CNO - College of Nurses of Ontario Safe Medication Administration Questions and Answers

Question 1

A nurse is preparing to administer a high-alert medication that requires an independent double check.
Which of the following actions best represents a true independent double check according to the Institute for Safe Medication Practices (ISMP) and CNO's principle of safety?

Accepted Answer

The first nurse prepares the medication, and the second nurse performs their own separate check of the order, calculation, and preparation before comparing results.

Answer

The first nurse states the dose they calculated out loud, and the second nurse confirms it is correct.

Answer

Both nurses look at the medication vial and the physician's order together at the same time.

Answer

The second nurse watches the first nurse draw up the medication and then signs the medication administration record (MAR).

Question 2

A physician gives a nurse a telephone order for a new medication. To comply with the CNO's Medication practice standard, what is the most critical action the nurse must take after transcribing the order?

Accepted Answer

Read the order back to the prescriber for verification.

Answer

Ask a colleague to review the transcribed order.

Answer

Administer the medication immediately to ensure timely care.

Answer

Wait for the prescriber to sign the order before administering the medication.

Question 3

A nurse discovers they administered a medication to the wrong client. After assessing the client and ensuring their immediate safety, what is the nurse's next accountability according to the CNO's standards?

Accepted Answer

Notify the prescriber and the nursing manager of the error.

Answer

Complete the incident report to fulfill organizational requirements.

Answer

Document the error only in the client's chart.

Answer

Ask the client not to mention the mistake to anyone.

Question 4

A competent client with a history of hypertension refuses their scheduled dose of metoprolol, stating, "I feel fine today and I don't want to take it." Which action by the nurse demonstrates accountability and respect for the client's right to refuse?

Accepted Answer

Documenting the refusal on the MAR and notifying the prescriber of the missed dose.

Answer

Insisting the client take the medication by explaining the risks of a hypertensive crisis.

Answer

Hiding the medication in the client's food to ensure they receive the dose.

Answer

Telling the client they cannot be responsible for what happens if they don't take the medication.

Question 5

When performing the three checks of medication administration, the nurse reads the medication administration record (MAR), retrieves the medication, and compares it to the MAR. What is the essential third check the nurse must perform?

Accepted Answer

Comparing the medication label to the MAR one last time at the client's bedside.

Answer

Asking the client if the medication looks familiar to them.

Answer

Checking the expiry date of the medication just before leaving the medication room.

Answer

Scanning the medication barcode after administering it to the client.

Question 6

A nurse is documenting the administration of a PRN (as needed) dose of morphine for a client's post-operative pain. In addition to the date, time, drug, dose, and route, what other information is essential to include in the client's record to meet CNO documentation standards?

Accepted Answer

The pre-administration pain assessment and the post-administration evaluation of the medication's effectiveness.

Answer

The name of the pharmacist who dispensed the medication.

Answer

The client's expected discharge date.

Answer

The time the client's family was notified.