a. Contact the nursing supervisor
b. Administer the dose prescribed
c. Hold the medication until the HCP can be contacted
d. Administer the recommended dose until the HCP can be located
A nurse calls the health care provider (HCP) regarding a new medication prescription. The
dosage prescribed is higher than the recommended dosage, however, the nurse is unable Rationale
to locate the HCP for an explanation. Which action should the nurse take if the medication is If the physician writes a prescription that requires clarification, the nurse's responsibility is to
due to be administered at this moment? contact the HCP. If there is no resolution regarding the prescription because the HCP cannot
be located or because the prescription remains as it was written after talking with the HCP,
the nurse should contact the nurse manager or nursing supervisor for further clarification as
to what the next step should be. Prescriptions should not be given until the practical nurse
obtains clarification.
a. Monitor to ensure that all statt consistently wash their hands between each client contact
b. Have a discussion about hand washing with fellow nurses during the morning break
c. Report the lack of hand washing to the local Medical Oflcer of Health for a follow-up with
the health care workers
A practical nurse has been reviewing research focusing on the benefits of hand washing in d. Develop a poster and pamphlet to be used at the sinks on each unit to promote hand
preventing the spread of microorganisms. The last few days he has notices a number of health washing
care workers not washing their hands between client contact. He wants to initiate a change
in practice. Which of the following actions should he perform? Rationale
Using posters and pamphlets is a good method to promote awareness regarding the im-
portance of hand washing between client contacts. This was the result of the practical nurse
reading evidence-based literature of the benefits of hand washing and using the research
results to initiate changes in practice.
a. Implement safety strategies to protect herself
b. Document and report the facts of the verbal abuse and threat to the nurse manager
c. Recognize that the behaviour is related to her diagnosis and not take the abuse personally
A 37-year-old female has just been admitted to the neurology unit. She is recovering from d. Obtain support from nursing colleagues who are involved in her care
a brain injury and also has unstable bipolar disorder. When the practical nurse enters the
room to assess her, she says to the nurse 'If you come near me I'm going to attack you!' What Rationale
should be the primary action by the practical nurse? Practical nurses should always first protect themselves from verbal abuse as it may lead to
physical abuse. The practical nurse should ensure all safeguards are in place for this client.
Then, she can address support, communication with colleagues, documentation and methods
to provide care.
a. To ensure that nurses are in good moral standing
b. To protect the safety of the public
c. To ensure that enough new nurses are available
d. To limit the number of nurses in practice
Professional regulations and laws that govern nursing practice are in place for which of the
following reasons?
Rationale
Provincial and territorial governing bodies, professional regulations, and laws are in place to
protect the public by ensuring that nurses are accountable for safe, competent, and ethical
nursing practice.
a. Battery
A 45-year-old client admitted to a mental health unit has exhibited physical behaviours that b. False imprisonment
put him and others at risk. The practical nurse applies four-point restraints on the client c. Negligence
d. Malpractice
without consent nor obtaining orders from the physician. The nurse is at risk of being accused
of which of the following?
Rationale
Battery is defined as "an intentional and wrongful physical contact with a person that entails an
, injury or ottensive touching. Performing a treatment without the client's permission or without
receiving informed consent might constitute both assault and battery. Battery suits have been
won based on the use of restraints when dealing with confused clients.
a. Asking the client about his sexual history
b. Sharing cookies and milk with the client during a therapeutic session
c. Smiling and nodding at the client
d. Keeping a secret from the healthcare team as requested by the client
Which of the following behaviours would be considered to be a boundary violation of the
nurse-client relationship in a mental health setting?
Rationale
Keeping a secret from the healthcare team is considered boundary crossing. It implies a
special relationship between the practical nurse and client. The nurse must inform the client
that all relevant information must be shared with other members of the healthcare team.
a. Clarify the challenge or problem
b. Describe the issue and identify the nature of the problem
c. Implement your decision as thoughtfully and sensitively as possible
d. Identify options for action, recognizing that the best option may not be obvious at the
outset
Rationale
Clarify the challenge or problem is the 3rd step in ethical decision making. Decision making
questions during this steps are:
What is the issue?
What ethical principles are at stake?
Based on CCPNR (Canadian Council for Practical Nurse Regulators) outline around ethical
What stakeholders need to be consulted or involved in resolving the issue?
decision making, which of the following step is next after gathering the factual information
relevant to the issue? Is unethical conduct by a peer or other professional colleague suspected?
The 8 steps of Ethical Decision Making are:
Step 1: Describe the issue and identify the nature of the problem
Step 2: Gather the factual information relevant to the issue
Step 3: Clarify the challenge or problem
Step 4: Identify options for action, recognizing that the best option may not be obvious at the
outset.
Step 5: Assess the options in light of applicable policy, legislation, or regulation in terms of
advantages and limitations of each.
Step 6: Decide on a course of action taking all the gathered information into account.
