RN exams clinical judgment practice questions, set 32
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 32
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 has avoidant personality disorder. Which of the following types of therapy should the nurse anticipate that the client's problems arise from issues of role definition and grief and will frame solutions in interpersonal terms. This therapy is useful for those with avoidant personality disorder who seek the approval of others and fear rejection.
A. Antipsychotic medications
B. Dialectical behavior therapy
C. Antidepressant medications
D. Interpersonal therapy
Show answer and rationale
Correct answer: D — Interpersonal therapy
The correct answer is D: Interpersonal therapy. This therapy focuses on addressing issues related to interpersonal relationships and communication. For clients with avoidant personality disorder who fear rejection and seek approval, interpersonal therapy helps them navigate their difficulties in forming and maintaining relationships. It also addresses issues of role definition and grief, which are common challenges for individuals with this disorder.
Antipsychotic medications (A) are typically used to treat psychotic disorders, not personality disorders like avoidant personality disorder. Dialectical behavior therapy (B) is more commonly used for borderline personality disorder, not avoidant personality disorder. Antidepressant medications (C) may be prescribed for individuals with avoidant personality disorder who also have comorbid depression, but they do not specifically target the interpersonal issues and fear of rejection that are core features of this disorder.
Question 2
Which primary prevention strategy will the nurse include in a community program on the prevention of hepatitis C?
A. Advising individuals with risky sexual behaviors to be screened for hepatitis C
B. Stressing that handwashing is important after changing diapers or using the bathroom
C. Recommending immunizations against the other viral hepatitis infections
D. Instructing individuals to avoid sharing needles, syringes, or other equipment contaminated with blood
Show answer and rationale
Correct answer: D — Instructing individuals to avoid sharing needles, syringes, or other equipment contaminated with blood
The correct answer is D because sharing needles or other equipment contaminated with blood is a significant risk factor for contracting hepatitis C. By instructing individuals to avoid sharing such equipment, the nurse is targeting a key mode of transmission for the virus. This primary prevention strategy directly addresses the root cause of hepatitis C transmission in high-risk populations.
Choice A is incorrect because while screening for hepatitis C is important, it is not a primary prevention strategy. Choice B is incorrect as handwashing is essential for preventing the spread of infections like hepatitis A and E, not hepatitis C. Choice C is incorrect because immunizations against other viral hepatitis infections do not protect against hepatitis C specifically.
In summary, advising individuals to avoid sharing needles or equipment contaminated with blood is the most effective primary prevention strategy for hepatitis C compared to the other choices provided.
Question 3
A nurse is caring for a patient diagnosed with anorexia nervosa. The patient states, 'I need to lose more weight.' What is the priority nursing diagnosis for this patient?
A. Imbalanced nutrition: Less than body requirements
B. Ineffective coping
C. Disturbed body image
D. Risk for injury
Show answer and rationale
Correct answer: C — Disturbed body image
The correct answer is C: Disturbed body image. This is the priority nursing diagnosis because the patient's statement indicates a distorted perception of their own body, which is a core issue in anorexia nervosa. Addressing the patient's distorted body image is crucial in promoting positive self-perception and working towards recovery.
Incorrect choices:
A: Imbalanced nutrition: Less than body requirements - While this is a common concern in anorexia nervosa, the patient's statement about needing to lose more weight indicates a deeper psychological issue that needs immediate attention.
B: Ineffective coping - While coping strategies are important, the primary focus should be on addressing the distorted body image in this case.
D: Risk for injury - While anorexia nervosa can lead to physical complications, the patient's statement does not directly suggest an immediate risk for injury, making this option less of a priority compared to addressing the distorted body image.
Question 4
A city has announced its plans to build a city dump near a community of poor and predominantly African-American citizens. Which of the following principles would the nurse be using when vocalizing opposition for this plan?
A. Environmental justice
B. Environmental epidemiology
C. Tertiary prevention
D. Risk communication
Show answer and rationale
Correct answer: A — Environmental justice
The correct answer is A: Environmental justice. Environmental justice is the principle that all individuals, regardless of race or socioeconomic status, have the right to equal protection from environmental risks. In this scenario, the nurse would oppose the city dump near a poor and predominantly African-American community because it violates the principle of environmental justice by disproportionately exposing this community to environmental hazards.
Summary of incorrect choices:
B: Environmental epidemiology focuses on studying the distribution and determinants of diseases in populations, not on environmental justice principles.
