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RN exams clinical judgment practice questions, set 154

RN exams · clinical judgment

RN exams clinical judgment practice questions set 154

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

The nurse reinforces the use of an incentive spirometer to a patient with a blunt chest injury. Understanding of nursing instructions is clear when the patient:

  1. A. exhales normally.
  2. B. takes rapid, shallow breaths.
  3. C. seals the mouthpiece during exhalation.
  4. D. tilts the incentive spirometer.
Show answer and rationale

Correct answer: C — seals the mouthpiece during exhalation.

The correct answer is C: 'seals the mouthpiece during exhalation.' When using an incentive spirometer, the patient should seal their lips tightly around the mouthpiece to ensure that all the inhaled air goes into the lungs and not out through the mouth. This technique helps to maximize the effectiveness of the therapy and ensures that the patient is receiving the intended benefit of improving lung function. Options A and B are incorrect as they do not demonstrate proper use of the incentive spirometer. Option D is also incorrect as tilting the spirometer would not facilitate proper inhalation technique. Therefore, the best answer is C as it reflects the correct technique for using an incentive spirometer effectively.

Question 2

A nurse is assessing a client with suspected tuberculosis. What test is commonly used for diagnosis?

  1. A. X-ray
  2. B. Sputum culture
  3. C. Skin biopsy
  4. D. Mantoux test
Show answer and rationale

Correct answer: D — Mantoux test

The correct answer is D: Mantoux test. The Mantoux test, also known as the tuberculin skin test, is commonly used for diagnosing tuberculosis. This test involves injecting a small amount of tuberculin protein derivative under the skin and checking for a delayed hypersensitivity reaction, which indicates exposure to the tuberculosis bacteria. X-ray may show signs of active tuberculosis but is not a definitive diagnostic test. Sputum culture can confirm the presence of the bacteria but is not as commonly used for initial diagnosis. A skin biopsy is not typically used for diagnosing tuberculosis. Therefore, the Mantoux test is the most appropriate test for initial diagnosis in a client suspected of having tuberculosis.

Question 3

A nurse is planning care for a client who is postpartum and has cardiac disease. For what script should the nurse seek clarification?

  1. A. Monitor clients wt. weekly
  2. B. Monitor blood pressure daily
  3. C. Monitor fluid intake and output
  4. D. Monitor for signs of heart failure
Show answer and rationale

Correct answer: A — Monitor clients wt. weekly

The correct answer is A: 'Monitor clients wt. weekly.' In the postpartum period, monitoring the client's weight daily is essential to detect any sudden weight gain, which could indicate fluid retention and potential exacerbation of cardiac disease. Weekly monitoring may not provide timely information to intervene if there is a sudden change. Monitoring blood pressure daily (B) is important for clients with cardiac disease to detect any hypertension. Monitoring fluid intake and output (C) is crucial to maintain fluid balance and prevent fluid overload. Monitoring for signs of heart failure (D) is important, but daily weight monitoring is more critical for early detection of fluid retention in this client population.

Question 4

A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have duration of 1 min and a frequency of 3 min. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min and maternal blood pressure 92/54 mmHg. Which of the following is the priority action for the nurse to take?

  1. A. Notify the provider of the findings.
  2. B. Position the client with one hip elevated.
  3. C. Ask the client if she needs pain medication.
  4. D. Have the client void.
Show answer and rationale

Correct answer: B — Position the client with one hip elevated.

The priority action for the nurse to take in this situation is to position the client with one hip elevated. This positioning helps optimize fetal oxygenation by improving blood flow through the maternal and placental vessels, especially in cases where the client may be experiencing contractions. Elevating one hip can alleviate pressure on the vena cava, reducing the risk of supine hypotension syndrome. This intervention can help improve maternal and fetal well-being while awaiting further assessment or intervention. Notifying the provider, offering pain medication, or having the client void can be important actions but positioning the client to improve blood flow and oxygenation takes precedence in this scenario.

