CNO - College of Nurses of Ontario Leadership and Collaboration Questions and Answers

Question 1

An RN on a palliative care unit disagrees with a physician's decision to order a series of invasive diagnostic tests for a client who has clearly expressed a desire for comfort measures only.
The RN has voiced this concern to the physician, who dismissed it.
What is the RN's most appropriate next action to demonstrate leadership and client advocacy?

Accepted Answer

Consult with the charge nurse or nurse manager to discuss the ethical conflict and determine the appropriate next steps in the chain of command.

Answer

Document the disagreement and the client's wishes in the nursing notes and proceed with preparing the client for the tests.

Answer

Discuss the situation with the client's family to gain their support in refusing the tests on the client's behalf.

Answer

Inform the physician that they will not participate in the care related to the ordered tests.

Question 2

Which of the following actions by a nurse best exemplifies the competency of 'role clarification' within an interprofessional healthcare team?

Accepted Answer

Actively listening to the physiotherapist's assessment and explaining the nursing role in mobility to create a shared plan.

Answer

Assuming the lead on all aspects of the client's care plan to ensure efficiency.

Answer

Focusing exclusively on nursing tasks and directing other team members to stay within their own professional domains.

Answer

Waiting for the physician to assign specific tasks to each member of the healthcare team.

Question 3

A charge nurse observes that staff members are reluctant to report near-miss medication errors for fear of disciplinary action. To foster a culture of safety, what is the most effective leadership strategy the charge nurse should implement?

Accepted Answer

Thank a nurse who reports a near miss in a team meeting, and facilitate a non-punitive discussion about system factors that may have contributed.

Answer

Implement a strict, zero-tolerance policy for all medication errors, including near misses.

Answer

Require nurses to sign a document acknowledging their individual accountability for any errors they make.

Answer

Designate one senior nurse per shift to be solely responsible for reporting all incidents, removing the burden from others.

Question 4

An RN is delegating the task of obtaining a routine capillary blood glucose reading to an Unregulated Care Provider (UCP). To meet the CNO standards for delegation and leadership, which instruction is most critical for the RN to provide?

Accepted Answer

"Check Mrs. Smith's blood sugar before her lunch. Please report the result to me immediately, and also let me know if she reports feeling dizzy or sweaty."

Answer

"Let me know what the result is when you get it."

Answer

"Please check Mrs. Smith's blood sugar now."

Answer

"You've done this before, just check her sugar and document it in the chart."

Question 5

A staff nurse identifies a recurring issue with the availability of translation services, which is negatively impacting informed consent for clients with language barriers. As a nurse leader, what is the most professional and effective first step to advocate for systemic change?

Accepted Answer

Collect specific examples and data on the frequency of the issue and its impact on client care to present to the unit manager.

Answer

Advise affected clients to file formal complaints with the hospital's patient advocate.

Answer

Create a petition and ask colleagues on the unit to sign it.

Answer

Refuse to care for clients with language barriers until the problem is resolved.

Question 6

Two experienced RPNs on a unit have an ongoing personal conflict that is causing tension and leading to brief, clipped communication during handover. As the RN team leader, what is the most appropriate initial action?

Accepted Answer

Meet with each RPN privately to discuss the observed communication behaviours and remind them of their professional responsibility to collaborate effectively.

Answer

Report both RPNs to the unit manager for unprofessional conduct immediately.

Answer

Address the communication issue during the team huddle, without naming the individuals involved.

Answer

Change the schedule to ensure the two RPNs never work the same shifts.