RN exams clinical judgment practice questions, set 160
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 160
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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
The nurse is educating a client on the types of anesthesia used in surgery. Which client statement indicates a correct understanding of the topic?
A. I am having general anesthesia, so I will be given a gas to breathe and medication in my IV.
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: A — I am having general anesthesia, so I will be given a gas to breathe and medication in my IV.
Option A is the correct answer because it accurately describes general anesthesia. General anesthesia involves both inhaling a gas to induce unconsciousness and receiving medications through an IV to maintain the anesthesia. This combination ensures the patient is completely unaware and does not feel any pain during surgery. Option B is incorrect as under general anesthesia, the patient is not aware of what is happening. Option C is incorrect as an epidural is a type of regional anesthesia, not general anesthesia. Option D is incorrect as general anesthesia is used to induce unconsciousness, not just numb an area, which is more characteristic of local anesthesia.
Question 2
A nurse is providing care for a client with chronic kidney disease. What dietary restriction should be emphasized?
A. Increase protein intake.
B. Limit phosphorus-rich foods.
C. Reduce calcium intake.
D. Increase potassium intake.
Show answer and rationale
Correct answer: B — Limit phosphorus-rich foods.
The correct answer is B: 'Limit phosphorus-rich foods.' In chronic kidney disease, the kidneys struggle to filter phosphorus from the blood, leading to high levels which can be harmful. Limiting phosphorus-rich foods such as dairy products, nuts, and whole grains can help prevent complications like bone disease and cardiovascular issues. Increasing protein intake (A) should be done with caution in kidney disease to prevent further strain on the kidneys. Reducing calcium intake (C) is not typically recommended as calcium is important for bone health. Increasing potassium intake (D) should also be avoided as high potassium levels can be dangerous in kidney disease.
Question 3
A nurse is monitoring a client’s oxygen saturation using a pulse oximeter. The client’s oxygen saturation is 88% on 2 L/min of oxygen via nasal cannula. Which of the following actions should the nurse take?
A. Reposition the sensor probe
B. Apply a cooling blanket to the client
C. Ambulate the client
D. Place the client in a side-lying position
Show answer and rationale
Correct answer: A — Reposition the sensor probe
The correct answer is A: 'Reposition the sensor probe.' When a client's oxygen saturation is 88% on 2 L/min of oxygen via nasal cannula, the first step should be to ensure accurate readings by repositioning the sensor probe. The accuracy of pulse oximetry readings can be affected by sensor placement, so adjusting the probe can improve accuracy. Applying a cooling blanket or ambulating the client are not appropriate actions in response to low oxygen saturation. Placing the client in a side-lying position is not directly related to improving oxygen saturation levels. Therefore, repositioning the sensor probe is the most appropriate action to take in this scenario.
Question 4
A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1min and a frequency of 3min. The nurse obtains the following vitals: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 92/54mmHg. Which of the following is the priority action for the nurse to take?
A. Notify the provider of the findings.
B. Position the client with one hip elevated.
C. Ask the client if she needs pain medication.
D. Have the client void.
Show answer and rationale
Correct answer: B — Position the client with one hip elevated.
The correct answer is B: Position the client with one hip elevated. This is the priority action because the client is experiencing painful contractions with a short duration and frequent frequency, indicating potential labor progression. Elevating one hip can help optimize fetal positioning and relieve pressure on the mother's blood vessels, potentially improving fetal heart rate and maternal blood pressure. This intervention can be implemented quickly by the nurse to promote better labor outcomes. Notifying the provider, asking about pain medication, or having the client void are important actions but are not as immediate or directly impactful in this scenario.
Question 5
.A nurse is assessing a client who has been diagnosed with generalized anxiety disorder. Which of the following findings should the nurse expect?
A. Shortness of breath
B. Chest pain
C. Excessive worry
D. Decreased appetite
Show answer and rationale
Correct answer: C — Excessive worry
The correct answer is C: "Excessive worry." Generalized anxiety disorder is characterized by persistent and excessive worry about various aspects of life, such as work, health, and other daily concerns. This worry is difficult to control and often interferes with daily activities. While shortness of breath and chest pain can be physical symptoms of anxiety, they are not specific to generalized anxiety disorder. Decreased appetite can also be a symptom of anxiety, but the hallmark characteristic of generalized anxiety disorder is the presence of excessive worry. Therefore, the nurse should expect to find excessive worry when assessing a client with this disorder.