Step 7: Implement your decision as thoughtfully and sensitively as possible
Step 8: Assess the consequences of your decision
a. Organizational chart
b. Job description
c. Personnel policies
To determine the structural relationship of one hospital department with another, the practical d. Procedures manual
nurse should review the:
Rationale
Organizational charts delineates the overall organizational structure, showing departments
exist and their relationship with one another both vertically and laterally.
a. Review hygiene practices will all clients
b. Identify clients who are at risk
c. Restrict visitors
b. Administer the dose prescribed
c. Hold the medication until the HCP can be contacted
d. Administer the recommended dose until the HCP can be located
A nurse calls the health care provider (HCP) regarding a new medication prescription. The
dosage prescribed is higher than the recommended dosage, however, the nurse is unable Rationale
to locate the HCP for an explanation. Which action should the nurse take if the medication is If the physician writes a prescription that requires clarification, the nurse's responsibility is to
due to be administered at this moment? contact the HCP. If there is no resolution regarding the prescription because the HCP cannot
be located or because the prescription remains as it was written after talking with the HCP,
the nurse should contact the nurse manager or nursing supervisor for further clarification as
to what the next step should be. Prescriptions should not be given until the practical nurse
obtains clarification.
a. Monitor to ensure that all statt consistently wash their hands between each client contact
b. Have a discussion about hand washing with fellow nurses during the morning break
c. Report the lack of hand washing to the local Medical Oflcer of Health for a follow-up with
the health care workers
A practical nurse has been reviewing research focusing on the benefits of hand washing in d. Develop a poster and pamphlet to be used at the sinks on each unit to promote hand
preventing the spread of microorganisms. The last few days he has notices a number of health washing
care workers not washing their hands between client contact. He wants to initiate a change
in practice. Which of the following actions should he perform? Rationale
Using posters and pamphlets is a good method to promote awareness regarding the im-
portance of hand washing between client contacts. This was the result of the practical nurse
reading evidence-based literature of the benefits of hand washing and using the research
results to initiate changes in practice.
a. Implement safety strategies to protect herself
b. Document and report the facts of the verbal abuse and threat to the nurse manager
c. Recognize that the behaviour is related to her diagnosis and not take the abuse personally
A 37-year-old female has just been admitted to the neurology unit. She is recovering from d. Obtain support from nursing colleagues who are involved in her care
a brain injury and also has unstable bipolar disorder. When the practical nurse enters the
room to assess her, she says to the nurse 'If you come near me I'm going to attack you!' What Rationale
should be the primary action by the practical nurse? Practical nurses should always first protect themselves from verbal abuse as it may lead to
physical abuse. The practical nurse should ensure all safeguards are in place for this client.
Then, she can address support, communication with colleagues, documentation and methods
to provide care.
a. To ensure that nurses are in good moral standing
b. To protect the safety of the public
c. To ensure that enough new nurses are available
d. To limit the number of nurses in practice
Professional regulations and laws that govern nursing practice are in place for which of the
following reasons?
Rationale
Provincial and territorial governing bodies, professional regulations, and laws are in place to
protect the public by ensuring that nurses are accountable for safe, competent, and ethical
nursing practice.
a. Battery
A 45-year-old client admitted to a mental health unit has exhibited physical behaviours that b. False imprisonment
put him and others at risk. The practical nurse applies four-point restraints on the client c. Negligence
d. Malpractice
without consent nor obtaining orders from the physician. The nurse is at risk of being accused
of which of the following?
Rationale
Battery is defined as "an intentional and wrongful physical contact with a person that entails an
, injury or ottensive touching. Performing a treatment without the client's permission or without
receiving informed consent might constitute both assault and battery. Battery suits have been
won based on the use of restraints when dealing with confused clients.
a. Asking the client about his sexual history
b. Sharing cookies and milk with the client during a therapeutic session
c. Smiling and nodding at the client
d. Keeping a secret from the healthcare team as requested by the client
Which of the following behaviours would be considered to be a boundary violation of the
nurse-client relationship in a mental health setting?
Rationale
Keeping a secret from the healthcare team is considered boundary crossing. It implies a
special relationship between the practical nurse and client. The nurse must inform the client
that all relevant information must be shared with other members of the healthcare team.
a. Clarify the challenge or problem
b. Describe the issue and identify the nature of the problem
c. Implement your decision as thoughtfully and sensitively as possible
d. Identify options for action, recognizing that the best option may not be obvious at the
outset
Rationale
Clarify the challenge or problem is the 3rd step in ethical decision making. Decision making
questions during this steps are:
What is the issue?
What ethical principles are at stake?
Based on CCPNR (Canadian Council for Practical Nurse Regulators) outline around ethical
What stakeholders need to be consulted or involved in resolving the issue?
decision making, which of the following step is next after gathering the factual information
relevant to the issue? Is unethical conduct by a peer or other professional colleague suspected?
The 8 steps of Ethical Decision Making are:
Step 1: Describe the issue and identify the nature of the problem
Step 2: Gather the factual information relevant to the issue
Step 3: Clarify the challenge or problem
Step 4: Identify options for action, recognizing that the best option may not be obvious at the
outset.
Step 5: Assess the options in light of applicable policy, legislation, or regulation in terms of
advantages and limitations of each.
Step 6: Decide on a course of action taking all the gathered information into account.
Step 7: Implement your decision as thoughtfully and sensitively as possible
Step 8: Assess the consequences of your decision
a. Organizational chart
b. Job description
c. Personnel policies
To determine the structural relationship of one hospital department with another, the practical d. Procedures manual
nurse should review the:
Rationale
Organizational charts delineates the overall organizational structure, showing departments
exist and their relationship with one another both vertically and laterally.
a. Review hygiene practices will all clients
b. Identify clients who are at risk
c. Restrict visitors