Question 5

A woman comes to the clinic reporting that she has little sexual desire. As part of the client\'s evaluation, the nurse would anticipate the need to evaluate which hormone level?

  1. A. progesterone
  2. B. estrogen
  3. C. gonadotropin-releasing hormone
  4. D. testosterone
Show answer and rationale

Correct answer: D — testosterone

The correct answer is D: testosterone. Testosterone plays a crucial role in both male and female sexual desire. In women, it is produced in the ovaries and adrenal glands and contributes to sexual arousal and libido. Low levels of testosterone in women can lead to decreased sexual desire. Therefore, evaluating the woman's testosterone levels would be important in assessing her reported lack of sexual desire. Progesterone (A) is primarily involved in the menstrual cycle and pregnancy, estrogen (B) is important for female reproductive health but not directly linked to sexual desire, and gonadotropin-releasing hormone (C) regulates the production of reproductive hormones but is not directly related to sexual desire.

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Question 6

.Which statement by the nurse indicates an understanding of the DSM-5 diagnosis?

  1. A. The DSM-5 includes information on cultural considerations.
  2. B. The DSM-5 is a tool for healthcare providers.
  3. C. The DSM-5 is not used for legal purposes.
  4. D. The DSM-5 includes information on the prevalence of mental disorders.
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Question 7

Which describes the major purpose of anticipatory guidance?

  1. A. To provide information about normal growth and development
  2. B. To provide information about developmental milestones
  3. C. To help parents anticipate the child\'s needs at each developmental stage
  4. D. To provide support for family caregivers
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Question 8

A nurse is providing discharge teaching to a client who is breastfeeding. Which of the following instructions should the nurse include?

  1. A. Feed the newborn every 4 hours.
  2. B. Apply warm compresses to the breasts after each feeding.
  3. C. Wear a supportive bra throughout the day and night.
  4. D. Pump the breasts twice daily.
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Question 9

A nurse is assessing a 2-day old newborn and notes an egg-shaped, edematous, bluish discoloration that does not cross the suture line. What pieces of info should the nurse provide to the mother when she inquiries about the finding?

  1. A. This will require surgical intervention.
  2. B. This is a sign of a birth injury.
  3. C. This will resolve within 3-6 weeks without treatment.
  4. D. This will require medical treatment.
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Question 10

A nurse is assessing a client with anemia. What laboratory test is most relevant?

  1. A. White blood cell count
  2. B. Hemoglobin level
  3. C. Platelet count
  4. D. Electrolyte levels
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Question 11

A nurse is educating a client about hypertension management. What lifestyle change is recommended?

  1. A. Increase salt intake.
  2. B. Decrease fiber intake.
  3. C. Increase physical activity.
  4. D. Increase alcohol consumption.
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Question 12

.A client with major depressive disorder is receiving electroconvulsive therapy (ECT). Which of the following is a priority assessment for the nurse after the procedure?

  1. A. Monitoring for signs of infection
  2. B. Monitoring for signs of respiratory distress
  3. C. Monitoring for signs of hypotension
  4. D. Monitoring for signs of bleeding
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Question 13

Which of the following is NOT a function of the placenta?

  1. A. respiratory gas transfer
  2. B. waste elimination
  3. C. nutrient transfer
  4. D. urine formation
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Question 14

The nurse is administering a tap-water enema. When the patient begins to complain of abdominal cramping, the nurse should:

  1. A. stop administration of the enema.
  2. B. lower the height of the container of water.
  3. C. clamp the enema tubing and withdraw it slowly.
  4. D. advance the tubing 1 to 2 inches.
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Question 15

.A nurse is providing education to a client who has been prescribed lithium for bipolar disorder. Which statement by the client indicates a need for further teaching?

  1. A. I should avoid eating aged cheeses and processed meats.
  2. B. I need to maintain a consistent sodium intake.
  3. C. I should drink plenty of fluids to stay hydrated.
  4. D. I can take over-the-counter medications without consulting my doctor.
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About these RN exams clinical judgment questions

RN exams clinical judgment practice questions, set 154 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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