RN exams clinical judgment practice questions, set 3
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 3
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 making assignments for a new graduate from a practical nursing program who is orienting to the unit. Because the unit is particularly busy this day, there will be little time to provide supervision of this new employee. Which client is the best for the nurse to assign to this newly graduated practical nurse?
A. Whose discharge has been delayed because of a postoperative infection
B. With poorly controlled type 2 diabetes who is on a sliding scale for insulin administration
C. Newly admitted with a head injury who requires frequent assessments
D. Receiving IV heparin that is regulated based on protocol
Show answer and rationale
Correct answer: A — Whose discharge has been delayed because of a postoperative infection
The correct answer is A: Whose discharge has been delayed because of a postoperative infection. This assignment is the best choice for the new graduate nurse because a client whose discharge has been delayed due to a postoperative infection is likely stable and requires minimal immediate interventions. This client would benefit from the new nurse's routine care and monitoring skills, allowing the nurse to focus on completing tasks efficiently.
Option B: With poorly controlled type 2 diabetes who is on a sliding scale for insulin administration requires close monitoring and frequent adjustments in insulin dosages, which may be challenging for a new nurse without adequate supervision.
Option C: Newly admitted with a head injury who requires frequent assessments demands critical thinking skills and quick decision-making abilities, which may overwhelm a new nurse who lacks experience in handling such cases.
Option D: Receiving IV heparin that is regulated based on protocol involves complex medication management and monitoring for potential complications, which may be beyond the scope of a new nurse's comfort level without proper guidance.
Question 2
Guidelines for the NA for rehabilitation and restorative care include
A. Not following the care plan if the resident seems to be making more progress than expected
B. Discouraging activity to make sure the resident gets enough rest
C. Providing plenty of privacy to avoid distractions and embarrassment
D. Focusing on setbacks so the resident will be motivated to do better
Show answer and rationale
Correct answer: C — Providing plenty of privacy to avoid distractions and embarrassment
The correct answer is C because providing plenty of privacy is essential for rehabilitation and restorative care. Privacy helps to avoid distractions and embarrassment, allowing the resident to focus on their therapy and recovery without feeling self-conscious. This creates a conducive environment for the resident to feel comfortable, respected, and supported during their rehabilitation process.
Incorrect Answer Rationale:
A: Not following the care plan if the resident seems to be making more progress than expected - This is incorrect because following the care plan is crucial for consistency and ensuring the resident receives the appropriate treatment.
B: Discouraging activity to make sure the resident gets enough rest - This is incorrect as activity is often an integral part of rehabilitation, and rest should be balanced with appropriate physical and occupational therapy.
D: Focusing on setbacks so the resident will be motivated to do better - This is incorrect because focusing on setbacks can lead to negative reinforcement and may hinder the resident's progress. Positive reinforcement and encouragement are more effective motivators.
Question 3
Lisa, a 35-year-old practicing attorney and marathon runner, presents to the clinic with a complaint of irregular menses. She tells the nurse, 'My husband and I want to start a family but it hasn't happened yet. We stopped using birth control 6 months ago. Should we be concerned?' What is the nurse's best response?
A. Relax and it will happen.
B. No, infertility is the failure to conceive after 1 year of unprotected intercourse.
C. Aging and extreme exercise regimens may impact fertility. You should address your concerns with your provider during today's visit.
D. Decreasing your exercise frequency and intensity will increase your chances of conceiving.
Show answer and rationale
Correct answer: C — Aging and extreme exercise regimens may impact fertility. You should address your concerns with your provider during today's visit.
The correct answer is C because it addresses Lisa's concerns about fertility in a comprehensive and logical manner. Firstly, it acknowledges the potential impact of aging and extreme exercise on fertility, which is important considering Lisa's age and marathon running. Secondly, it emphasizes the importance of discussing her concerns with her healthcare provider during the visit, ensuring a thorough evaluation and appropriate guidance. This response shows understanding of the possible factors contributing to her irregular menses and infertility concerns.
Now, let's analyze the other choices:
A: "Relax and it will happen" is dismissive and lacks medical advice or addressing potential underlying causes of infertility.
B: "No, infertility is the failure to conceive after 1 year of unprotected intercourse" provides a definition of infertility but does not offer practical advice or address Lisa's specific situation.
D: "Decreasing your exercise frequency and intensity will increase your chances of conceiving" assumes exercise is the sole factor affecting fertility and oversimplifies the issue without considering other potential causes.
Question 4
Main symptom associated with retinal detachment is?
