RN exams clinical judgment practice questions, set 147
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 147
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
Transient tachypnea of the neonate develops due to what pathophysiologic phenomenon?
A. failure to clear lung fluid by the usual mechanism
B. failure of the patent ductus arteriosus to close
C. insufficient surfactant production
D. aspiration of meconium during vaginal or cesarean birth that interferes with surfactant activity
Show answer and rationale
Correct answer: A — failure to clear lung fluid by the usual mechanism
The correct answer is A because transient tachypnea of the neonate is primarily caused by the failure to clear lung fluid by the usual mechanism. During birth, the baby may not expel the lung fluid properly, leading to respiratory distress. This results in rapid breathing (tachypnea) due to the retained fluid in the lungs. The other choices are incorrect as they do not directly relate to the pathophysiology of transient tachypnea. Choice B involves the heart (patent ductus arteriosus), choice C relates to insufficient surfactant production seen in respiratory distress syndrome, and choice D mentions meconium aspiration syndrome, which is a different condition caused by the aspiration of meconium into the lungs, not related to the failure to clear lung fluid.
Question 2
An elderly client seems confused and reports the onset of nausea, dysuria, and urgency with incontinence. Which action should the nurse implement?
A. Auscultate for renal bruits
B. Obtain a clean catch mid-stream specimen
C. Use a dipstick to measure for urinary ketones
D. Begin to strain the client's urine
Show answer and rationale
Correct answer: B — Obtain a clean catch mid-stream specimen
This elderly client is presenting symptoms consistent with a urinary tract infection (UTI), such as confusion, nausea, dysuria, urgency, and incontinence. The best course of action for the nurse is to obtain a clean catch mid-stream specimen. This specimen will help identify the causative agent of the UTI, allowing for targeted treatment with an appropriate anti-infective agent. Auscultating for renal bruits (Choice A) is not indicated in this scenario as the client's symptoms point towards a UTI rather than a renal issue. Using a dipstick to measure for urinary ketones (Choice C) is not relevant in the context of UTI symptoms. Beginning to strain the client's urine (Choice D) would not address the need to identify the causative agent for targeted treatment.
Question 3
The nurse is reviewing a list of foods high in folic acid with a patient who is considering becoming pregnant. The nurse determines that the patient understands the teaching when the patient states she will include which list of foods in her diet?
A. Peaches, yogurt, and tofu
B. Strawberries, milk, and tuna
C. Asparagus, lemonade, and chicken breast
D. Spinach, orange juice, and fortified bran flakes
Show answer and rationale
Correct answer: D — Spinach, orange juice, and fortified bran flakes
The correct answer is D. Spinach, orange juice, and fortified bran flakes are high in folic acid, which is essential for pregnant women to prevent neural tube defects in the fetus. Spinach is rich in folate, the natural form of folic acid. Orange juice is often fortified with folic acid, and fortified bran flakes also contain high levels of folic acid.
A, B, and C are incorrect choices because they do not contain foods that are particularly high in folic acid. While peaches, yogurt, tofu, strawberries, milk, tuna, asparagus, lemonade, and chicken breast are all nutritious choices, they are not as rich in folic acid as the foods listed in option D. It is crucial for the patient to focus on foods with high folic acid content to support a healthy pregnancy.
Question 4
The charge nurse tells the staff to choose their own assignments and work it out with each other. What type of leadership style is this charge nurse demonstrating?
A. Laissez-faire
B. Democratic
C. Transactional
D. Autocratic
Show answer and rationale
Correct answer: A — Laissez-faire
The correct answer is A: Laissez-faire. This leadership style is characterized by minimal supervision and allowing employees to make their own decisions. In this scenario, the charge nurse is giving the staff the autonomy to choose their assignments and resolve any conflicts themselves, reflecting a hands-off approach typical of laissez-faire leadership.
Incorrect choices:
B: Democratic leadership involves collaborative decision-making, which is not evident in the scenario.
C: Transactional leadership is based on a system of rewards and punishments for performance, which is not demonstrated here.
D: Autocratic leadership is characterized by a top-down approach with strict control and little input from employees, which is not the case in this scenario.
Question 5
You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this case?
