Dos Final Semester 5 Past Paper PDF

**DOS FINAL SEMESTER5** **15.** Mr. Patrick, 78 years old, often uncooperative, refuses to go to the dining room for breakfast this morning. The RPN is in a hurry and needs him to cooperate. She places her hands on her hips and tells him he must get to the dining room now or else he will not get an...

**DOS FINAL SEMESTER5** **15.** Mr. Patrick, 78 years old, often uncooperative, refuses to go to the dining room for breakfast this morning. The RPN is in a hurry and needs him to cooperate. She places her hands on her hips and tells him he must get to the dining room now or else he will not get anything to eat until lunch. Would the College of Nurses classify this as abuse? a. Yes, it is neglect b. Yes, it is physical abuse c. No d. Yes, it is emotional abuse **17.** A client writes to the College of Nurses stating that a nurse assaulted them during care. What action may the College take in this situation? a. Refer the complaint to local law enforcement b. Report the nurse to the employer c. Investigate the allegation d. Request that the nurse's employment be terminated **16.** The practical nurse witnesses a colleague yelling at a client. The nurse steps in and takes over care of the patient. What knowledge is their response based on? a. They know their colleague is under a lot of stress right now b. They know the client has a difficult personality and needs to be controlled c. They know abuse stops when someone intervenes d. They know it is an isolated incident and will not happen again. **11.** The 91-year-old gentleman with dementia is constantly yelling in the long-term care facility. When the RPN tries to toilet him, he yells "No, No" in a loud voice. The nurse is afraid people will think she is abusing him so she covers his mouth with her hand. What is this called? a. Negligence b. Battery c. Unintentional tort d. Assault **9.** Using the 3-factor framework, select the appropriate caregiver for the following patient scenario. The assignment for the day shift is being determined on a unit in the large well-equipped hospital. The charge nurse is using the three-factor framework to decide who would be the best person to care for a 24-year-old client who has been admitted from the emergency department to the surgical unit after a motor vehicle accident. The patient will be going to the operating room as soon as possible to repair a badly broken hip. The patient is to be observed closely as they have an injured spleen and broken ribs. a. A RPN who will consult with the RN as needed b. An RN c. A RPN with ten years experience working in the surgical unit d. Either nurse is qualified in the situation **7.** The nurse has completed the Quality Assurance requirements for the College of Nurses of Ontario. What is their next step? a. Indicate when they review their registration that they have completed the requirements b. Show the completed reflection and learning plan to her manager c. Keep a copy of the reflection & learning plan on file for 10 years d. Send the required paperwork into the College of Nurses of Ontario **14.** A client in the long-term care facility has no relatives. The nurses feel sorry for him as he is very likeable and is like a grandfather to many of them. His health is declining and he has asked the RPN who has cared for him for eight years to be his substitute decision maker for health. What should she do? a. Accept the honour and agree to do so b. Call the CNO nursing advisor for advice c. Discuss the request with the manager of the unit d. Decline and talk to the social worker about the situation **13.** According to the CNO, the Duty to Provide Care has underlying principles to guide decision making. What statement identifies that a new RPN does NOT understand this decision-making process for working in an unsafe working condition? a. If a patient requires ongoing emergency nursing care, they are entitled to have those needs satisfied throughout any job action b. Nurses do not have the right to refuse assignments that they believe will subject them or their clients to an unacceptable level of risk. c. Nurses are accountable for their own actions and decisions. Thus, they need to ensure their response must be guided by the Professional Standards & Ethics Standard d. Safety and wellbeing of the client is of primary concern **10.** Where is the best setting for autonomous RPN practice? a. As the nurse in an outpatient clinic b. As the recovery room nurse c. As the triage nurse in the Emergency department d. As the only health care provider in an outpost nursing station in Northern Ontario **8.** An RPN working as a Community Nurse recognizes that they must consult with an RN or transfer care to an RN in which of the following situations? a. A client has no psychological supports or coping mechanisms in place b. The nurse is providing care for a family unit c. The potential changes in a client status would be very obvious d. There are changes in the client status which were anticipated **6.** A nurse working in a Family Physician (General practitioner)'s office. One of the job expectations is to relay INR results to clients via telephone. Is this appropriate? a. Yes, as relaying this information is not a controlled act b. No, as they are not considered a nurse in a tele practice position c. No, since this is the communication of a diagnosis d. Yes, as communicating a diagnosis is within the nursing scope of practice **3.