A. Flashing lights and floaters
B. Pain and tenderness
C. Increased IOP
D. Ptosis
Show answer and rationale
Correct answer: A — Flashing lights and floaters
Retinal detachment occurs when the retina, the light-sensitive layer at the back of the eye, separates from its supportive tissue, risking permanent vision loss if untreated. The hallmark symptom is the sudden onset of flashing lights and floaters. Flashing lights, or photopsia, result from the retina being pulled or torn, stimulating photoreceptors and creating light perceptions. Floaters appear as spots or cobwebs drifting in the visual field, caused by vitreous gel detaching and casting shadows on the retina. As detachment progresses, a shadow or curtain may obscure vision, but early recognition hinges on these initial signs. Pain is absent because the retina lacks pain receptors; discomfort suggests other issues like infection. Elevated intraocular pressure relates to glaucoma, damaging the optic nerve, not detaching the retina. Drooping eyelids, or ptosis, stem from muscular or nerve issues, unrelated to retinal changes. Ophthalmological studies emphasize these visual phenomena as critical early warnings, distinguishing retinal detachment from conditions with different mechanisms, urging prompt medical attention to preserve sight.
Question 5
Which muscle type(s) can be accurately described as visceral, nonstriated and involuntary?
A. smooth
B. skeletal
C. cardiac
D. both cardiac and skeletal
Show answer and rationale
Correct answer: A — smooth
Smooth muscle, found in visceral organs like the stomach and blood vessels, lacks striations due to its unorganized actin and myosin arrangement, unlike the sarcomeres of skeletal and cardiac muscle. It operates involuntarily, controlled by the autonomic nervous system, enabling functions like peristalsis without conscious effort. Skeletal muscle, attached to bones, is striated and voluntary, governed by the somatic nervous system for deliberate movements. Cardiac muscle, in the heart, is striated with intercalated discs and involuntary, but its rhythmic contractions distinguish it from smooth muscle's slower, sustained actions. Visceral typically denotes internal organs, aligning with smooth muscle's role, not cardiac or skeletal. Histologically, smooth muscle's spindle-shaped, uninucleate cells contrast with skeletal's multinucleate fibers and cardiac's branched structure. Physiological texts emphasize smooth muscle's unique calcium regulation via calmodulin, not troponin, reinforcing its distinct involuntary nature. This specificity clarifies why only smooth muscle fits all three descriptors, avoiding overlap with striated types.
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Question 6
Lisa, a 35-year-old practicing attorney and marathon runner, presents to the clinic with a complaint of irregular menses. She tells the nurse, 'My husband and I want to start a family but it hasn't happened yet. We stopped using birth control 6 months ago. Should we be concerned?' What is the nurse's best response?
A. Relax and it will happen.
B. No, infertility is the failure to conceive after 1 year of unprotected intercourse.
C. Aging and extreme exercise regimens may impact fertility. You should address your concerns with your provider during today's visit.
D. Decreasing your exercise frequency and intensity will increase your chances of conceiving.
Correct answer:
The correct answer is C because it addresses Lisa's concerns about fertility in a comprehensive and logical manner. Firstly, it acknowledges the potential impact of aging and extreme exercise on fertility, which is important considering Lisa's age and marathon running. Secondly, it emphasizes the importance of discussing her concerns with her healthcare provider during the visit, ensuring a thorough evaluation and appropriate guidance. This response shows understanding of the possible factors contributing to her irregular menses and infertility concerns.
Now, let's analyze the other choices:
A: "Relax and it will happen" is dismissive and lacks medical advice or addressing potential underlying causes of infertility.
B: "No, infertility is the failure to conceive after 1 year of unprotected intercourse" provides a definition of infertility but does not offer practical advice or address Lisa's specific situation.
D: "Decreasing your exercise frequency and intensity will increase your chances of conceiving" assumes exercise is the sole factor affecting fertility and oversimplifies the issue without considering other potential causes.
The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate?
A. Did you smoke marijuana when pregnant with your other child?
B. To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester.
C. Using marijuana while pregnant can have a negative effect on the neurological development of your baby.
D. Marijuana use while pregnant greatly increases your risk of miscarriage.
Correct answer:
The correct answer is C: Using marijuana while pregnant can have a negative effect on the neurological development of your baby.
Rationale:
1. Marijuana use during pregnancy has been associated with adverse effects on the developing fetus, including potential negative impacts on neurological development.
2. The nurse's statement acknowledges the potential harm to the baby's neurological development, emphasizing the importance of avoiding marijuana during pregnancy.
3. This response focuses on providing essential information to the patient about the specific risks associated with marijuana use during pregnancy, highlighting the importance of making informed choices for the health of the baby.
Summary:
A: This choice makes assumptions about the patient's past behavior and does not provide essential information about the risks of marijuana use during pregnancy.
B: This choice focuses on the timing of stopping marijuana use rather than addressing the potential harm to the baby's neurological development.
D: This choice mentions miscarriage as a risk, which is not the primary concern associated with marijuana use during pregnancy.
