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RN exams clinical judgment practice questions, set 118

RN exams · clinical judgment

RN exams clinical judgment practice questions set 118

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 community health nurse is providing education on gestational diabetes mellitus (GDM) to a group of clients who are pregnant. When discussing risk factors, which of the following ethnicities should the nurse identify as having the lowest incidence of GDM?

  1. A. Asian
  2. B. Non-Hispanic White American
  3. C. Hispanic
  4. D. African American
Show answer and rationale

Correct answer: B — Non-Hispanic White American

The correct answer is B: Non-Hispanic White American. Non-Hispanic White Americans have been found to have the lowest incidence of gestational diabetes mellitus (GDM) compared to other ethnicities. Studies have shown that Asian, Hispanic, and African American populations have higher rates of GDM. Asian individuals, in particular, have a higher risk due to genetic predisposition and lifestyle factors. Hispanic individuals are also at increased risk due to genetic factors and higher rates of obesity and sedentary lifestyles. African Americans are more likely to develop GDM as well, possibly due to a higher prevalence of obesity and insulin resistance in this population. Therefore, in this scenario, the nurse should identify Non-Hispanic White Americans as having the lowest incidence of GDM when discussing risk factors with the pregnant clients.

Question 2

Sudden chest pains combined with dyspnea, cyanosis, and tachycardia are symptoms associated with which complications?

  1. A. Hypovolemic shock
  2. B. Dehiscence
  3. C. Atelectasis
  4. D. Pulmonary embolus
Show answer and rationale

Correct answer: D — Pulmonary embolus

The correct answer is D: Pulmonary embolus. Sudden chest pains, dyspnea (shortness of breath), cyanosis (bluish discoloration of the skin), and tachycardia (rapid heart rate) are classic symptoms of a pulmonary embolus. A pulmonary embolus occurs when a blood clot travels to the lungs and blocks blood flow. This can lead to serious complications such as decreased oxygenation, chest pain, and cardiovascular instability. Hypovolemic shock (A) is characterized by low blood volume and is typically associated with severe bleeding or fluid loss. Dehiscence (B) refers to the separation of surgical incisions before they have healed completely. Atelectasis (C) is the collapse of lung tissue and may present with symptoms like shortness of breath and decreased oxygen levels, but it does not typically cause sudden chest pains, cyanosis, and tachycardia.

Question 3

A nurse at a long-term care facility is caring for an older adult client who has dementia and is at risk for malnutrition. Which of the following actions should the nurse take to promote an increase in food intake?

  1. A. Restrict visitors during meals
  2. B. Provide the client with finger foods for meals
  3. C. Limit snacks between meals
  4. D. Provide the client with three large meals each day
Show answer and rationale

Correct answer: B — Provide the client with finger foods for meals

The correct answer is B: 'Provide the client with finger foods for meals.' This option is the most appropriate because older adults with dementia may have difficulty using utensils or sitting through a full meal. Finger foods are easier to eat and can help promote increased food intake. Restricting visitors during meals (option A) is not recommended as social interaction can positively impact the client's mood and overall wellbeing. Limiting snacks between meals (option C) may not be beneficial for an older adult at risk for malnutrition, as snacks can provide additional opportunities for nutrient intake. Providing the client with three large meals each day (option D) may be overwhelming and could lead to decreased food intake. Therefore, offering finger foods is a practical and effective strategy to support the client's nutritional needs.

Question 4

A nurse is planning care for a child with severe eczema. Which of the following interventions should the nurse include?

  1. A. Apply wet dressings to affected areas.
  2. B. Expose affected areas to sunlight.
  3. C. Encourage frequent bathing with mild soap.
  4. D. Avoid the use of emollients.
Show answer and rationale

Correct answer: A — Apply wet dressings to affected areas.

The correct answer is A: 'Apply wet dressings to affected areas.' Wet dressings help soothe and hydrate the skin in children with severe eczema by providing a barrier to prevent scratching and allowing for better absorption of topical medications. Sunlight exposure (option B) can exacerbate eczema due to the potential for increased skin irritation and dryness. Encouraging frequent bathing with mild soap (option C) can help remove irritants and bacteria from the skin, but overly frequent bathing can also strip the skin of natural oils, worsening eczema. Avoiding the use of emollients (option D) is incorrect as emollients help to moisturize and protect the skin barrier in eczema. Therefore, the most appropriate intervention for a child with severe eczema is to apply wet dressings to affected areas to promote healing and alleviate symptoms.

