CANS Risk Management & Mitigation 3 — Questions and Answers
Question 1: A patient presents with erythema, warmth, and purulent discharge at a recent filler injection site. The most likely diagnosis is:
- Delayed hypersensitivity granuloma
- Biofilm infection (Correct answer)
- Tyndall effect
- Angioedema
Correct answer: Biofilm infection
Purulent discharge with erythema and warmth weeks post-injection suggests biofilm-associated bacterial infection requiring antibiotic therapy.
Question 2: To reduce the risk of intravascular injection during filler treatments, which technique is MOST recommended?
- Inject rapidly to minimize patient discomfort
- Use a sharp needle with high injection pressure
- Aspirate before injecting and use a slow, retrograde technique (Correct answer)
- Inject large boluses at a single deep plane
Correct answer: Aspirate before injecting and use a slow, retrograde technique
Aspiration before injection, slow delivery, and retrograde threading reduce the likelihood of inadvertent intravascular placement.
Question 3: A patient on anticoagulation therapy requests neurotoxin treatment. The appropriate risk management action is to:
- Refuse treatment categorically
- Advise holding anticoagulants for 2 weeks without consulting their physician
- Proceed after informing the patient of increased bruising risk and documenting consent (Correct answer)
- Administer neurotoxin only to the forehead to reduce vascular risk
Correct answer: Proceed after informing the patient of increased bruising risk and documenting consent
Neurotoxin can generally be safely administered to anticoagulated patients after informed consent, as intravascular injection is not a primary risk with toxin.
Question 4: Which cooling strategy best minimizes bruising and discomfort risk before filler injections?
- Applying heat pack for 5 minutes
- Topical anesthetic cream applied 45–60 minutes before (Correct answer)
- Vigorous massage of the injection site
- Dry ice application directly on skin
Correct answer: Topical anesthetic cream applied 45–60 minutes before
Topical anesthetic applied 45–60 minutes prior reduces pain and procedural movement that contributes to bruising and inadvertent vessel trauma.
Question 5: What is the PRIMARY role of the CANS certification in risk management?
- It guarantees malpractice insurance coverage
- It demonstrates advanced competency in aesthetic nursing to reduce patient harm (Correct answer)
- It replaces the need for physician oversight
- It eliminates the need for continuing education
Correct answer: It demonstrates advanced competency in aesthetic nursing to reduce patient harm
CANS certification validates advanced knowledge and skills in aesthetic nursing, directly supporting safer patient outcomes and reduced adverse event risk.
Question 6: A patient develops Frey syndrome after parotid region neurotoxin injection. This represents which type of complication?
- Systemic toxin spread
- Inadvertent muscle paralysis
- Autonomic nerve aberrant regeneration causing gustatory sweating (Correct answer)
- Anaphylactic reaction to toxin protein
Correct answer: Autonomic nerve aberrant regeneration causing gustatory sweating
Frey syndrome involves aberrant reinnervation of sweat glands by parotid nerve fibers, causing sweating during eating; neurotoxin can treat but also occasionally trigger localized symptoms.
Question 7: Which practice BEST reduces the risk of cross-contamination between aesthetic patients?
- Reusing opened single-use vials between patients of the same day
- Using sterile single-use needles and cannulas for each patient (Correct answer)
- Cleaning needles with alcohol between uses
- Pooling leftover filler from multiple vials for use within the same session
Correct answer: Using sterile single-use needles and cannulas for each patient
Single-use sterile needles and cannulas per patient is the standard infection control practice to prevent cross-contamination in aesthetic settings.
CANS Risk Management & Mitigation 3
A patient presents with erythema, warmth, and purulent discharge at a recent filler injection site.
The most likely diagnosis is: