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

Incapacity under the HCCA requires that the person cannot understand information relevant to the decision AND cannot appreciate the reasonably foreseeable consequences of consenting or refusing.

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

A court-appointed guardian of the person who has been granted authority to make treatment decisions ranks highest in the HCCA substitute decision maker hierarchy.

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

SDMs must first apply any prior capable wishes expressed by the incapable person; only when no wishes are known may they use the best interests standard.

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

When conflict arises with an SDM's decision, the nurse should first address concerns through team discussion and available resources such as ethics consultation before escalating to the Consent and Capacity Board.

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

Ontario's HCCA sets no minimum age for capacity; any person capable of understanding a treatment decision — including minors — has the right to consent or refuse.

CNO - College of Nurses of Ontario Practice Test

CNO - College of Nurses of Ontario Practice Test

CNO Consent and Capacity in Nursing Practice 2