C: Tertiary prevention involves managing and treating complications of existing diseases, not related to opposing unjust environmental decisions.
D: Risk communication involves effectively communicating risks and hazards to the public, which is not directly related to opposing unjust environmental actions based on principles of justice.
Question 5
A patient is brought to the unit with mediastinal chest tubes with no fluctuation in the water seal chamber; arterial blood gas results reveal pH, 55; CO , 55; HCO, 28 mEq/L, and O , 98%. Carotid artery pulsation is visible with the head of the bed elevated and the use of tangential lighting. The first action of the nurse is to: The above question represents which level of Bloom's taxonomy?
A. Knowledge
B. Comprehension
C. Application
D. Analysis
Show answer and rationale
Correct answer: C — Application
The correct answer is C: Application. In this scenario, the nurse needs to apply knowledge of arterial blood gas results and assessment findings to determine appropriate actions. With the patient having abnormal ABG results and visible carotid artery pulsation, the nurse must recognize impending respiratory failure and act promptly, such as notifying the healthcare provider or respiratory therapist. This requires applying critical thinking skills to make decisions based on collected data.
Incorrect choices:
A: Knowledge - Choosing this option implies only recalling facts, which is not sufficient in this situation.
B: Comprehension - This choice suggests understanding the information given, but it does not involve applying that understanding to make decisions.
D: Analysis - While analysis involves breaking down information, the immediate action needed in this case is more about applying knowledge to prevent a potential crisis, rather than deeply analyzing the situation.
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Question 6
The RN in the newborn nursery is reviewing the newborn’s chart and notices that the bilirubin levels are elevated. What intervention should the nurse perform next?
A. Place the patient NPO and notify a physician.
B. Weigh the patient to see if weight loss has occurred.
C. Take the newborn’s vital signs and report to the physician.
D. Apply phototherapy according to the hospital protocol, then notify the physician.
Correct answer:
The correct answer is D because elevated bilirubin levels in newborns indicate jaundice, which can lead to complications if not treated promptly. Phototherapy helps break down bilirubin and is the first-line treatment for neonatal jaundice. Applying phototherapy as per hospital protocol is essential to decrease bilirubin levels. Notifying the physician is also crucial for ongoing monitoring and management.
Choice A (Place the patient NPO and notify a physician) is incorrect because NPO status is not necessary for managing neonatal jaundice, and phototherapy is the primary intervention.
Choice B (Weigh the patient to see if weight loss has occurred) is incorrect because weight loss is not directly related to elevated bilirubin levels in newborns.
Choice C (Take the newborn’s vital signs and report to the physician) is incorrect because while vital signs are important, the immediate intervention for elevated bilirubin levels is phototherapy to prevent complications.
The administration at a local medical center examines the trends in health problems when developing long-range plans for staffing and space allocation. Which of the following sources of information would be most helpful?
A. Local data drawn from a professional survey in the city
B. The National Health Interview Survey
C. The National Hospital Discharge Survey
D. The state’s vital statistics
Correct answer:
The correct answer is C: The National Hospital Discharge Survey. This source provides comprehensive data on hospital discharges, including diagnoses and procedures. It offers a broad overview of health problems and treatment trends on a national level, which can be valuable for long-range planning at a local medical center.
A: Local data from a professional survey in the city may not capture a comprehensive picture of health trends compared to a national survey like the National Hospital Discharge Survey.
B: The National Health Interview Survey focuses more on health behaviors and access to healthcare, rather than specific health problems and treatment trends, which may not be as directly relevant for staffing and space allocation planning.
D: State vital statistics provide information on births, deaths, and other vital events but may not offer detailed data on specific health problems and treatment trends, as needed for staffing and space allocation planning.
Lori, who is 32 years old, is taking clomiphene citrate to induce ovulation and presents to the office for a vaginal ultrasound. As the nurse is walking Lori to ultrasound, Lori mentions that over the past 12 hours she has experienced abdominal bloating, nausea, and weight gain of 5 pounds. The nurse recognizes these signs and symptoms to be associated with what condition?
