RPNCE - Registered Psychiatric Nurse of Canada Examination Co-occurring Disorders and Addictions Questions and Answers

Question 1

A client with a known diagnosis of Bipolar I Disorder is admitted during a manic episode.
They are agitated, have pressured speech, and report using stimulants "to keep the energy up." What is the RPN's priority nursing action?

Accepted Answer

Ensure the client's immediate physical safety and medical stability.

Answer

Develop a detailed psychoeducational plan about substance use.

Answer

Initiate a referral to an addictions counsellor.

Answer

Administer a PRN dose of a mood stabilizer immediately.

Question 2

Which of the following best describes the principle of an 'integrated treatment' model for clients with co-occurring disorders?

Accepted Answer

The mental health disorder and the substance use disorder are treated at the same time, by the same team.

Answer

The client must complete a substance detoxification program before starting psychotherapy.

Answer

The client attends a mental health clinic and is referred to a separate agency for substance use treatment.

Answer

The client's family members are primarily responsible for coordinating care between different providers.

Question 3

An RPN is working with a client who has schizophrenia and a cannabis use disorder. The client is not ready to commit to complete abstinence from cannabis. Which intervention best aligns with a harm reduction approach?

Accepted Answer

Collaborating with the client to identify strategies to reduce the frequency and quantity of cannabis use.

Answer

Informing the client that continued cannabis use will make their antipsychotic medication ineffective.

Answer

Discharging the client from the service until they are willing to abstain.

Answer

Insisting the client attend a 12-step meeting for marijuana anonymous.

Question 4

A client with a long history of Panic Disorder, who has been taking a high dose of a prescribed benzodiazepine for several years, abruptly stops their medication. They present with severe anxiety, tachycardia, tremors, and perceptual disturbances. The RPN should recognize these symptoms are most likely indicative of:

Accepted Answer

Benzodiazepine withdrawal syndrome.

Answer

A paradoxical reaction to the medication.

Answer

The onset of a new psychotic disorder.

Answer

A severe relapse of their underlying panic disorder.

Question 5

An RPN is using Motivational Interviewing (MI) with a client who is ambivalent about reducing their alcohol use, which they state helps with their social anxiety. Which statement by the RPN best exemplifies the MI principle of 'developing discrepancy'?

Accepted Answer

"It sounds like the alcohol helps you feel more comfortable socially in the short term, yet you've also mentioned that it has led to arguments with your partner. How do you see these two things fitting together?"

Answer

"You have to stop drinking if you want to get your anxiety under control."

Answer

"I think you should try going to an AA meeting to see how others have managed."

Answer

"Let's be clear, your drinking is the main problem here, not your anxiety."

Question 6

A client with co-occurring major depressive disorder and opioid use disorder is being considered for naltrexone treatment. The RPN must ensure which critical prerequisite is met before the first dose is administered?

Accepted Answer

The client has been completely abstinent from opioids for at least 7-10 days.

Answer

The client's depressive symptoms are in full remission.

Answer

The client has secured stable housing.

Answer

The client has successfully completed a 12-step program.