INPA level 3 UPDATED ACTUAL
Questions and CORRECT Answers
what are some things that cause you to be unable to provide safe ethical care? - CORRECT
ANSWER - - excessive workload, may cause med errors, mess up during interventions,
provide wrong patient education
- not reading documentation or doctor's orders, or having falsified documentation
- not having the knowledge or the equipment (also PPE) to provide care
- shortage of staff (unable to ask for help or consult the right healthcare professionals)
- not being able to advocate for the patient which leads to their impairment of the health and
having trust issues
- language barrier
- emergency situations where the patient needs to have something done but it's outside of your
scope
- not having patient involvement
things that impact communication - CORRECT ANSWER - - attitude of the nurse: being
polite, patient, and calm helps the patient to answer questions to their best ability without feeling
a lot of anxiety
- trust: if the patient doesn't trust the nurse there may be information that is being withheld
- empathy: if the nurse provides empathy for the patient the patient will feel like they are heard
and they are able to trust the nurse
- language: difference in what the patient says and what the nurse hears
- culture: different cultures have different expectations of communication that nurses may not
know of
- time constraints
- environmental noise or distractions
- use of jargon and information overload
communication techniques to use - CORRECT ANSWER - - providing silence to allow
the patient to collect their thoughts and calm down
,- accepting what they say (not necessarily agreeing) but allows the patient to know that they are
being heard and seen
- open ended questions to spark conversation and also to allow the patient to talk about how they
feel
- active listening
- clarification for better understanding
- offering hope, humour, empathy to provide a positive state of mind for the patient
- identifying verbal and non verbal cues (can allow us to see underlying emotions)
professional practice issues - CORRECT ANSWER - - not having the knowledge or the
competency to perform care
- not communicating with other healthcare professionals regarding the patient's care
- not documenting your findings, and not looking at other documentations before assessments
- inability to recognize unsafe work and any signs of impaired practice by others, and inability to
identify ethical issues
- not following scope of practice
b - Bubble he - CORRECT ANSWER - - palpating the breast
- can stroke downwards towards nipple to gently release milk
- assess breast, is it full, firm, tender, shiny?
- veins distended? skin warm?
- complaints of sore nipples? engorged? pain medication
- secretion of colostrum
u - bUbble he - CORRECT ANSWER - - uterus
- palpating uterus to feel involution (transforming back to pre-pregnancy)
- checking for infection
- should decrease approximately one fingerbreadth below per day
- unsatisfactory involution may mean the bladder is not completely empty
, - should be firm, round, smooth, not boggy (caused by the uterus not contracting effectively,
causing blood and clots to collect, making it hard to contract), will be soft, should massage
fundus (top of uterus)
- full bladder impedes uterine contraptions and may displace it away from the midline, causes
blood and clots go collect on uterus that can lead to boggy uterus and hemorrhage
b - buBble he - CORRECT ANSWER - - bladder
- assess for paresthesia (burning or prickling sensation usually felt in arms, legs, or feet, caused
by disorders affecting CNS e.g. stroke, TIA)
- assess for distention that could mean uterine atony or UTI
- recatheterize in 6 hours if not voided
- measure urine output
- check height of fundus
- educate patient about perineal care (front to back after voiding)
- bladder distention is abnormal, should measure first three post partum voiding, small frequent
voiding with pain and burning could indicate infection or retention
b - bubBle he - CORRECT ANSWER - - assess bowel sounds, passing of gas
- should have BM 2-3 days post delivery
- may need gas relief method, laxatives, stool softeners, enemas, encourage walking and
mobilizing to help pass gas
l - bubbLe he - CORRECT ANSWER - - should assess amount, drainage, number of pads
and change frequency (hourly)
- dilatation curettage (scraping after placenta retention) to prevent infection
- assess colour (rubra: 3-4 days, small to moderate, blood, dark red; serosa: 4-10 days, small
amount, brown or pink; alba after 10 days, white or pale yellow, discharge composed of WBCs)
- educate patient about lochia changes
- should assess if there are clots
- should not have foul odour, large amount, increased amount, clots
