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RN exams clinical judgment practice questions, set 116

RN exams · clinical judgment

RN exams clinical judgment practice questions set 116

You notice cues, form a hypothesis, act, and evaluate — the same loop Next Generation items reward. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the RN exams exam guide or more RN exams practice questions.

Five clinical judgment questions with answers

Cover the key. Write the first action. Then open the rationale and name why the other choices fail.

Question 1

A nurse is admitting a client who is in labor and experiencing moderate bright red vaginal bleeding. Which of the following actions should the nurse take?

  1. A. Obtain blood samples for baseline laboratory values.
  2. B. Perform a vaginal examination.
  3. C. Apply pressure to the fundus.
  4. D. Administer Rh immunoglobulin.
Show answer and rationale

Correct answer: A — Obtain blood samples for baseline laboratory values.

The correct answer is A: 'Obtain blood samples for baseline laboratory values.' When a client is experiencing moderate bright red vaginal bleeding during labor, it is important for the nurse to obtain blood samples for baseline laboratory values to assess the client's hemoglobin level, clotting factors, and blood type. This information is crucial for determining the severity of the bleeding and guiding appropriate interventions. Performing a vaginal examination (B) may exacerbate the bleeding and should be avoided unless necessary. Applying pressure to the fundus (C) is not indicated as it may not address the underlying cause of the bleeding. Administering Rh immunoglobulin (D) is not necessary unless the client is Rh-negative and the bleeding is confirmed to be due to fetomaternal hemorrhage. Therefore, the priority action is to obtain blood samples for baseline laboratory values.

Question 2

A nurse is caring for a client who is in the first stage of labor and is using pattern-paced breathing. The client says she feels lightheaded, and her fingers are tingling. Which of the following actions should the nurse take?

  1. A. Administer oxygen via nasal cannula.
  2. B. Assist the client to breathe into a paper bag.
  3. C. Have the client tuck her chin to her chest.
  4. D. Instruct the client to increase her respiratory rate to more than 42 breaths per min.
Show answer and rationale

Correct answer: B — Assist the client to breathe into a paper bag.

In the scenario described, the client is experiencing symptoms of hyperventilation, which can occur during labor due to anxiety or pain. When a person hyperventilates, they exhale too much carbon dioxide, leading to decreased carbon dioxide levels in the blood, causing symptoms like lightheadedness and tingling in the fingers. Breathing into a paper bag helps the client rebreathe the exhaled carbon dioxide, restoring the balance of gases in the blood and alleviating symptoms. Administering oxygen via nasal cannula would not address the underlying issue of low carbon dioxide levels. Having the client tuck her chin to her chest or instructing her to increase her respiratory rate would not be appropriate interventions for hyperventilation. Therefore, the correct action for the nurse to take is to assist the client in breathing into a paper bag to rebalance her carbon dioxide levels.

Question 3

.A nurse is caring for a client who is experiencing panic attacks. Which intervention should the nurse implement to help the client manage anxiety?

  1. A. Encourage the client to avoid situations that trigger anxiety.
  2. B. Encourage the client to practice deep breathing exercises.
  3. C. Encourage the client to take anti-anxiety medication as prescribed.
  4. D. Encourage the client to engage in regular physical activity.
Show answer and rationale

Correct answer: B — Encourage the client to practice deep breathing exercises.

The correct intervention to help a client experiencing panic attacks manage anxiety is to encourage the client to practice deep breathing exercises (Option B). Deep breathing exercises can help reduce anxiety and panic by activating the body's relaxation response. This technique can help the client focus on their breathing, slow down their heart rate, and calm their mind during moments of distress. Avoiding triggering situations (Option A) may provide short-term relief but does not address the underlying anxiety. Taking anti-anxiety medication (Option C) should be done as prescribed by a healthcare provider and is not always the first-line intervention for managing panic attacks. Engaging in regular physical activity (Option D) is beneficial for overall mental health, but in the moment of a panic attack, deep breathing exercises are more effective at providing immediate relief.

Question 4

A nurse is monitoring a client who has preeclampsia and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings should the nurse reports to the provider?

