CPNRE Legal Scope and Accountability 4 — Questions and Answers
Question 1: A practical nurse witnesses a colleague administer a medication to the wrong patient. What is the practical nurse's primary legal obligation?
- Confront the colleague privately and ask them to self-report
- Document the incident and report it to the supervising nurse or manager immediately (Correct answer)
- Wait to see if the patient experiences adverse effects before reporting
- File a complaint directly with the provincial regulatory body
Correct answer: Document the incident and report it to the supervising nurse or manager immediately
Practical nurses are legally obligated to report medication errors through the facility's incident reporting system promptly to protect patient safety.
Question 2: Which concept describes the legal responsibility a practical nurse holds when delegating a task to an unregulated care provider?
- Vicarious liability
- Contributory negligence
- Accountability for delegation (Correct answer)
- Respondeat superior
Correct answer: Accountability for delegation
The practical nurse retains accountability for delegation decisions, including assessing whether the task is appropriate for the unregulated care provider's competency.
Question 3: A practical nurse is asked to perform a procedure they have not performed since nursing school and feel uncertain about. What should they do first?
- Attempt the procedure and ask for help if problems arise
- Refuse the assignment entirely and document the refusal
- Inform the supervisor of the competency gap and request supervision or support (Correct answer)
- Review the policy and proceed independently
Correct answer: Inform the supervisor of the competency gap and request supervision or support
Nurses must practice within their competence; acknowledging a gap and seeking supervision is the legally and ethically correct response.
Question 4: Which of the following best defines 'standard of care' in the context of practical nursing negligence claims?
- The highest level of care provided anywhere in Canada
- The care a reasonably competent practical nurse would provide in similar circumstances (Correct answer)
- The care outlined in the individual facility's policy manual only
- The care the patient expected to receive
Correct answer: The care a reasonably competent practical nurse would provide in similar circumstances
Standard of care is measured against what a reasonably competent practical nurse with similar training would do in the same or similar circumstances.
Question 5: A patient asks the practical nurse to keep their diagnosis secret from their spouse, who is listed as next of kin. The nurse should:
- Tell the spouse because next of kin have the right to all medical information
- Respect the patient's confidentiality and not disclose to the spouse without consent (Correct answer)
- Document the request but share the information if the spouse directly asks
- Consult the regulatory body before responding
Correct answer: Respect the patient's confidentiality and not disclose to the spouse without consent
Competent adult patients control their own health information; next-of-kin status does not override a competent patient's right to confidentiality.
Question 6: Under Canadian nursing legislation, which term refers to the legally protected activities that only regulated nurses may perform?
- Controlled acts
- Reserved acts (Correct answer)
- Authorized procedures
- Licensed functions
Correct answer: Reserved acts
Provincial legislation designates certain nursing activities as 'reserved acts' (or controlled acts in some provinces) that only regulated professionals may perform.
Question 7: A practical nurse suspects that a long-term care resident is being financially exploited by a family member. The nurse's legal duty is to:
- Discuss concerns with the family member before taking any action
- Report the suspicion to the appropriate authority as required by mandatory reporting legislation (Correct answer)
- Document the suspicion in the chart and take no further action
- Consult with other nurses to reach consensus before reporting
Correct answer: Report the suspicion to the appropriate authority as required by mandatory reporting legislation
Mandatory reporting laws require healthcare providers to report suspected abuse or exploitation of vulnerable persons regardless of who the perpetrator is.
CPNRE Legal Scope and Accountability 4
A practical nurse witnesses a colleague administer a medication to the wrong patient.
What is the practical nurse's primary legal obligation?