A. Cluster sampling
B. Random sampling
C. Stratified sampling
D. Systematic sampling
Show answer and rationale
Correct answer: C — Stratified sampling
The correct method to use in this case is C: Stratified sampling. This method divides the population into subgroups (strata) based on certain characteristics (in this case, barangays) and then samples randomly from each stratum. This ensures representation from each barangay, leading to a more accurate overall estimate. Cluster sampling (A) involves dividing the population into clusters and then randomly selecting entire clusters, which may not guarantee representation from each barangay. Random sampling (B) involves selecting individuals randomly from the entire population without considering strata, leading to potential bias. Systematic sampling (D) involves selecting every nth individual from a list, which may not ensure representation from each barangay.
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 47 year old house painter is brought to the hospital after falling 6 meters from a ladder and landing straddled on a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study for evaluation of the urinary tract in this patient should be:
A. "Cystoscopy"
B. "Cystography"
C. "IV pyelography"
D. "Retrograde urethrography"
Correct answer:
The correct answer is D: "Retrograde urethrography." In this case, the patient presents with blood in the external urethral meatus, indicating a possible urethral injury. Retrograde urethrography is the most appropriate initial diagnostic study to evaluate the integrity of the urethra. This procedure involves injecting contrast material into the urethra to visualize any disruptions or strictures. Cystoscopy (choice A) is invasive and not the initial study of choice for evaluating urethral injuries. Cystography (choice B) is used to assess bladder injuries, not urethral injuries. IV pyelography (choice C) is used to assess the kidneys and ureters, not the urethra. Therefore, retrograde urethrography is the most suitable option for this patient's presentation.
According to __________ theory, children learn primarily through modeling.
A. reinforcement
B. operant conditioning
C. social learning
D. classical conditioning
Correct answer:
According to social learning theory, children primarily learn through modeling, observation, and imitation of others. This theory emphasizes the importance of cognitive processes in learning, as opposed to only focusing on direct reinforcement or punishment. Social learning theory was developed by psychologist Albert Bandura and is a key theory in the field of child development. Choice A, reinforcement, is incorrect as it refers to the process of strengthening a behavior through rewards or punishments. Choice B, operant conditioning, is also incorrect as it is a learning process that involves reinforcement and punishment to shape behavior. Choice D, classical conditioning, is not the correct answer as it involves learning through association between stimuli.
An adult male is brought to the emergency department following a motorcycle accident, presenting with periorbital bruising and bloody drainage from both ears. Which assessment finding warrants immediate intervention by the nurse?
A. Rebound abdominal tenderness.
B. Diminished bilateral breath sounds.
C. Rib pain with deep inspiration.
D. Nausea with projectile vomiting.
Correct answer:
In this scenario, the patient's presentation with periorbital bruising and bloody ear drainage suggests a basilar skull fracture. Projectile vomiting, as described in choice D, is concerning for increased intracranial pressure due to the skull fracture. This finding warrants immediate intervention to prevent further neurological compromise. Choices A, B, and C are not the priority in this situation. Rebound abdominal tenderness (choice A) is indicative of intra-abdominal injury but is not as urgent as managing potential intracranial issues. Diminished breath sounds (choice B) and rib pain with deep inspiration (choice C) may suggest underlying chest injuries, which need attention but are not as immediately life-threatening as increased intracranial pressure.
The VALUE mnemonic is a helpful strategy to enhance communication with family members of critically ill patients. Which of the following statements describes a VALUE strategy?
A. View the family as guests on the unit.
B. Acknowledge family emotions.
C. Learn as much as you can about family structure and f unction.
D. Use a trained interpreter if the family does not speak English.
Correct answer:
The correct answer is B: Acknowledge family emotions. This is a key component of the VALUE strategy as it emphasizes empathy and understanding towards the emotions that family members may be experiencing during a difficult time. By acknowledging their emotions, healthcare providers can build trust and establish a supportive relationship with the family.
Choice A is incorrect because the VALUE strategy focuses on treating family members as integral members of the care team, not just as guests. Choice C is incorrect as learning about family structure and function is important but not specifically part of the VALUE strategy. Choice D is incorrect as using a trained interpreter is important for effective communication but is not specific to the VALUE mnemonic.
You decided to include 5 barangays in your municipality and chose a sampling method that would get representative samples from each barangay. What should be the appropriate method for you to use in this case?
A. Cluster sampling
B. Random sampling
C. Stratified sampling
D. Systematic sampling
Correct answer:
The correct method to use in this case is C: Stratified sampling. This method divides the population into subgroups (strata) based on certain characteristics (in this case, barangays) and then samples randomly from each stratum. This ensures representation from each barangay, leading to a more accurate overall estimate. Cluster sampling (A) involves dividing the population into clusters and then randomly selecting entire clusters, which may not guarantee representation from each barangay. Random sampling (B) involves selecting individuals randomly from the entire population without considering strata, leading to potential bias. Systematic sampling (D) involves selecting every nth individual from a list, which may not ensure representation from each barangay.
