RN exams clinical judgment practice questions, set 47
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 47
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
Which patient may require more help and understanding when integrating the newborn into the family?
A. A primipara from an upper income family
B. A primipara who comes from a large family
C. A multipara (gravida 2) who has a supportive husband and mother
D. A multipara (gravida 6) who has two children younger than 3 years
Show answer and rationale
Correct answer: D — A multipara (gravida 6) who has two children younger than 3 years
The correct answer is D because a multipara with six pregnancies and two young children may require more help and understanding due to the potential challenges of caring for multiple young children simultaneously. The presence of two children younger than 3 years old indicates that the mother may be experiencing higher levels of stress and demands on her time and energy. This situation could lead to difficulties in integrating the newborn into the family dynamics.
Choice A is incorrect because being from an upper-income family does not necessarily indicate a need for more help and understanding. Choice B is incorrect because coming from a large family does not directly correlate with requiring more assistance when integrating a newborn. Choice C is incorrect because having a supportive husband and mother can provide valuable assistance and may not necessarily indicate a greater need for help compared to the scenario described in choice D.
Question 2
Which bacterium is known as a common cause of hospital-acquired infections?
A. Clostridium botulinum
B. Staphylococcus aureus
C. Treponema pallidum
D. Mycobacterium leprae
Show answer and rationale
Correct answer: B — Staphylococcus aureus
The correct answer is B: Staphylococcus aureus. This bacterium is known as a common cause of hospital-acquired infections due to its ability to colonize the skin and mucous membranes of healthcare workers and patients. Staphylococcus aureus can cause various infections, including surgical site infections and bloodstream infections, in healthcare settings.
Rationale:
1. Clostridium botulinum is known for causing foodborne botulism, not hospital-acquired infections.
2. Treponema pallidum causes syphilis, which is primarily transmitted through sexual contact, not hospital settings.
3. Mycobacterium leprae causes leprosy, which is not commonly associated with hospital-acquired infections.
In summary, Staphylococcus aureus is the correct answer as it is a common cause of hospital-acquired infections due to its prevalence in healthcare environments, unlike the other choices which are not typically associated with hospital-acquired infections.
Question 3
An elderly woman with dementia is brought in by her daughter for a "rectal mass." On examination you notice a moist pink mass protruding from the anus, which is nontender. It is soft and does not have any associated bleeding. Which of the following is most likely?
A. Rectal prolapse
B. External hemorrhoid
C. Perianal fistula
D. Prolapsed internal hemorrhoid
Show answer and rationale
Correct answer: A — Rectal prolapse
Rectal prolapse occurs when the rectum protrudes through the anus. It typically appears as a moist, pink mass that protrudes outside the body. The prolapse is usually painless and can be seen and felt by the patient or the examiner. It is commonly seen in elderly individuals, especially women, and those with conditions like chronic constipation, pelvic floor weakness, or dementia. On the other hand, external hemorrhoids are swollen veins located around the anus, usually painful and may cause bleeding. Perianal fistula is an abnormal tunnel-like connection between the skin near the anus and the rectum, which can cause pain and discharge. Prolapsed internal hemorrhoids are internal hemorrhoids that have descended outside the anal canal and may require manual reduction. Given the symptoms described in the scenario - a moist pink mass protruding from the anus that is nontender and soft without bleeding - the most likely diagnosis is rectal prol
Question 4
A patient reports, 'I am overwhelmed by stress.' Which question by the nurse would be most important to use in the initial assessment of this patient?
A. Tell me about your family history. Do you have any relatives who have problems with stress?'
B. Tell me about your exercise. How much activity do you typically get in a day?'
C. Tell me about the kinds of things you do to reduce or cope with your stress.'
D. Stress can interfere with sleep. How much did you sleep last night?'
Show answer and rationale
Correct answer: C — Tell me about the kinds of things you do to reduce or cope with your stress.'
