DOS II FINAL EXAM QUESTIONS

DOS II FINAL EXAM QUESTIONS What are the three types of authorizing mechanisms? a) Medical directives, MD orders, NP orders b) Standing orders, medical directives, delegation c) MD orders, NP orders, directives d) Order, initiation, delegation Ans- D When initiating a controlled act, an RN or RPN must : (put the following into the correct order as per the CNO document Authorizing Mechanisms) 1) Assess the client and identify the problem 2) Anticipate the management of potential outcomes 3) Decide on a course of action 4) Accept accountability for deciding the particular procedure is required and for ensuring that any potential outcomes are managed appropriately 5) Weight the risks and benefits of each option, considering the clients condition 6) Consider all of the available options to address the problem Ans- 1,6,5,3,2,4 The nurse provides immunizations to a primary school class of 40 patients Ans- Medical directive The nurse provides her patient with 500 mg of Tylenol to treat the patients headache Ans- Order The nurse goes through a formal process to allow a family member provide wound care to the client Ans- Delegation The nurse in the community independently decides it is the patients best interest to have an I/O catheter to address the patients urinary retention Ans- Initiation A patient needs to have emergent surgery. The patient will need intravenous access for the surgery. The RPN starts the patient's IV. What will she need to be able to do this? a) Nothing, she is able to initiate this procedure b) An order c) A medical directive d) Permission from the CNO Ans- B Which Controlled Acts are authorized to nurses? 1) Performing allergy testing 2) Dispensing a drug 3) Treating by means of psychotherapy technique 4) Putting a hand, instrument or finger beyond a natural or artificial opening of the body 5) Managing labour, or conducting a delivery 6) Performing a prescribed procedure below the dermis or mucous membrane 7) Administering a substance by inhalation or injection Ans- 2,3,4,6,7 An RPN orders an RPN colleague to insert a urinary catheter for a newly admitted patient. a) Confirm RPN order with MD before proceeding b) Accept the order and proceed with the intervention c) Consult with an RN before proceeding d) Decline to accept the order Ans- D Shannon is an RN in an urban hospital and a preceptor for Mei, a nursing student on a clinical placement. Sharon has a client who requires urinary catheterization. Sharon introduces Mei to the client and asks for consent to allow Mei to perform the procedure. After the client agrees, Sharon supervises Mei as she inserts the catheter. It was appropriate for Sharon to allow to perform this controlled act. True or False? Ans- True A professional standard is an authoritative statement that sets out the legal and professional basis of nursing practice. All nurses are held to the same standard throughout their careers a) True b) False Ans- A Which of the following are NOT entry to Practice requirements? a) Successful completion of the nursing education requirements b) Proof of citizenship, permanent residency or authorization under the immigration protection act c) Obtain a minimum average of 70% on your academic record d) Successful of the jurisprudence exam Ans- C Which of the following is NOT considered one of the roles of the CNO in supporting Nursing Self Regulation? a) Establishing requirements for entry to practice b) Administering the QA program c) Developing and Reviewing Nursing Curriculum d) Articulating, Promoting, and Enforcing Standards of practice Ans- C The Registered Health Professions Act applies to all of the following except: a) Nurses b) Physiotherapists c) Paramedics d) Physicians Ans- C The purpose of entry to practice competencies are the following except: a) Inform the public about what they can expect from the nurses b) Expectations for nurses to provide cost effective and efficient care c) Demonstrate how nursing practice is influenced by the current competencies d) Describe the expected performance behaviors that reflect safe, competent and ethical care. Ans- B Which of the following does NOT apply to the nursing act? a) The nursing act identifies each of the controlled acts and what professionals can perform them b) The nursing act authorizes nurses to perform their controlled acts c) The nursing act provides title protection for nurses d) The nursing act defines professional misconduct Ans- A When initiating a controlled act an RN or RPN must Assess, consider options, weigh the risks, decide on action and anticipate or accept a) treatment and outcomes b) outcomes and accountability c) observe and accountability d) observe and treatment Ans- B Mandatory reporting requirements for the college of nurses apply to all regulated health care providers, employers and facility