  1. A. Blood pressure 148/94mm Hg
  2. B. Respiratory rate 14/min
  3. C. Urinary output 20 mL/hr
  4. D. 2+ deep tendon reflexes
Show answer and rationale

Correct answer: C — Urinary output 20 mL/hr

The correct answer is C. A urinary output of 20 mL/hr is significantly low and indicates decreased kidney perfusion, which can lead to magnesium sulfate toxicity. Magnesium sulfate is excreted by the kidneys, so a low urinary output can result in magnesium accumulation and potential toxicity. It is crucial for the nurse to report this finding promptly to the provider for further evaluation and adjustment of the magnesium sulfate infusion rate to prevent adverse effects. The other options are within normal limits for a client receiving magnesium sulfate for preeclampsia: A) Blood pressure of 148/94mm Hg is slightly elevated but expected in preeclampsia; B) Respiratory rate of 14/min is normal; D) 2+ deep tendon reflexes are an expected finding in a client receiving magnesium sulfate. Therefore, the urinary output is the most concerning finding that warrants immediate attention.

Question 5

The nurse points out that as a result of the aging process, one change in the immune system is:

  1. A. thickened skin
  2. B. reduced ciliary action
  3. C. thinned periosteum
  4. D. reduced saliva
Show answer and rationale

Correct answer: B — reduced ciliary action

The correct answer is B: reduced ciliary action. As we age, the immune system undergoes various changes, including a reduction in the effectiveness of the cilia, tiny hair-like structures in the respiratory tract that help trap and remove foreign particles. This reduction can lead to a decrease in the ability to clear pathogens and irritants from the respiratory system, making older adults more susceptible to respiratory infections. Thickened skin (option A) is a result of aging in the integumentary system, not the immune system. Thinned periosteum (option C) refers to the outer layer of bone, which is not directly related to the immune system. Reduced saliva (option D) is a common issue in older adults but is not a specific change in the immune system due to aging. Therefore, the most accurate choice is B, as it directly relates to immune system changes in the aging process.

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Question 6

A nurse on a medical-surgical unit is caring for a group of clients. Which of the following findings should the nurse identify as a safety hazard?

  1. A. An assistive personnel places a weight-sensitive sensor mat on the mattress beneath the client’s buttocks.
  2. B. An assistive personnel raises all four side rails of a client’s bed before leaving the room.
  3. C. A client who has bilateral wrist restraints has a capillary refill less than 2 seconds.
  4. D. A client who has a transcutaneous electrical nerve stimulation unit reports a buzzing sensation at the application site.
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Question 7

What make you think is the most effective leadership style that can be used during emergency situations?

  1. A. Democratic
  2. B. Laissez-faire
  3. C. Autocratic
  4. D. Supportive
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Question 8

Which behavior is most characteristic of a therapeutic nurse-patient-family relationship?

  1. A. Delivering care that is consistent and flexible
  2. B. Acting in the best interest of the patient and family
  3. C. Maintaining professional boundaries
  4. D. Developing a close, friendly relationship
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Question 9

A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider?

  1. A. A client who has a urinary output of 300 ml in 8 hr.
  2. B. A client who reports abdominal cramping during breastfeeding
  3. C. A client who is receiving magnesium sulfate and has absent deep tendon reflexes
  4. D. A client who reports lochia rubra requiring changing perineal pads every 3 hr.
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Question 10

A nurse is reviewing laboratory results for client who is pregnant. The Nurse should expect which of the following laboratory values to increase?

  1. A. RBC count
  2. B. Bilirubin
  3. C. Fasting blood glucose
  4. D. Bun
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Question 11

As a new nursing professional development practitioner, the mastery of which skill is most important?

  1. A. Communicating effectively
  2. B. Coordinating programs
  3. C. Managing resources
  4. D. Serving as facilitator
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Question 12

The nurse knows that cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?

  1. A. Decreased red blood cell (RBC) production
  2. B. Less audible heart sounds (s1, s2)
  3. C. Increased blood pressures
  4. D. Increased pulse rate
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Question 13

.A nurse is providing education to a client who has been prescribed diazepam for anxiety. Which statement by the client indicates an accurate understanding of the medication?

  1. A. I should take this medication only when I feel anxious.
  2. B. I should avoid drinking alcohol while taking this medication.
  3. C. I should avoid driving until I know how this medication affects me.
  4. D. I can stop taking this medication abruptly if I feel better.
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Question 14

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that is used to maximize the achievement of the desired objective. Which decision-making model does this manager use?

  1. A. Political decision-making model
  2. B. Experimentation process
  3. C. Rational decision-making model
  4. D. Trial-and-error method
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Question 15

A nurse is testing the reflexes of a newborn to assess neurologic maturity. What reflexes is the nurse assessing when she quickly and gently turns the newborn\'s head to one side?

  1. A. Moro reflex
  2. B. Rooting reflex
  3. C. Babinski reflex
  4. D. Tonic neck reflex
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About these RN exams clinical judgment questions

RN exams clinical judgment practice questions, set 116 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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