RN exams clinical judgment practice questions, set 156
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 156
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 is caring for a child who is undergoing surgery. What nursing intervention is most effective in helping the child cope?
A. Encouraging parental participation in care
B. Preparing the child and family about what to expect
C. Providing postoperative pain relief
D. Encouraging peer support for the child
Show answer and rationale
Correct answer: B — Preparing the child and family about what to expect
Preparing the child and family about what to expect is the most effective nursing intervention in helping the child cope with surgery. By providing information and education about the surgical procedure, potential sensations, and recovery process, the child and family can feel more prepared and less anxious. This proactive approach promotes a sense of control and reduces fear of the unknown, ultimately improving the child's coping mechanisms. Encouraging parental participation in care, providing postoperative pain relief, and encouraging peer support are also important interventions, but preparing the child and family about what to expect is foundational in reducing anxiety and promoting coping skills.
Question 2
A nurse is preparing a client for a colonoscopy. What instructions should the nurse give?
A. Eat a light breakfast the day of the procedure.
B. Drink clear liquids 24 hours before the procedure.
C. Take a laxative the night before the procedure.
D. Refrain from all food and drink 12 hours before the procedure.
Show answer and rationale
Correct answer: B — Drink clear liquids 24 hours before the procedure.
The correct answer is B: 'Drink clear liquids 24 hours before the procedure.' This instruction is crucial to ensure the colon is clear for the colonoscopy, as consuming only clear liquids helps to avoid any solid residue in the colon that could obstruct the view during the procedure. Eating a light breakfast (A) may introduce solid residue, taking a laxative (C) is typically done closer to the procedure time, and refraining from all food and drink (D) for 12 hours could lead to dehydration and discomfort for the client. Clear liquids include water, plain tea or coffee without milk, clear juices without pulp, and broth. Following this instruction helps in achieving a successful and accurate colonoscopy.
Question 3
After having an I.V. line in place for 72 hours, a patient complains of tenderness, burning, and swelling. Assessment of the I.V. site reveals that it is warm and erythematous. This usually indicates:
A. Infection
B. Infiltration
C. Phlebitis
D. Bleeding
Show answer and rationale
Correct answer: C — Phlebitis
The correct answer is C: Phlebitis. Phlebitis is inflammation of the vein, which can be caused by various factors including prolonged catheterization. Symptoms of phlebitis include tenderness, warmth, redness, and swelling at the site of the intravenous catheter. In contrast, infiltration refers to the leaking of intravenous fluid into the surrounding tissues, which may cause swelling and discomfort but not necessarily warmth or redness. Infection at an IV site would typically present with additional signs such as fever and pus. Bleeding would manifest as visible blood at the insertion site. Therefore, in this scenario, the warm, erythematous, and tender IV site suggests phlebitis as the likely cause.
Question 4
The nurse is assessing a client with a head injury. The nurse notes that the client opens the eyes only in response to pain, responds with sounds that are not understandable, and has abnormal extension of the extremities. The client\'s Glasgow coma scale score is 6. What is the nurse\'s next action?
A. Attempt to arouse the client
B. I may still be aware of what\'s happening with general anesthesia.
C. An epidural is used for general anesthesia.
D. When I had my skin cancer removed on my leg, the doctor used general anesthesia to numb the area.
Show answer and rationale
Correct answer: D — When I had my skin cancer removed on my leg, the doctor used general anesthesia to numb the area.
The correct answer is D because the client's Glasgow Coma Scale (GCS) score of 6 indicates severe brain injury. In this scenario, the client is only responsive to pain stimuli, has incomprehensible sounds, and shows abnormal extension of extremities. Using general anesthesia for a skin cancer removal procedure, as mentioned in option D, is irrelevant to the assessment of a client with a head injury and a low GCS score. The nurse's priority should be to provide immediate medical attention and interventions to stabilize the client's condition and prevent further neurological deterioration. Options A, B, and C do not address the critical situation presented in the question, making them incorrect choices.
Question 5
A nurse is preparing a client for surgery. What medication should be administered preoperatively?
A. Antibiotics to prevent infection.
B. Sedatives to reduce anxiety.
C. Pain management medications.
D. Anticoagulants to prevent blood clots.
Show answer and rationale
Correct answer: B — Sedatives to reduce anxiety.
