CNO - Entry to Practice Competencies

Question 1

Regulatory body for nursing in Ontario.

Answer 1

College of Nurses of Ontario (CNO)

Question 2

Accountable for public protection by ensuring that nurses in Ontario practice safely,
competently and ethically.

Answer 2

CNO

Question 3

Fulfills its mandate through a variety of regulatory activities, including the following:
■ registration
■ maintaining standards of nursing practice and
education
■ enforcing nursing standards
■ conducting continuing competence reviews
■ establishing competencies required for nursing
practice

Answer 3

CNO

Question 4

Foundation for nursing practice.

Answer 4

Entry-to-practice competencies

Question 5

Guide the assessment of nurses’ continuing competence for maintaining registration with CNO.

Answer 5

Entry-to-practice competencies

Question 6

Include professional practice, ethical practice, legal practice, foundations of practice and, collaborative practice.

Answer 6

Entry-to-practice competencies

Question 7

Guide to entry-level practice expectations for RPNs in Ontario.

Answer 7

Entry-to-practice competencies

Question 8

Through government legislation (Nursing Act, 1991 and Regulated Health
Professions Act, 1991), CNO is mandated by the public to promote and ensure safe, competent and ethical nursing in Ontario.

Answer 8

Protection of the public

Question 9

The competencies assist RPNs in understanding entry-level practice expectations and ongoing applications within their professional roles.

Answer 9

Practice reference

Question 10

Competencies are used by CNO in evaluating practical nursing education programs tCo ensure that the curriculum prepares graduates to successfully achieve professional practice standards before entering practice.

Answer 10

Approval of nursing education programs

Question 11

CNO uses the competencies to inform its decisions about registration eligibility.

Answer 11

Registration and membership requirements

Question 12

The ___ definition of nursing practice included in the Nursing Act, 1991 establishes the basis for the scope of practice in which any nurse may engage. The competencies are the expectations for RPNs upon their entry to practice in Ontario, and are used as a ___ when evaluating the RPNs’ standard of care.

Answer 12

legal / reference

Question 13

Competencies inform the public, employers, and other health are
providers about RPN practice and assist with accurate expectations for RPN practice at entry level.

Answer 13

Public information

Question 14

In accordance with CNO’s Quality Assurance Program, the competencies are used by nurses annually when self-assessing their nursing practice and developing
their professional learning goals.

Answer 14

Continuing competence

Question 15

CNO has regularly reviewed and revised the competencies to ensure they remain relevant with ___ practices.

Answer 15

current

Question 16

True or false: each province’s and territory’s practical nurse regulatory body validates and approves the entry-to-practice competencies that apply within its jurisdiction.

Answer 16

True

Question 17

Each regulatory body confirms that the competencies are consistent with
___ and territorial legislation.

Answer 17

provincial

Question 18

Include Professional Standards and Ethics and the Code of Conduct that is expected to be used in entry-level practice.

Answer 18

CNO practice documents

Question 19

The following ___ apply to the practice of practical nursing in Canada and to the entry-to-practice competencies included later in this document:
■ The foundation of practical nursing is defined
by:
◗ entry-to-practice competencies
◗ professional nursing standards of practice of the regulatory authority
◗ nursing code(s) of ethics and ethical standards
◗ scope of nursing practice applicable in the jurisdiction
◗ provincial, territorial and federal legislation and regulations that direct practice
■ RPN practice is built upon the four concepts of person, environment, health and nursing, and is grounded within the context of the current Canadian health care system, primary healthcare, and emerging health trends
■ RPNs possess competencies that are transferable across all areas of responsibility (for example, direct care, administration, education and research)
■ RPNs are active participants in health promotion, illness prevention and harm reduction activities
■ RPNs practice in any setting or circumstance where health care is delivered
■ Requisite skills and abilities are required to attain the RPN entry-to-practice competencies
■ RPNs practice autonomously, safely, competently, and ethically along the continuum of care in situations of health and illness across a client’s lifespan
■ RPNs practice in situations of varying complexity and work collaboratively with the
health care team to maximize client outcomes
■ RPNs demonstrate leadership by fostering continued self-growth to meet the challenges of an evolving health care system
■ RPNs follow a systematic approach to deliver safe, competent, and ethical care by using the nursing process
■ RPNs advocate for the implementation and use of evidence-informed practice

Answer 19

assumptions

Question 20

Central focus of practical nursing practice.

Answer 20

Client

Question 21

Refers to a person who receives health care services from a nurse.

Answer 21

Client

Question 22

In most circumstances, the ___ is an individual, but the ___ can include family
members or substitute decision-makers. A ___ also can be a group, community or population.

Answer 22

client x3

Question 23

The 79 entry-level competencies are organized in five categories:

1. professional practice
2. legal practice
3. ethical practice
4. foundations of practice
5. collaborative practice.