Question 5

A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for infection.

  1. A. Meconium-stained fluid
  2. B. Placenta previa
  3. C. Midline episiotomy
  4. D. Gestational hypertension
Show answer and rationale

Correct answer: C — Midline episiotomy

The correct answer is C: Midline episiotomy. A midline episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. This incision can increase the risk of infection due to the potential for wound contamination and impaired healing. Meconium-stained fluid (option A) is not a direct risk factor for infection in the postpartum client. Placenta previa (option B) is a condition where the placenta partially or completely covers the cervix, increasing the risk of bleeding but not necessarily infection. Gestational hypertension (option D) is a condition characterized by high blood pressure during pregnancy and is not directly associated with an increased risk of infection in the postpartum period. Therefore, the most relevant factor placing the client at risk for infection in this scenario is the midline episiotomy.

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Question 6

A nurse is reinforcing teaching with a client about how to collect a stool specimen. Which of the following instructions should the nurse include?

  1. A. Avoid placing the toilet tissue in the bedpan after defecation.
  2. B. Urinate after the specimen collection.
  3. C. Place 1.3 cm (0.5 in) of formed stool into a culture tube.
  4. D. Keep the specimen in a warm area.
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Question 7

The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?

  1. A. Purposeful and goal directed
  2. B. A simple developmental process
  3. C. Based on deliberate and irrational thought
  4. D. Assists individuals in guessing what is most appropriate
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Question 8

A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?

  1. A. Inform the healthcare provider immediately.
  2. B. Administer the correct drug as prescribed.
  3. C. Monitor the client for adverse effects.
  4. D. Write an incident report.
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Question 9

When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?

  1. A. menstrual
  2. B. proliferative
  3. C. secretory
  4. D. ischemic
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Question 10

.A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?

  1. A. I can stop taking this medication once I feel less anxious.
  2. B. I should avoid drinking alcohol while taking this medication.
  3. C. It may take several weeks for this medication to take full effect.
  4. D. This medication can cause dependency.
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Question 11

A nurse is reviewing the use of inhalers with a client who has asthma. What is important to include?

  1. A. Shake the inhaler well before use.
  2. B. Use a spacer with the inhaler.
  3. C. Rinse mouth after using the inhaler.
  4. D. Take quick, deep breaths while inhaling.
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Question 12

A nurse is caring for a newborn who is premature in the neonatal ICU. What action should the nurse take to promote development?

  1. A. Position the naked newborn on the parents’ bare chest
  2. B. Keep the newborn in a dark, quiet room
  3. C. Provide a stimulating environment with toys
  4. D. Swaddle the newborn tightly
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Question 13

A nurse is providing teaching to the parents of a newborn about home phototherapy. Which of the following instructions should the nurse include?

  1. A. Keep the newborn\'s eyes uncovered during phototherapy.
  2. B. Apply lotion to the newborn\'s skin every 4 hours.
  3. C. Reposition the newborn every 2 hours.
  4. D. Discontinue phototherapy if the skin becomes discolored.
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Question 14

A nurse is caring for a 2-day-old newborn who was born at 35 weeks of gestation. Which of the following actions should the nurse the nurse takes?

  1. A. Administer nitric oxide inhalation therapy to the newborn
  2. B. Insert an orogastric decompression tube with low wall suction.
  3. C. Provide the newborn with an iron-rich formula containing vitamin B12 every 2 hr.
  4. D. Measure the abdominal circumference at the level of the newborn\'s umbilicus every 2 hr.
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Question 15

A nurse is teaching a client who is at 12 weeks of gestation and has HIV. What should the nurse include in the teaching?

  1. A. You should continue to take zidovudine throughout the pregnancy.
  2. B. You should avoid breastfeeding to prevent transmission to the baby.
  3. C. You should expect to have a cesarean birth to reduce the risk of transmission.
  4. D. You should have an elective abortion to prevent complications.
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About these RN exams clinical judgment questions

RN exams clinical judgment practice questions, set 118 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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