CNO Consent and Capacity in Nursing Practice 2

Question 1

Under the Health Care Consent Act, which TWO criteria must BOTH be met to find a person incapable of making a treatment decision?

Accepted Answer

Unable to understand relevant information AND unable to appreciate the consequences

Answer

Age over 65 and presence of a cognitive diagnosis

Answer

Diagnosis of mental illness AND refusal of recommended treatment

Answer

Inability to communicate verbally AND absence of a substitute decision maker

Question 2

Who holds the highest priority as a substitute decision maker (SDM) for an incapable adult under Ontario's Health Care Consent Act hierarchy?

Accepted Answer

Court-appointed guardian of the person with treatment authority

Answer

Spouse or partner

Answer

Attorney for personal care named in a power of attorney

Answer

Adult child of the incapable person

Question 3

When making treatment decisions on behalf of an incapable person, what standard must a substitute decision maker apply first?

Accepted Answer

The prior capable wishes expressed by the incapable person when they were capable

Answer

What the SDM believes is in the incapable person's best medical interest

Answer

The recommendation of the treating healthcare team

Answer

The consensus of the majority of family members present

Question 4

A nurse disagrees with a substitute decision maker's refusal of a recommended treatment for an incapable client. What is the most appropriate first action?

Accepted Answer

Discuss concerns with the healthcare team and consider ethics consultation

Answer

Proceed with the treatment to protect the client from harm

Answer

Immediately file an application with the Consent and Capacity Board

Answer

Document the disagreement and take no further action

Question 5

A capable 16-year-old refuses a blood transfusion on religious grounds. How should the nurse respond?

Accepted Answer

Respect the capable minor's refusal and escalate to the healthcare team

Answer

Obtain consent from the parents, who have authority over all minors in Ontario

Answer

Proceed with the transfusion because it is life-saving

Answer

Contact child protective services immediately

Question 6

A client who was previously capable and is now found incapable once stated clearly that they never wanted cardiopulmonary resuscitation. What is this statement's legal status?

Accepted Answer

A prior capable wish that the substitute decision maker is legally obligated to follow

Answer

An advance directive that is no longer enforceable once the person loses capacity

Answer

A general preference that requires physician verification before it can be honored

Answer

An informal oral statement with no legal weight under the HCCA

Question 7

Which body in Ontario has the authority to review findings of incapacity made by health practitioners and resolve disputes between substitute decision makers and healthcare providers?

Accepted Answer

The Consent and Capacity Board

Answer

The College of Nurses of Ontario

Answer

The Ministry of Health and Long-Term Care

Answer

The Office of the Public Guardian and Trustee