** The RPN is discussing the issue of initiation with colleagues. Which of the following contributed acts can a RPN initiate for health maintenance? a. Initiating a suppository into a stoma b. Probing to check undermining of a wound c. Assessing a client for disimpaction using a finger d. Assessing a cervix using a speculum **1.** The nurse is explaining to the student the regulatory function of the College of Nurses of Ontario. Which statement shows the nurse does not know the regulatory functions of the CNO? a. Establishing requirements for entry practice b. Administering a quality assurance program c. Developing education programs d. Articulating and promoting practice standards **4.** The nurse working in a community health clinic would like to administer influenza vaccinations to vulnerable clients. What will they need to be able to do this? a. Delegation b. A medical directive c. A physician's order d. Permission form CNO **5.** A nurse is working in an Emergency Room. Nurses working in this setting are sometimes required to perform defibrillation through delegation. Which of the following is true regarding a nurse accepting delegation? a. The nurse can perform defibrillation provided the act is delegated by an experienced health care provider, such as a paramedic or physician's assistant b. The nurse can sub-delegate defibrillation to a colleague, provided they ensure their colleague has the knowledge, skill, and judgement c. The nurse must document the care in the client's chest d. The nurse can accept delegation provided they are registered with the CNO in one of the registration classes, including Temporary Class **35.** The PSW has been working with the same client in the community for two years. The client has MS (multiple sclerosis) and needs increasing help with activities of daily living and mobility. Lately, the PSW has started to feed the client. Which of the following would be beyond the responsibility of the PSW role? a. Adding the feeding intervention to the plan of care b. Assisting the client to complete the outlined by the physiotherapist c. Observing and reporting reddened mucous membranes in the client's mouth d. Observing the clients swallowing ability as the PSW feeds the client **40.** A nurse who regularly works with unregulated care providers as part of their role understands that which of the following is true: a. Supervision involves a nurse directly observing the care provided by the unregulated care provider b. A nurse can assign procedures that may or may not be controlled act c. An unregulated care provider can perform some controlled acts without delegation, provided that procedure is considered an activity of daily living. d. Teaching is only required if the nurse is formally delegating a controlled act **36.** One type of nursing model is an emerging model among intraprofessional nursing teams and other health care providers who are members of the interprofessional team. What is this model called? a. Team nursing model b. Primary nursing model c. Functional nursing model d. Collaborative practice model **37.** The charge nurse asks an experienced nurse to admit a palliative patient who arrives on the pediatric unit. What is this action referred to as? a. Delegation b. Supervision c. Assigning d. Evaluation **39.** The nurse is working with unregulated care providers (PSW) in a long-term care facility. A PSW forgets to leave the call bell within reach of the resident. The resident gets up on their own and falls, injuring themselves. Who is accountable for the residents\' negative outcome? a. The nurse must document that they taught the client not to get up without help the previous night to not be held accountable b. The PSW and the client are both accountable for the fall and injuries c. The nurse is accountable for their own actions as soon as they find out about the resident d. The nurse and the PSW and equally accountable for the resident's injuries **2.** Which statement meets the CNO leadership professional standard? a. Engaging in a learning process to enhance one's own practice b. Leading research in nursing, the health sciences, and related disciplines c. Participating in the CNO QA progress d. Collaboration with clients and the health care team using communication skills **34.** Which of the following is a requirement for a nurse when delegating tasks to an unregulated care provider (UCP)? a. Always supervising the UCP b. Obtaining the UCP's voluntary acceptance of the task c. Functioning with a laissez-faire style of leadership d. Communicating the task in understandable terms **32.** A recently hired home care nurse is working with three UCP's for the first time. The nurse has never worked with UCP's in their previous position. In order for the nurse to enhance their collaborative practice with the UCP's they set up an opportunity to meet with the UCP's to talk about their experience, questions and roles. What Interprofessional competence is the nurse attempting to develop? a. Team functioning b. Interprofessional communication c. Role certification d. Collaborative leadership **29.