RN exams clinical judgment practice questions, set 150
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 150
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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 soldier in a combat zone tells the nurse, "I saw a child get blown up over a year ago, and I still keep seeing bits of flesh everywhere. I see something red, and the visions race back to my mind." Which phenomenon associated with PTSD is the soldier describing?
A. Reexperiencing
B. Hyperarousal
C. Avoidance
D. Psychosis
Show answer and rationale
Correct answer: A — Reexperiencing
The correct answer is A: Reexperiencing. The soldier's description aligns with the reexperiencing symptom of PTSD, where traumatic memories intrude into consciousness causing distress. This is evident as the soldier vividly recalls the traumatic event and experiences flashbacks triggered by red objects. Hyperarousal (B) involves heightened sensitivity to potential threats, not the vivid recall of traumatic events. Avoidance (C) refers to efforts to avoid reminders of the trauma, which is not the case here. Psychosis (D) involves a loss of touch with reality, such as hallucinations or delusions, which are not described in the scenario. In summary, the soldier's experience of intrusive memories and flashbacks corresponds to the reexperiencing symptom of PTSD.
Question 2
A few days after a summer hiking trip, a 25-year-old man comes to the clinic with a rash. On examination, the nurse notes that the rash is red and circular with central clearing, and is located across his midriff and behind his knees. The nurse suspects:
A. rubeola.
B. Lyme disease.
C. allergy to mosquito bites.
D. Rocky Mountain spotted fever.
Show answer and rationale
Correct answer: B — Lyme disease.
The correct answer is B: Lyme disease. The presentation of a red circular rash with central clearing, known as erythema migrans, following a hiking trip in the summer is highly indicative of Lyme disease. The specific distribution of the rash across the midriff and behind the knees aligns with typical areas where the rash appears in Lyme disease cases. This rash is a hallmark sign of early Lyme disease caused by the bacterium Borrelia burgdorferi transmitted through the bite of an infected tick. Other answer choices are incorrect because rubeola presents with a different rash pattern, an allergy to mosquito bites would not typically present in this manner, and Rocky Mountain spotted fever typically presents with a different rash appearance and distribution.
Question 3
A nurse is reinforcing teaching with a client who has crutches regarding the use of the three-point gait. Which of the following instructions should the nurse include?
A. Standing with the crutch tips against the feet
B. Bear weight on the unaffected leg
C. Keep the crutches at the level of the axillae
D. Hold the arms straight when walking
Show answer and rationale
Correct answer: B — Bear weight on the unaffected leg
The correct answer is B: 'Bear weight on the unaffected leg.' In the three-point gait, the client should bear weight on the unaffected leg while moving both crutches and the affected leg together. This gait pattern provides maximum stability and balance. Option A is incorrect as the crutch tips should be placed about 6 inches in front of and slightly to the side of the feet. Option C is incorrect as the crutches should not be positioned at the level of the axillae to prevent nerve and tissue damage. Option D is incorrect as the arms should be slightly bent to absorb shock and prevent strain on the wrists and arms. Therefore, instructing the client to bear weight on the unaffected leg is the most appropriate advice for using the three-point gait effectively.
Question 4
A nurse in a prenatal clinic is caring for a client. Using Leopold maneuvers, the nurse palpates a round, firm, moveable part in the fundus of the uterus and a long, smooth surface on the client\'s right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?
A. Left lower
B. Right lower
C. Left upper
D. Right upper
Show answer and rationale
Correct answer: D — Right upper
The correct answer is D: Right upper. During Leopold maneuvers, the nurse palpates for specific fetal positions and parts in the mother's abdomen to determine the baby's presentation. In this scenario, the round, firm, moveable part in the fundus of the uterus indicates the baby's head, which is typically found in the fundal region. The long, smooth surface on the client's right side likely represents the baby's back. Since the baby's back is on the right side, the nurse would expect to auscultate fetal heart tones in the right upper quadrant where the baby's back is located. This is because fetal heart tones are best heard over the baby's back, where the heart is located. Therefore, the nurse should auscultate fetal heart tones in the right upper quadrant.
Question 5
A nurse is using analytic epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing?
A. Reviewing communicable disease statistics
B. Determining factors contributing to childhood obesity
C. Analyzing locations where family violence is increasing
D. Documenting population characteristics for healthy older citizens
Show answer and rationale
Correct answer: B — Determining factors contributing to childhood obesity
The correct answer is B: Determining factors contributing to childhood obesity. Analytic epidemiology involves analyzing the determinants of health and disease in populations. By studying the factors contributing to childhood obesity, the nurse is using analytic epidemiology to identify risk factors, trends, and patterns to develop prevention and intervention strategies. The other choices involve descriptive epidemiology (A: Reviewing communicable disease statistics, C: Analyzing locations where family violence is increasing) and basic data collection (D: Documenting population characteristics for healthy older citizens), which do not involve the in-depth analysis and investigation of causes and contributing factors that characterize analytic epidemiology.
