CPNRE - Canadian Practical Nurse Registration Examination Collaborative Practice and Teamwork Questions and Answers 1 — Questions and Answers
Question 1: A practical nurse (PN) is concerned about a post-operative client's increasing restlessness and shortness of breath. When contacting the Registered Nurse (RN) team leader, which statement best demonstrates the use of the SBAR (Situation-Background-Assessment-Recommendation) communication tool?
- "You need to come see the client in room 302 right away; something is wrong."
- "This is the PN for room 302. The client had a hip replacement this morning, their vital signs were stable, but now their respiratory rate is 28 and O2 sat is 89% on room air. I think they might be developing a pulmonary embolism. I recommend you assess the client immediately." (Correct answer)
- "I'm calling about the client in 302. They seem anxious and are breathing fast. I'm not sure what to do."
- "Room 302 is the post-op hip that came from the recovery room at 1100. They have an IV of Normal Saline running. Their family visited earlier. Now the client is restless and short of breath."
Correct answer: "This is the PN for room 302. The client had a hip replacement this morning, their vital signs were stable, but now their respiratory rate is 28 and O2 sat is 89% on room air. I think they might be developing a pulmonary embolism. I recommend you assess the client immediately."
The correct answer effectively uses the SBAR framework: Situation (client's name/room, the problem), Background (hip replacement), Assessment (vital signs, what the PN thinks is happening), and Recommendation (what the PN needs from the RN). This provides a clear, concise, and actionable report to facilitate timely intervention.
Question 2: A practical nurse is planning the daily assignments on a stable medical unit. Which task is appropriate for the PN to delegate to an Unregulated Care Provider (UCP)?
- Administering a pre-measured dose of insulin to a client with stable diabetes.
- Performing a routine sterile dressing change on a small, healing incision.
- Teaching a client how to use their new inhaler for the first time.
- Assisting a client who is steady on their feet with their morning bath and grooming. (Correct answer)
Correct answer: Assisting a client who is steady on their feet with their morning bath and grooming.
Assisting with personal care, such as a bath for a stable client, falls within the typical role description of a UCP. Administering medications (insulin), performing sterile procedures, and client teaching are all activities that require the professional judgment, knowledge, and skill of a licensed nurse and cannot be delegated to a UCP.
Question 3: A practical nurse observes a physician speaking to a client's family in a dismissive and unprofessional manner, causing them distress. What is the PN's most appropriate initial action to advocate for the client and their family?
- Report the physician's behaviour to the hospital's patient advocate immediately.
- Wait until the physician has left, and then find a private moment to respectfully address the physician about the impact of their communication style. (Correct answer)
- Interrupt the conversation and tell the physician their behaviour is inappropriate in front of the family.
- Document the interaction in the nursing notes and discuss it with colleagues in the break room.
Correct answer: Wait until the physician has left, and then find a private moment to respectfully address the physician about the impact of their communication style.
The most professional and constructive first step is to address the conflict directly and respectfully with the individual involved, but not in front of the family, as this could escalate the situation. This approach seeks to resolve the issue at the source while maintaining a professional relationship. If this is unsuccessful or the behaviour continues, escalating to a manager or patient advocate would be the next step.
Question 4: Which of the following is a key principle of effective interprofessional collaboration in a healthcare setting?
- A hierarchical structure where the physician makes all final decisions for the team.
- Each team member working independently on their tasks to maximize efficiency.
- Mutual respect, shared decision-making, and open communication among all team members, including the client. (Correct answer)
- Ensuring that each profession's roles are kept separate to avoid overlap and conflict.
Correct answer: Mutual respect, shared decision-making, and open communication among all team members, including the client.
Effective interprofessional collaboration is built on a foundation of mutual respect for each member's expertise, a client-centered approach that involves shared decision-making, and clear, open communication. This approach contrasts with hierarchical or siloed models and leads to improved patient outcomes.
Question 5: A practical nurse is participating in a weekly care conference for a long-term care resident. The team is discussing the resident's recent decline in mobility. What is the PN's most valuable contribution to this discussion?
- Making the final decision on whether the resident needs a wheelchair.
- Providing specific, daily observations about the resident's ability to ambulate, their level of fatigue, and their response to assistance. (Correct answer)
- Suggesting a new medication to manage the resident's joint pain.
- Contacting the resident's family to inform them of the team's decisions.
Correct answer: Providing specific, daily observations about the resident's ability to ambulate, their level of fatigue, and their response to assistance.
The PN has the most frequent contact with the resident and can provide crucial, detailed information about their daily functional status. These specific observations are vital for the physiotherapist, occupational therapist, and physician to make informed decisions about the plan of care. Making final decisions, suggesting new medications (prescribing), and primary communication of the plan are typically roles of other team members.
Question 6: During a busy shift, the Registered Nurse (RN) team leader assigns the Practical Nurse (PN) to care for a client who requires complex wound care that the PN has not been trained to perform. Which action by the PN demonstrates accountability and promotes patient safety?
- Attempting to perform the wound care after watching an online video tutorial.
- Asking an Unregulated Care Provider (UCP) to assist with the procedure.
- Accepting the assignment and documenting that the RN is responsible for any negative outcomes.
- Informing the RN that the assignment is outside their current individual competence and requesting assistance or a different assignment. (Correct answer)
Correct answer: Informing the RN that the assignment is outside their current individual competence and requesting assistance or a different assignment.
Professional accountability requires nurses to practice within their legislated scope of practice and their individual level of competence. The safest and most accountable action is to recognize one's limitations and communicate them clearly to the assigning nurse. This protects the patient from potential harm and is a key component of collaborative teamwork.
CPNRE - Canadian Practical Nurse Registration Examination Collaborative Practice and Teamwork Questions and Answers 1
A practical nurse (PN) is concerned about a post-operative client's increasing restlessness and shortness of breath.
When contacting the Registered Nurse (RN) team leader, which statement best demonstrates the use of the SBAR (Situation-Background-Assessment-Recommendation) communication tool?