The most important data to collect during an initial assessment is that which reflects how stress is affecting the patient and how he is coping with stress at present. This data would indicate whether or not his distress is placing him in danger (e.g., by elevating his blood pressure dangerously or via maladaptive responses, such as drinking) and would help the nurse understand how he copes and how well his coping strategies and resources serve him. Of the choices presented, the highest priority would be to determine what he is doing to cope at present, preferably via an open-ended inquiry. Family history, the extent of his use of exercise, and how much sleep he is getting are all helpful but seek data that is less of a priority. Also, the manner in which such data is sought here is likely to provide only brief responses (e.g., how much sleep he got on one particular night is probably less important than how much he is sleeping in general).
Question 5
An older adults unexplained weight loss of 15 pounds over the past 3 months has prompted a thorough o diagnostic workup. What is the nurses rationale for prioritizing biochemical assessment when appraising a persons nutritional status? N
A. It identifies abnormalities in the chemical structure of nutrients.
B. It predicts abnormal utilization ogf nutrients.
C. It reflects the tissue level of a given nutrient. n
D. It predicts metabolic abnormalities in nutritional intak
Show answer and rationale
Correct answer: D — It predicts metabolic abnormalities in nutritional intak
The correct answer is D because prioritizing biochemical assessment in nutritional status appraisal helps predict metabolic abnormalities in nutritional intake. By analyzing blood levels of key nutrients and metabolic markers, the nurse can identify deficiencies or excesses that indicate how well the body is utilizing nutrients. This information can guide interventions to correct imbalances and improve overall health.
Choice A is incorrect as it refers to identifying abnormalities in the chemical structure of nutrients, which is not directly related to predicting metabolic abnormalities in nutritional intake. Choice B is incorrect because predicting abnormal utilization of nutrients does not necessarily directly correlate to metabolic abnormalities. Choice C is incorrect as it refers to reflecting the tissue level of a given nutrient, which is not the primary focus when prioritizing biochemical assessment for nutritional status appraisal.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
A patient reports, 'I am overwhelmed by stress.' Which question by the nurse would be most important to use in the initial assessment of this patient?
A. Tell me about your family history. Do you have any relatives who have problems with stress?'
B. Tell me about your exercise. How much activity do you typically get in a day?'
C. Tell me about the kinds of things you do to reduce or cope with your stress.'
D. Stress can interfere with sleep. How much did you sleep last night?'
Correct answer:
The most important data to collect during an initial assessment is that which reflects how stress is affecting the patient and how he is coping with stress at present. This data would indicate whether or not his distress is placing him in danger (e.g., by elevating his blood pressure dangerously or via maladaptive responses, such as drinking) and would help the nurse understand how he copes and how well his coping strategies and resources serve him. Of the choices presented, the highest priority would be to determine what he is doing to cope at present, preferably via an open-ended inquiry. Family history, the extent of his use of exercise, and how much sleep he is getting are all helpful but seek data that is less of a priority. Also, the manner in which such data is sought here is likely to provide only brief responses (e.g., how much sleep he got on one particular night is probably less important than how much he is sleeping in general).
The wife of a patient with schizophrenia is worried about her 17-year-old daughter and asks the nurse what symptoms mark the prodromal stage of schizophrenia. The nurse should respond by listing behaviors such as:
A. withdrawal, poor concentration, phobic or obsessive behavior, oddities of speech.
B. auditory hallucinations, ideas of reference, thought insertion, and broadcasting.
C. stereotyped behavior, echopraxia, echolalia, waxy flexibility, thought-blocking.
D. looseness of associations, concrete thinking, echolalia, paranoid delusions.
Correct answer:
The correct answer is A because the symptoms listed: withdrawal, poor concentration, phobic or obsessive behavior, and oddities of speech are characteristic of the prodromal stage of schizophrenia. During this phase, individuals may start to exhibit subtle changes in behavior and thinking, which may signal the onset of the disorder.
