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RN exams clinical judgment practice questions, set 166

RN exams · clinical judgment

RN exams clinical judgment practice questions set 166

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

A nurse is caring for a client who is 14 weeks of gestation. At which of the following locations should the nurse place the Doppler device when assessing the fetal heart rate?

  1. A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis
  2. B. Left upper abdomen
  3. C. Two fingerbreadths above the umbilicus
  4. D. Lateral at the xiphoid process
Show answer and rationale

Correct answer: A — Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis

The correct answer is A: 'Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis.' At 14 weeks of gestation, the uterus is typically still within the pelvis and not palpable above the umbilicus. Placing the Doppler device midline just above the symphysis pubis allows the nurse to locate the fetal heart rate, as the fetus is still low in the pelvis during the first trimester. Placing the device in other locations such as the left upper abdomen, two fingerbreadths above the umbilicus, or lateral at the xiphoid process would not be appropriate for locating the fetal heart rate at this gestational age. It is important for the nurse to understand the anatomical landmarks and fetal positioning to accurately assess the fetal heart rate during pregnancy.

Question 2

A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of the birth method?

  1. A. Hypoglycemia
  2. B. Polycythemia
  3. C. Facial palsy
  4. D. Bronchopulmonary dysplasia
Show answer and rationale

Correct answer: C — Facial palsy

The correct answer is C: 'Facial palsy.' Facial palsy can occur as a complication of forceps-assisted birth due to pressure on the facial nerve during delivery. This can lead to temporary or permanent weakness or paralysis of the facial muscles. Hypoglycemia (A) is more commonly associated with maternal diabetes or prematurity, while polycythemia (B) is an increased red blood cell count, which can occur but is not directly related to forceps-assisted birth. Bronchopulmonary dysplasia (D) is a lung condition primarily seen in premature infants who require mechanical ventilation, not typically associated with the birth method. Therefore, the nurse should identify facial palsy as a complication to monitor and address following a forceps-assisted birth.

Question 3

A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for infection?

  1. A. Meconium-stained fluid
  2. B. Placenta previa
  3. C. Midline episiotomy
  4. D. Gestational hypertension
Show answer and rationale

Correct answer: C — Midline episiotomy

The correct answer is C. A midline episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. This incision increases the risk of infection due to its location near the perineum, which is a moist and warm environment conducive to bacterial growth. Meconium-stained fluid (A) is not a direct risk factor for infection but may indicate fetal distress. Placenta previa (B) is a condition where the placenta partially or completely covers the cervix, increasing the risk of bleeding but not necessarily infection. Gestational hypertension (D) is a risk factor for pre-eclampsia but is not directly related to postpartum infection risk. Therefore, the midline episiotomy poses the highest risk for infection in this scenario.

Question 4

A nurse is caring for a client who is 4 hr. postpartum and is experiencing hypovolemic shock. Which of the following actions should the nurse take?

  1. A. Administer indomethacin.
  2. B. Insert a second using a 22-gauge IV catheter.
  3. C. Insert an indwelling urinary catheter.
  4. D. Administer oxygen at 4 L/min via nasal cannula.
Show answer and rationale

Correct answer: C — Insert an indwelling urinary catheter.

The correct answer is C: 'Insert an indwelling urinary catheter.' Hypovolemic shock is a life-threatening condition caused by a rapid loss of fluid or blood volume. In this situation, it is crucial to monitor the client's urinary output to assess kidney function and fluid balance. Inserting an indwelling urinary catheter will allow for accurate measurement of urinary output, which is a key indicator of the client's fluid status. Administering medications such as indomethacin (A) or inserting a second IV catheter (B) may not address the immediate need to assess and manage fluid volume. Administering oxygen (D) is important in managing shock, but inserting a urinary catheter takes priority in this scenario to monitor fluid balance.

Question 5

A nurse is providing teaching to a client who is at 40 weeks of gestation and has a new prescription for misoprostol. Which of the following instructions should the nurse include in the teaching?

  1. A. I can administer oxytocin 4 hours after the insertion of the medication
  2. B. You will need a full bladder prior to the insertion of the medication
  3. C. Remain in a side-lying position for 15 minutes after the medication is inserted
  4. D. An antacid will be given 20 minutes prior to the insertion of the medication
Show answer and rationale

Correct answer: C — Remain in a side-lying position for 15 minutes after the medication is inserted

The correct answer is C. Remaining in a side-lying position for 15 minutes after the insertion of misoprostol is important to allow the medication to be absorbed properly and reduce the risk of side effects. This position helps prevent the medication from leaking out, ensuring its effectiveness. Option A is incorrect because oxytocin is not typically administered after misoprostol for induction of labor. Option B is incorrect as a full bladder is not necessary for the insertion of misoprostol. Option D is also incorrect as antacids are not routinely given prior to the insertion of misoprostol. Therefore, the best instruction for the client is to remain in a side-lying position for 15 minutes after the medication is inserted.

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Question 6

A nurse is teaching a client about managing chronic kidney disease. What dietary restriction is important?

  1. A. Limit potassium-rich foods
  2. B. Increase protein intake
  3. C. Limit phosphorus intake
  4. D. Increase calcium intake
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Question 7

Which is the most effective way to control the transmission of infection in health care facilities?

  1. A. Hand hygiene practices
  2. B. Using personal protective equipment
  3. C. Vaccination programs
  4. D. Cleaning the environment
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Question 8

In order to provide the optimum nursing care, it is important for the nurse to know that the standard of pain and pain control is best determined by which person?

  1. A. Patient
  2. B. Nurse
  3. C. Doctor
  4. D. Family
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Question 9

A nurse is providing care for a client with chronic heart failure. What is a common medication prescribed?

  1. A. Metoprolol
  2. B. Furosemide
  3. C. Aspirin
  4. D. Ibuprofen
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Question 10

After interviewing a newly admitted patient, the student nurse notices that the LPN/LVN reviews the data with the patient. The student is aware that this action occurs for what reason?

  1. A. It is usually a hospital policy.
  2. B. This shows how well the nurse has listened.
  3. C. It is a mandate of the Patient\'s Bill of Rights.
  4. D. To confirm the accuracy of the information.
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Question 11

A nurse is assessing a client with suspected pancreatitis. What laboratory test is relevant?

  1. A. Complete blood count
  2. B. Liver function tests
  3. C. Amylase and lipase
  4. D. Electrolyte panel
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Question 12

A patient who had undergone a hysterectomy 10 days ago came for a follow-up visit. The patient notices purulent drainage at the incision site. The nurse suspects wound infection and performs assessment for confirmation.What clinical findings would the nurse rarely evaluate?

  1. A. Pain
  2. B. Redness
  3. C. Swelling
  4. D. Tenderness
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Question 13

A nurse is preparing a client for an endoscopy. What instruction is essential?

  1. A. Refrain from eating 8 hours before the procedure
  2. B. Avoid drinking liquids 2 hours before the procedure
  3. C. Avoid all food and drink for 12 hours before the procedure
  4. D. Consume a high-fiber diet
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Question 14

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). What therapy is often used?

  1. A. Oxygen therapy
  2. B. Inhaled corticosteroids
  3. C. Bronchodilators
  4. D. Antibiotic therapy
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Question 15

A nurse is planning care for a child who is 2 hours postoperative following a tonsillectomy. Which of the following interventions should the nurse include in the plan?

  1. A. Encourage the child to cough and deep breathe.
  2. B. Offer ice cream for comfort.
  3. C. Position the child in a supine position.
  4. D. Place the child in a side-lying position.
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About these RN exams clinical judgment questions

RN exams clinical judgment practice questions, set 166 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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