RPN - Registered Practical Nurse Legal Practice and Scope Questions and Answers

Question 1

An RPN in Ontario is asked by a physician to perform a procedure that is within the RPN's scope of practice but one they have not performed in several years. Which of the following is the most appropriate initial action for the RPN to take?

Accepted Answer

Inform the physician and their supervisor that they are not currently competent to perform the procedure and request supervision or further training.

Answer

According to the College of Nurses of Ontario (CNO), nurses are accountable for practicing within the limits of their individual competence. While a procedure may be within the general scope of practice for an RPN, each nurse must self-assess their own knowledge, skill, and judgment to perform it safely. Informing the relevant parties and seeking assistance is the professionally responsible action that prioritizes client safety.

Question 2

A competent client with a known history of refusing medical advice now requires a routine medication injection. The client verbally refuses the injection. What is the RPN's legal obligation?

Accepted Answer

Document the client's refusal, inform the primary health care provider, and do not administer the medication.

Answer

Competent clients have the legal right to refuse treatment, even if that refusal may lead to negative health consequences. Forcing treatment on a competent client who has refused can be considered battery. The RPN's duty is to respect the client's autonomy, document the refusal and the education provided, and inform the appropriate health care team members.

Question 3

Which of the following is defined as professional misconduct under the regulations governing nursing in Ontario?

Accepted Answer

Failing to report a colleague who is suspected of practicing while impaired.

Answer

The College of Nurses of Ontario (CNO) regulations and practice standards clearly state that nurses have a professional and ethical obligation to report unsafe or unethical conduct by other healthcare providers to protect the public. Failing to report a colleague suspected of being impaired while on duty is a serious breach of this obligation and constitutes professional misconduct.

Question 4

An RPN is working in a long-term care facility. A resident's family member, who is not the substitute decision-maker, asks the RPN for specific details about the resident's recent diagnostic test results. How should the RPN respond?

Accepted Answer

Politely decline to provide the specific results, explaining that personal health information can only be shared with the resident or their legal substitute decision-maker.

Answer

Under privacy legislation, such as the Personal Health Information Protection Act (PHIPA) in Ontario, and the CNO's Code of Conduct, nurses have a strict duty to maintain the confidentiality of client information. Disclosing personal health information without the client's consent (or that of their legal representative) is a breach of privacy and professional misconduct. The correct action is to explain the privacy rules and direct the inquiry appropriately.

Question 5

Under the Regulated Health Professions Act, 1991, and the Nursing Act, 1991, which of the following is a controlled act that RPNs are authorized to perform with an order or through initiation under specific conditions?

Accepted Answer

Performing a procedure below the dermis or a mucous membrane.

Answer

The Nursing Act, 1991, authorizes RNs and RPNs to perform five controlled acts under specific conditions, such as with an order or through initiation. Performing a prescribed procedure below the dermis or a mucous membrane (e.g., giving an injection or wound care) is one of these authorized controlled acts. Communicating a diagnosis and prescribing are generally reserved for Nurse Practitioners or physicians, and setting fractures is outside the nursing scope.

RPN - Registered Practical Nurse Practice Test

RPN - Registered Practical Nurse Practice Test

RPN - Registered Practical Nurse Legal Practice and Scope Questions and Answers