This is the supplemental questionnaire for the classification of Psychiatric Nurse - II. Part I will not be scored or used for determining minimum qualifications but is provided for the applicant to review prior to completing the questionnaire and may also be used when determining assignment. Part II will be scored based on your checked responses.
By continuing in this examination process, you are certifying that all information provided in the supplemental questionnaire is true to the best of your knowledge. If selected for an interview, you may be required to display and respond to questions to validate your responses to this exam.
NOTE: Resumes, letters, and other materials will not be evaluated nor considered as responses to the items in this supplemental questionnaire. In addition, responses to this questionnaire will not be used for determining minimum qualifications for this position.
I have read and understood the above information.
Part I: Minimum Qualifications (Not Scored)
This section will not be scored but may assist the applicant with determining how he/she meets the minimum qualifications for this position.
1.
Do you possess two years of responsible professional psychiatric nursing experience performing duties similar to a Psychiatric Nurse I with Placer County?
Yes
No
2.
Do you possess the equivalent of a Bachelor's degree from an accredited college or university with major course work in nursing or a related field?
Yes
No
3.
Do you possess a valid license as a Registered Nurse issued by the California Board of Registered Nursing?
Yes
No
If yes, please provide the license number and issue date.
Part II: Relevant Knowledge and Experience (Scored)
This section of the supplemental questionnaire is the Civil Service examination for this position. This supplemental questionnaire will be scored based on your checked responses below. Narratives provided by applicants describing training and/or experience will not be scored, but will be available to the hiring authority and may be utilized for interview and selection determination. Scores received from this section will determine applicant ranking and placement on the eligible list.
For the items in this section, please indicate your level of training and experience and then provide a brief description of your related experience in the space provided.
1.
Do you currently possess a valid CPR certificate?
Yes
No
2.
Do you currently possess certification(s) in crisis intervention?
Yes
No
3.
Please select all the settings where you have provided nursing care.
Hospital Setting
Outpatient Setting
Residential Setting
In-Home Care Setting
None of the above
If you indicated any experience, please describe.
4.
Please select all the age populations that you have provided nursing care.
Children
Adolescents
Adults
Elderly
None of the above
If you indicated any experience, please describe.
5.
Please select all the types of medication you have administered.
Oral
Injection
None of the above
If you indicated any experience, please describe.
6.
Describe your experience communicating medical information and patient care instructions to providers and/or other health care professionals.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
7.
Describe your experience interpreting a physician’s order regarding patient medication needs and care.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
8.
Describe your experience providing specific medication, counseling and education to patients regarding the need, purpose and side effects of prescribed medications.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
9.
Describe your experience administering psychotropic medications to patients.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
10.
Describe your experience interviewing, observing, and recording patients as a means of collecting psychosocial and/or medical history.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
11.
Describe your experience using clinical supplies and equipment, including blood pressure cuff, stethoscope, syringes and needles.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
12.
Describe your experience overseeing medication crisis telephone calls and walk-ins.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
13.
Describe your experience with legal and regulatory issues involved in treating the mentally ill.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task independently under normal supervision.
I have applied this knowledge or skill independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
14.
Describe your experience assisting in developing standards and procedures for medication monitoring by nursing staff.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
15.
Describe your experience working with an Electronic Health Record (EHR) to document client/patient treatment for compliance/insurance purposes including progress notes, lab work, and ordering medications.
I have no or very limited experience in performing this task.
I have some experience performing this task but would need additional training.
I have performed this task under close supervision.
I have performed this task independently under normal supervision.
I have extensive experience performing this task and have trained and/or supervised others in the performance of this task.
If you indicated any experience, please describe.
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