The correct answer is B: Sedatives to reduce anxiety. Preoperative sedatives are commonly administered to help reduce a patient's anxiety and promote relaxation before surgery. This can help the patient feel calmer and more comfortable going into the surgical procedure. Antibiotics (option A) are typically given intraoperatively to prevent infection during surgery. Pain management medications (option C) are usually administered postoperatively to manage pain after the procedure. Anticoagulants (option D) may be given postoperatively to prevent blood clots. Therefore, the most appropriate medication to administer preoperatively in this scenario is a sedative to help the client relax and reduce anxiety.
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Question 6
What make you think is the most effective leadership style that can be used during emergency situations?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Supportive
Correct answer:
During emergency situations, an autocratic leadership style is often the most effective. This style involves a leader making quick decisions without consulting others, which can be crucial in urgent and high-stress situations where immediate action is needed. Autocratic leaders provide clear direction and can ensure swift and decisive responses to emergencies, helping to maintain order and safety. In contrast, democratic and laissez-faire styles may be too slow or lack the necessary authority and decisiveness required during emergencies. Supportive leadership, while important for morale and motivation, may not be as effective in rapidly changing and high-pressure situations as an autocratic approach.
.After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, \'You are incompetent!\' Which is the nurse\'s best response?
A. Do you believe that I was the cause of your blood test being canceled?
B. I see that you are upset, but I feel uncomfortable when you swear at me.
C. Have you ever thought about ways to express anger appropriately?
D. I\'ll give you some space. Let me know if you need anything.
Correct answer:
The correct response, option B, addresses the client's behavior assertively by acknowledging their emotions ('I see that you are upset') and setting a boundary ('I feel uncomfortable when you swear at me'). This response validates the client's feelings while also emphasizing the impact of their behavior on the nurse. By calmly expressing discomfort with the swearing, the nurse maintains professionalism and encourages respectful communication. Options A and C do not directly address the inappropriate behavior and may escalate the situation. Option D, while offering space, does not address the swearing or establish boundaries for communication. Therefore, option B is the best response in this scenario.
A nurse is conducting a class for a group of adolescent girls about the menstrual cycle. The nurse determines that the class was successful when the girls identify the source of the menstrual blood as being from which layer of the uterus?
A. endometrium
B. myometrium
C. perimetrium
D. cervix
Correct answer:
The correct answer is A: "endometrium." The endometrium is the inner lining of the uterus that thickens and sheds during the menstrual cycle. It is the layer where the blood vessels are located, allowing for the shedding of the lining and resulting in menstrual bleeding. The myometrium is the middle layer of the uterus composed of smooth muscle, responsible for contracting during menstruation and childbirth. The perimetrium is the outer layer of the uterus that covers the organ. The cervix is the lower part of the uterus that connects to the vagina and is not the source of menstrual blood. Understanding the source of menstrual blood helps adolescent girls grasp the biological process of menstruation.
A nurse is planning care for a newborn who is post-term. Which of the following characteristics should the nurse expect?
A. Vernix caseosa covering the body
B. Long, brittle nails
C. Abundant lanugo
D. Thin, translucent skin
Correct answer:
The correct answer is B: Long, brittle nails. Post-term newborns are babies born after 42 weeks gestation, which can result in longer exposure to amniotic fluid. This extended time in the womb can lead to the baby having long, overgrown nails that may appear brittle. Vernix caseosa covering the body (A) is typically seen in full-term newborns to protect their skin in utero. Abundant lanugo (C) is fine, downy hair that is also more common in premature or low birth weight babies. Thin, translucent skin (D) is a characteristic of premature newborns, not post-term babies. Therefore, the nurse should expect to see long, brittle nails in a post-term newborn due to the extended exposure to amniotic fluid.
.A nurse is providing discharge instructions to a client who has been prescribed lorazepam (Ativan) for the treatment of anxiety. Which of the following instructions should the nurse include?
A. Take the medication with food to avoid stomach upset.
B. Avoid driving until you know how the medication affects you.
C. Take the medication on an empty stomach.
D. Double the dose if you miss a dose.
Correct answer:
The correct answer is B: "Avoid driving until you know how the medication affects you." This instruction is crucial because lorazepam (Ativan) is a benzodiazepine medication that can cause drowsiness, dizziness, and impair cognitive function. Driving or operating heavy machinery while under the influence of lorazepam can be dangerous. It is important for the client to understand the potential side effects of the medication before engaging in activities that require mental alertness. Taking the medication with food, on an empty stomach, or doubling the dose if a dose is missed are not appropriate instructions for lorazepam and could lead to adverse effects or reduced effectiveness of the medication.