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Question 6
Parents of a hospitalized toddler ask the nurse, What is meant by family-centered care? The nurse should respond with which statement?
A. Family-centered care reduces the effect of cultural diversity on the family.
B. Family-centered care encourages family dependence on the health care system.
C. Family-centered care recognizes that the family is the constant in a childs life.
D. Family-centered care avoids expecting families to be part of the decision-making process.
Correct answer:
Family-centered care is an approach to healthcare that involves the family as an essential component of a child's care team. This approach recognizes that the family plays a crucial role in a child's life and care, providing support, continuity, and familiarity. By involving the family in decision-making and care planning, family-centered care enhances communication, collaboration, and trust between healthcare providers and the family. It empowers families to be active participants in their child's care, rather than relying solely on the healthcare system. Therefore, option C is the correct answer as it reflects the fundamental principle of family-centered care.
.A client experiencing a manic episode is talking rapidly and jumping from one topic to another. Which term describes this symptom?
A. Circumstantiality
B. Flight of ideas
C. Tangentiality
D. Perseveration
Correct answer:
The correct term describing a client talking rapidly and jumping from one topic to another during a manic episode is 'flight of ideas.' Flight of ideas refers to a symptom of mania where thoughts move rapidly from one subject to another with only superficial associations between them. Circumstantiality involves providing unnecessary detail before getting to the point. Tangentiality is when the individual goes off on a tangent and never returns to the original point. Perseveration is the repetition of a particular response, idea, or activity despite the cessation of the stimulus. Therefore, in this scenario, 'flight of ideas' best captures the symptom described.
A pregnant client asks the nurse, \"How many extra calories should I eat each day while I am pregnant?\" Which response by the nurse would be most appropriate?
A. 200 calories
B. 300 calories
C. 400 calories
D. 500 calories
Correct answer:
The most appropriate response for the nurse to give to a pregnant client inquiring about additional calorie intake per day is 200 calories. During pregnancy, an additional 200-300 calories per day are recommended to support the growth and development of the baby and to meet the increased energy needs of the mother. Consuming too many excess calories can lead to excessive weight gain, which may pose risks for both the mother and the baby. It is important for pregnant women to focus on nutrient-dense foods rather than simply increasing caloric intake. By advising an additional 200 calories, the nurse is promoting a balanced approach to nutrition during pregnancy.
A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). What is a common finding?
A. Wheezing
B. Chest pain
C. Coughing
D. Fever
Correct answer:
The correct answer is A: "Wheezing." In COPD, wheezing is a common finding due to airway obstruction and inflammation. Wheezing is a high-pitched whistling sound heard when breathing out, as air tries to pass through narrowed airways. Chest pain is not a typical symptom of COPD and is more commonly associated with other conditions like heart problems. While coughing is also common in COPD due to mucus production and airway irritation, wheezing is more specific to the obstruction of airflow in the lungs. Fever is not a typical symptom of COPD unless there is an underlying infection present. Therefore, wheezing is the most relevant finding in a client with COPD.
Which of the following is considered a class IA Sodium Channel blocker?
A. Propafenone
B. Disopyramide
C. Aminodarone
D. Quinidine
Correct answer:
Propafenone is classified as a class IA antiarrhythmic drug, which means it exhibits sodium channel blocking properties. This medication works by slowing down the conduction of sodium ions through cardiac muscle fibers, ultimately prolonging the refractory period of the heart. This action helps in treating certain types of arrhythmias by stabilizing the heart's electrical activity. Disopyramide, Aminodarone, and Quinidine belong to different classes of antiarrhythmic drugs, such as class IA, III, and I, respectively, and do not primarily act as sodium channel blockers. Therefore, the correct answer is A: Propafenone as it is a class IA Sodium Channel blocker.
.A nurse is caring for a client who has been diagnosed with schizoaffective disorder. The client states, \'I am the president of the United States.\' Which of the following responses should the nurse make?