Choice B includes symptoms of active psychosis, such as auditory hallucinations and delusions, which are not typically seen in the prodromal stage. Choice C describes symptoms of catatonia, which are not specific to the prodromal phase. Choice D includes symptoms of acute psychosis, such as paranoid delusions, which are not typically present during the prodromal stage.
In summary, the correct answer is A because it accurately reflects the early, subtle symptoms that may precede the full onset of schizophrenia, while the other choices describe symptoms that are more indicative of later stages of the disorder.
The home health nurse visits a client with heart failure who has increased dyspnea and peripheral edema and weight gain. The nurse suspects the client is not restricting fluids as prescribed. Which action by the nurse is most appropriate?
A. Teach the client about the consequences of not following the fluid restrictions.
B. Ask the client to report the amount of fluid intake for the past 24 hours.
C. Provide the client with sugarless candy or gum to decrease the thirst sensation.
D. Consult with the healthcare provider about increasing the dose of the diuretic.
Correct answer:
Step 1: Asking the client to report the amount of fluid intake for the past 24 hours is the most appropriate action because it provides objective data on the client's adherence to fluid restrictions.
Step 2: This information helps the nurse to assess the client's compliance and make informed decisions about the next steps in care.
Step 3: By obtaining accurate information on fluid intake, the nurse can identify any discrepancies between prescribed fluid restrictions and actual intake, leading to appropriate interventions.
Step 4: This action promotes client accountability and empowers them to take an active role in managing their health.
In summary, choice B is correct as it directly addresses the issue of non-adherence to fluid restrictions by gathering crucial information for assessment and intervention. Choices A, C, and D do not provide immediate actionable data on the client's fluid intake and do not address the core issue effectively.
The patient has just started on enteral feedings, and the patient is reporting abdominal cramping. Which action will the nurse takenext?
A. Slow the rate of tube feeding.
B. Instill cold formula to “numb” the stomach.
C. Change the tube feeding to a high-fat formula.
D. Consult with the health care provider about prokinetic medication.
Correct answer:
Correct Answer: A
Rationale: Abdominal cramping in a patient on enteral feedings could indicate feeding intolerance. The nurse's initial action should be to slow down the rate of the tube feeding to allow the patient's gastrointestinal tract to adjust gradually. This helps reduce the risk of further complications and allows for better tolerance. Slowing the rate is a safe and effective intervention that can help alleviate the abdominal cramping without causing additional stress on the patient's digestive system.
Summary of Incorrect Choices:
B: Instilling cold formula is not a recommended practice and can potentially cause harm or discomfort to the patient.
C: Changing to a high-fat formula may exacerbate the abdominal cramping as it can be harder to digest for some patients.
D: Consulting with the healthcare provider about prokinetic medication should come after trying less invasive interventions such as slowing the rate of tube feeding.
Which type of formula should not be diluted before being administered to an infant?
A. Powdered
B. Concentrated
C. Ready to use
D. Modified cow's milk
Correct answer:
The correct answer is C: Ready to use. Ready to use formula should not be diluted before being administered to an infant because it is already in the appropriate concentration for consumption. Diluting it further could result in the infant not receiving the necessary nutrients in the right proportions, potentially leading to nutritional deficiencies or other health issues.
Explanation of why other choices are incorrect:
A: Powdered formulas are designed to be mixed with water according to specific instructions provided by the manufacturer, so they should be diluted before administering to an infant.
B: Concentrated formulas are meant to be mixed with water before feeding to the infant, so they should be diluted as per the instructions.
D: Modified cow's milk should be diluted as it is not suitable for infants in its concentrated form and needs to be appropriately prepared according to guidelines provided by healthcare professionals.
A patient has just been diagnosed with breast cancer and the nurse is performing a patient interview. In assessing this patients ability to cope with this diagnosis, what would be an appropriate question for the nurse to ask this patient?
