RN exams clinical judgment practice questions, set 170
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 170
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
An RN has critical care experience and is proficient in advanced cardiac life support and often helps to lead "codes" and is an expert clinician with superior health assessment skills. Enjoying a challenge of a fast-paced environment with autonomy, this nurse would best be suited for which nursing role?
A. Flight nurse
B. Home health nurse
C. Hospice nurse
D. Occupational health nurse
Show answer and rationale
Correct answer: A — Flight nurse
The correct answer is A: Flight nurse. This nurse is described as having critical care experience, proficiency in advanced cardiac life support, leading "codes," and superior health assessment skills, indicating a high level of clinical expertise. Flight nursing involves providing critical care in high-stress environments, often in emergency situations where quick thinking and advanced skills are crucial. The fast-paced environment and autonomy mentioned align well with the responsibilities of a flight nurse, who must make rapid decisions and provide life-saving interventions in challenging conditions. Home health, hospice, and occupational health nursing roles typically do not involve the same level of acuity, speed, and independence required in flight nursing.
Question 2
A registered nurse is on break and checking e-mails. One e-mail contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, "check out my Facebook," which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the "friend" to supervisors. Based on the action of the nurse who received the message, which statement is correct?
A. The nurse is not at risk for having his or her license suspended since removing the photos made them temporary and invisible to all others.
B. Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline.
C. Failing to report receiving the message demonstrates poor ethical and legal role-modeling as well as placing the nurse at risk for discipline.
D. Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared.
Show answer and rationale
Correct answer: C — Failing to report receiving the message demonstrates poor ethical and legal role-modeling as well as placing the nurse at risk for discipline.
The correct answer is C. The nurse is at risk for discipline because failing to report the receipt of the message demonstrates poor ethical and legal role-modeling. By deleting the photo and not reporting the incident, the nurse is not upholding patient confidentiality and is potentially violating privacy laws. Sharing patient information, even if the patient is on the same floor, is unethical and illegal. Choices A and B are incorrect because simply deleting the photos does not absolve the nurse from potential consequences, and not being the sender does not excuse the nurse from being responsible for maintaining patient confidentiality. Choice D is incorrect because sharing patient information without authorization is a violation of ethical and legal standards.
Question 3
A nurse learns of a mass casualty disaster following a known terrorist attack. On arriving at the scene, the nurse knows that:
A. the response of local hospitals will be dictated by the federal government.
B. the same ground rules practiced in other settings and during smaller crises will be applicable.
C. the least experienced nurses will be assigned to triage low-risk victims and victims who have no chance of survival.
D. multiple incident commanders ensure a quick, effective response.
Show answer and rationale
Correct answer: B — the same ground rules practiced in other settings and during smaller crises will be applicable.
The correct answer is B because in a mass casualty disaster following a terrorist attack, the same ground rules practiced in other settings and during smaller crises will be applicable. This is because the scale and complexity of the disaster require established protocols and procedures to manage the situation effectively.
Choice A is incorrect because the response of local hospitals may not necessarily be dictated by the federal government in such situations. Choice C is incorrect because assigning the least experienced nurses to triage patients based on their perceived risk or chances of survival is not ethical or effective. Choice D is incorrect because having multiple incident commanders can lead to confusion and delays in decision-making during a crisis.
Question 4
A group of nurses are meeting to decide how to staff the upcoming holidays. Each of the four members freely expresses thoughts about fair staffing but is willing to listen to other thoughts and reconsider their first recommendations. The nurses are avoiding conflict and supporting professional communication through:
A. empathy.
B. positiveness.
C. supportiveness.
D. accommodation.
Show answer and rationale
Correct answer: C — supportiveness.
The correct answer is C: supportiveness. In this scenario, the nurses are engaging in a collaborative process, listening to each other's perspectives, and being open to reconsidering their initial recommendations. Supportiveness involves actively encouraging others, showing understanding, and fostering a positive and constructive environment. Empathy (A) involves understanding and sharing others' feelings, which is important but not the primary focus in this context. Positiveness (B) is about having a positive attitude, which is beneficial but does not capture the essence of the nurses' behavior. Accommodation (D) involves making concessions, which is not the main theme in this situation where the nurses are aiming for mutual understanding and collaboration.
Question 5
A nurse is providing discharge instructions for a client with heart failure. What should the nurse emphasize?