Questions and CORRECT Answers
what are some things that cause you to be unable to provide safe ethical care? - CORRECT
ANSWER - - excessive workload, may cause med errors, mess up during interventions,
provide wrong patient education
- not reading documentation or doctor's orders, or having falsified documentation
- not having the knowledge or the equipment (also PPE) to provide care
- shortage of staff (unable to ask for help or consult the right healthcare professionals)
- not being able to advocate for the patient which leads to their impairment of the health and
having trust issues
- language barrier
- emergency situations where the patient needs to have something done but it's outside of your
scope
- not having patient involvement
things that impact communication - CORRECT ANSWER - - attitude of the nurse: being
polite, patient, and calm helps the patient to answer questions to their best ability without feeling
a lot of anxiety
- trust: if the patient doesn't trust the nurse there may be information that is being withheld
- empathy: if the nurse provides empathy for the patient the patient will feel like they are heard
and they are able to trust the nurse
- language: difference in what the patient says and what the nurse hears
- culture: different cultures have different expectations of communication that nurses may not
know of
- time constraints
- environmental noise or distractions
- use of jargon and information overload
communication techniques to use - CORRECT ANSWER - - providing silence to allow
the patient to collect their thoughts and calm down
,- accepting what they say (not necessarily agreeing) but allows the patient to know that they are
being heard and seen
- open ended questions to spark conversation and also to allow the patient to talk about how they
feel
- active listening
- clarification for better understanding
- offering hope, humour, empathy to provide a positive state of mind for the patient
- identifying verbal and non verbal cues (can allow us to see underlying emotions)
professional practice issues - CORRECT ANSWER - - not having the knowledge or the
competency to perform care
- not communicating with other healthcare professionals regarding the patient's care
- not documenting your findings, and not looking at other documentations before assessments
- inability to recognize unsafe work and any signs of impaired practice by others, and inability to
identify ethical issues
- not following scope of practice
b - Bubble he - CORRECT ANSWER - - palpating the breast
- can stroke downwards towards nipple to gently release milk
- assess breast, is it full, firm, tender, shiny?
- veins distended? skin warm?
- complaints of sore nipples? engorged? pain medication
- secretion of colostrum
u - bUbble he - CORRECT ANSWER - - uterus
- palpating uterus to feel involution (transforming back to pre-pregnancy)
- checking for infection
- should decrease approximately one fingerbreadth below per day
- unsatisfactory involution may mean the bladder is not completely empty
, - should be firm, round, smooth, not boggy (caused by the uterus not contracting effectively,
causing blood and clots to collect, making it hard to contract), will be soft, should massage
fundus (top of uterus)
- full bladder impedes uterine contraptions and may displace it away from the midline, causes
blood and clots go collect on uterus that can lead to boggy uterus and hemorrhage
b - buBble he - CORRECT ANSWER - - bladder
- assess for paresthesia (burning or prickling sensation usually felt in arms, legs, or feet, caused
by disorders affecting CNS e.g. stroke, TIA)
- assess for distention that could mean uterine atony or UTI
- recatheterize in 6 hours if not voided
- measure urine output
- check height of fundus
- educate patient about perineal care (front to back after voiding)
- bladder distention is abnormal, should measure first three post partum voiding, small frequent
voiding with pain and burning could indicate infection or retention
b - bubBle he - CORRECT ANSWER - - assess bowel sounds, passing of gas
- should have BM 2-3 days post delivery
- may need gas relief method, laxatives, stool softeners, enemas, encourage walking and
mobilizing to help pass gas
l - bubbLe he - CORRECT ANSWER - - should assess amount, drainage, number of pads
and change frequency (hourly)
- dilatation curettage (scraping after placenta retention) to prevent infection
- assess colour (rubra: 3-4 days, small to moderate, blood, dark red; serosa: 4-10 days, small
amount, brown or pink; alba after 10 days, white or pale yellow, discharge composed of WBCs)
- educate patient about lochia changes
- should assess if there are clots
- should not have foul odour, large amount, increased amount, clots
