RPNCE - Registered Psychiatric Nurse of Canada Examination Ethical and Legal Practice Questions and Answers

Question 1

An RPN is caring for a client who was admitted involuntarily under a provincial Mental Health Act.
The client is refusing a prescribed antipsychotic medication, stating, 'I don't need that, I'm not sick.' The client is able to explain the risks and benefits of the medication when asked.
What is the RPN's most appropriate and legal first action?

Accepted Answer

Document the refusal and notify the psychiatrist to formally assess the client's capacity to make treatment decisions.

Answer

Administer the medication via injection because the client is certified and cannot refuse treatment.

Answer

Contact the client's substitute decision-maker to obtain consent for the medication.

Answer

Explain that the refusal will be reported to the review board and may prolong their hospitalization.

Question 2

A Registered Psychiatric Nurse (RPN) is legally and ethically required to breach client confidentiality in which of the following situations?

Accepted Answer

The client discloses a specific, credible threat to cause serious bodily harm to an identifiable person.

Answer

A client's employer calls to inquire about the reason for their sick leave.

Answer

A police officer requests information for a minor investigation without presenting a warrant or subpoena.

Answer

The client admits to a history of illegal drug use several years ago.

Question 3

An RPN has developed a strong therapeutic rapport with a client over several months. On the day of discharge, the client presents the RPN with an expensive watch, stating, 'You saved my life, and I want you to have this.' What is the most professionally appropriate response?

Accepted Answer

Politely decline the gift, explain the professional policy about accepting gifts, and therapeutically explore the client's feelings of gratitude.

Answer

Accept the gift to avoid hurting the client's feelings and document it per facility policy.

Answer

Suggest the client donate the watch to the unit or a mental health charity.

Answer

Accept the watch but immediately turn it over to the unit manager to hold for safekeeping.

Question 4

According to most provincial Mental Health Acts in Canada, which right is fundamentally retained by a client upon being involuntarily admitted to a psychiatric facility?

Accepted Answer

The right to be informed of the reason for admission and to have access to legal counsel.

Answer

The unrestricted right to access and use their personal smartphone.

Answer

The right to refuse all prescribed psychotropic medication without a capacity assessment.

Answer

The right to leave the hospital grounds for short periods without an escort.

Question 5

An RPN has placed a highly agitated client in seclusion as a last resort to prevent imminent harm to others. When documenting this intervention, which element is most critical from a legal and ethical standpoint?

Accepted Answer

A detailed description of the less restrictive alternatives attempted and their outcomes.

Answer

The names of all staff members who assisted with the seclusion process.

Answer

The client's reaction to being informed they were being placed in seclusion.

Answer

A verbatim transcript of what the client was yelling prior to the intervention.

Question 6

An RPN is caring for a competent adult client with severe anorexia nervosa who is refusing a feeding tube despite being medically unstable. The nurse feels a strong duty to preserve the client's life but also knows the client has the right to refuse treatment. This situation creates a conflict between which two primary ethical principles?

Accepted Answer

Autonomy and Beneficence

Answer

Justice and Fidelity

Answer

Veracity and Confidentiality

Answer

Accountability and Non-maleficence