RPN Legal Practice and Scope 2 — Questions and Answers
Question 1: An RPN documents a medication error in the patient's chart. What is the NEXT required action?
- File an incident report per facility policy (Correct answer)
- Notify the patient's family immediately
- Administer a corrective dose without documentation
- Wait to see if the patient shows adverse effects before reporting
Correct answer: File an incident report per facility policy
Medication errors must be documented in the chart AND reported via an incident report per facility policy to ensure patient safety and quality improvement.
Question 2: Which action by an RPN constitutes professional misconduct under nursing practice legislation?
- Performing a skill outside the approved scope without delegation (Correct answer)
- Asking a physician to clarify an ambiguous order
- Reporting a colleague's unsafe practice to a supervisor
- Documenting patient refusal of care
Correct answer: Performing a skill outside the approved scope without delegation
Performing tasks outside the legislated or employer-approved scope without proper delegation constitutes professional misconduct.
Question 3: A patient who is a Jehovah's Witness refuses a blood transfusion ordered by the physician. The RPN should:
- Respect the refusal and document it, then notify the physician (Correct answer)
- Proceed with the transfusion because the physician ordered it
- Contact the patient's family to obtain consent
- Call the ethics committee before taking any action
Correct answer: Respect the refusal and document it, then notify the physician
Competent adult patients have the legal right to refuse treatment; the RPN must document the refusal and inform the physician.
Question 4: Under mandatory reporting laws, an RPN is required to report suspected child abuse to:
- The appropriate child protective services agency (Correct answer)
- The hospital ethics board only
- The attending physician, who then decides whether to report
- The nursing supervisor, who files the report on the nurse's behalf
Correct answer: The appropriate child protective services agency
Mandatory reporting laws require healthcare professionals, including RPNs, to report suspected child abuse directly to child protective services.
Question 5: An RPN receives a verbal order from a physician by phone. The best practice is to:
- Repeat the order back to verify, then document it and have the physician countersign within the required timeframe (Correct answer)
- Write it in the chart and have another nurse witness the documentation
- Refuse verbal orders and insist on written orders only
- Administer the medication and document the verbal order after the physician's next visit
Correct answer: Repeat the order back to verify, then document it and have the physician countersign within the required timeframe
Verbal orders require read-back verification for safety and must be countersigned by the physician within the facility's required timeframe.
Question 6: Which statement best describes the legal concept of 'standard of care' as it applies to RPNs?
- The level of care a reasonably competent RPN would provide in similar circumstances (Correct answer)
- The highest level of care that any nurse in any specialty could provide
- The care outlined exclusively in the RPN's job description
- The minimum care required to keep a patient alive
Correct answer: The level of care a reasonably competent RPN would provide in similar circumstances
Standard of care is measured against what a reasonably competent RPN with similar training would do under the same circumstances.
Question 7: An RPN notices that a colleague has been charting vital signs without actually taking them. The RPN should FIRST:
- Report the observation to the nurse manager or appropriate supervisor (Correct answer)
- Confront the colleague publicly at the nursing station
- Document the concern in the patient's chart
- Contact the regulatory college immediately before speaking to management
Correct answer: Report the observation to the nurse manager or appropriate supervisor
The appropriate first step is to report the observation through the facility's internal chain of command (supervisor/manager) to protect patient safety.
RPN Legal Practice and Scope 2
An RPN documents a medication error in the patient's chart.
What is the NEXT required action?