A. Ovulation
B. Premenstrual syndrome
C. Ovarian hyperstimulation syndrome
D. Failed ovulation induction
Correct answer:
The correct answer is C: Ovarian hyperstimulation syndrome (OHSS). OHSS is a potential complication of ovulation induction with medications like clomiphene citrate. The symptoms Lori is experiencing (abdominal bloating, nausea, and weight gain) are classic signs of moderate OHSS. The mechanism involves excessive response to the ovulation induction medication leading to enlarged ovaries and fluid accumulation in the abdomen. It is crucial to monitor patients on ovulation induction therapy for signs of OHSS to prevent severe complications.
Choice A: Ovulation - This is incorrect because the symptoms described are not typical of ovulation itself.
Choice B: Premenstrual syndrome - This is incorrect because the symptoms are not specific to premenstrual syndrome and are more indicative of a complication related to medication.
Choice D: Failed ovulation induction - This is incorrect because the symptoms suggest a response to the medication rather than a failure of ovulation.
You are a fourth-year medical student with a patient who has been in a severe motor vehicle accident. The patient has a subdural hematoma that led to cerebral herniation before it could be drained. Over the last few days, the patient has lost all brainstem reflexes and is now brain dead. You have the closest relationship with the family of anyone on the team. The ventilator is to be removed soon and organ donation is considered. Who should ask for consent for organ donation in this case?
A. You, because you are the person with the best relationship with the family
B. The resident because you are only a student
C. Attending of record
D. Organ-donor network
Correct answer:
The rules concerning organ donation are quite specific that the medical team taking care of the patient must not be the ones asking for the donation of organs. This is a conflict of interest. It pits the family's perception of the physician as caregiver against the impression that the medical staff just wants the organs. There can also be significant amounts of irrational thinking associated with grief such as the family thinking you only want to turn off the ventilator so you can harvest the organs. The medical team must stay clearly in the role of the people trying to preserve the life of the patient. The other most practical reason for the organ-donor network to ask is that their chance of successfully obtaining consent is far, far in excess of physicians who ask. The organ-donor network doing the asking both preserves the ethical integrity of the medical team in the eyes of the family as well as markedly increasing the supply of viable organs available for donation.
A nurse believes that the nurse-patient relationshipis a partnership and that both are equal participants. Which term should the nurse use to describe this belief?
A. Critical thinking
B. Authentic
C. Mutuality
D. Attend
Correct answer:
The correct term to describe the belief that the nurse-patient relationship is a partnership where both are equal participants is "Mutuality" (C). This term emphasizes the idea of shared responsibility, respect, and collaboration between the nurse and the patient. It signifies a relationship built on equality and mutual understanding, fostering trust and positive outcomes.
Choice A (Critical thinking) involves analyzing and evaluating information, which is essential for decision-making but does not directly reflect the equality and partnership aspect of the nurse-patient relationship.
Choice B (Authentic) relates to being genuine and true to oneself, which is important in building trust but does not specifically address the equal participation aspect in the relationship.
Choice D (Attend) means to be present or pay attention, which is a fundamental aspect of nursing care but does not capture the full essence of a partnership based on equality and mutual involvement.
You are a fourth-year medical student with a patient who has been in a severe motor vehicle accident. The patient has a subdural hematoma that led to cerebral herniation before it could be drained. Over the last few days, the patient has lost all brainstem reflexes and is now brain dead. You have the closest relationship with the family of anyone on the team. The ventilator is to be removed soon and organ donation is considered. Who should ask for consent for organ donation in this case?
A. You, because you are the person with the best relationship with the family
B. The resident because you are only a student
C. Attending of record
D. Organ-donor network
Correct answer:
The rules concerning organ donation are quite specific that the medical team taking care of the patient must not be the ones asking for the donation of organs. This is a conflict of interest. It pits the family's perception of the physician as caregiver against the impression that the medical staff just wants the organs. There can also be significant amounts of irrational thinking associated with grief such as the family thinking you only want to turn off the ventilator so you can harvest the organs. The medical team must stay clearly in the role of the people trying to preserve the life of the patient. The other most practical reason for the organ-donor network to ask is that their chance of successfully obtaining consent is far, far in excess of physicians who ask. The organ-donor network doing the asking both preserves the ethical integrity of the medical team in the eyes of the family as well as markedly increasing the supply of viable organs available for donation.
Todays critical care nursing environment is constantly changing. What nursing behavior best illustrates awareness of current events affecting critical care nursing?