Answer 23

Competency framework

Question 24

The ___ entry-level competencies are organized in five categories:

1. professional practice
2. legal practice
3. ethical practice
4. foundations of practice
5. collaborative practice.

Answer 24

79

Question 25

1. professional practice
2. legal practice
3. ethical practice
4. foundations of practice
5. collaborative practice

Answer 25

Categories of the 79 entry-level competencies

Question 26

Registered Practical Nurses (RPNs) adhere to practice standards. They are responsible and accountable for safe, competent and ethical nursing practice. They are expected to demonstrate professional conduct as reflected through personal attitudes, beliefs, opinions, and actions. RPNs focus on personal and professional
growth. RPNs are expected to use knowledge, critical thinking, critical inquiry and research to build an evidence-informed practice.

Answer 26

Professional Practice

Question 27

Which competency statement does the following belong to:

• Demonstrates accountability and accepts responsibility for own decisions and actions
• Practices autonomously within legislated scope of practice
• Displays self-awareness and recognizes when to seek assistance and guidance
• Adheres to regulatory requirements of jurisdictional legislation
• Practices within own level of competence

Answer 27

Professional Practice

Question 28

Which competency statement does the following belong to:

• Initiates, maintains, and terminates the therapeutic nurse-client relationship
• Provides client care in a non-judgmental manner
• Adapts practice in response to the spiritual beliefs and cultural practices of clients
• Supports clients in making informed decisions about their health care, and respects their decisions
• Engages in self-reflection and continuous learning to maintain and enhance competence

Answer 28

Professional Practice

Question 29

Which competency statement does the following belong to:

• Integrates relevant evidence into practice
• Collaborates in the analysis, development, implementation, and evaluation of practice and policy
• Integrates continuous quality improvement principles and activities into nursing practice
• Recognizes, responds, and reports own and others’ near misses, errors and adverse events
• Distinguishes between the mandates of regulatory bodies, professional associations, and unions

Answer 29

Professional Practice

Question 30

Which competency statement does the following belong to:

• Demonstrates a professional presence, honesty, integrity, and respect in all interactions
• Demonstrates fitness to practice
• Maintains current knowledge about trends and issues that impact the client, the RPN, the healthcare team and the delivery of health services

• Identifies and responds to inappropriate behaviour and incidents of professional
misconduct

Answer 30

Professional Practice

Question 31

RPNs use ethical frameworks (e.g. Code of Ethics, ethical standards) when making professional judgments and practice decisions. They engage in critical thinking and critical inquiry to inform decision-making and use self-reflection to understand the impact of personal values, beliefs and assumptions in the provision of care.

Answer 31

Ethical Practice

Question 32

Which competency statement does the following belong to:

• Establishes and maintains professional boundaries

• Takes action to minimize the impact of personal values and assumptions on
interactions and decisions

• Demonstrates respect for the values, opinions, needs and beliefs of others

Answer 32

Ethical Practice

Question 33

Which competency statement does the following belong to:

• Applies ethical frameworks and reasoning to identify and respond to situations involving moral and ethical conflict, dilemma or distress.
• Obtains knowledge of and responds to the Calls to Action of the Truth and Reconciliation Commission of Canada
• Preserves the dignity of clients in all personal and professional contexts

Answer 33

Ethical Practice

Question 34

Which competency statement does the following belong to:

• Advocates for equitable access, treatment and allocation of resources, particularly
for vulnerable and/or diverse clients and populations

• Advocates for clients, especially when they are unable to advocate for themselves
• Adheres to the duty to provide care

Answer 34

Ethical Practice

Question 35

RPNs adhere to applicable provincial/territorial and federal legislation and regulations, professional standards, and employer policies that direct practice. They engage in professional regulation
by enhancing their competence, promoting safe practice, and maintaining their fitness to practise. RPNs recognize that safe nursing practice includes knowledge of relevant laws and legal boundaries within which RPNs must practise.

Answer 35

Legal Practice

Question 36

Which competency statement does the following belong to:

• Practices according to legislation, practice standards, ethics and organizational policies
• Practices according to relevant mandatory reporting legislation
• Recognizes, responds, and reports questionable orders, actions or decisions, made by others

Answer 36

Legal Practice

Question 37

Which competency statement does the following belong to:

• Adheres to the duty to report
• Protects clients’ rights by maintaining confidentiality and privacy in all personal and professional contexts

Answer 37

Legal Practice

Question 38

Which competency statement does the following belong to:

• Respond to the clients’ right to healthcare information in adherence within relevant privacy legislation
• Documents according to established legislation, practice standards, ethics, and organizational policies
• Obtains informed consent to support the client’s informed decision-making

Answer 38

Legal Practice

Question 39

RPNs use critical thinking, reflection, and evidence integration to assess clients, plan care, implement interventions, and evaluate outcomes and processes. Foundational knowledge includes:
nursing theory, health sciences, humanities, pharmacology. and ethics.