** A client, unsure of the need for surgery, asks the nurse, "What should I do?" What answer by the nurse will support the ethical principle of advocacy? a. "Would it help if I brought another client in to talk to you who just had surgery?" b. "Let me talk to your doctor and I will get back to you as soon as I can" c. "Tell me more about what makes you think you don't want surgery" d. "It is a tough decision, maybe you should wait and make it when you are stronger" **38.** In the community, the nurse has taught a PSW to change a dressing on a decubitus ulcer of a client who has had the open area for a long time. The nurse has evaluated the PSW and knows she is competent to do the dressing. What else must the nurse consider before delegating this to be PSW? a. Is it a controlled act authorized to the PSW? b. The length of time the client has had the open area c. Do the community agency policies allow the nurse to delegate this to the PSW? d. Will the PSW be changing wound dressings on other clients? **33.** A patient who has lived with IDDM for 10 years is living at home and has an order for insulin. What is the 1st step the nurse must take to determine whether the insulin injection requires delegation? a. Does the PSW have the necessary knowledge, skill, and judgement? b. Is this a routine activity of daily living for this client? c. Will there be someone available to evaluate the PSW continued competence doing this skill? d. Has the PSW given an injection before? **31.** The client is a Jehovah Witness and has refused a packed cell transfusion. Her plan of care post-op requires her to get up in the chair on day two and it is now day three. She states she is too tired to get up. Her hemoglobin was 72. What should the nurse do? a. Discuss with the physician other ways to increase her hemoglobin b. Suggest some foods to the client that are high in iron c. Encourage the client to reconsider having the blood transfusion d. Get other nurses to help mobilize her to a Geri-chair **26.** Natalie, an inpatient in a community hospital has been diagnosed with terminal cancer. Natalie does not speak English, so her daughter is translating for them. Her daughter has informed the team that the family has decided not to inform Natalie of her terminal diagnosis, instead, they are telling Natalie that she has an infection. They assure the team that as part of her cultural and religious beliefs. Natalie would want it this way. What is the best course of action of the nursing staff in this situation? a. Inform Natalie of her condition, as it is their professional and legal obligation to disclose health information to a client b. Request a meeting with the course manager to discuss the situation c. Speak with the nurse manager and ask her in assign only casual staff in Natalie d. Seek the assistance of a translate to explain the situation to Natalie **18.** A community health nurse has been approached to sell a herbal supplement to their clients. They would receive compensation via a 10% commission. The nurse uses this supplement themselves and can attest to its positive effects. What would the nurse conclude after considering the CNO position on this issue? a. There are absolutely no circumstances in which a nurse could sell a product to a client, therefore it is inappropriate b. The nurse is considering these best interests of their client, therefore this would be appropriate c. The CNO would consider this a conflict of interest, and therefore inappropriate d. The 10% commission is minimal so it would be considered appropriate **20.** Grace, an RPN working in labour & delivery, has struggled with back pain while providing nursing care. She started taking Tylenol for her pain, but now requires stronger medications to get through a shift. She has been using her partner\'s Oxycontin and cannot get through a shift without a dose of Oxycontin. Would this constitute incapacity? a. Yes, because she should go to her family physician to get a prescription for a medication that does not influence her cognitive status b. No, because she has not had any errors associated with her care while taking Oxycontin c. No, because she is not obtaining the Oxycontin from the unit medication stock d. Yes, because she is dependant on Oxycontin to get through her shift, putting her patients at risk **59.** Which of the following is an example of revolutionary change in health care? a. Changes to bedside handover to include the patient b. Implementation of a new computer charting system c. The role of the RPN in Ontario **58.** There are two main types of change: revolutionary, evolutionary. When managing either type of change resistance to the change will occur. With which type of change will you experience greater resistance a. Evolutionary b. Revolutionary c. Neither will cause resistance d. Resistance is equally intense with both **19.** An RPN has just been diagnosed with chronic depression. They are under the care of their psychiatrist and are able to manage their depression on a low dose antidepressant. When they have difficulty coping, they use their sick time appropriately. Does the nurse need to report their condition to the CEO? a. Yes, as it could put their patients at risk b. Yes, all high-risk health concerns of nurses need to be reported to the CEO c. No, as their condition is under control, and they are compliant with their treatment **55.