RPNCE Exam Latest Updated Graded A+

What is a form 1? - ANSWER-Request for admission (voluntary patients) What is a form 2? - ANSWER-Consent for treatment (voluntary Pts) What is a form 4? - ANSWER-Involuntary medical certification form (signed by a Dr) What is the timeline and forms for recertification? - ANSWER-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? - ANSWER-Renewal certificate What is a Form 5? - ANSWER-Consent for tx (involuntary) What is the criteria for invol admission? - ANSWER-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? - ANSWER-Notification of rights When does a form 13 need to be completed? - ANSWER-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? - ANSWER-Request for a review panel (review panel must occur within 14 days of request) Who sits on a review panel? - ANSWER-Dr, lawyer, pt advocate How often can a review panel be requested? - ANSWER-After a person is certified and after each renewal. What is a form 20? - ANSWER-Authorization for pt to leave of extended leave (invol pt) What are the 6 Ps of compartment syndrome? - ANSWER-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? - ANSWER-Color, temperature, capillary refill, peripheral pulses, & edema What is checked during a Peripheral Neurological Assessment? - ANSWER-Sensation, motor function, & pain What is osteoporosis? - ANSWER-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 (#)? - ANSWER-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 (#)? - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-Worsening joint pain Limitation of movement Crepitus (grating sensation/ sound of bone on bone rubbing) Stiffness Deformity What are the components of the MSE? - ANSWER-Appearance, behaviour, affect, mood*, speech, thought content*, thought process, perception*, cognitive functioning, insight/judgement, risk assessment*. What is Generalized anxiety disorder. - ANSWER-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: - ANSWER-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? - ANSWER-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? - ANSWER-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? - ANSWER-Rating scales, Identifying triggers, Diet, Exercise, Breathing Control, Distraction, Positive Self Talk Progressive Muscle Relaxation, Meditation, Mindfulness. Psychotherapies: CBT, exposure therapy. what are some Symptoms of PTSD? - ANSWER-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? - ANSWER-The failure of the circulatory system to maintain adequate perfusion of the vital organs Which types of shock involve low blood flow? - ANSWER-Cardiogenic (cardiac output is decreased) Hypovolemic (not enough blood flowing) Which types of shock involve maldistribution of blood flow? - ANSWER-AKA: blood not going where it needs to go. septic anaphylactic neurogenic What are the General Signs of Shock? - ANSWER-Hypotension* Tachypnea Tachycardia* Cool, pale skin Anxiety Diaphoresis Change in or loss of consciousness Oliguria What are the characteristicw of Bipolar I? - ANSWER-At least 1 manic episode. Multiple depressive episodes are common but not required for a dx of BADI . Manic behaviour must last at least 1 week. The mood disturbance is severe enough to cause marked impairment in social or occupational funct. Not caused by the effects of drugs or other medical conditions. May include psychosis. What are the characteristics of Bipolar II? - ANSWER-At least 1 episode of hypomania. One or more depressive episodes. Never had a manic episode. Usually begins with a depressive episode. Depressive episodes are more debilitating over time.