Answer 39

Foundations of Practice

Question 40

Which competency statement does the following belong to:

• Completes comprehensive health assessments of clients across the lifespan
• Selects and uses information and communication technologies (ICTs) in the delivery of client care
• Researches and responds to relevant clinical data
• Engages in evidence-informed practice by considering a variety of relevant sources of information

Answer 40

Foundations of Practice

Question 41

Which competency statement does the following belong to:

• Comprehends, responds to, and reports assessment findings
• Formulates clinical decisions consistent with client needs and priorities
• Identifies nursing diagnoses
• Develops the care plan with the client, healthcare team, and others

Answer 41

Foundations of Practice

Question 42

Which competency statement does the following belong to:

• Implements nursing interventions based on assessment findings, client preferences, and desired outcomes.
• Responds to clients’ conditions by organizing competing priorities into actions
• Assesses clients’ health literacy, knowledge, and readiness to learn
• Assesses, plans, implements and evaluates the teaching and learning process
• Provides information and access to resources to facilitate health education

Answer 42

Foundations of Practice

Question 43

Which competency statement does the following belong to:

• Evaluates the effectiveness of health education
• Applies principles of client safety
• Engages in quality improvement and risk management to promote a quality practice environment
• Evaluates the effectiveness of nursing interventions by comparing actual outcomes to expected outcomes
• Reviews and revises the plan of care and communicates accordingly

Answer 43

Foundations of Practice

Question 44

Which competency statement does the following belong to:

• Assesses implications of own decisions
• Uses critical thinking, critical inquiry, and clinical judgment for decision-making
• Demonstrates professional judgment in using information and communication technologies (ICTs) and social media
• Recognizes high-risk practices and integrates mitigation strategies that promote safe care
• Applies strategies to prevent, de-escalate, and manage disruptive, aggressive, or violent behaviour

Answer 44

Foundation of Practice

Question 45

Which competency statement does the following belong to:

• Recognizes and responds immediately when a client’s condition is deteriorating
• Demonstrates knowledge of nursing theory, pharmacology, health sciences, humanities, and ethics
• Applies knowledge of pharmacology and principles of safe medication practice

Answer 45

Foundation of Practice

Question 46

RPNs work collaboratively with clients and other members of the healthcare team. They recognize that collaborative practice is guided by shared values and accountability, a common purpose
or care outcome, mutual respect, and effective communication.

Answer 46

Collaborative Practice

Question 47

Which competency statement does the following belong to:

• Engages clients in identifying their health needs, strengths, capacities and goals
• Communicates collaboratively with the client and the healthcare team
• Provides essential client information to the client and the healthcare team

Answer 47

Collaborative Practice

Question 48

Which competency statement does the following belong to:

• Promotes effective interpersonal interaction
• Uses conflict resolution strategies to promote healthy relationships and optimal client outcomes
• Articulates own role based on legislated scope of practice, individual competence and care context, including employer policies

• Determines their own professional and interprofessional role within the team by considering the roles, responsibilities and the
scope of practice of others

• Advocates for the use of Indigenous health knowledge and healing practices in collaboration with the client

Answer 48

Collaborative Practice

Question 49

Which competency statement does the following belong to:

• Demonstrates leadership, direction, and supervision to unregulated health workers and others
• Participates in emergency preparedness and disaster management
• Participates in creating and maintaining a quality practice environment that is healthy, respectful, and psychologically safe
• Fosters an environment that encourages questioning and exchange of information
• Initiates and fosters mentoring relationships

Answer 49

Collaborative Practice

Question 50

Which competency statement does the following belong to:

• Applies the principles of team dynamics and group processes in interprofessional team collaboration
• Demonstrates formal and informal leadership in practice
• Organizes workload, assigns/coordinates nursing care, sets priorities, and demonstrates effective time-management skills
• Prepares client and collaborates with healthcare team in transition and transfer of responsibility of care

Answer 50

Collaborative Practice

Question 51

Obligation to answer for the professional, ethical, and legal responsibilities of one’s activities and duties, including high standards for individual practice and responsibility for exemplary client care.

Answer 51

Accountability

Question 52

An event that results in unintended harm to the patient, and is related to the care or services provided to the patient rather than to the patient’s underlying medical condition.

Answer 52

Adverse event

Question 53

To actively support a right or cause; to support others when speaking for themselves or when speaking on behalf of those who cannot speak for themselves. It can be direct or indirect and often
addresses inequity or inequality issues in healthcare.

Answer 53

Advocate

Question 54

Having the authority to make decisions and the freedom to act in accordance with one’s professional knowledge base.