A. Limit salt intake
B. Weigh daily
C. Exercise regularly
D. Follow a low-fat diet
Show answer and rationale
Correct answer: A — Limit salt intake
The correct answer is A: 'Limit salt intake.' In heart failure, excess salt can lead to fluid retention, worsening the condition. By limiting salt intake, the client can help control fluid buildup and reduce strain on the heart. Weighing daily is important to monitor for sudden weight gain, indicating fluid retention, but limiting salt intake is a more direct measure to prevent this. While exercise is beneficial, it should be tailored to the individual's condition and may not be safe in all cases. Following a low-fat diet can be beneficial for heart health overall, but limiting salt intake is more specific to managing heart failure. Therefore, the nurse should emphasize the importance of limiting salt intake to the client with heart failure.
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Question 6
In a hospital, a patient who is having trouble breathing is very upset because the LPN/LVN has to help the patient bathe. The patient says to the nurse, \'I don\'t think you should have to bathe me.\' The nurse\'s response is based on which of these understandings about the nurse\'s role?
A. Meeting one\'s basic needs may require assistance from someone until one is able to manage independently.
B. Patients must be encouraged to meet their own needs at all times.
C. Hospital patients deserve to have basic needs cared for by someone else regardless of their ability to care for themselves.
D. When a patient indicates that he or she is uncomfortable about getting assistance, then no assistance should be given.
Correct answer:
The correct answer is A: 'Meeting one's basic needs may require assistance from someone until one is able to manage independently.' This response reflects the understanding that in a healthcare setting, it is common for patients to require assistance with activities of daily living, including bathing, especially when they are unwell or having trouble breathing. Nurses recognize the importance of providing necessary care to help patients maintain their hygiene and comfort. It is part of the nurse's role to ensure that patients receive the care they need to promote their well-being and recovery. Encouraging independence is important, but sometimes patients need temporary assistance, which is a normal part of healthcare delivery.
A nurse is caring for a client receiving chemotherapy. What is a critical assessment to perform?
A. Monitor for hair loss
B. Check for bleeding
C. Monitor for jaundice
D. Check for signs of infection
Correct answer:
The correct answer is B: 'Check for bleeding.' When a client is receiving chemotherapy, one of the critical assessments to perform is to monitor for signs of bleeding. Chemotherapy can affect the body's ability to produce blood cells, leading to a decreased number of platelets, which are crucial for blood clotting. Therefore, checking for any signs of bleeding, such as easy bruising, nosebleeds, or blood in the stool or urine, is essential to prevent complications and ensure prompt intervention if needed. While hair loss, jaundice, and signs of infection are potential side effects of chemotherapy, monitoring for bleeding takes priority due to the increased risk of bleeding complications in clients undergoing chemotherapy.
The nurse is assessing a postoperative patient. Which intervention will best determine if peristalsis has returned?
A. Ask the patient if he or she has been passing gas.
B. Place a stethoscope on the abdomen and listen for bowel sounds.
C. Percuss the abdomen to determine whether there is bowel activity.
D. Palpate the abdomen to determine whether it reacts to touch.
Correct answer:
The correct answer is B. Listening for bowel sounds with a stethoscope is the most appropriate intervention to determine if peristalsis has returned after surgery. Bowel sounds indicate that the intestines are active and functioning properly, which is a good indicator that peristalsis has resumed. Asking the patient if they have passed gas (option A) may provide some information, but it is not as reliable as directly assessing bowel sounds. Percussing the abdomen (option C) and palpating the abdomen (option D) can provide some information about bowel activity, but they are not as specific as auscultating bowel sounds. Therefore, listening for bowel sounds is the best intervention to assess peristalsis postoperatively.
A nurse is preparing to start intravenous therapy on a client with dehydration. What is the primary goal?
A. Restore electrolyte balance
B. Prevent fluid overload
C. Maintain fluid balance
D. Hydrate the client
Correct answer:
The primary goal of starting intravenous therapy on a client with dehydration is to maintain fluid balance (Option C). This involves replacing lost fluids to restore the body's hydration levels without causing fluid overload or imbalance. While restoring electrolyte balance (Option A) is an important aspect of treating dehydration, the immediate goal is to ensure the client receives adequate fluid to rehydrate. Preventing fluid overload (Option B) is crucial to avoid complications like edema or heart failure. Simply hydrating the client (Option D) is not specific enough as the focus should be on achieving and maintaining a proper fluid balance. Therefore, maintaining fluid balance is the primary goal in this scenario.
The nurse is preparing to administer a blood transfusion. Which action should the nurse take first?