Which of the following situations would require a sterile dressing?
A. A paper cut
B. An intact wound
C. A draining wound
D. A clean dry wound
Correct answer:
The correct answer is C: A draining wound. Sterile dressings are necessary for draining wounds to prevent infection and promote proper healing. Draining wounds have an increased risk of contamination, making the use of sterile dressings essential. Choice A, a paper cut, typically does not require a sterile dressing as it is a minor wound. Choice B, an intact wound, does not require a sterile dressing unless there is a risk of infection. Choice D, a clean dry wound, also does not require a sterile dressing as long as it remains clean and dry. In summary, choice C is correct because draining wounds require sterile dressings to prevent infection, while the other choices do not necessarily require sterile dressings unless there are specific risk factors present.
A community health nurse determines exactly how many cases of a particular disease were occurring in the community. Which action should be taken by the nurse before determining which intervention should be planned?
A. Compare the current rate with the previous rate of diseases
B. Nothing can be done
C. Report to the state health department
Correct answer:
Step 1: Comparing current rate with previous rate helps identify trends and if disease is increasing or decreasing.
Step 2: This information is crucial to determine the urgency and effectiveness of interventions.
Step 3: It guides the nurse in selecting appropriate strategies based on the disease trend.
Step 4: This step is essential before planning any intervention, as it provides a baseline for decision-making.
Summary:
- Option B is incorrect because inaction is not an appropriate response for a public health nurse.
- Option C is incorrect as reporting to the state health department comes after assessing the situation.
- Option D is incomplete. The correct answer is A because it is essential for informed decision-making in planning interventions.
Which of the following is the most common site of fertilization in females?
A. Uterus
B. Ovary
C. Fallopian tube
D. Cervix
Correct answer:
The correct answer is C: Fallopian tube. Fertilization typically occurs in the fallopian tube, where sperm meets the egg. The fallopian tube provides a suitable environment for fertilization to take place due to its proximity to the ovary, where ovulation occurs. Sperm travel through the fallopian tube to reach the egg, and once fertilization occurs, the resulting zygote then travels down to the uterus for implantation.
Incorrect answers:
A: Uterus - Fertilization does not occur in the uterus as it is the site for implantation of the fertilized egg.
B: Ovary - Ovulation occurs in the ovary, but fertilization usually takes place in the fallopian tube.
D: Cervix - The cervix serves as the entrance to the uterus and does not play a role in fertilization.
An 11-year-old child stays home from school to care for his siblings while his mother works, is demeaned by his father, and has negative self-perceptions. Which intervention(s) would be appropriate? Select all that apply.
A. Crisis intervention
B. Create a safety plan.
C. Refer to family therapy.
D. Refer for case management.
Correct answer:
The correct answer is A: Crisis intervention. This is appropriate because the child is experiencing multiple stressors that require immediate support. Crisis intervention focuses on providing immediate assistance to individuals in distress and can help address the child's current emotional and psychological needs.
Summary of other choices:
B: Creating a safety plan may be relevant if there are safety concerns, but it does not address the child's emotional well-being.
C: Referring to family therapy may be beneficial in addressing family dynamics, but it may not be the most urgent intervention in this case.
D: Referring for case management is important for coordinating services, but it may not provide the immediate emotional support needed in this situation.
A 47 year old house painter is brought to the hospital after falling 6 meters from a ladder and landing straddled on a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study for evaluation of the urinary tract in this patient should be:
A. "Cystoscopy"
B. "Cystography"
C. "IV pyelography"
D. "Retrograde urethrography"
Correct answer:
The correct answer is D: "Retrograde urethrography." In this case, the patient presents with blood in the external urethral meatus, indicating a possible urethral injury. Retrograde urethrography is the most appropriate initial diagnostic study to evaluate the integrity of the urethra. This procedure involves injecting contrast material into the urethra to visualize any disruptions or strictures. Cystoscopy (choice A) is invasive and not the initial study of choice for evaluating urethral injuries. Cystography (choice B) is used to assess bladder injuries, not urethral injuries. IV pyelography (choice C) is used to assess the kidneys and ureters, not the urethra. Therefore, retrograde urethrography is the most suitable option for this patient's presentation.
RN exams clinical judgment practice questions, set 147 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.
