, she is found guilty of this offense.
Following this finding, does the nurse have any obligations to CNO?
– Yes, because the nurse must self-report a finding of guilt for an offense.
136.
Who does the regulated Health Professions Act, 1991 govern in Ontario? – all health care providers.
137.
Who may determine capacity for the purpose of the Substitute Decisions Act, 1992? – The Office of the
Public Guardian and Trustee.
138.
Why is using the title RPN, RN or NP considered misrepresentation if an individual is not registered with
CNO? – the titles are protected under legislation.