A. Participating in the hospitals efforts to recruit new nurses
B. Volunteering to serve on a disaster response planning committee
C. Adhering to content taught in basic nursing program
D. Attending hospital-mandated in-services without other education Answer Key
Correct answer:
The correct answer is B because volunteering to serve on a disaster response planning committee demonstrates awareness of current events affecting critical care nursing. By actively participating in planning for potential disasters, the nurse shows a proactive approach to staying informed and prepared for emergencies. This behavior indicates a commitment to staying up-to-date with the evolving landscape of critical care nursing.
Choices A, C, and D are incorrect because:
A: Participating in recruitment efforts may be important but does not directly demonstrate awareness of current events affecting critical care nursing.
C: Adhering to basic nursing program content is necessary but does not show active engagement with current events in critical care nursing.
D: Attending hospital-mandated in-services is valuable, but without seeking additional education or involvement in current events, it does not illustrate awareness of the changing critical care nursing environment.
Which of the following is a normal age-related change for the female reproductive system?
A. Lung capability increases.
B. The response to vaccines decreases.
C. The amount of calcium in the body increases.
D. Vaginal walls become drier and thinner.
Correct answer:
The correct answer is D: Vaginal walls become drier and thinner. This is a normal age-related change in the female reproductive system due to decreasing levels of estrogen during menopause. Estrogen helps maintain the thickness and moisture of vaginal walls. As estrogen levels decline with age, the vaginal walls can become drier and thinner, leading to symptoms like vaginal dryness and increased risk of infection.
A, B, and C are incorrect:
A: Lung capability increasing is not a normal age-related change for the female reproductive system. It is more related to factors like physical fitness and environmental exposures.
B: Decreased response to vaccines is not a direct age-related change in the female reproductive system. It is influenced by factors like immune function and overall health.
C: The amount of calcium in the body increasing is not a normal age-related change for the female reproductive system. It is more related to bone health and hormonal regulation.
Mrs. Maroldo is an 81-year-old female who presents for evaluation of pain in her left lower quadrant. She has had this pain before and says she usually takes antibiotics and it goes away. However, this time it seems worse, and she has had it for 4 days even though she says she started taking her leftover antibiotics from the last episode. She denies any nausea or vomiting but says she simply isnt hungry. She had a little diarrhea yesterday but no bowel movements today. She has a temperature of 100.9F and a pulse of 104 bpm, respirations of 20 breaths per minute, and a blood pressure of 9460 mm Hg. She has some discomfort to deep palpation in the left lower quadrant. The AGACNP suspects
A. Irritable bowel syndrome
B. Inflammatory bowel disease
C. Diverticulitis
D. Appendicitis
Correct answer:
Mrs. Maroldo's presentation with left lower quadrant pain, fever, elevated heart rate, history of previous episodes of similar pain that improved with antibiotics, and recent diarrhea are all concerning for diverticulitis. Diverticulitis is an infection or inflammation of small pouches that can form in the wall of the colon, known as diverticula. The symptoms typically include localized abdominal pain, fever, elevated heart rate, and changes in bowel habits such as diarrhea or constipation. The discomfort to deep palpation in the left lower quadrant indicates inflammation in that area. The presence of fever, elevated heart rate, and low blood pressure suggests an infectious process requiring urgent evaluation and treatment. Further diagnostic tests such as a CT scan may be ordered to confirm the diagnosis and assess the extent of the inflammation. Appendicitis can also present with abdominal pain, but the location of the pain in the left lower quadrant makes diverticul
In which stage of disease progression would the nurse classify a client who has elevated blood pressure but no symptoms?
A. Susceptibility stage
B. Subclinical stage
C. Clinical stage
D. Carrier stage
Correct answer:
The correct answer is B: Subclinical stage. In this stage, the client has elevated blood pressure but no symptoms are present. This stage is characterized by the presence of the disease without noticeable symptoms. It is important for the nurse to identify and monitor clients in the subclinical stage to prevent progression to more severe stages.
Choice A: Susceptibility stage refers to the stage where the client is at risk of developing the disease but has not yet been affected. Elevated blood pressure without symptoms indicates that the disease has already manifested, ruling out the susceptibility stage.
Choice C: Clinical stage would involve the presence of symptoms, which is not the case with the client in question. Therefore, this choice is incorrect.
Choice D: Carrier stage typically refers to individuals who harbor a pathogen without showing symptoms themselves, which is not applicable to a client with elevated blood pressure. Hence, this choice is incorrect.
RN exams clinical judgment practice questions, set 32 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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