RPNCE ATTEMPT COMPLETE QUESTIONS AND ANSWERS 2025/ 2026 LATEST UPDATE
What is psychotic depression? ▪A serious form of Major Depression
▪Older adults may present with psychotic thought content including delusions.
▪Delusions of self-deprecation are often seen in connection with severe depression. The client
describes feeling unworthy, sinful, ugly, or foul smelling.
▪They may also have perceptual disturbances e.g. hallucinations.
What is the acronym SIGECAPS for and what does it stand for? Symptoms of depression in
older adults:
▪Sleep-disorders or problems - ^ or v sleep, (decreased sleep is more common in older adults)
▪Interest decreased, reduced activities, and lack of pleasure (anhedonia)
▪Guilt*** - self-blame, worthlessness, hopelessness, regrets
▪Energy decreased, fatigue
▪Concentration difficulties
▪Appetite disturbance-weight loss or weight gain (weight loss more common in older adults)
▪Psychomotor retardation or agitation
▪Suicidality, suicidal thoughts
What is the IS PATH WARM acronym used for? What does it stand for? I Ideation
S Substance Use
P Purposelessness
,A Anxiety / Agitation
T Trapped
H Hopelessness / Helplessness
W Withdrawal (from substances and people)
A Anger
R Recklessness
M Mood changes
What do M3, M2, M1, C1, C2 mean Scope of treatment
¨M3 - full medical treatment
¨M2 - transfer only when comfort measures cannot be achieved
¨M1 - comfort measures only
Critical care:
¨C2 - intubation
¨C1 - no intubation
What is needed for the RPN to pronounce death? What is the typical protocol? No apical
heart beat for 1 minute
No spontaneous respiration for 1 minute
Pupils dilated and fixed
Typical protocol:
Notify physician
,Notify family
Call Funeral Home
Post mortem care
(follow facility protocol)
What are the charting requirements post mortem? -Events leading to death
-Time respiration ceased
-Criteria to pronounce death
-Pronounced death at ___ time and date'
-Time physician notified
-Time family notified
(Pain and /s management is #1 of a good (dignified) death. Proper pain management is
ABSOLUTELY #1 WE WANT PPL TO BE AS COMFORTABLE AS POSSIBLE)
What are the symptoms of someone who is about to die? Decreased LOC / confusion
Muscle relaxation /inability to swallow (dysphagia)
Restlessness
Congestion
Breathing laboured / irregular /apneic/Cheyene-Stokes/Moan-like sounds/ noisy respiration
Incontinence/decreased urinary output /dark urine
Mottling (irregular red or purple marbled spots on skin) with poor circulation / cool
extremities),
, Non-reactive pupils,
Weak pulse, dropping BP
What needs to be assessed in the 48/6 assessments? 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? 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
Which neurotransmitter is related to parkison's disease? Dopamine (deficiency)
What are the cardinal symptoms of parkinson's disease? Tremor (at rest)
What is psychotic depression? ▪A serious form of Major Depression
▪Older adults may present with psychotic thought content including delusions.
▪Delusions of self-deprecation are often seen in connection with severe depression. The client
describes feeling unworthy, sinful, ugly, or foul smelling.
▪They may also have perceptual disturbances e.g. hallucinations.
What is the acronym SIGECAPS for and what does it stand for? Symptoms of depression in
older adults:
▪Sleep-disorders or problems - ^ or v sleep, (decreased sleep is more common in older adults)
▪Interest decreased, reduced activities, and lack of pleasure (anhedonia)
▪Guilt*** - self-blame, worthlessness, hopelessness, regrets
▪Energy decreased, fatigue
▪Concentration difficulties
▪Appetite disturbance-weight loss or weight gain (weight loss more common in older adults)
▪Psychomotor retardation or agitation
▪Suicidality, suicidal thoughts
What is the IS PATH WARM acronym used for? What does it stand for? I Ideation
S Substance Use
P Purposelessness
,A Anxiety / Agitation
T Trapped
H Hopelessness / Helplessness
W Withdrawal (from substances and people)
A Anger
R Recklessness
M Mood changes
What do M3, M2, M1, C1, C2 mean Scope of treatment
¨M3 - full medical treatment
¨M2 - transfer only when comfort measures cannot be achieved
¨M1 - comfort measures only
Critical care:
¨C2 - intubation
¨C1 - no intubation
What is needed for the RPN to pronounce death? What is the typical protocol? No apical
heart beat for 1 minute
No spontaneous respiration for 1 minute
Pupils dilated and fixed
Typical protocol:
Notify physician
,Notify family
Call Funeral Home
Post mortem care
(follow facility protocol)
What are the charting requirements post mortem? -Events leading to death
-Time respiration ceased
-Criteria to pronounce death
-Pronounced death at ___ time and date'
-Time physician notified
-Time family notified
(Pain and /s management is #1 of a good (dignified) death. Proper pain management is
ABSOLUTELY #1 WE WANT PPL TO BE AS COMFORTABLE AS POSSIBLE)
What are the symptoms of someone who is about to die? Decreased LOC / confusion
Muscle relaxation /inability to swallow (dysphagia)
Restlessness
Congestion
Breathing laboured / irregular /apneic/Cheyene-Stokes/Moan-like sounds/ noisy respiration
Incontinence/decreased urinary output /dark urine
Mottling (irregular red or purple marbled spots on skin) with poor circulation / cool
extremities),
, Non-reactive pupils,
Weak pulse, dropping BP
What needs to be assessed in the 48/6 assessments? 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? 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
Which neurotransmitter is related to parkison's disease? Dopamine (deficiency)
What are the cardinal symptoms of parkinson's disease? Tremor (at rest)