The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session?
A. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature.
B. The empty ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen.
C. About day 14, a surge of hormones cause the ovum to burst through the ovary.
D. The uterus prepares for implantation of an ovum.
Correct answer:
During the follicular phase of the ovarian cycle, follicle-stimulating hormone (FSH) stimulates several follicles in the ovaries to start maturing. Each follicle contains an ovum (egg) that begins to mature within it. This process is crucial for the eventual release of a mature egg during ovulation. The other options are incorrect: Option B describes events during the luteal phase, where the ruptured follicle becomes the corpus luteum. Option C refers to ovulation, which occurs around day 14 but is not specific to the follicular phase. Option D involves the uterine lining preparing for implantation, which is part of the menstrual cycle but not specifically the follicular phase of the ovarian cycle.
What can be done to reduce a group\'s primary tension?
A. Establish clear lines of communication among members
B. Establish clear roles among members
C. Take the time for members to get acquainted
D. None of the above
Correct answer:
Primary tension refers to the initial discomfort or awkwardness that arises in a group due to members not knowing each other. Taking the time for members to get acquainted is an effective way to reduce this tension as it helps build rapport and familiarity among members. Establishing clear lines of communication (option A) can help reduce task-related tensions, while establishing clear roles (option B) can help reduce secondary tension, which arises from conflicts over responsibilities. However, in this case, the focus is on reducing primary tension through member acquaintance. Therefore, option C is the correct answer as it directly addresses the specific type of tension mentioned in the question.
The LPN/LVN is to interview a newly admitted patient. For which of these reasons should the nurse review the patient\'s records before beginning the interview?
A. To check the accuracy of those records
B. To avoid asking the patient to repeat information already obtained
C. To determine other people\'s opinion of the patient\'s problems
D. To learn as much about the disease process as possible
Correct answer:
The correct answer is B. Reviewing the patient's records before the interview helps the nurse avoid asking the patient to repeat information already obtained, which can demonstrate respect for the patient's time and prevent potential frustration. It also allows the nurse to be prepared with relevant information and tailor their questions effectively. Checking the accuracy of the records (option A) is important but not the primary reason for reviewing them before the interview. Determining other people's opinions of the patient's problems (option C) and learning about the disease process (option D) are not directly related to the immediate need of avoiding redundant questioning during the interview.
A nurse is caring for a client who is receiving oxytocin for induction of labor and notes late decelerations of the fetal heart rate on the monitor Tracing. Which of the following action should the nurse take?
A. Decrease maintenance IV solution infusion rate.
B. Place the client in lateral position.
C. Administer misoprostol 25 mcg vaginally D
D. Administer oxygen via face mask at 2 L/min
Correct answer:
The correct answer is B: 'Place the client in lateral position.' Late decelerations on the fetal heart rate monitor tracing indicate uteroplacental insufficiency, where the fetus is not receiving enough oxygen during contractions. Changing the client's position to a lateral position can help improve blood flow to the placenta, potentially alleviating the late decelerations. Decreasing the IV infusion rate (Option A) may not address the underlying issue of reduced oxygenation, administering misoprostol (Option C) can be contraindicated during labor, and administering oxygen (Option D) may be necessary but placing the client in a lateral position is the initial priority to improve fetal oxygenation.
.How is the DSM-5 not useful in the practice of psychiatric nursing?
A. It informs the nurse of accurate and reliable medical diagnosis.
B. It represents progress toward a more holistic view of mind-body.
C. It provides a framework for interdisciplinary communication.
D. It provides a template for nursing care plans.
Correct answer:
The DSM-5, while a valuable resource for psychiatric diagnosis, is not specifically designed to guide nursing care plans. Nursing care plans in psychiatric nursing require a more comprehensive and individualized approach that considers not only the diagnosis but also the patient's unique needs, preferences, and responses to treatment. Nursing care plans should encompass a holistic view of the patient, taking into account their physical, psychological, social, and spiritual aspects. Therefore, while the DSM-5 is essential for accurate diagnosis, it does not directly provide the detailed framework needed for developing tailored nursing care plans, making option D the correct answer in this scenario.
RN exams clinical judgment practice questions, set 156 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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