A. You are not the president. You are a client in the hospital.
B. Tell me more about being the president.
C. Why do you think you are the president?
D. Let\'s talk about something else.
Correct answer:
The correct response is option C: 'Why do you think you are the president?' This response demonstrates therapeutic communication by addressing the client's delusion in a non-confrontational manner. It allows the nurse to explore the client's thoughts and feelings behind the delusion, gaining insight into their perspective. Option A is dismissive and may increase resistance. Option B encourages elaboration on the delusion without challenging it directly. Option D avoids the issue and may hinder the therapeutic relationship. By choosing option C, the nurse maintains rapport and opens the door for further discussion and understanding of the client's experiences.
A nurse is caring for a postpartum client 8hrs after delivery. What factors place the client at risk for uterine atony?
A. Prolonged labor
B. Mag sulfate infusion
C. Distended bladder
D. All of the above
Correct answer:
The correct answer is D, 'All of the above.' Uterine atony is a condition where the uterus fails to contract after childbirth, leading to excessive bleeding. Prolonged labor can cause uterine fatigue, making it more prone to atony. Magnesium sulfate infusion, often used to prevent seizures in preeclampsia, can also relax the uterus and contribute to atony. Additionally, a distended bladder can prevent the uterus from contracting properly by obstructing its ability to shrink back to its pre-pregnancy size. Therefore, all three factors - prolonged labor, mag sulfate infusion, and a distended bladder - increase the risk of uterine atony in the postpartum client.
A nurse is caring for a client who is flushed and has a temperature of 38.7 C (101.7 F). Which of the following actions should the nurse take?
A. Give the client an alcohol sponge bath.
B. Place cold packs on the client’s axillae.
C. Place a fan to blow air across the client.
D. Remove blankets from the client.
Correct answer:
When a client is flushed and has an elevated temperature, it indicates a fever. The nurse should prioritize actions to help reduce the client's temperature. Removing blankets can help dissipate excess body heat and aid in cooling the client down. Alcohol sponge baths can actually lead to shivering, which can increase the body's temperature. Placing cold packs on the axillae can constrict blood vessels and hinder heat dissipation. Using a fan can also cause dehydration and does not directly address the client's elevated temperature. Therefore, removing blankets from the client is the most appropriate action to promote cooling and improve the client's comfort.
The nurse is providing nutritional education to a client in her first pregnancy. Which statement made by the client indicates an understanding of a dietary needs?
A. I need to increase the calories only slightly if I am taking prenatal vitamins. I was told I will gain too much weight if I increase the calories at this time. And the vitamins have everything I need.
B. I will need to increase my calcium and iron as well as drink additional water each day stay well hydrated
C. As vegan I must take iron supplements since I do not eat meat
D. I will need to drink 60 ounces of something. I can only drink apple juice. So that will be enough fluid to stay well hydrated.
Correct answer:
Option B is the correct answer because it demonstrates an understanding of the specific nutritional needs during pregnancy. Calcium and iron requirements increase during pregnancy to support fetal development and prevent deficiencies. Additionally, staying well-hydrated is crucial during pregnancy to support circulation, amniotic fluid production, and overall health. The client's awareness of these needs shows a comprehensive understanding of the importance of proper nutrition during pregnancy. Options A, C, and D contain inaccuracies or incomplete information regarding essential nutrients and hydration needs during pregnancy, making them incorrect choices.
A nurse is wearing sterile gloves in preparation for assisting with a client’s sterile procedure. While waiting for the procedure to begin, how should the nurse position her hands?
A. Interlock her fingers and hold her hand away from her body above her waist
B. Keep her arms at the sides of her body with her hands in a relaxed position
C. Place one hand over the other against the part of the gown covering her upper body
D. Clasp her hands together in a relaxed position behind her body at her waist
Correct answer:
The correct answer is A: 'Interlock her fingers and hold her hand away from her body above her waist.' This position is recommended for a nurse wearing sterile gloves while waiting for a sterile procedure to begin because it helps maintain the sterility of the gloves. By interlocking her fingers and holding her hands above her waist, the nurse keeps her hands in a higher, more visible position, reducing the chances of contamination. Keeping her hands away from her body also prevents accidental contact with non-sterile surfaces. This positioning is crucial to adhere to strict aseptic techniques and prevent the introduction of pathogens during the procedure.
RN exams clinical judgment practice questions, set 160 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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