A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction. She complains of vague pains, menstrual problems, and headaches. She entered the partial hospital program to prevent another suicide gesture or self-mutilation. The nurse recognizes that collaborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
A. Occupational therapist exploring ways to reduce stress
B. Physical therapist exploring ways to reduce back pain
C. Acupuncturist exploring ways to reduce pain
D. Sexologist exploring healthy sexuality and safe sex
Correct answer:
The correct answer is A: Occupational therapist exploring ways to reduce stress. In the case of a client with borderline personality disorder experiencing trauma-related symptoms, such as memories of sexual abuse, the focus is on addressing underlying emotional issues and coping strategies. Collaborative therapy involving the client, nurse, and occupational therapist can be beneficial. The occupational therapist can help the client develop coping skills, manage stress, and improve daily functioning. This approach targets the root of the client's difficulties and provides holistic support.
Summary:
- Choice B (Physical therapist exploring ways to reduce back pain): This option does not directly address the client's primary concerns related to trauma and emotional distress.
- Choice C (Acupuncturist exploring ways to reduce pain): While pain management is important, it does not address the client's complex psychological needs and trauma history.
- Choice D (Sexologist exploring healthy sexuality and safe sex): While important in some cases, focusing solely on sexuality does not address the broader range of issues the client
In females, the onset of puberty is first marked by
A. Menarche
B. Thelarche
C. Pubarche
D. Adrenarche
Correct answer:
Puberty in females begins with thelarche, the development of breast buds, typically at ages 10-11. Triggered by rising estrogen from ovarian activation via gonadotropins (FSH, LH) from the pituitary, it marks the start of secondary sexual characteristics. Breast budding often appears unilaterally first, reflecting hormonal sensitivity in mammary tissue. Menarche, the first menstrual period, follows 2-3 years later, around 12-13, after significant growth and hormonal maturation, peaking before menstruation starts. Pubarche, pubic hair growth, and adrenarche, adrenal androgen increase, occur later, driven by adrenal and ovarian androgens, not initial puberty onset. Thelarche's precedence reflects the hypothalamic-pituitary-ovarian axis activating earlier than adrenal changes. Puberty spans years, completing by 15-17, with thelarche as the visible starting point, followed by growth spurts and reproductive capability. Pediatric endocrinology data confirm this sequence, distinguishing thelarche from later milestones like menarche, which depends on established ovarian cycles, highlighting its role as puberty's initial physical sign.
What occurred after childbirth migrated from the home to the hospital?
A. Infection rates dropped in the hospital.
B. Laboring persons were given greater support in labor.
C. The childbirth model became a medical model.
D. Pain relief allowed laboring persons to spend more time with their partners in labor.
Correct answer:
The correct answer is C: The childbirth model became a medical model. This occurred because as childbirth moved from the home to the hospital, it shifted from a natural, family-centered event to a medicalized process. Hospitals introduced medical interventions, procedures, and protocols, making childbirth more clinical and less holistic. This transition from a social and emotional experience to a medical one changed the way labor and delivery were managed.
Explanation of why other choices are incorrect:
A: Infection rates dropped in the hospital - This is not necessarily a direct result of childbirth moving to the hospital, as infection rates can be influenced by various factors such as hygiene practices and medical advancements.
B: Laboring persons were given greater support in labor - While support during labor is important, the movement of childbirth to hospitals did not necessarily guarantee greater support, as medical interventions sometimes took precedence over emotional support.
D: Pain relief allowed laboring persons to spend more time with their partners in labor - Although pain relief may have benefits, it is
The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago). Which type of assessment approach is the nurse using?
A. Gordon’s Functional Health Patterns
B. Activity-exercise pattern assessment
C. General to specific assessment
D. Problem-oriented assessment
Correct answer:
The correct answer is C: General to specific assessment. In this scenario, the nurse is starting with a broad assessment of the surgical dressing and the type of drainage present, then will progress to more specific assessments based on the findings. This approach allows for a systematic and comprehensive evaluation of the patient's condition by moving from general observations to detailed examinations.
Explanation:
1. General assessment: The nurse is initially assessing the overall appearance of the surgical dressing and the type of drainage.
2. Specific assessment: Based on the initial findings, the nurse will proceed to conduct more focused assessments, such as checking for signs of infection, monitoring vital signs, and assessing the surgical site for any complications.
Other choices are incorrect:
A: Gordon’s Functional Health Patterns - This framework focuses on assessing different aspects of an individual's health patterns, such as activity level, sleep patterns, and coping mechanisms. It is not the most appropriate approach in this situation.
B: Activity-exercise pattern assessment - This type of assessment focuses
A patient has been diagnosed with AIDS complicated by chronic diarrhea. What nursing intervention would be appropriate for this patient?