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Question 6
A nurse at a provider's office receives a phone call from a client who reports unrelieved chest pain after taking a nitroglycerin (Nitrostat) tablet 5 minutes ago. Which of the following is an appropriate response by the nurse?
A. Tell the client to take an aspirin.
B. Instruct the client to call 911.
C. Have the client take another nitroglycerin tablet in 15 minutes.
D. Advise the client to come to the office.
Correct answer:
In this scenario, the client reporting unrelieved chest pain after taking a nitroglycerin tablet could be indicative of a serious cardiac event. Instructing the client to call 911 is the most appropriate response because immediate medical attention is necessary for chest pain that is not relieved by nitroglycerin. Telling the client to take an aspirin (Choice A) may not address the urgency of the situation, and aspirin might not be appropriate depending on the client's medical history. Having the client take another nitroglycerin tablet (Choice C) without relief could lead to overdosage. Advising the client to come to the office (Choice D) is not the best course of action when dealing with a potential cardiac emergency that requires immediate intervention.
According to Freud, an individual who experiences problems during the phallic stage of development may have a poorly developed superego. This construct is most relevant to planning care for a client who has the DSM-IV-TR diagnosis of:
A. Obsessive-compulsive personality disorder
B. Schizoid personality
C. Borderline personality disorder
D. Antisocial personality disorder
Correct answer:
Step 1: Freud's phallic stage is when the superego develops.
Step 2: Antisocial personality disorder is associated with a poorly developed superego.
Step 3: Individuals with antisocial personality disorder often lack empathy and have a disregard for rules.
Step 4: This behavior aligns with Freud's concept of a weak superego.
Step 5: Therefore, the correct answer is D, Antisocial personality disorder.
Summary: A: Obsessive-compulsive personality disorder is characterized by perfectionism, not related to a weak superego. B: Schizoid personality is marked by social detachment, not directly linked to superego development. C: Borderline personality disorder involves instability in relationships and self-image, not specifically tied to superego development.
A man is diagnosed with prostate cancer. Which of the following data should the nurse know to answer the man when he asks, “What are the chances I’ll survive this thing?â€Â
A. Attack rate
B. Case fatality rate
C. Cause-specific morbidity rate
D. Crude mortality rate
Correct answer:
The correct answer is B: Case fatality rate. This is the proportion of people diagnosed with a specific disease who die from that disease within a specified period. For a man diagnosed with prostate cancer, the case fatality rate would give him an estimate of the likelihood of dying from the cancer.
A: Attack rate is the proportion of people who develop a specific disease among those exposed to the disease. It does not provide information on survival chances.
C: Cause-specific morbidity rate is the proportion of people with a specific disease in a population. It does not directly indicate survival chances.
D: Crude mortality rate is the total number of deaths from all causes in a population. It does not focus on a specific disease's survival chances.
Oxygen-rich blood is pumped from the left ventricle via the
A. Right ventricle
B. Aorta
C. Capillaries
D. Veins
Correct answer:
The correct answer is B: Aorta. The left ventricle pumps oxygen-rich blood into the aorta, which is the main artery that carries blood away from the heart to the rest of the body. This is a crucial step in the systemic circulation of the circulatory system. The aorta then branches out into smaller arteries, leading to the capillaries where gas exchange occurs.
Explanation for Incorrect Choices:
A: Right ventricle - The right ventricle pumps deoxygenated blood to the lungs, not oxygen-rich blood.
C: Capillaries - Capillaries are tiny blood vessels where gas exchange occurs, but blood is not pumped directly from the left ventricle to capillaries.
D: Veins - Veins carry blood back to the heart, but they do not receive blood directly from the left ventricle.
A nurse in a provider’s office is reviewing the medical record of an older adult who reports having nausea and vomiting for the last 48 hrs. Which of the following findings indicate fluid volume deficit? (Select all that apply.)\nA) Dry mucous membranes.\nB) Decreased skin turgor.\nC) Heart rate 72/min.\nD) Distended neck veins.
A. A, B,
B. A, B, E
C. A, B, c
D. D, B, C
Correct answer:
The correct findings that indicate fluid volume deficit include dry mucous membranes (choice A) and decreased skin turgor (choice B). Dry mucous membranes are a sign of dehydration, indicating a decrease in fluid volume. Decreased skin turgor is another indicator of dehydration, suggesting a deficit in body fluids. The other options, such as a heart rate of 72/min (choice C) and distended neck veins (choice D), are not typical findings of fluid volume deficit. A normal heart rate and absence of distended neck veins do not necessarily point to dehydration. Therefore, choices C and D are not correct in this context. This question assesses the nurse's knowledge of signs and symptoms of fluid volume deficit in older adults presenting with nausea and vomiting.
