Exam (elaborations)
RPNCE EXAM QUESTIONS AND ANSWERS
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RPNCE EXAM QUESTIONS AND ANSWERS
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RPNCE EXAM QUESTIONS AND ANSWERSWhat is a form 1? - Answers- Request for admission (voluntary patients)
What is a form 2? - Answers- Consent for treatment (voluntary Pts)
What is a form 4? - Answers- Involuntary medical certification form (signed by a Dr)
What is the timeline and forms for recertification? - Answers- Cert 1: 48h F4 (need 2
f4s)
Cert 2: 1 month F4
Renew 1: 1 month F6
Renew2: 3months F6
Renew 3: Q6 months (any certs after are q6months)
What is a form 6? - Answers- Renewal certificate
What is a Form 5? - Answers- Consent for tx (involuntary)
What is the criteria for invol admission? - Answers- Pt must be suffering from a mental
disorder that seriously impairs ability to react appropriately to their environment or to
associate with others.
Pt requires tx in or through a designated facility.
Pt requires care, supervision and control in or through a designated faculty to prevent
the person's substantial mental or physical deterioration or for the person's own
protection or the protection of others.
Pt is not suitable as a voluntary patient.
What is a form 13? - Answers- Notification of rights
When does a form 13 need to be completed? - Answers- When pt is first admitted as
invol, following a transfer to another facility, whenever a renewal certificate (f6) is
completed, when pts status changes (from vol to invol).
What is a form 7? - Answers- Request for a review panel (review panel must occur
within 14 days of request)
Who sits on a review panel? - Answers- Dr, lawyer, pt advocate
How often can a review panel be requested? - Answers- After a person is certified and
after each renewal.
What is a form 20? - Answers- Authorization for pt to leave of extended leave (invol pt)
,What are the 6 Ps of compartment syndrome? - Answers- 1.) Pain (present on passive
movement and out of proportion to injury)
2.) Paresthesias (numbness, tingling, decreased sensation)
3.) Pallor (or cyanosis)
4.) Pressure (firm feeling muscle compartment, elevated pressure reading)
5.) Paralysis (late, ominous sign)
6.) Pulselessness (very late, ominous sign)
What is checked during a Peripheral Vascular Assessment? - Answers- Color,
temperature, capillary refill, peripheral pulses, & edema
What is checked during a Peripheral Neurological Assessment? - Answers- Sensation,
motor function, & pain
What is osteoporosis? - Answers- a chronic, progressive metabolic bone disease in
which the bones become brittle and fragile from loss of tissue, typically as a result of
hormonal changes, or deficiency of calcium or vitamin D.
What are the Classification of Fractures (#)? - Answers- Closed #: Intact skin over the #
site (no open skin)
Open #: A break in skin over the # site. Bone fragments stick out through the skin OR
wound penetrates down to the broken bone (worry about infc)
Complete or Incomplete #: bones are fully separated vs only going through one side of
the bone [children are more at risk of this].
Displaced: # displaces the bones out of the normal anatomic position [often bc of
muscle spasm]
Nondisplaced: goes through both bones but maintains normal placement.
What are the clinical manifestations of a fracture (#)? - Answers- Deformity, edema and
swelling, muscle spasm, pain and tenderness, ecchymosis or contusions (bruising), loss
of normal functioning, crepitation (bone on bone sound and sensation), neurovascular
impairment.
What are some Complications After Fracture and how do we tx and assess? - Answers-
Infection: (Discharge, colour, odor, heat, redness, swelling), BW (WBC, C+S of wound,
blood cultures), VS (fever), antibiotics (prophylaxis).
Compartment Syndrome: 6 Ps, neruovascular assessment, remove restrictive items, do
not elevate or apply cold.
Fat Embolism Syndrome (FES): broken bones release fat globules into systemic
circulation-> emboli can travel to heart, lungs, brain. S/S: dyspnea, petichaie,
tachypnea, CP, change in mental status. Apply O2, sit them up, monitor sppo2 and RR,
calling RT
Venous Thromboembolism: PE: thrombus in pulmonary arteries. Anticoagulants-
heparin, dalteparin
DVT: thrombus in deep veins of leg; pain/ tenderness in the leg <passive moving;
redness/ warmth, unilateral swelling.
,What is Compartment syndrome? - Answers- elevated intracompartmental pressure
c/in a confined space leads to compression of blood vessels and nerves, then ischemia,
then healthy tis replaced c fibrotic tis.
What are some clinical manifestations of osteoarthritis? - Answers- Worsening joint
pain
Limitation of movement
Crepitus (grating sensation/ sound of bone on bone rubbing)
Stiffness
Deformity
What are the components of the MSE? - Answers- Appearance, behaviour, affect,
mood*, speech, thought content*, thought process, perception*, cognitive functioning,
insight/judgement, risk assessment*.
What is Generalized anxiety disorder. - Answers- Characterized by persistent and
excessive anxiety and worry about occupational/ social/ interpersonal situations.
Affects daily functioning.
Has physical symptoms.
GAD can be a debilitating disorder with a serious negative impact on quality of life.
Often associated with other disorders like Depression or substance abuse
Anxiety is associated with 3 or more of the following symptoms: - Answers-
Restlessness or feeling keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance
What is OCD? - Answers- Characterized by the presence of obsessions and
compulsions.
Obsessions are recurrent, persistent unwanted thoughts that increase anxiety.
Compulsions are repetitive acts that the person does in hopes to relieve anxiety.
Most common reason that people with OCD seek help is for relationship problems,
GAD, drug & ETOH use, depression.
What is Panic disorder? - Answers- Sudden short periods of intense fear or discomfort
that are accompanied by significant physical and cognitive symptoms. Mimic symptoms
of a heart attack. Restricted perceptual field, feeling disconnected
Peaks within 10 minutes.
Panic Attacks are often followed by a concern of experiencing more attacks.
What are some tx options for anxiety disorders? - Answers- Rating scales, Identifying
triggers, Diet, Exercise, Breathing Control, Distraction, Positive Self Talk
, Progressive Muscle Relaxation, Meditation, Mindfulness.
Psychotherapies: CBT, exposure therapy.
What needs to be assessed in the 48/6 assessments? - Answers- 6 areas to be
assessed within 48 hours:
Bowel and bladder management
Cognitive functioning
Functional mobility
Medication management
Nutrition and hydration management
Pain management
What are the parts of the Fulmer SPICES Screening? - Answers- S is for Sleep
Disorders
P is for Problems with Eating or Feeding
I is for Incontinence
C is for Confusion
E is for Evidence of Falls
S is for Skin Breakdown
What are some Symptoms of PTSD? - Answers- Re-experiencing the event: intrusive
thoughts and recollections (flashbacks), or recurrent dreams/nightmares
Avoidance behaviour: avoiding activities, situations and people associated with the
trauma. Feelings of guilt.
General numbness and loss of interest in surroundings
Hypersensitivity: inability to sleep, anxious feelings, overactive startle response,
hypervigilance, irritability, angry outbursts
What is shock? - Answers- The failure of the circulatory system to maintain adequate
perfusion of the vital organs
Which types of shock involve low blood flow? - Answers- Cardiogenic (cardiac output is
decreased)
Hypovolemic (not enough blood flowing)
Which types of shock involve maldistribution of blood flow? - Answers- AKA: blood not
going where it needs to go.
Septic
Anaphylactic
Neurogenic
What are the General Signs of Shock? - Answers- Hypotension*
Tachypnea
Tachycardia*
Cool, pale skin
Anxiety
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