RN exams clinical judgment practice questions, set 131
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 131
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 client in the final stages of terminal cancer tells the nurse: “I wish I could be just be allowed to die. I’m tired of fighting this illness. I have lived life a good life. I only continue my chemotherapy and radiation treatment because my family wants me to.” What is the best nurse’s best response?
A. “Would you like to talk to a psychologist about your thoughts and feelings?”
B. “Would you like to talk to your minister about the significance of death?”
C. “Would you like to meet with your family and your physician about this matter?”
D. “I know you are tired of fighting this illness, but death will come in due time.”
Show answer and rationale
Correct answer: C — “Would you like to meet with your family and your physician about this matter?”
The correct response is C: “Would you like to meet with your family and your physician about this matter?”
Rationale:
1. Involving the family and physician ensures a collaborative decision-making process.
2. It respects the client's autonomy and involves them in the decision-making process.
3. It promotes open communication and support from loved ones.
4. It addresses the client's concerns about continuing treatment based on family wishes.
Summary:
A: Refers to psychological support, but the client's primary concern is medical treatment decisions.
B: Involves religious support, which may not align with the client's beliefs or address the medical decision.
D: Acknowledges the client's feelings but lacks a collaborative approach involving family and healthcare team.
Question 2
In Transmissive infections, the vector is:
A. Air
B. Objects
C. Medical devices
D. Water
Show answer and rationale
Correct answer: A — Air
The correct answer is A: Air. In transmissive infections, the vector refers to the means by which the infectious agent is transmitted from one host to another. Air can carry pathogens such as viruses and bacteria, leading to respiratory infections like the flu or tuberculosis. Airborne transmission occurs when droplets containing the pathogens are inhaled. Objects (B), medical devices (C), and water (D) can also transmit infections, but they are not specifically related to transmissive infections. Objects and medical devices can harbor pathogens, while waterborne infections are transmitted through contaminated water sources. However, in the context of transmissive infections, the primary vector is the air due to its ability to carry infectious agents over distances.
Question 3
What genetic tests are performed by a “Public Health Laboratory�
A. Newborn screening
B. Foodborne disease testing
C. Both of the above
D. Neither of the above Week 1 – Lecture 2
Show answer and rationale
Correct answer: C — Both of the above
The correct answer is C (Both of the above) because a Public Health Laboratory typically conducts genetic tests for both newborn screening and foodborne disease testing to monitor and prevent public health risks. Newborn screening helps identify genetic disorders in infants early on, while foodborne disease testing detects genetic markers in pathogens causing foodborne illnesses. Option A (Newborn screening) is correct as it is a common genetic test performed by Public Health Laboratories. Option B (Foodborne disease testing) is also correct as these labs play a crucial role in identifying and preventing foodborne illnesses. Option D (Neither of the above) is incorrect as Public Health Laboratories indeed perform both types of genetic tests to protect public health.
Question 4
Which maternal condition always necessitates delivery by cesarean birth?
A. Partial abruptio placentae
B. Total placenta previa
C. Ectopic pregnancy
D. Eclampsia
Show answer and rationale
Correct answer: B — Total placenta previa
The correct answer is B: Total placenta previa. In this condition, the placenta completely covers the cervix, posing a risk of severe bleeding during vaginal delivery. Cesarean birth is necessary to avoid potential life-threatening complications for both the mother and the baby.
Partial abruptio placentae (choice A) involves premature separation of the placenta, but it doesn't always require a cesarean birth. Ectopic pregnancy (choice C) occurs when the fertilized egg implants outside the uterus, typically requiring surgical intervention but not always a cesarean birth. Eclampsia (choice D) is a serious condition characterized by high blood pressure and seizures, but it doesn't always necessitate cesarean birth unless there are other complications that require it.
Question 5
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.
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Question 6
A 56-year-old man is thrown violently against the steering wheel of his truck during a motor vehicle crash. On arrival in the ED he is diaphoretic and complaining of chest pain. His BP is 60/40mmHg and his respiratory rate is 40 breaths per minute. Which of the following best differentiates cardiac tamponade from tension pneumothorax as the cause of his hypotension?
