Exam (elaborations)
RPNCE EXAM QUESTIONS AND ANSWERS
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RPNCE EXAM QUESTIONS AND ANSWERS
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RPNCE EXAM QUESTIONS AND ANSWERSMr. Lopez, 39 yr, recently transferred to inpatient mh from intensive care after a serious
suicide attempt. Mr. Lopes cut his throat and requires a daily dressing change that the
nurse is unfamiliar with. What is the best practice?
A.) Request education from the unit nurse in charge
B.) Ask a colleague to perform the dressing change
C.) Search types of dressings and techniques online
D.) Consult with wound care specialist - answers- d.) Consult with wound care
specialist - (this is the best resource in this situation)
The rpn refuses to provide care due to feeling negative about mr. Lopez suicide attempt.
What might the rpn be experiencing?
A.) Moral distress
B.) Moral uncertainty
C.) Moral dissonance
D.) Moral fatigue - answers- a.) Moral distress - goes against her personal morals,
refusing care exemplifies her moral distress
4 year old lilly is malnourished, what is she most at risk for?
A. Refeeding syndrome
B. Bulimia
C. Developmental delay
D. Stunted growth - answers- a. Refeeding syndrome
This is a risk factor when reinitiating nutritional support after a period of underfeeding
Lilly's mom discloses a new incident of abuse to the psychologist who tells you it does
not need to be reported as social services is already involved. What is the best action?
A. Chart the discussion
B. Phone social services
C. Document the verbal order
D. Consult another psychiatrist - answers- b. Phone social services
You are obligated to report all incidences of child abuse
4 yr old lilly approaches the nursing station a day before discharge and asks if she will
be okay and asks what will happen to her. The best response is ?
A. Tell lilly she will be safe with the people who care for her
B. Validate lilly's fears and concerns
C. Consult the team so everyone delivers a united response
D. Reassure lilly that her mom is working hard on herself. - answers- b. Validate lilly's
fears and concerns
This addresses her current concerns and needs and does not give her false hope
,Mr. Mar was currently prescribed antidepressants. He is off work and gets into frequent
arguments with his supportive partner. He drinks alochol frequently and reports being
under a lot of stress.
The rpn smells alcohol on his breath, and mr. Mar reports that the medication is useless
and hes been taking it for 3 weeks. After addressing his alcohol use, the rpn should do
what?
A. Refer mr. Mar for a medication review
B. Instruct him to discontinue the medication
C. Discuss cbt techniques
D. Provide information on alcoholics annonymous - answers- c. Discuss cbt techniques
This technique is often used in conjunction with medication treatment
Mr. Mar states he had an affair and asks the rpn to support him to disclose this
information to his partner. What should the rpn do?
A. Share her own relationship story
B. Suggest this information not be shared
C. Help mr. Mar plan to inform his partner
D. Offer to speak to his partner on his behalf. - answers- c. Help mr. Mar plan to inform
his partner
Honour the client's desire to disclose such information and support the initiation of
conversation
A client who is being discharged presents the rpn with a box of chocolates, what is the
best action?
A. Inform the patient you are unable to accept gifts from clients
B. Suggest that the client parter would appreicate the gift instead
C. State how nice it is to be appreciated for once
D. Thank the client and inform him the gift will be shared with the other staff. - answers-
d. Thank the client and inform him the gift will be shared with the other staff.
Gift is small, and its the end of the nurse-client relationship so it is appropriate
Mrs. P found her husband dead 6 months ago due to suicide and now has ptsd. During
a conversation with the rpn she begins to describe the incident. What is the best
response?
A. Change the subject as its upsetting the client
B. Encourage her to share her experience in a group meeting
C. Allow her to describe the event
D. Reassure her that as time passes it will be less upsetting - answers- c. Allow her to
describe the event
,The rpn notices slight swelling, redness and warmth to a patient's calf when palpitated -
what would the rpn suspect?
A. Muscle spasm
B. Cellulitis
C. Deep vein thrombosis
D. Peripheral artery disease - answers- c. Deep vein thrombosis - common after a
surgical procedure where the patient spends days in bed.
4 yr old lilly was taken to hospital after being removed from her mothers care, they lived
in a park where lilly's mom struggled with alcohol abuse. Lilly is malnourished and
diagnosed with reactive attachment disorder .
The nurse would expect to see what presentation from lilly?
A. Exciteable, high energy, and giving hugs
B. Expresses her needs and regulates her emotions well
C. Irritated, sad, and withdrawn from adults that engage with her
D. Crying, inconsolable and asking for her mother - answers- c. Irritated, sad, and
withdrawn from adults that engage with her
- irritability, sadness, depression, and withdraw are dsm criteria for reactive attachment
disorder
This allows her to process the event in a safe environment
What is mrs. P most likely to exhibit when assessing her?
A. Auditory hallucinations
B. Intrusive thoughts
C. Inability to recall the event
D. Mood instability - answers- b. Intrusive thoughts
This is a common symptom of ptsd
During the therapeutic relationship with mrs. P, what is an appropriate action?
A. Give details of the rpns partners death
B. Explain that they understand what the client is going through as they too have lost a
partner
C. Share that a bereavement support group was helpful after their partners death
D. Refer the client to independent practice counselling - answers- c. Share that a
bereavement support group was helpful after their partners death
This is appropriate as it provides additional resources but does not disclose personal
details related to the rpns personal experience
17 year old susan is admitted after losing 11kg in 6 months. Her weight is 44kg and
height is 108 cm. She is diagnosed with an eating disorder.
Susan fears being weight and states that she doesn't want to be weighed this morning
as she had a glass of juice. What is the best response?
, A. I'm pleased you drank some juice
B. We can get around this if you eat some fruit too
C. The rule is to be weighed before eating and drinking. We will weigh you tomorrow
instead
D. This is weight day so lets complete your weight. Please step on the scale. -
answers- d. This is weight day so lets complete your weight. Please step on the scale.
What symptom would indicate that susan has not had a period of many weeks?
A. Paratoid gland enlargement
B. Weight 15% below whats normal for her height
C. Lethargy and muscle weakness
D. Alopecia - answers- b. Weight 15% below whats normal for her height
What action would help meet daily required food intake ?
A. Schedule breakfast, lunch and dinner at regular times
B. Provide snacks throughout the day
C. Allow susan to take as long as she wants to eat
D. Restrict food preferences and insist she finishes each meal - answers- b. Provide
snacks throughout the day
During the facilitation of a communication group, one client displays disruptive
communcaiton outbursts. What is the best action?
A. Confront the client outside the group
B. Downplay the behaviour by continuing to facilitate the group meeting
C. Reinforce boundaries with the client
D. Request that the client leaves the group - answers- c. Reinforce boundaries with the
client
The rpn is working towards termination of a client- nurse relationship. The client
becomes angry and negatiave towards the nurse and the session. What is the client
likely experiencing?
A. Overt signs of dependency
B. Feelings of abandonement and grief
C. The need for support and structure
D. Desire for power and control - answers- b. Feelings of abandonment and grief
Group termination can cause difficulty with separation
What should a group leader considder when selecting a new group member to join?
A. Emotional intelligence
B. Self-confidence
C. Engagement
D. Appropriateness - answers- d. Appropriateness
Groups should have specific goals that meet group memebers goals
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