CPNRE Professional and Ethical Practice 5 — Questions and Answers
Question 1: A PN working in a long-term care facility discovers that a colleague has been falsifying vital sign records. The PN should:
- Confront the colleague privately and warn them to stop
- Report the behaviour to the supervisor or appropriate authority (Correct answer)
- Monitor the situation for several days before acting
- Ignore it if no client harm has occurred yet
Correct answer: Report the behaviour to the supervisor or appropriate authority
Falsifying records is professional misconduct that must be reported to protect client safety and uphold professional integrity.
Question 2: Informed consent for a surgical procedure is primarily the responsibility of:
- The PN, who explains the procedure in plain language
- The surgeon performing the procedure (Correct answer)
- The charge nurse on the unit
- The hospital's consent coordinator
Correct answer: The surgeon performing the procedure
The physician or surgeon performing the procedure is responsible for obtaining informed consent; the PN may witness the signature and reinforce information.
Question 3: A PN is caring for a client who is expressing suicidal ideation. The most immediate ethical and legal obligation is to:
- Maintain confidentiality and not disclose to anyone without permission
- Ensure client safety by reporting to the responsible physician and team immediately (Correct answer)
- Ask the client to sign a safety contract before taking further action
- Document the statements and reassess at the next shift
Correct answer: Ensure client safety by reporting to the responsible physician and team immediately
When there is risk of serious harm, the duty to protect overrides confidentiality and requires immediate escalation.
Question 4: Which action best demonstrates the PN's commitment to evidence-informed practice?
- Following the same care routines used for the past ten years
- Consulting current clinical practice guidelines when planning care (Correct answer)
- Relying on the most experienced nurse's advice for all decisions
- Using procedures taught during initial nursing education without updates
Correct answer: Consulting current clinical practice guidelines when planning care
Evidence-informed practice requires integrating current best evidence, clinical expertise, and client preferences into care decisions.
Question 5: A client with dementia is unable to provide informed consent for a procedure. Who is the most appropriate decision-maker?
- The most senior nurse on the unit
- The client's legally designated substitute decision-maker (Correct answer)
- The attending physician
- Any family member present at the time
Correct answer: The client's legally designated substitute decision-maker
When a client lacks decision-making capacity, the legally designated substitute decision-maker is responsible for providing consent according to provincial legislation.
Question 6: A PN who disagrees with a physician's order should first:
- Refuse to carry out the order immediately
- Clarify the order directly with the physician and express concerns professionally (Correct answer)
- Ask another nurse to administer the medication instead
- Administer the medication and document personal disagreement
Correct answer: Clarify the order directly with the physician and express concerns professionally
PNs have a professional responsibility to question orders that appear unsafe or unclear through direct, respectful communication with the prescriber.
Question 7: In the context of professional self-regulation, which body holds the authority to discipline a PN for professional misconduct in most Canadian provinces?
- The provincial Ministry of Health
- The provincial regulatory body for practical nurses (Correct answer)
- The employer or hospital administration
- The Canadian Nurses Association
Correct answer: The provincial regulatory body for practical nurses
Provincial regulatory colleges (e.g., CLPNBC, CNO) have statutory authority to investigate complaints and impose disciplinary measures on PNs.
CPNRE Professional and Ethical Practice 5
A PN working in a long-term care facility discovers that a colleague has been falsifying vital sign records.
The PN should: