Free NACC Practice Questions on Medication Safety (Ontario PSW Exam Prep)

If you are studying for the NACC Personal Support Worker (PSW) exam in Ontario, medication safety is one of the highest-yield topics on the test — and one of the easiest to lose marks on, because nearly every medication question is really a question about scope. The exam wants to know that you understand what a PSW can do (assist with medication, follow the care plan, document, and report) and what a PSW must never do (prescribe, decide on their own to give or hold a dose, or give an injection without an exception or a delegation that covers it). This free practice set gives you real NACC-style questions on the rights of medication, the three checks, refusals, errors, storage, and the PSW's role, each with a clear answer and a plain-language explanation. Work through them, check your reasoning, then keep going with the full question bank at pswleap.com/learn. You can also take the free 10-question PSW practice test for a quick check across other NACC-style topics, with no signup and no payment.

What is the PSW's role with medication, and why does the NACC exam test it?

In Ontario, a PSW assists clients with their medication. Assisting includes reminding a client it is time, bringing the medication to them, opening containers, reading the label, and helping with positioning so the client can take it. Depending on the setting's legislation, the client's care plan, the employer's policy and the PSW's training, a PSW may also administer a medication by a route that is not a controlled act, such as oral or topical — a task that is assigned, not delegated, because delegation applies only to controlled acts.

What a PSW never does matters just as much: a PSW does not prescribe, and does not decide on their own to give, withhold or change a dose. Injection and inhalation are different: they are controlled acts under Ontario's Regulated Health Professions Act, so a PSW gives a medication by either route only through an exception the Act sets out — most often a routine activity of living, where a nurse has assessed that, for this client, the task's need, response and outcome are known and predictable, and has taught the PSW to do it for this client and found them competent — or through a delegation from a regulated professional who has found the PSW competent, and in either case only as the setting's legislation, the care plan and the employer's policy allow. The single-best-answer logic on the exam almost always rewards the option that stays inside assist, follow the plan, document, and report.

Sources: the Regulated Health Professions Act, 1991, s. 27 (2) para 5 and s. 29 (1) (accessed September 26, 2026); the College of Nurses of Ontario FAQ Teaching an unregulated care provider (accessed September 26, 2026); Ontario's Personal Support Worker Program Standard, January 2022 (PDF), vocational learning outcome 9 and its element B, printed pp. 31–32 (accessed September 26, 2026).

Quick terms to memorize: MAR = Medication Administration Record (the chart you check against). PRN = "as needed." Controlled act = a task the law restricts to regulated professionals unless an exception or a delegation applies (e.g., an injection). The "rights" = the safety checks done before any medication.

The "rights" of medication — the facts to know cold

The exam expects you to recognize the rights of medication administration. Ontario's PSW training standard (January 2022) names nine rights:

• Right client — confirm identity against the MAR.
• Right medication — confirm the drug against the label and the MAR.
• Right dose — the amount ordered, no more, no less.
• Right route — oral, topical, eye/ear, and so on (an injection or inhalation needs an RHPA exception or a delegation first, and the care plan and employer policy must allow it).
• Right time — the scheduled time the medication is due.
• Right day — check the MAR date, not just the clock; weekly and alternate-day schedules make "right time, wrong day" a real error.
• Right reason — know why the medication is given, so you can watch for expected effects and problems.
• Right expiry date — confirm the product has not expired; report an expired medication to the nurse.
• Right documentation — record what was taken (or refused) on the MAR, immediately.

Older resources list the classic five or six rights — the nine include them all, so learn the full list. And alongside the rights, remember the client's right to refuse: check the rights, every time, before assisting with any medication.

The PSW's role: assist, follow the plan, report

A PSW's job with medication lives inside a few safe verbs:

• Assist within your assigned scope — remind, bring, open, read the label, position. Administer only as the setting's legislation, the care plan, your employer's policy and your training allow — and an injection or inhalation only through an RHPA exception or a delegation.
• Check the rights and do the three checks (read the label three times: at storage, before pouring, and before the client takes it).
• Document what the client took — or refused — immediately and exactly, on the MAR.
• Report refusals, errors, side effects, and anything outside your scope to the nurse.