** A nurse is working as a Stroke Care Coordinator within the community. The nurse is planning education sessions to ensure the interdisciplinary team incorporates current Best Practice Guidelines in the care of their stroke clients. Several staff members have demonstrated their resistance to this change. Which initial strategy would best help the nurse effectively influence change? a. Requesting feedback from stakeholders, hold information sessions to share the feedback, and using a democratic process to determine which change theory to apply b. Educate themselves on the new guidelines, apply a change theory to the process, and use information sessions as a beginning step of the change process c. Using information sessions to inform the audience, gathering input, and recording questions from the attendees. **62.** In which situation would a competing style of conflict management be appropriate? a. The nurse is upset by how the charge nurse has distributed the client assignment b. A nurse is upset another nurse is planning to change the work schedule without talking to them first c. The nursing leader tells the nurse that they are concerned about the number of sick days the nurse has taken d. Two nurses are arguing about the appropriateness of calling a code blue **56.** Lewin's Model of Change can be often compared to the nursing process. If this is true, which of the following statements demonstrates that comparison? a. Evolution aligns with evaluation b. Revolution aligns with planning c. Refreezing aligns with assessing d. Moving aligns with implementation **52.** The nurse is working on a committee to change the way coffee and meal breaks are assigned. Which characteristic makes the nurse a good change agent? a. They are respected by their colleagues b. They always get to breaks and meals on time c. They remind the staff that they work harder than anyone else d. They are an experienced nurse **54.** Which of the following statements accurately describe the concept of change? (Select all that apply) a. Change is essential for growth b. Change is avoidable c. Change is a natural process and easy to navigate d. Change is a continual process e. Change can occur from within or from outside an individual of organizational **57.** Lewin's model of change can be compared with moving through the nursing process. Which of the following is an accurate statement? a. Moving aligns with implementation b. Refreezing aligns with planning c. Refreezing aligns with assessing d. Unfreezing aligns with evaluation **53.** How can nurses, as a profession, best cope with the rapid changes occurring within the Canadian healthcare system? a. Consider that changes may be a threat to the nurses' role in health care, and can have a negative impact on the nursing profession. b. React to the change in a slow, methodical manner c. Maintain their position and not "give in" d. Be proactive and anticipate potential change **49.** What does the term political action refer to? a. A means of taxing individuals to meet health care needs b. A method to influence decision making and the allocation of resources c. Influencing the actions of government bodies d. The election of representation at the municipal, provincial, and federal levels of government **50.** Which of the following is an example of evolutionary change in healthcare? a. Changes to visiting hour policies due to a hospital-wide outbreak b. Response to significant illness such as SARS c. Implementation of a new computer charting system d. The role of the RPN in Ontario **47.** A group of nurses want to change the scheduling policy at their workplace. What would be their first step in making this change? a. Determine if the majority want the change b. Inquire if it is economically feasible c. Find out what needs are currently being met d. Think about who will be advantaged and disadvantaged **45.** Evidence has shown that when healthcare institutions use interprofessional models to provide care for patients with chronic disease, it leads to all of the following outcomes. (Select all that apply) a. Higher healthcare costs due to the number of healthcare providers involved in a client's care b. Allowing better access to healthcare resources c. Patients report they receive better care d. Patients report a better healthcare experience e. Efficient use of healthcare resources **51.** You will be joining the nursing profession during a time of significant change. Considering these changes, which of the following areas will be most important for you to develop as you progress in your career? a. Understanding of the public healthcare sector, since private sector healthcare is on the decline b. A specific focus on nursing care and client nursing care plan c. Your knowledge of the treatment of disease d. Being aware of the nurse's scope of practice and any changes to the role and scope of practice of healthcare team members **42.** UCPs are allowed to perform tasks with patients in which situation? a. When tasks are delegated by another UCP b. With another UCP c. When tasks are delegated by a nurse d. When asked by the patient **46.