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RN exams clinical judgment practice questions, set 16

RN exams · clinical judgment

RN exams clinical judgment practice questions set 16

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

During resuscitation ,which one of the following is the most reliable as a guide to volume replacement?

  1. A. Heart rate
  2. B. Hematocrit
  3. C. Blood pressure
  4. D. Urinary output
Show answer and rationale

Correct answer: D — Urinary output

The correct answer is D: Urinary output. Urinary output is the most reliable guide to volume replacement during resuscitation because it directly reflects the perfusion of vital organs and the body's ability to eliminate excess fluid. Adequate urinary output indicates effective fluid resuscitation, while decreased urinary output may indicate inadequate perfusion and the need for further volume replacement. Monitoring urinary output helps ensure appropriate fluid balance and prevents complications such as fluid overload or organ damage. Other choices are not as reliable for volume replacement guidance: A: Heart rate can be influenced by various factors such as pain, stress, medications, and underlying medical conditions. B: Hematocrit reflects the concentration of red blood cells in the blood, which may not accurately reflect volume status during resuscitation. C: Blood pressure can be affected by many factors such as medications, pain, and underlying conditions, making it less reliable as a sole guide for volume replacement.

Question 2

During orientation, a novice nurse sits and "virtually spends" the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing?

  1. A. Honeymoon
  2. B. Shock or rejection
  3. C. Recovery
  4. D. Resolution
Show answer and rationale

Correct answer: A — Honeymoon

The nurse is experiencing the "Honeymoon" phase of reality shock. In this phase, individuals feel excited, optimistic, and idealistic about their new role and workplace. The nurse's positive visualization of enjoying the benefits of their hard work during orientation aligns with the honeymoon phase. This phase is characterized by a sense of satisfaction, fulfillment, and a belief that the sacrifices made, such as enduring nursing school, were worth it. The nurse's emotional state of smiling and feeling content reflects the honeymoon phase. Other choices are incorrect: B: Shock or rejection - This phase involves feeling overwhelmed, anxious, and doubting one's abilities. The nurse's positive emotions do not align with this phase. C: Recovery - This phase involves adjusting and finding ways to cope with the challenges of the new role. The nurse is not in a phase of recovery as they are not struggling or adapting to the new environment. D: Resolution - This phase involves accepting the reality of the new role and moving forward

Question 3

Mr. Costigan is a 50-year-old male patient who recently had a screening colonoscopy because it was recommended by his primary care provider as a screening measure. He received a report that noted inflammatory polyps. He is concerned because one of his friends had polyps that turned into cancer. While advising Mr. Costigan, the AGACNP tells him that

  1. A. The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant
  2. B. The primary danger is when there is a family history of colon cancer; he should discuss with his mother and father the presence of any colon cancer in the family
  3. C. There is no chance that these polyps could become cancerous, and their presence does not require any additional action or concern on his part
  4. D. He would be best served at this point to discuss with an oncologist the risks and benefits of aggressive versus conservative treatment.
Show answer and rationale

Correct answer: A — The polyps are considered precancerous, but if he has a colonoscopy every 3 to 5 years, any new polyps can be removed before they become malignant

The correct answer is A because inflammatory polyps are indeed considered precancerous, meaning they have the potential to develop into cancer over time. By having regular colonoscopies every 3 to 5 years, any new polyps can be detected early and removed before they have a chance to become malignant. This approach helps in preventing the progression of polyps to cancerous lesions, thus reducing the risk of developing colon cancer. Choice B is incorrect because while family history is a risk factor for colon cancer, the presence of inflammatory polyps in Mr. Costigan should not be overlooked or solely attributed to family history. Choice C is incorrect because all polyps have the potential to become cancerous, including inflammatory polyps. Ignoring their presence can lead to missed opportunities for early intervention. Choice D is incorrect because at this stage, the primary focus should be on surveillance and prevention through regular colonoscopies, rather than jumping into discussions about aggressive treatment options.

Question 4

A school nurse is teaching a 14-year-old girl of normal weight some of the key factors necessary to maintain good nutrition in this stage of her growth and development. What interventions should the t nurse most likely prioritize? r A

  1. A. Decreasing her calorie intake and encouraging her to maintain her weight to avoid obesity
  2. B. Increasing her BMI, taking a multivitamin, and discussing body image s
  3. C. Increasing calcium intake, eating a balanced diet, and discussing eating disorders e
  4. D. Obtaining a food diary along with providing close monitoring for anorexia t
Show answer and rationale

Correct answer: C — Increasing calcium intake, eating a balanced diet, and discussing eating disorders e

The correct answer is C because at the age of 14, a girl of normal weight should focus on increasing calcium intake for bone development, eating a balanced diet for overall health, and discussing eating disorders for awareness and prevention. This is crucial during the growth and development stage to ensure proper nutrition and healthy habits. Choice A is incorrect because decreasing calorie intake in a normal-weight 14-year-old can lead to nutrient deficiencies and hinder growth. Encouraging weight maintenance to avoid obesity is unnecessary in this scenario. Choice B is incorrect as increasing BMI is not necessary for a normal-weight individual. Taking a multivitamin without addressing specific nutritional needs may not be beneficial. Discussing body image, while important, is not the priority in this context. Choice D is incorrect as obtaining a food diary and close monitoring for anorexia assumes a problem that may not exist. It is not appropriate to assume disordered eating without evidence in a girl of normal weight.

