RN exams clinical judgment practice questions, set 127
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 127
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
You are called to the scene where a 36-year-old male was shot in the back while running away from an assailant. While treating and attempting to stabilize the patient, what should be done with the clothing he was wearing?
A. Lay them to the side when they are cut or taken off; notify the officers on scene to allow them to gather the evidence properly
B. Place all cut or removed clothing between the patient's legs on the stretcher during transport to ensure the items make it to the emergency department where law enforcement will gather them properly
C. Place them in a plastic evidence bag, do not seal the bag; label it with the time, date, and your name with affiliation; and give it to law enforcement on scene
D. Place them in a paper bag along with the disposable latex gloves you were wearing when you took or cut the clothing off; seal the bag listing the items it contains; document patient's name, time/date, and your name and title on the bag
Show answer and rationale
Correct answer: D — Place them in a paper bag along with the disposable latex gloves you were wearing when you took or cut the clothing off; seal the bag listing the items it contains; document patient's name, time/date, and your name and title on the bag
The correct answer is D because placing the clothing in a paper bag with the disposable gloves helps preserve any potential evidence without contaminating it. Sealing the bag ensures the integrity of the evidence, and documenting all details on the bag maintains a clear chain of custody. This method follows proper forensic protocol for preserving evidence.
Choice A is incorrect because simply laying the clothing to the side may lead to contamination and loss of evidence integrity. Choice B is incorrect as placing the clothing between the patient's legs on the stretcher risks contamination and may not preserve evidence properly. Choice C is incorrect because sealing the evidence bag is crucial to maintain integrity, and not sealing it could compromise the evidence.
Question 2
Which of the following pairs of drugs would be most appropriate as a therapeutic regimen for the 37-year-old woman with acute psychotic state and history of seizures?
A. Haloperidol and clonazepam
B. Chlorpromazine and lamotrigine
C. Clozapine and ethosuximide
D. Thioridazine and ethosuximide
Show answer and rationale
Correct answer: A — Haloperidol and clonazepam
The correct answer is A: Haloperidol and clonazepam. Haloperidol is an antipsychotic medication used to treat acute psychotic states, while clonazepam is a benzodiazepine commonly used to manage seizures. The combination is appropriate as it addresses both the acute psychotic symptoms and the history of seizures in the patient.
Explanation for incorrect choices:
B: Chlorpromazine and lamotrigine - Chlorpromazine is an antipsychotic, but lamotrigine is primarily used for mood disorders, not seizures.
C: Clozapine and ethosuximide - Clozapine is an antipsychotic, but ethosuximide is used to treat absence seizures, not generalized seizures.
D: Thioridazine and ethosuximide - Thioridazine is an antipsychotic, but ethosuximide is not commonly used for seizures in adults.
Question 3
A client experiences intrusive, insulting auditory hallucinations. Which independent behavioral technique can the nurse teach the client to employ when the voices are troublesome?
A. Take additional antipsychotic medication
B. Lie down in bed and try to sleep
C. Sing or whistle to compete with the voices
D. Eat a large portion of chocolate
Show answer and rationale
Correct answer: C — Sing or whistle to compete with the voices
The correct answer is C: Sing or whistle to compete with the voices. This technique is effective as it can help distract the client from the intrusive auditory hallucinations. By engaging in singing or whistling, the client can shift their focus away from the voices, making them less bothersome. This method can also empower the client by giving them a sense of control over the situation.
Other choices are incorrect:
A: Taking additional antipsychotic medication may not be necessary in this situation and should be prescribed by a healthcare provider.
B: Lying down and trying to sleep may not address the immediate distress caused by the hallucinations.
D: Eating a large portion of chocolate is not a valid behavioral technique for managing auditory hallucinations.
Question 4
During a clinical examination, you observe that a patient's ears are positioned significantly below the level of the lateral eye canthi. What might this indicate about the patient's head and neck anatomy?
A. Normal anatomical variation
B. Potential congenital deformity
C. Increased risk of hearing loss
D. No clinical significance
Show answer and rationale
Correct answer: B — Potential congenital deformity
The correct answer is B: Potential congenital deformity. This observation suggests a condition called "low-set ears," which can be a sign of certain congenital anomalies affecting the development of the head and neck structures during fetal growth. It is important to investigate further to rule out any associated syndromes or genetic disorders.
Choice A: Normal anatomical variation is incorrect because this positioning is not commonly considered a normal variation in the general population.
Choice C: Increased risk of hearing loss is incorrect as the position of the ears alone does not directly correlate with hearing loss.
Choice D: No clinical significance is incorrect because this observation warrants further evaluation to assess for potential underlying issues.