Answer 54

Autonomous practice

Question 55

Person with whom the nurse is engaged in a therapeutic relationship.

Answer 55

Client

Question 56

Pursuit of the reduction and mitigation of unsafe acts within the health care system and the use of best practices shown to lead to optimal patient outcomes.

Answer 56

Client saftey

Question 57

Various ways individuals or institutions address conflict (for example, interpersonal, work) to move toward positive change and growth.

Answer 57

Conflict resolution

Question 58

Process of purposive thinking and reflective reasoning through which practitioners examine ideas, assumptions, principles, conclusions, beliefs, and actions within a particular context.

Answer 58

Critical inquiry

Question 59

Concept of acceptance, respect, and understanding that each individual is different. These differences include race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious beliefs, political beliefs or other ideologies.

Answer 59

Diversity

Question 60

Legal and ethical duty to report incompetent or impaired practice or unethical conduct of regulated health professionals. Most provinces or territories have legislation setting out the duty for nurses to
report situations in which there is a good reason to believe a health professional’s practice is impaired or incompetent and may pose a significant risk to the public. The duty to report also requires nurses to report any sexual misconduct of a health professional.

Answer 60

Duty to report

Question 61

How nursing decisions are made with clients, using an ongoing process that incorporates research, clinical expertise, client preferences, and other available resources.

Answer 61

Evidence-informed practice

Question 62

Freedom from any cognitive, physical, psychological or emotional condition or dependence on alcohol or drugs that impairs
ability to provide nursing care.

Answer 62

Fitness to practise

Question 63

Number of healthcare providers from different disciplines (often including both regulated professionals and unregulated workers) working together to provide care for and with persons,
families, groups, communities, or populations.

Answer 63

Healtcare team

Question 64

Ability to access, comprehend, evaluate and communicate information as a way to promote, maintain, and improve health in a variety of settings across the life course.

Answer 64

Health literacy

Question 65

Client received information about the proposed treatment’s nature, expected benefits, risks and side effects, alternative courses of action, and likely consequences of not receiving treatment. The individual also must have an opportunity to obtain additional requests for information prior to granting permission to the proposed care.

Answer 65

Informed consent

Question 66

Process of developing and maintaining effective working relationships with learners, practitioners, patients/clients/families, and communities to enable optimal health outcomes.

Answer 66

Interprofessional team collaboration

Question 67

Client’s safety incident that did not reach the client and therefore resulted in no harm.

Answer 67

Near miss

Question 68

Clinical judgment based on human response to health conditions or life processes, affecting an individual, family, group or community. It provides the basis for choosing nursing interventions that address client care goals, for which the nurse has accountability.

Answer 68

Nursing diagnosis

Question 69

Point at which the relationship changes from professional and therapeutic to unprofessional and personal; the limits of the professional role. Crossing a boundary means that the care provider
is misusing the relationship’s power to meet personal needs, rather than the client’s needs or are behaving in an unprofessional manner with the client. The misuse of power does not have to be intentional to be considered a boundary-crossing.

Answer 69

Professional boundaries

Question 70

Behaviour outside the boundaries of what is considered acceptable or worthy of its membership by a profession’s governing body; any nursing conduct that is harmful or detracts from the professional caring relationship with a client and is inconsistent with the Code of Conduct or expected professional standards.

Answer 70

Professional misconduct

Question 71

Systematic, formal approach to the analysis of practice performance and efforts to improve performance.

Answer 71

Quality improvement

Question 72

Systematic inquiry using scientific methods to advance knowledge, establish facts, answer questions, or solve problems. Conducting research involves identifying a research question, using an appropriate methodology to answer the question, and disseminating the results. A nurse who collects data as part of a project may be “participating” in research, but not “conducting” research.

Answer 72

Research

Question 73

Expectations and limitations of duties and responsibilities of Registered Practical Nurses who are legislated, educated, and authorized to perform roles, responsibilities and functions, as defined in Section 3 of the Nursing Act, 1991: “The practice of
nursing is the promotion of health and assessment of, the provision of, care for, and the treatment of, health conditions by supportive, preventive, therapeutic, palliative, and rehabilitative means in order to attain or maintain optimal function.”

Answer 73

Scope of practice

Question 74

Software applications (web-based and mobile) allowing creation, engagement, and sharing of new or existing content, through messaging or video-chat, texting, blogging, and other social media
platforms.

Answer 74

Social media

Question 75

Developed when two or more people who interact interdependently and adaptively toward a common goal which influences a team’s behaviour and performance.

Answer 75

Team dynamics

Question 76

A connection a nurse establishes and maintains with a client, through the use of professional knowledge, skills, and attitudes to provide nursing care expected to contribute to the client’s well-
being.

Answer 76

Therapeutic nurse-client relationship