When an exam scenario asks what the PSW should do, the correct answer almost always stays inside assist, follow the plan, document, and report — never decide or treat.

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Free NACC-style practice questions: medication safety

Each question below mirrors the scenario-based, multiple-choice style of the NACC PSW exam. Try to answer before you read the explanation.

Q1. What is a PSW allowed to do with a client's medication in Ontario?

Answer: Assist within an assigned scope — not prescribe or decide. A PSW reminds, brings, opens, reads the label, and helps with positioning. Depending on the setting's legislation, the care plan, the employer's policy and the PSW's training, a PSW may also administer a medication by a route that is not a controlled act, such as oral or topical — an assigned task, not a delegated one. An injection or inhalation is a controlled act that a PSW gives only through a Regulated Health Professions Act exception — a routine activity of living that a nurse has assessed for this client and taught the PSW to do, finding them competent — or a delegation, and only as the setting's legislation, the care plan and the employer's policy allow. A PSW never prescribes and never decides on their own to give, hold or change a dose. The safe answer always stays inside assisting and following the care plan.

Q2. How many "rights" of medication does the Ontario PSW standard name?

Answer: Nine — right client, medication, dose, route, time, day, reason, expiry date, and documentation. These are the safety checks a PSW confirms before assisting with any medication, using the label and the MAR. Older sources list the classic five or six rights; the nine-right list in Ontario's PSW training standard (January 2022) includes them all — and "right client" plus "right medication" still prevent the most dangerous errors.

Q3. A PSW is about to help a client take a pill. How many times should the label be checked?

Answer: Three times — the three checks. Read the medication label three times: when you take it from storage, before you open or pour it, and again before the client takes it, confirming it against the MAR each time. The three checks combined with the rights are the routine that catches wrong-medication and wrong-dose errors before they reach the client.

Q4. A client says, "I don't want my blood pressure pill today." What should the PSW do?

Answer: Respect the refusal, document it, and report it to the nurse. A client has the right to refuse medication. The PSW never forces, hides, or tricks the client into taking it. The PSW records the refusal — the time and what the client said — and reports it to the nurse, because a missed dose can matter. Deciding to give it later, or leaving it at the bedside, is outside the PSW scope.

Q5. A client has trouble swallowing a large extended-release tablet. Can the PSW crush it into applesauce?

Answer: No — never crush an extended-release or enteric-coated medication, and report the swallowing problem. Crushing a sustained-release tablet can release the whole dose at once, which is unsafe, and a PSW does not decide on their own to crush or hide a medication. The right action is to report the swallowing difficulty to the nurse, who can arrange a safe alternative. (Swallowing safety overlaps with dysphagia care.)

Q6. A PSW realizes a client was given the wrong dose an hour ago. What is the first thing to do?

Answer: Report it to the nurse immediately and document it. The priority is the client's safety, not avoiding blame. The PSW tells the nurse right away and records exactly what happened, so a regulated professional can check on the client. A PSW never hides a medication error or tries to "fix" it alone — early reporting is the safe, expected action.

Q7. Can a PSW give a client a medication by injection if the client usually gets one daily?

Answer: Not on your own decision. An injection is a controlled act under the Regulated Health Professions Act, so a PSW may give one only through an exception the Act sets out or through a delegation. The College of Nurses of Ontario works through this case for a nurse in a retirement home whose client receives daily insulin injections. A regular dose (not a sliding scale) can count as a routine activity of living when, over time, its need, response and outcome are known and the client's condition is predictable; then a nurse can teach the PSW to give it to that client. In CNO's words: "If the insulin injection for this client does not meet the criteria of a routine activity of living, the UCP requires delegation in order to perform it." So the injection becomes a PSW's task only when a nurse has assessed that it is a routine activity of living for this client and has taught the PSW for this client and found them competent — or when a regulated professional has delegated it to the PSW after finding them competent — and in either case the setting's legislation, the care plan and the employer's policy must allow it. If no exception or delegation covers it, do not give it: report to the nurse that the injection is due.