A. Position the patient in the high Fowlers position whenever possible.
B. Temporarily eliminate animal protein from the patients diet.
C. Make sure the patient eats at least two servings of raw fruit each day.
D. Obtain a stool culture to identify possible pathogens.
Correct answer:
The correct answer is D: Obtain a stool culture to identify possible pathogens. This is the most appropriate nursing intervention because chronic diarrhea in a patient with AIDS can be caused by various pathogens such as parasites, bacteria, or viruses. By obtaining a stool culture, the healthcare team can identify the specific pathogen responsible for the diarrhea and initiate targeted treatment.
A: Positioning the patient in the high Fowler's position is not directly related to addressing the underlying cause of chronic diarrhea in this patient.
B: Temporarily eliminating animal protein from the patient's diet may not be necessary or effective in treating chronic diarrhea without knowing the specific cause identified through stool culture.
C: Making sure the patient eats raw fruit is not recommended as raw fruits can sometimes worsen diarrhea due to their high fiber content and potential for carrying pathogens.
In summary, obtaining a stool culture is the most appropriate intervention as it helps identify the specific pathogen causing the diarrhea, while the other options do not directly address the underlying cause.
A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction. She complains of vague pains, menstrual problems, and headaches. She entered the partial hospital program to prevent another suicide gesture or self-mutilation. The nurse recognizes that collaborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
A. Occupational therapist exploring ways to reduce stress
B. Physical therapist exploring ways to reduce back pain
C. Acupuncturist exploring ways to reduce pain
D. Sexologist exploring healthy sexuality and safe sex
Correct answer:
The correct answer is A: Occupational therapist exploring ways to reduce stress. In the case of a client with borderline personality disorder experiencing trauma-related symptoms, such as memories of sexual abuse, the focus is on addressing underlying emotional issues and coping strategies. Collaborative therapy involving the client, nurse, and occupational therapist can be beneficial. The occupational therapist can help the client develop coping skills, manage stress, and improve daily functioning. This approach targets the root of the client's difficulties and provides holistic support.
Summary:
- Choice B (Physical therapist exploring ways to reduce back pain): This option does not directly address the client's primary concerns related to trauma and emotional distress.
- Choice C (Acupuncturist exploring ways to reduce pain): While pain management is important, it does not address the client's complex psychological needs and trauma history.
- Choice D (Sexologist exploring healthy sexuality and safe sex): While important in some cases, focusing solely on sexuality does not address the broader range of issues the client
A mother discusses her concerns about genetic transmission of schizophrenia with the nurse saying, 'My son is a fraternal twin. He has been diagnosed with schizophrenia. Will my other son develop schizophrenia, too?' The response that is both sensitive and shows understanding of the genetic component is:
A. You poor woman! I wish I could tell you he will be free of the disorder.'
B. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.'
C. No one can say what will happen, so we will hope for the best for you and your sons.'
D. In fraternal twins, the chance of the other twin developing the disorder is quite small.'
Correct answer:
The correct answer is D because it provides an accurate and sensitive response. Fraternal twins do not share the same genetic makeup as identical twins, so the genetic risk for the other twin developing schizophrenia is lower. By acknowledging this fact, the nurse offers reassurance to the mother without giving false hope or inaccurate statistics. This response shows understanding of the genetic component of schizophrenia and addresses the mother's concerns in a compassionate and informative manner.
Choices A, B, and C are incorrect:
A: This response is dismissive of the mother's concerns and does not provide any helpful information. It also lacks sensitivity and empathy towards the mother's situation.
B: This response provides an inaccurate statistic about the likelihood of the other twin developing schizophrenia. It does not consider the difference between identical and fraternal twins, leading to a potentially misleading statement.
C: This response is vague and does not address the mother's question directly. It does not provide any useful information or reassurance, leaving the mother uncertain and anxious about
What occurred after childbirth migrated from the home to the hospital?
A. Infection rates dropped in the hospital.
B. Laboring persons were given greater support in labor.
C. The childbirth model became a medical model.
D. Pain relief allowed laboring persons to spend more time with their partners in labor.
Correct answer:
The correct answer is C: The childbirth model became a medical model. This occurred because as childbirth moved from the home to the hospital, it shifted from a natural, family-centered event to a medicalized process. Hospitals introduced medical interventions, procedures, and protocols, making childbirth more clinical and less holistic. This transition from a social and emotional experience to a medical one changed the way labor and delivery were managed.
Explanation of why other choices are incorrect:
A: Infection rates dropped in the hospital - This is not necessarily a direct result of childbirth moving to the hospital, as infection rates can be influenced by various factors such as hygiene practices and medical advancements.
B: Laboring persons were given greater support in labor - While support during labor is important, the movement of childbirth to hospitals did not necessarily guarantee greater support, as medical interventions sometimes took precedence over emotional support.
D: Pain relief allowed laboring persons to spend more time with their partners in labor - Although pain relief may have benefits, it is
RN exams clinical judgment practice questions, set 3 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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