Question 5

The nurse is caring for a postoperative patient in the critica l care unit. The physician has ordered patient-controlled analgesia (PCA) for the patient. The nurse understands what facts about the PCA? (Select all that apply.)

  1. A. It is a safe and effective method for administering anal gesia.
  2. B. It has potentially fewer side effects than other routes of analgesic administration.
  3. C. It is an ideal method to provide critically ill patients so me control over their treatment.
  4. D. It does not work well without family assistance
Show answer and rationale

Correct answer: A — It is a safe and effective method for administering anal gesia.

Step-by-step rationale for why Answer A is correct: 1. Patient-controlled analgesia (PCA) allows patients to self-administer pain medication within preset limits, promoting pain management. 2. PCA is considered safe and effective as it provides better pain control, reduces the risk of overdose, and allows for individualized dosing. 3. Healthcare providers can monitor and adjust the PCA settings as needed to ensure optimal pain relief. 4. Studies have shown that PCA is a preferred method for postoperative pain management due to its efficacy and safety profile. 5. Overall, PCA is a reliable and beneficial approach to analgesia administration in postoperative patients. Summary of why other choices are incorrect: B: While PCA may have fewer side effects compared to some routes, this is not a defining characteristic of PCA. C: While patients do have some control over their treatment with PCA, the primary focus is on pain management rather than giving control to critically ill patients. D: PCA can be used effectively without family

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Question 6

Why is it important for the healthcare provider to monitor blood pressure in clients receiving antipsychotic drugs?

  1. A. Orthostatic hypotension is a common side effect.
  2. B. Most antipsychotic drugs cause elevated blood pressure.
  3. C. This provides information on the amount of sodium allowed in the diet.
  4. D. It will indicate the need to institute antiparkinsonian drugs.
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Question 7

The nurse is caring for a patient with Huntington disease who has been admitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the patients plan of care?

  1. A. Firmly redirect the patients head when feeding.
  2. B. Administer phenothiazines after each meal as ordered.
  3. C. Encourage the patient to keep his or her feeding area clean.
  4. D. Apply deep, gentle pressure around the patients mouth to aid swallowing.
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Question 8

A client admitted with delusions, hallucinations, and thought disorder has the admitting diagnosis schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the client will:

  1. A. Undergo an MRI test
  2. B. Have psychological testing
  3. C. Have an immunologic assay performed
  4. D. Participate in a dexamethasone suppression test
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Question 9

Which of the following actions represents the use of secondary prevention to reduce environmental health risks?

  1. A. Collecting blood specimens from preschool children to check for lead levels
  2. B. Meeting with local government officials to request that the city clean up a hazardous vacant lot
  3. C. Referring a child with toxic lead levels to a neurologist
  4. D. Teaching parents of a 2-year-old about the dangers of lead-based paint in older homes
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Question 10

A new mother and father are inspecting their baby after the nurse brings the infant to them. The mother wants to know why her baby has bruises on the buttocks area. Which statement should be made by the nurse?

  1. A. Bruises are common after a traumatic delivery. I will ask the physician to come discuss the delivery.'
  2. B. These areas are called blue/gray macules and are common in certain ethnic groups, but will disappear around 3 years of age.'
  3. C. These are not bruises; these spots are birthmarks and are usually a permanent impairment.'
  4. D. The previous nurse did not report these findings. Who else has been in the room with the baby?'
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Question 11

The A band in a muscle appears and contains

  1. A. dark, both thick and thin myofilaments
  2. B. dark, thin myofilaments
  3. C. light, thick myofilaments
  4. D. light, thin myofilaments
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Question 12

Which nursing action is most effective in preventing ventilator-associated pneumonia (VAP)?

  1. A. Performing oral care with chlorhexidine.
  2. B. Administering antibiotics prophylactically.
  3. C. Suctioning the airway every hour.
  4. D. Keeping the patient sedated at all times.
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Question 13

A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?

  1. A. Hyperthyroidism
  2. B. Hypothyroidism
  3. C. Euthyroid sick syndrome
  4. D. Subclinical hyperthyroidism
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Question 14

A nurse cares for a first-generation American whose family emigrated from Germany. Which worldview about the source of knowledge would this patient likely have?

  1. A. Knowledge is acquired through use of affective or feeling senses.
  2. B. Science is the foundation of knowledge and proves something exists.
  3. C. Knowledge develops by striving for transcendence of the mind and body.
  4. D. Knowledge evolves from an individual's relationship with a supreme being.
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Question 15

A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse knows she needs to assess the client further for:

  1. A. Dementia
  2. B. Depression
  3. C. Delirium
  4. D. Amnesia
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About these RN exams clinical judgment questions

RN exams clinical judgment practice questions, set 16 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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