A nurse in a provider\'s office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?
A. This will determine if there is more than one fetus.
B. It is useful for estimating fetal age.
C. It assists in identifying the location of the placenta and fetus.
D. This is a screening tool for spina bifida.
Correct answer:
The correct answer is C: 'It assists in identifying the location of the placenta and fetus.' Prior to an amniocentesis, an ultrasound is typically performed to determine the position of the placenta and fetus. This information is crucial in guiding the amniocentesis procedure to avoid complications such as puncturing the placenta or harming the fetus. Option A is incorrect because determining the number of fetuses is usually done through ultrasound earlier in pregnancy. Option B is incorrect as estimating fetal age is not the primary purpose of the ultrasound in this scenario. Option D is incorrect as screening for spina bifida is usually done through other tests like maternal serum alpha-fetoprotein screening, not the ultrasound prior to amniocentesis.
.A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention should the nurse implement to address this symptom?
A. Encourage the client to express feelings about the hallucinations.
B. Distract the client from the hallucinations.
C. Provide reality-based feedback about the hallucinations.
D. Encourage the client to ignore the hallucinations.
Correct answer:
Providing reality-based feedback about the hallucinations is the most appropriate nursing intervention for a client with schizophrenia experiencing auditory hallucinations. This intervention helps the client differentiate between what is real and what is not, promoting improved insight and understanding of their condition. Encouraging the client to express feelings about the hallucinations (option A) may not address the core issue of distinguishing reality from hallucinations. Distracting the client (option B) or encouraging them to ignore the hallucinations (option D) may not help the client confront and cope with the symptoms effectively. Therefore, option C is the best choice to help the client manage auditory hallucinations in a constructive manner.
A nurse is completing a health history for a client who is at 6-week gestation. The client informs the nurse that she smokes one park of cigarettes per day. The nurse should advise the client that smoking places the client9s newborn at risk for what complication?
A. Hearing loss
B. Intrauterine growth restriction
C. Type 1 diabetes mellitus
D. Congenital heart defects
Correct answer:
The correct answer is B: Intrauterine growth restriction. Smoking during pregnancy can lead to decreased blood flow to the placenta, which can result in inadequate oxygen and nutrients reaching the developing fetus. This can lead to intrauterine growth restriction, where the baby is smaller than expected for the gestational age. Smoking has been associated with low birth weight, preterm birth, and other complications. Hearing loss (option A) is not directly linked to smoking during pregnancy. Type 1 diabetes mellitus (option C) is an autoimmune condition and not typically caused by smoking. While smoking during pregnancy can increase the risk of congenital heart defects (option D), the primary concern in this scenario is intrauterine growth restriction.
The nurse suspects early complications of immobility in a 45-year-old patient admitted for multiple stab wounds to the chest. What sign would the nurse most likely find? (Select ONE that does not apply.)
A. Increased muscle strength
B. Generalized weakness
C. Moist breath sounds
D. Limited range of motion
Correct answer:
The correct answer is A: 'Increased muscle strength.' When a patient is immobile, their muscles can weaken due to lack of use and atrophy. Therefore, it is unlikely for the nurse to find increased muscle strength in a patient experiencing early complications of immobility. Options B, C, and D are more likely to be present in a patient with early complications of immobility. Generalized weakness, moist breath sounds, and limited range of motion are common signs that can occur due to immobility and underlying conditions such as pneumonia, muscle wasting, and joint stiffness. These signs indicate the need for interventions to prevent further complications associated with immobility, such as deep vein thrombosis, pressure ulcers, and respiratory infections.
A nurse is caring for a client who is postoperative and is preparing to walk for the first time in several days. Which of the following interventions should the nurse give the client to prevent orthostatic hypotension?
A. Perform regular isometric exercise.
B. Increase your intake of protein.
C. Use your incentive spirometer.
D. Dangle your legs over the side of the bed.
Correct answer:
The correct answer is D: 'Dangle your legs over the side of the bed.' This intervention helps the client gradually adjust to an upright position, reducing the risk of orthostatic hypotension. By dangling the legs, blood flow to the legs increases, allowing the body to adapt to the change in position. Isometric exercises (option A) involve muscle contractions without joint movement and may not directly address the issue of orthostatic hypotension. Increasing protein intake (option B) is important for wound healing but does not specifically prevent orthostatic hypotension. Using an incentive spirometer (option C) helps with lung expansion but does not directly address the risk of orthostatic hypotension when mobilizing for the first time postoperatively.
RN exams clinical judgment practice questions, set 150 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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