A. Tachycardia
B. Pulse volume
C. Breath sounds
D. Pulse pressure
Correct answer:
The correct answer is C: Breath sounds. In cardiac tamponade, there may be muffled or distant heart sounds due to the accumulation of fluid around the heart, impacting its ability to pump effectively. In tension pneumothorax, breath sounds may be absent or decreased on the affected side due to lung collapse. This differentiation is important as cardiac tamponade requires emergent pericardiocentesis, while tension pneumothorax necessitates needle decompression. Choices A, B, and D are not as useful in differentiating between the two conditions. Tachycardia may be present in both conditions, pulse volume may be decreased in both, and pulse pressure may be narrowed in both due to decreased cardiac output. Breath sounds are a key differentiating factor in this scenario.
After assessing a patient, a nurse develops a standard formal nursing diagnosis. What is the rationale for the nurse’s actions?
A. To form a language that can be encoded only by nurses
B. To distinguish the nurse’s role from the physician’s role
C. To develop clinical judgment based on other’s intuition
D. To help nurses focus on the scope of medical practice
Correct answer:
The correct answer is D because developing a standard formal nursing diagnosis helps nurses focus on the scope of their practice. By identifying specific patient problems and their potential causes, nurses can provide appropriate interventions and evaluate patient outcomes effectively. This process enhances the quality of care delivery and promotes patient safety.
A: This is incorrect because nursing diagnoses are not meant to be a language exclusive to nurses but rather a standardized way to communicate patient data.
B: This is incorrect as nursing diagnoses are not about distinguishing roles but rather about identifying and addressing patient problems.
C: This is incorrect as nursing diagnoses are based on evidence and critical thinking, not solely on intuition.
The correct statement about malaria prophylaxis during pregnancy is that
A. Sulfadoxine Pyrimethamine should be given to all pregnant women in malaria endemic zones
B. All pregnant women in malaria endemic zones are assumed free of the parasite until tested
C. Sulfadoxine Pyrimethamine should be administered with each alternate visit after quickening
D. All antenatal clients in Kenya should receive intermittent presumptive treatment at least 6 doses
Correct answer:
Step 1: Sulfadoxine Pyrimethamine is recommended for pregnant women in malaria endemic areas due to its safety and efficacy in preventing malaria during pregnancy.
Step 2: Pregnant women are at higher risk of severe complications from malaria, making prophylaxis crucial.
Step 3: The World Health Organization recommends intermittent preventive treatment with Sulfadoxine Pyrimethamine for pregnant women in malaria-endemic areas.
Step 4: Option A aligns with these guidelines, making it the correct choice.
Summary: Option B is incorrect because pregnant women are considered at risk regardless of testing. Option C is incorrect as the timing of administration is not based on quickening. Option D is incorrect as the recommended number of doses may vary based on guidelines.
A nurse is assisting a laboring person who is in the first stage of labor. What is the most appropriate intervention to promote relaxation and comfort?
A. encourage ambulation
B. administer pain medication
C. provide distraction and breathing techniques
D. offer relaxation techniques
Correct answer:
The correct answer is A: encourage ambulation. Walking during the first stage of labor can help facilitate the descent of the fetus, promote optimal positioning, and enhance comfort by utilizing gravity to aid in the progression of labor. Ambulation also encourages blood circulation and may provide a distraction from discomfort. Administering pain medication (B) is not the initial intervention in promoting relaxation and comfort during early labor. Providing distraction and breathing techniques (C) may be beneficial, but ambulation is more effective in promoting relaxation. Offering relaxation techniques (D) is helpful, but encouraging movement through ambulation is a more active approach in easing discomfort and promoting relaxation during the first stage of labor.
In order to promote a resident's right to privacy which item is used to cover a resident while making an occupied bed?
A. A bath blanket
B. A bedspread
C. A waterproof bed protector
D. A fitted bottom sheet
Correct answer:
The correct answer is A: A bath blanket. When making an occupied bed to promote a resident's right to privacy, a bath blanket is used to cover the resident. This item provides adequate coverage while maintaining the resident's dignity. A bath blanket is specifically designed for this purpose, ensuring the resident's privacy is respected during the bed-making process.
Summary:
- B: A bedspread is not suitable for covering a resident during bed-making as it is typically heavier and not designed for this purpose.
- C: A waterproof bed protector is used to protect the mattress from spills and accidents, not for covering the resident.
- D: A fitted bottom sheet is used to cover the mattress, not the resident, and does not provide adequate privacy during bed-making.
Which of the following is an example of a correct way to write a blood pressure reading?