** Why is it important to understand the role of each regulated health profession in Ontario? a. The RPN will better understand the power imbalances written the interprofessional healthcare team b. It is an important aspect of the College of Nurses of Ontario quality assurance program c. It helps the health professionals work together in a team recognizing each other's skills and contributions d. The nurse can tell the professional if they are doing something outside the controlled acts **43.** A nurse needs to determine if a PSW can perform intermittent catheterization for a home care patient as part of their routine care. The need for response to and outcome of the catheterization has been established for a long time. What would the nurse need to do to ensure the PSW is able to catheterize the patient if needed. a. Remove the client from the nurse's patient food, since the PSW will be now able to perform the care required b. Request that the physician provide an order, establishing that the PSW may catheterize the patient c. Delegate the procedure to the PSW d. Determine whether the PSW has the knowledge, skill, and judgment to perform the procedure **44.** According to the CNA Position Statement, which of the following principles of interprofessional Collaboration involves the recognition that clients should be actively involved in the prevention, promotion, and management of their health? a. Evidence-informed decision-making b. Ethics c. Epidemiology d. Client-centred care **76.** The "R" when using the SBAR communication technique represents which of the following? a. Recommendation b. Reorganization c. Reintegration d. Repeat back **78.** A nurse preceptor is working with a student nurse. Which behaviour by the student nurse will prompt the nurse preceptor to intervene? a. The student nurse documents medication administered to the patient b. The student nurse reviews the patient's medical record c. The student nurse shares patient information with a friend d. The student nurse reads the patient's plan of care **80.** A preceptor is working with a new nurse on documentation. Which situation will cause the preceptor to interview? a. The new nurse keeps the password secure b. The new nurse ends each entry with signature and title c. The new nurse uses a black ink to chart d. The new nurse charts consecutively on every other line **40.** A nurse who regularly works with unregulated care providers as part of their role understands that which of the following is true: a. Supervision involves a nurse directly observing the care provided by the unregulated care provider b. A nurse can assign procedures that may or may not be a controlled act c. An unregulated care provider can perform some controlled acts without delegation, provided that procedure is considered an activity of daily living d. Teaching is only required if the nurse is formally delegating a controlled act **74.** A new graduate nurse will make the best clinical decisions by applying the components of the nursing critical thinking model and which of the following? a. Using the nursing process b. Relying on recall of information from past lectures and textbooks c. Drawing on past clinical experiences to formulate standardized care plans d. Depending on the charge nurse to determine priorities of care **79.** What action should the nurse take if they make an error when documenting in a paper chart? a. Draw a line through the error and initial and date it b. Footnoting the error at the bottom of the page, including initials and the date c. Erase the error and writing over the material in the same spot d. Using a dark-coloured marker to cover the error and continuing immediately after that point **71.** The RPN is in charge on the 34-bed wing of a LTC facility. During her shift she notices the PSW is transferring Mrs. Jones in a manner that is unsafe for both the client and for the PSW. HOw does she best demonstrate leadership? a. Talk to the PSW in private about the correct procedure when the PSW is finishing the transfer b. Recognizing a need for teaching planning an in-service for all the PSW's to teach them correct client transfers c. Intervening to ensure that Mrs. Jones is safe by sharing her knowledge of the correct way to transfer the client d. Reprimand the PSW and showing her the correct way and then informing the manager of (the rest of this part is cut off in the picture) **77.** According to documentation guidelines, which notation is the most appropriate? a. "0700 hours: Patient drank adequate amount of fluids." b. "0830 hours: Increased IV fluid rate to 100 mL per hour." c. "0900 hours: Morphine given for lower abdominal pain." d. "1230 hours: Patient's vital signs taken." **75.** A nurse is creating a plan to reduce data entry errors and maintain confidentiality. Which guidelines should the nurse include? a. Create a password with just letters b. Shred papers containing personal health information c. Bypass the firewall d. Avoid use of a programmed speed-dial key when faxing **41.** A nurse has delegated a task to an unregulated care provider (UCP). What is the nurse responsible for? a. Maintaining accountability for the task b. Performing the task safely c. Weekly performance evaluations of the UCP d. Reporting any mistakes made by the UCP to all staff on the unit **60.