A. Obtain the patient\'s vital signs.
B. Verify the patient\'s blood type and crossmatch.
C. Start an intravenous line with normal saline.
D. Prime the blood tubing with the blood product.
Correct answer:
The correct answer is B: Verify the patient's blood type and crossmatch. Before administering a blood transfusion, it is crucial to confirm the patient's blood type and crossmatch to ensure compatibility and prevent any adverse reactions. This is the first step in the transfusion process to guarantee the safety and effectiveness of the procedure. Obtaining the patient's vital signs (A) is important but should come after confirming blood type compatibility. Starting an intravenous line with normal saline (C) may be necessary, but verifying blood type is the priority. Priming the blood tubing with the blood product (D) should only be done after confirming compatibility and once all other preparations are in place.
Which intervention is appropriate when the nurse is providing postmortem care to a patient?
A. Place the patient in a prone position.
B. Remove all tubes and indwelling lines.
C. Call the family to verify the patient\'s identity.
D. Apply a sterile dressing to any wounds.
Correct answer:
The correct answer is B: 'Remove all tubes and indwelling lines.' When providing postmortem care, it is important to remove all tubes and lines from the deceased patient to ensure a dignified appearance and prevent potential injury during transport. Placing the patient in a prone position (A) is incorrect as the supine position is recommended. Calling the family to verify the patient's identity (C) is not typically part of postmortem care as the patient's identity would have already been confirmed. Applying a sterile dressing to any wounds (D) is not necessary after death. Therefore, the most appropriate intervention during postmortem care is to remove all tubes and indwelling lines (B).
The nurse is providing discharge teaching to a patient with a new colostomy. Which statement indicates that the patient needs further teaching?
A. I will change the colostomy bag every day.
B. I will empty the colostomy bag when it is one-third full.
C. I will clean the skin around the stoma with mild soap and water.
D. I will avoid foods that can cause gas.
Correct answer:
Option A indicates that the patient needs further teaching because changing the colostomy bag every day is not recommended unless necessary due to leakage or odor. Colostomy bags can typically be worn for up to 3-7 days. Option B is correct as it is important to empty the colostomy bag when it is one-third full to prevent leakage. Option C is also correct as cleaning the skin around the stoma with mild soap and water helps prevent skin irritation. Option D is correct as avoiding foods that can cause gas, such as beans and carbonated drinks, can help prevent excess gas production and discomfort. Therefore, Option A is the best choice as it indicates a need for further teaching.
An overweight male patient rips off his hospital gown, throws it out the door, and shouts, \'I\'m not wearing this stupid gown! It is too small, too short, and exposes my backside to the world!\' Which response is most appropriate?
A. Remind patient of the need to wear the gown for convenience in care.
B. Confer with the patient for methods to acquire a larger gown.
C. Replace the torn gown with another.
D. Inform the charge nurse of the hostile behavior.
Correct answer:
Option B is the most appropriate response because it acknowledges the patient's concerns and involves them in finding a solution. By conferring with the patient for methods to acquire a larger gown, it shows empathy and respect for the patient's feelings, fostering a collaborative approach to address the issue. This approach can help de-escalate the situation by empowering the patient and promoting a sense of control over their care. Options A and C do not directly address the patient's complaint, while option D may escalate the situation unnecessarily without attempting to address the patient's needs. Therefore, option B is the best choice in this scenario.
The nurse is planning to insert a nasogastric (NG) tube. Which action is most important to ensure correct placement of the tube?
A. Measure the tube from the tip of the nose to the earlobe to the xiphoid process.
B. Lubricate the tip of the tube with water-soluble lubricant.
C. Have the patient swallow water while the tube is being advanced.
D. Verify placement with an x-ray.
Correct answer:
Verifying the placement of a nasogastric (NG) tube with an x-ray is the most important action to ensure correct placement. This method is considered the gold standard for confirming that the tube is in the correct position, specifically in the stomach and not in the lungs or other unintended areas. Measuring the tube length, lubricating the tip, and having the patient swallow water can all be important steps in the NG tube insertion process, but verifying placement with an x-ray is crucial for patient safety and to prevent complications such as aspiration pneumonia. Therefore, option D is the correct answer in this scenario.
The nurse is caring for a patient with deep vein thrombosis (DVT). Which intervention should the nurse implement to prevent complications?
A. Encourage the patient to ambulate frequently.
B. Apply warm compresses to the affected area.
C. Administer anticoagulant therapy as prescribed.
Correct answer:
The correct answer is C: Administer anticoagulant therapy as prescribed. Anticoagulants help prevent the formation of additional blood clots and reduce the risk of complications such as pulmonary embolism. While ambulating frequently can help prevent DVT, it is not the primary intervention for a patient already diagnosed with the condition. Warm compresses may provide comfort but do not directly address the underlying issue of blood clot formation. Administering anticoagulant therapy as prescribed is crucial in managing DVT and preventing further complications, making it the most appropriate intervention for this scenario.
RN exams clinical judgment practice questions, set 170 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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