A. 0/70
B. 0+70
C. 0-70
D. 0*70
Correct answer:
The correct way to write a blood pressure reading is in the format of systolic pressure over diastolic pressure, with a slash (/) separating the two numbers. In this case, the correct answer is A: 0/70. The systolic pressure (top number) is always written first, followed by the diastolic pressure (bottom number). This format helps healthcare professionals quickly and accurately interpret the blood pressure reading.
Explanation of why the other choices are incorrect:
B: 0+70 - The plus sign is not the appropriate symbol to separate systolic and diastolic pressure.
C: 0-70 - The minus sign is not the correct symbol for indicating blood pressure readings.
D: 0*70 - The asterisk symbol is not used in blood pressure readings to separate systolic and diastolic pressure.
What is the primary focus of secondary prevention in community mental health care?
A. Teaching stress-reduction techniques
B. Early detection of mental illness
C. Leading support groups for clients with substance use disorder
D. Rehabilitation and prevention of further issues
Correct answer:
The correct answer is B: Early detection of mental illness. Secondary prevention in community mental health care focuses on identifying mental health issues at an early stage to provide timely interventions. Choice A, teaching stress-reduction techniques, is more aligned with primary prevention aimed at preventing the onset of mental health problems. Choice C, leading support groups for clients with substance use disorder, pertains more to providing specific interventions for individuals with substance use issues rather than the general focus of secondary prevention. Choice D, rehabilitation and prevention of further issues, is more related to tertiary prevention, which involves addressing existing mental health conditions and preventing complications or recurrence.
A nurse is caring for a patient who is post-operative following hip replacement surgery. Which of the following should be included in the nursing care plan to prevent complications?
A. Encouraging the patient to avoid physical activity for several weeks.
B. Administering pain medication only when requested by the patient.
C. Monitoring the patient for signs of infection and deep vein thrombosis.
D. Providing education on safe lifting techniques.
Correct answer:
The correct answer is C because monitoring the patient for signs of infection and deep vein thrombosis is crucial in preventing complications post-hip replacement surgery. Infections can lead to serious complications, while deep vein thrombosis can result in blood clots that can be life-threatening. By closely monitoring for these signs, the nurse can intervene early and prevent further complications.
Choice A is incorrect because complete avoidance of physical activity can lead to other complications such as muscle atrophy and delayed recovery. Choice B is incorrect because pain management should be proactive to prevent unnecessary suffering. Choice D, while important, is not directly related to preventing complications such as infection and deep vein thrombosis.
During a detailed physical exam of your dyspneic 73-year-old female patient, you palpate small pockets of air in the subcutaneous tissue of the skin in the upper right region of her chest, just below her clavicle. Which of the following medical conditions is most likely to cause this abnormal finding?
A. Bacterial pneumonia
B. Spontaneous pneumothorax
C. Dry pleurisy
D. Chronic obstructive pulmonary disease
Correct answer:
The correct answer is B: Spontaneous pneumothorax. In this scenario, the presence of small pockets of air in the subcutaneous tissue of the chest indicates air escaping from the lung into the chest cavity, leading to pneumothorax. Spontaneous pneumothorax commonly presents with sudden chest pain and dyspnea, more prevalent in older individuals, like the patient described. Bacterial pneumonia (A) typically presents with fever, productive cough, and consolidation on lung auscultation. Dry pleurisy (C) refers to inflammation of the pleura without significant fluid accumulation, unlikely to cause subcutaneous emphysema. Chronic obstructive pulmonary disease (D) is characterized by progressive airflow limitation and is not directly associated with subcutaneous emphysema.
Which of the following outcome criteria is appropriate for the client with dementia?
A. The client will return to an adequate level of self-functioning.
B. The client will learn new coping mechanisms to handle anxiety.
C. The client will seek out resources in the community for support.
D. The client will follow an established schedule for activities of daily living.
Correct answer:
The correct answer is D because clients with dementia often struggle with memory and cognitive functioning, making it essential to establish a routine for activities of daily living to promote independence and reduce confusion. This outcome criterion focuses on maintaining a structured schedule to support the client's ability to perform tasks consistently.
A is incorrect because expecting the client to return to an adequate level of self-functioning is unrealistic given the progressive nature of dementia. B is incorrect as learning new coping mechanisms may be challenging for someone with dementia due to cognitive impairment. C is incorrect because relying on the client to seek out resources in the community may not be feasible given their cognitive limitations.
RN exams clinical judgment practice questions, set 131 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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