** What should be present if conflict resolution is to be successful? a. People must hold the same values b. A mediator must be hired to work with the group c. The parties involved must be willing to negotiate d. People need to voice their role in the conflict **61.** Which of the following is the best example of assertive communication? a. "Think about my feelings for a change. When you talk to me like that it hurts me." b. "You make me feel bad when you talk behind my back." c. "I am upset when you speak to me with that tone and I want you to stop it." d. "I need to get a break right now. You will have to do that client's dressing change." **67.** In the current COVID-19 crisis, nurses are exercising their leadership role on a daily basis. which of the following is an accurate demonstration of nurses upholding the leadership professional standard indicator that states "the nurse advocates for clients, the workplace and the profession"? a. Advocating for the provision of appropriate PPE b. Hoarding PPE supplies for their units c. Posting on social media the perils of working during the COVID-19 crisis **68.** in the test couple of weeks or months a. We will prioritize bed bath The Palliative Care Unit wants to use a CQI process to prevent pressure ulcers (bed sores) in their patients. Identify which statement would meet the AIM criteria for this project. b. We will reduce the time to reposition patients on the Palliative Care Unit from every 2 hours to every hour. We will accomplish this within 4 months c. On the Palliative Care Unit, we will prioritize repositioning of patients every hour d. We will reduce the repositioning time of patients on the Palliative Care Init. We will attempt to accomplish this and wound changes on our patients with ulcers every hour **72.** When determining which style of leadership to employ in a situation, which of the following will shape the nursing leader's decision? a. The leader's vision b. The financial soundness of the organization c. The amount of power she wields d. The urgency of the problem **69.** What is the best way for the RPN to advocate for the profession? a. Inform clients that she/he is a RPN b. Join the RPN regulatory body c. Model professional behaviour d. Take pride in her/his appearance **73.** What is the first component of the critical thinking model for clinical decision making? a. Nursing process b. Experience c. A scientific knowledge bases d. Attitude **65.** What is a nursing manager's greatest challenge? a. Communication b. Delegation c. Time management d. Clinical decision making **66.** The new nurse manager in a long-term care facility wants to make a change to the established policies that allow only RNs to change simplex dressings. She elicits the help of the RNs and RPNs to come up with a strategy to make the change smooth and effective. What is this an example of? a. Influence b. Delegation c. Empowerment d. Management **70.** Which of the following statements best defines effective leadership? a. Leadership is exerting power over someone to motivate them b. Leadership is defined by one's position in an organization c. Leadership is not defined by role, it is defined by action d. Leaders are born with unique qualities that cannot be learned **63.** How is management best defined? a. Investigating and disciplining staff for failing to practice according to standards b. The preparation of work schedules for workers in such a way as to meet everyone's needs c. The process of getting activities completed efficiently through and with other people d. The process of long-term planning for budgeting purposes **62.** In which situation would a competing style of conflict management be appropriate? a. The nurse is upset by how the charge nurse has distributed the client assignment b. A nurse is upset another nurse is planning to change the work schedule without talking to theme first c. The nursing leader tells the nurse that they are concerned about the number of sick days the nurse has taken d. Two nurses are arguing about the appropriateness of calling a code blue **64.** When transcribing the order, the RPN asks Janie, a new nurse on the unit, to go over the procedure for transcribing orders with him in order for Jamie to learn the process. Why does the nurse do this? a. To be sure he learns her way of transcribing orders b. To make her workload easier c. To ensure he is in charge as soon as possible d. To model leadership **48.** Why does weRPN and the RNAO indicate that Canadian Nurses have the ability to be a social force? a. Because they are highly regulated by weRPN/RNAO b. Because the public trusts the profession of nursing c. Because the are motivated to instigate change d. Because of the number of nurses there are in Ontario **12.** Mr. Goodall, 91-years-old, is aphasic after a CVA, but is competent to make his own decisions in the long-term care facility where he lives. His treatment plan indicates he is to have a shower twice a week. He always looked forward to the shower. Today, when the RPN comes to help the PSW get him to the shower he shakes his head no. What should the RPN do? a. Encourages him to go back to bed and get more sleep b. Come back later to see if he has changed his mind c. Let him know if he does not shower now, he will have to wait until next week d. Take him to the shower room to remind him of how nice it is