Sources: College of Nurses of Ontario, Teaching an unregulated care provider (accessed September 26, 2026); the Regulated Health Professions Act, 1991, s. 27 (2) para 5 and s. 29 (1) (e) (accessed September 26, 2026). Rules differ by setting: for long-term care homes, and for the training standard's long-term-care footnote, see PSW medication rules in long-term care and other settings.

Q8. A client asks for "something for pain" that is ordered PRN. Can the PSW decide to give it?

Answer: No — report the request to the nurse, who decides. PRN means "as needed," and deciding whether a PRN medication is needed is a clinical judgment that belongs to a regulated professional. The PSW observes the client, reports the pain and the request to the nurse, and follows the direction given. The PSW's role is to observe, report, and assist — not to judge when a PRN dose is warranted.

Q9. After a new medication, a PSW notices the client has a spreading rash and looks flushed. What should the PSW do?

Answer: Observe, document, and report promptly — and escalate if it looks severe. A PSW does not decide whether a symptom is a side effect or give anything to counter it; they record what they saw and report it to the nurse. Signs of a severe allergic reaction — facial swelling, trouble breathing — are an emergency and are escalated at once. The safe answer is report and escalate, never treat.

Q10. How should a PSW document that a client took their morning medication?

Answer: Record the time, medication, dose, route, and that it was taken — right after it happens. Good documentation on the MAR is specific and immediate: never chart a medication before the client actually takes it, and if the client refuses, record the refusal and the reason. Vague notes do not hold up. Accurate, timely charting is what lets the nurse track the client and is exactly what the NACC exam rewards.

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Common medication-safety mistakes to avoid on the NACC exam

• Choosing to decide, give, or hold a dose on your own instead of following the order and reporting — that is outside the PSW scope.
• Forcing or hiding a medication when a client refuses, instead of respecting the refusal and reporting it.
• Crushing an enteric-coated or extended-release tablet, or altering a medication without direction.
• Giving an injection on your own decision — it is a controlled act that needs an RHPA exception or a delegation first, and the care plan and employer policy must allow it.
• Charting a medication before the client takes it, or covering up an error instead of reporting it.

Each of these matches the single-best-answer logic the NACC exam uses: the correct option is the safest action that stays within the PSW scope — assist, follow the plan, document, report.

The medication-safety facts the NACC exam expects you to know

Use these one-line facts as a final review — they are the kind of definitive statements the exam rewards:

• A PSW assists with medication; administering depends on the setting's legislation, the care plan, employer policy and training — and an injection or inhalation needs an RHPA exception or a delegation.
• A PSW never prescribes or decides on their own to give, hold or change a dose, and gives a medication by injection or inhalation only through an RHPA exception (a routine activity of living a nurse has assessed and taught for this client) or a delegation, as the care plan and employer policy allow.
• The five core rights: right client, medication, dose, route, time — confirmed against the MAR.
• The three checks: read the label three times (at storage, before pouring, before the client takes it).
• A client has the right to refuse — never force or hide; document and report the refusal.
• Never crush an enteric-coated or extended-release medication.
• Report a medication error immediately — safety first, never cover it up.
• PRN = "as needed"; a PSW does not decide when a PRN dose is needed — the nurse does.
• Observe and report side effects; never treat. Severe allergic signs are an emergency.

Remember: PSW practice in Ontario always follows the client's individual care plan and your employer's policies. This article is exam-prep study material, not medical advice.

Practice more free NACC questions

You just answered 10 medication-safety questions — the NACC PSW exam can include questions across all of its modules, from medication and safety to nutrition, dementia care, and infection control. The fastest way to find your weak spots is to keep practising with instant feedback.

👉 Start practising free at pswleap.com/learn — 2,500 NACC-style questions, full timed mock exams, and a Duolingo-style study path built specifically for Ontario PSW students. No subscription, and you can start with sample questions before you pay.

Want the deeper reference on scope? Read The PSW Medication Assistance Scope in Ontario, or keep working through the free series with Free NACC Practice Questions on Dysphagia & Safe Swallowing.

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PSW Leap is an independent NACC PSW exam-prep platform for Ontario candidates. We are not affiliated with NACC. Always follow your training, your client's care plan, and your employer's policies on the job.