operators. a) True b) False Ans- B what must an individual achieve in order to use the title "nurse" in Ontario a) Complete an accredited nursing program b) Membership with the College of Nurses of Ontario c) Completion of the CPNRE d) Completion of the Jurisprudence Exam Ans- B an oncology nurse attends a conference on new pain management techniques during the end of life. upon returning to the unit, he works with the educator to share the new knowledge he attained at the conference. By sharing these new techniques with his colleagues, he is upholding which professional standard? a) Ethics b) Accountability c) Continuing Competence d) Knowledge Translation Ans- C What are Controlled Acts? a) Activities that have been established by the Nursing Act b) Activities that are considered to be potentially harmful if they are performed by unauthorized persons c) Activities assigned to nurses that include prescribing, dispensing, selling or compounding a drug d) Activities that only apply to RNs and RPNs Ans- B The College of Nurses of Ontario assess the knowledge, skill and judgement of members by asking them to complete the CNO's Quality Assurance Program. The purpose of the QA program includes which of the following (select all that apply). a) Support nurses in practicing according to CNO's standards of practice b) Increase the public's confidence in the nursing profession c) Help nurses develop the practice areas in which they have identified learning need d) Ensure that nurses pay their registration each year to maintain their membership Ans- A,B,C Environmental factors that influence decision-making regarding RPN assignments include: a) Charge Nurse Qualifications b) Practice Supports c) Predictability of the Environment d) Experience of the Nurse e) Acuity of the Client Ans- B,C Nurses participate in the QA program a) Annually b) Every 3 years c) Upon graduation d) When called upon by the College Ans- A The three factor framework considers: a) Model of care of a particular hospital b) The relevance of the assignment c) Standardized policies of the community d) Predictability of the Client Ans- D The Quality Assurance Program includes all except: a) Practice Reflection b) Learning Goals c) Exam d) Learning Plan Ans- C Lucy is a RPN working on a medical unit. She is the Charge Nurse today and is formulating the assignments for the evening shift. Lucy knows she must consider the 3 factor framework when deciding Nursing assessment. Which of the following should she recognize? a) Environment is the most important factor in the 3 factor framework b) RPNs are expected to meet a wide range of nursing care needs for complex and unpredictable patients c) When consulting with a RN impacts the RPNs ability to provide efficient and appropriate care, then care should be transferred to the RN d) RPNs may autonomously care for clients for whom signs and symptoms of complications may be subtle Ans- C How many learning goals are nurses in the General Class (RNs & RPNs) required to develop and achieve each year? a) 2 b) 3 c) 5 d) 1 Ans- A Complaints regarding nursing practice are often made to the College of Nurses. Which of the following complaints must the College of Nurses address? (Select all that apply) a) Repeatedly not following the 8 rights of medication administration b) The facility where the nurse works is always short staffed c) A person observes a nurse sexually assaulting a patient d) The complaint is anonymous e) The nurse takes money from a sleeping patients personal belongings f) A witness saw a nurse cut someone off in traffic Ans- A,C,E The nurse restrains a patient without the patient's permission and without a physician's order. the nurse may be found guilty of what type of tort? a) Assault b) False imprisonment c) Invasion of privacy d) Neglect Ans- B Mandatory reporting requirements for the college of nurses apply to all regulated health care providers, employers and facility operators. a) True b) False Ans- B In the CBC article about Spencer Sullivan, his nurse Rose McKenzie was alleged to have committed all of the following acts, except: a) Over-medicating the patient by administering drugs ordered by 2 separate doctors without question b) Failing to monitor and document appropriately, leaving hours between checks c) Not recognizing that her IV fluids were mismanaged and putting Spencer into fluid volume excess d) Failing to respond quickly enough when Spencer stopped breathing Ans- C A nurse has been charge with negligence and a family is suing the nurse and hospital for damages. What must a lawyer prove for the nurse to be found guilty of negligence? a) Assault, battery, false imprisonment, or invasion of privacy b) Assault, battery, false imprisonment and invasion of privacy c) Carelessness, thoughtlessness and inattention d) Duty, Breech, Harm and Causation Ans-