Question 5
Which of the following drugs most likely caused the patient's syndrome?
A. Amyl nitrite
B. Nitrous oxide
C. Propane
D. Helium
Show answer and rationale
Correct answer: A — Amyl nitrite
The correct answer is A: Amyl nitrite. Amyl nitrite is known to cause methemoglobinemia, which can present as the syndrome described in the patient. Nitrous oxide, propane, and helium do not typically cause methemoglobinemia. Amyl nitrite acts as a vasodilator and can lead to the formation of methemoglobin, reducing the oxygen-carrying capacity of blood. Methemoglobinemia can manifest as cyanosis, headache, dizziness, fatigue, and shortness of breath. Nitrous oxide is an anesthetic gas that does not cause methemoglobinemia. Propane and helium are gases used for various purposes but are not associated with methemoglobinemia. Therefore, based on the patient's symptoms and the mechanism of action of the drugs listed, amyl nitrite is the most likely cause of the syndrome.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
A patient has been brought to the hospital with the complaints of headache, pain in left hypochondrium. He has been ill for 1,5 weeks. The sudden illness began with the increase of body temperature up to 39, 90C. In 3 hours the temperature decreased and hydropoiesis began. The attacks repeat rhythmically in 48 hours. The patient had visited one an African country. The doctors have suspected malaria. What method of laboratory diagnostics is necessary to use?
A. Blood examination
B. Immunological tests
C. Stool examination
D. Urine examination
Correct answer:
The correct method of laboratory diagnostics for suspected malaria is blood examination. Malaria is diagnosed by detecting the presence of the Plasmodium parasite in the patient's blood. This can be done through microscopy to identify the parasite in a blood smear or through rapid diagnostic tests (RDTs) that detect specific antigens produced by the parasite. Blood examination allows for the direct visualization of the parasite, making it the most accurate method for diagnosing malaria. Immunological tests, stool examination, and urine examination are not suitable for diagnosing malaria as the parasite primarily resides in the red blood cells. Stool and urine examinations are more commonly used for diagnosing gastrointestinal or urinary tract infections, respectively.
This event occurs during muscular contraction L. H-zone disappears I. A band widens I. I band shortens IV. Width of $A$ band is unaffected V. $M$ line and $Z$ line get closer
A. I, II and III
B. I, III, IV and V
C. II, IV and V
D. I, II and V
Correct answer:
During muscular contraction, the sliding filament theory explains sarcomere changes: actin filaments slide over myosin, shortening the sarcomere. The H-zone (myosin-only region) disappears as actin overlaps it. The I band (actin-only) shortens as Z lines approach each other. The A band (myosin length) remains constant, unaffected by sliding. The M line and Z lines get closer due to overall shortening. The A band widening doesn't occur, as its width is fixed by myosin filament length. The correct combination includes the H-zone vanishing, I band shortening, A band staying unchanged, and Z lines nearing the M line, reflecting the mechanics of contraction where filament overlap drives muscle shortening without altering myosin's span, a key principle in muscle physiology.
Which of the following drugs most likely caused the patient's syndrome?
A. Amyl nitrite
B. Nitrous oxide
C. Propane
D. Helium
Correct answer:
The correct answer is A: Amyl nitrite. Amyl nitrite is known to cause methemoglobinemia, which can present as the syndrome described in the patient. Nitrous oxide, propane, and helium do not typically cause methemoglobinemia. Amyl nitrite acts as a vasodilator and can lead to the formation of methemoglobin, reducing the oxygen-carrying capacity of blood. Methemoglobinemia can manifest as cyanosis, headache, dizziness, fatigue, and shortness of breath. Nitrous oxide is an anesthetic gas that does not cause methemoglobinemia. Propane and helium are gases used for various purposes but are not associated with methemoglobinemia. Therefore, based on the patient's symptoms and the mechanism of action of the drugs listed, amyl nitrite is the most likely cause of the syndrome.
A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?
A. They improve treatment adherence.
B. They reduce the duration of illness.
C. They exhibit synergistic antiviral effects.
D. They prevent opportunistic infections.
Correct answer:
The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.
A client with osteoarthritis is given a new prescription for a nonsteroidal anti-inflammatory drug (NSAID). The client asks the nurse, 'How is this medication different from the acetaminophen I have been taking?' Which information about the therapeutic action of NSAIDs should the nurse provide?
A. Are less expensive.
B. Provide anti-inflammatory response.
C. Increase hepatotoxic side effects.
D. Cause gastrointestinal bleeding.
Correct answer:
The correct answer is B: Provide anti-inflammatory response. NSAIDs work by inhibiting the enzyme cyclooxygenase, thereby reducing inflammation, pain, and fever. This is different from acetaminophen, which primarily acts as a pain reliever and fever reducer but lacks significant anti-inflammatory properties.
