RPNCE - Registered Psychiatric Nurse of Canada Examination Quality Care and Client Safety Questions and Answers

Question 1

An RPN is admitting a client with a history of recurrent self-harm to an acute inpatient psychiatric unit.
To ensure the safety of the client and the milieu, which of the following is the highest priority nursing action during the admission process?

Accepted Answer

Completing a thorough search of the client's belongings for hazardous items.

Answer

Orienting the client to the unit's daily schedule and activities.

Answer

Introducing the client to their roommate and other clients in the dayroom.

Answer

Developing a long-term, goal-oriented recovery plan with the client.

Question 2

An 82-year-old client is admitted to a geriatric psychiatry unit for management of severe depression and is started on a new antidepressant known to cause orthostatic hypotension. The client also has a slow, shuffling gait. The RPN's priority safety intervention is to:

Accepted Answer

implement a comprehensive fall prevention protocol.

Answer

encourage participation in group therapy to improve mood.

Answer

request a nutritional consult to address potential weight loss.

Answer

provide a quiet, low-stimulation environment to reduce anxiety.

Question 3

What is the primary purpose of conducting a medication reconciliation for a client upon admission, transfer, and discharge from a healthcare facility?

Accepted Answer

To create the most accurate and complete list of the client's current medications to prevent medication errors.

Answer

To educate the client about the side effects of each new medication prescribed during their stay.

Answer

To determine which medications are covered by the client's provincial or private insurance plan.

Answer

To simplify the client's medication regimen by discontinuing non-essential prescriptions.

Question 4

A client on an inpatient unit is becoming increasingly agitated, pacing rapidly, and speaking loudly to others. According to the principle of least restraint, what is the RPN's most appropriate initial action?

Accepted Answer

Approaching the client calmly and attempting verbal de-escalation techniques.

Answer

Administering a prescribed PRN dose of an antipsychotic medication immediately.

Answer

Placing the client in the seclusion room to prevent escalation.

Answer

Calling a 'code white' to assemble a response team for a potential takedown.

Question 5

Which of the following best describes the primary goal of completing an incident report after a client experiences a medication error, even if no harm occurred?

Accepted Answer

To identify system-level issues and improve processes to prevent future errors. [1, 2]

Answer

To provide documentation for potential legal action by the client.

Answer

To discipline the staff member who made the error.

Answer

To inform the prescribing physician that their order was not followed correctly.

Question 6

An RPN is caring for a client who has been placed in seclusion as a last resort due to imminent risk of harm to others. Which ongoing nursing intervention is the highest priority for ensuring the client's safety?

Accepted Answer

Continuously monitoring the client's vital signs, circulation, and respiratory status.

Answer

Offering the client fluids and an opportunity for toileting every four hours.

Answer

Documenting the client's verbal responses to the intervention in the chart.

Answer

Processing the event with the client to identify triggers for the behaviour.