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

The highest priority is to ensure the immediate safety of the client and others on the unit. A thorough search of belongings for contraband or potentially harmful items (e.g., sharp objects, ligatures, non-prescribed substances) directly addresses the risk of self-harm and is a critical first step in creating a safe therapeutic environment. [16, 25]

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

This client has multiple significant risk factors for falls: advanced age, a shuffling gait (mobility impairment), and a new medication with a side effect of orthostatic hypotension. Therefore, implementing a comprehensive fall prevention protocol (e.g., ensuring a clear path, using a bed alarm, assisting with ambulation, regular toileting) is the priority intervention to prevent injury. [21, 30]

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

Medication reconciliation is a formal process to create the most accurate list possible of all medications a patient is taking — including drug name, dosage, frequency, and route — and comparing that list against the physician's admission, transfer, and/or discharge orders. Its primary purpose is to prevent adverse drug events by identifying and resolving discrepancies. [6, 7, 12]

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

The principle of least restraint requires that healthcare providers use the least restrictive and intrusive interventions first. Verbal de-escalation is the initial and most appropriate response to manage agitation, as it is non-coercive and respects the client's autonomy while attempting to ensure safety. [10, 18, 27]

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

The fundamental purpose of incident reporting in a modern patient safety culture is not to assign blame but to learn from failures and near misses. By analyzing incident reports, organizations can identify patterns, systemic vulnerabilities, and opportunities to improve processes, ultimately enhancing patient safety for everyone. [1, 2, 4]

RPNCE - Registered Psychiatric Nurse of Canada Examination Practice Test

RPNCE - Registered Psychiatric Nurse of Canada Examination Practice Test

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