Explanation of why other choices are incorrect:
A: Are less expensive - Cost is not related to the therapeutic action of NSAIDs.
C: Increase hepatotoxic side effects - While NSAIDs can have adverse effects on the liver, hepatotoxicity is not a primary therapeutic action of these drugs.
D: Cause gastrointestinal bleeding - While NSAIDs can increase the risk of gastrointestinal bleeding, this is a potential side effect rather than the primary therapeutic action.
The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?
A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
B. Re-crossmatch the blood until the antibodies are identified
C. Have the client sign a permit to receive uncrossmatched blood
D. Have the unlicensed nursing assistant stay with the client
Correct answer:
Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is essential when the cross-match reveals the presence of antibodies that cannot be cross-matched. This precaution allows the nurse to monitor for any adverse reactions due to the antibodies. Re-crossmatching the blood until the antibodies are identified (choice B) may delay the transfusion process and put the client at risk. Having the client sign a permit to receive uncrossmatched blood (choice C) is not a standard practice and does not address the immediate need for precautions during transfusion. Having the unlicensed nursing assistant stay with the client (choice D) is unrelated to the safe initiation of the transfusion and is not a precaution specific to managing antibodies in blood products.
The correct answer is D: active transport system. Permeases are specific carriers that actively transport molecules across a cell membrane against their concentration gradient, requiring energy input. This process is known as active transport, which is essential for maintaining cellular homeostasis and allowing the cell to accumulate specific molecules. Facilitated diffusion (A) and passive transport (B) both involve the movement of molecules down their concentration gradient without the need for energy input. Simple diffusion (C) also does not involve specific carriers and relies on the natural movement of molecules from areas of high concentration to low concentration. Therefore, the correct choice is D as permeases specifically function in active transport systems.
In the preoperative assessment of a patient for the likelihood of postoperative risk, ascorbic acid deficiency, anemia, and volume contraction are all risk factors for
A. Prolonged intubation
B. Thromboembolism
C. Delayed wound healing
D. Atelectasis
Correct answer:
Step-by-step rationale for why choice D (Atelectasis) is correct:
1. Ascorbic acid deficiency can lead to impaired lung function, increasing the risk of atelectasis.
2. Anemia can cause decreased oxygen-carrying capacity, contributing to atelectasis.
3. Volume contraction can lead to reduced lung expansion, further predisposing to atelectasis.
Summary:
- Choice A (Prolonged intubation): Intubation duration is more related to respiratory complications, not directly linked to the mentioned risk factors.
- Choice B (Thromboembolism): Risk factors like immobility and hypercoagulability are more relevant to thromboembolism.
- Choice C (Delayed wound healing): More associated with factors like malnutrition and impaired immune function rather than the mentioned risk factors.
A nurse is assessing a newborn following a forceps assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method?
A. Hypoglycemia
B. Polycythemia
C. Facial Palsy
D. Bronchopulmonary dysplasia
Correct answer:
The correct answer is C: "Facial Palsy." During a forceps-assisted birth, pressure applied by the forceps on the baby's face can cause facial nerve injury leading to facial palsy. This condition presents as weakness or paralysis of the facial muscles, affecting the baby's ability to close the eye or move the mouth symmetrically. Hypoglycemia (choice A) can occur in newborns for various reasons unrelated to the birth method. Polycythemia (choice B) is an increase in red blood cell concentration, often seen in babies born to diabetic mothers. Bronchopulmonary dysplasia (choice D) is a lung condition usually associated with premature birth and mechanical ventilation. Therefore, the most relevant complication to identify following a forceps-assisted birth is facial palsy.
A nurse is caring for a client who is in active labor and notes late decelerations on the fetal monitor. Which of the following is the priority nursing action?
A. Elevate the client\'s legs
B. Position the client on her side.
C. Administer oxygen via face mask.
D. Increase the infusion rate of the IV fluid.
Correct answer:
The correct answer is to position the client on her side (Option B). Late decelerations on the fetal monitor indicate decreased blood flow to the placenta, which can compromise fetal oxygenation. By positioning the client on her side, you can help improve blood flow to the placenta by relieving pressure on the vena cava and improving perfusion to the fetus. Elevating the client's legs (Option A) may not address the underlying issue of decreased blood flow. Administering oxygen via face mask (Option C) is important, but positioning the client on her side takes precedence. Increasing the infusion rate of the IV fluid (Option D) may not directly address the fetal oxygenation concern. Therefore, the priority is to reposition the client to optimize blood flow to the fetus.
RN exams clinical judgment practice questions, set 127 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the RN exams exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
