CNO CNO - College of Nurses of Ontario Patient Safety and Risk Management 2 — Questions and Answers
Question 1: A nurse observes a colleague administering medication without performing client identification checks. What is the most appropriate action?
- Ignore it as it is not the nurse's responsibility
- Address the concern directly with the colleague and, if needed, escalate to a supervisor (Correct answer)
- Report the colleague anonymously without speaking to them
- Document nothing unless the client is harmed
Correct answer: Address the concern directly with the colleague and, if needed, escalate to a supervisor
CNO standards require nurses to address unsafe practices directly with colleagues first, and escalate if the behavior continues or poses immediate risk.
Question 2: Which of the following best describes the purpose of a root cause analysis (RCA) following a critical incident?
- To determine which nurse is at fault and assign discipline
- To identify underlying systemic factors that contributed to the incident and prevent recurrence (Correct answer)
- To create a legal record for litigation purposes
- To compare incident rates across hospitals
Correct answer: To identify underlying systemic factors that contributed to the incident and prevent recurrence
RCA is a structured process for identifying contributing systemic factors — not individual blame — so that processes can be improved to prevent future incidents.
Question 3: A client who is confused attempts to remove their IV line. What is the least restrictive intervention a nurse should try first?
- Apply wrist restraints immediately
- Reorient the client, involve family, and explore alternatives such as distraction or IV line camouflage (Correct answer)
- Administer sedation
- Discharge the client
Correct answer: Reorient the client, involve family, and explore alternatives such as distraction or IV line camouflage
Least-restrictive alternatives such as reorientation, family engagement, and environmental strategies should always be tried before physical restraints.
Question 4: A nurse is about to administer blood to a client. Which safety check is essential immediately before beginning the transfusion?
- Check the client's pain score
- Verify client identity and blood product details with a second nurse at the bedside (Correct answer)
- Confirm the client's dietary preferences
- Measure the client's weight
Correct answer: Verify client identity and blood product details with a second nurse at the bedside
Blood transfusion requires a two-nurse verification of client identity and blood product compatibility to prevent potentially fatal transfusion reactions.
Question 5: According to CNO risk management principles, what is the nurse's role when a client refuses a prescribed treatment?
- Proceed with the treatment anyway to ensure client safety
- Document the refusal, ensure the client has received adequate information to make an informed decision, and notify the healthcare team (Correct answer)
- Discharge the client immediately
- Contact the client's family to override the decision
Correct answer: Document the refusal, ensure the client has received adequate information to make an informed decision, and notify the healthcare team
Clients have the right to refuse treatment; the nurse must document the refusal, confirm informed decision-making, and communicate with the team.
Question 6: Which of the following is a key principle of safe client handling and mobility (SCHM) to prevent musculoskeletal injury in nurses?
- Always use manual lifting techniques to build strength
- Use mechanical lifts and assistive devices for all dependent transfers (Correct answer)
- Limit client ambulation to prevent falls
- Rely on client cooperation alone to perform transfers safely
Correct answer: Use mechanical lifts and assistive devices for all dependent transfers
Safe client handling programs require use of mechanical lifts and assistive devices to eliminate manual lifting and reduce nurse musculoskeletal injuries.
CNO CNO - College of Nurses of Ontario Patient Safety and Risk Management 2
A nurse observes a colleague administering medication without performing client identification checks.
What is the most appropriate action?