A. What is your level of education?
B. Are you feeling alright these days?
C. Is there someone you trust to help you make treatment choices?
D. Are you concerned about receiving this diagnosis?
Correct answer:
The correct answer is C: Is there someone you trust to help you make treatment choices? This question assesses the patient's support system and ability to make informed decisions, which are crucial in coping with a breast cancer diagnosis. It shows the nurse's consideration for the patient's emotional well-being and involvement in the decision-making process.
Choice A: What is your level of education? This question is not directly related to coping with the diagnosis of breast cancer and may not provide relevant information about the patient's ability to cope.
Choice B: Are you feeling alright these days? While this question shows concern for the patient's well-being, it does not specifically address coping mechanisms or support systems.
Choice D: Are you concerned about receiving this diagnosis? This question focuses on the patient's emotional reaction to the diagnosis but does not directly assess coping strategies or support systems.
The nurse is performing tuberculosis (TB) skin tests in a clinic that has many patients who have immigrated to the United States. Which question is most important for the nurse to ask before the skin test?
A. Do you take any over-the-counter (OTC) medications?
B. Do you have any family members with a history of TB?
C. How long has it been since you moved to the United States?
The correct answer is C: How long has it been since you moved to the United States? This question is important because TB prevalence varies in different countries, and individuals who have recently immigrated from high TB burden countries may have a higher risk of TB infection. It helps the nurse assess the individual's potential exposure risk.
A: Do you take any over-the-counter (OTC) medications? - This question is not directly related to TB skin testing and does not provide information relevant to assessing TB risk.
B: Do you have any family members with a history of TB? - While a family history of TB can be a risk factor, it is not as directly relevant as the timing of immigration in this context.
D: Did you receive the bacille Calmette-Guérin (BCG) vaccine for TB? - While BCG vaccination history is important for interpreting TB skin test results, it is not as crucial as determining recent immigration status when assessing TB risk.
The spouse of a patient with terminal cancer visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year. When the nurse asks about any concerns, the spouse says, 'I’m busy at work, but otherwise, things are fine.' Which nursing diagnosis is most appropriate?
A. Ineffective coping related to lack of grieving.
B. Anxiety related to the complicated grieving process.
C. Caregiver role strain related to feeling overwhelmed.
D. Hopelessness related to knowledge deficit about cancer.
Correct answer:
The correct answer is A: Ineffective coping related to lack of grieving. The spouse's behavior of avoiding the reality of the terminal illness and focusing on future plans indicates maladaptive coping. The cheerfulness and denial suggest a lack of acceptance and processing of the impending loss. This can lead to emotional distress and hinder the grieving process.
Choice B (Anxiety related to the complicated grieving process) is incorrect because the spouse's behavior does not exhibit signs of anxiety but rather avoidance and denial. Choice C (Caregiver role strain related to feeling overwhelmed) is incorrect as the spouse does not express feeling overwhelmed but instead deflects by focusing on work. Choice D (Hopelessness related to knowledge deficit about cancer) is incorrect because the spouse's behavior does not indicate hopelessness or lack of understanding about cancer, but rather an avoidance of facing the reality of the situation.
A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic?
A. Smoking is the reason you are here.
B. The doctor left orders for you not to smoke.
C. You are anxious about the surgery. Do you see smoking as helping?
D. Smoking is OK right now, but after your surgery it is contraindicated.
Correct answer:
The correct answer is C: "You are anxious about the surgery. Do you see smoking as helping?" This response acknowledges the patient's anxiety and invites him to explore his reasons for wanting to smoke, opening up a dialogue and potentially uncovering underlying issues. It also avoids judgment or direct orders, fostering a therapeutic nurse-patient relationship.
Explanation of why the other choices are incorrect:
A: "Smoking is the reason you are here." - This response is blaming and may increase the patient's guilt or anxiety, hindering effective communication.
B: "The doctor left orders for you not to smoke." - This response is authoritative and may lead to resistance or defensiveness from the patient, rather than addressing his concerns.
D: "Smoking is OK right now, but after your surgery it is contraindicated." - This response is unclear and may send mixed messages to the patient, potentially leading to confusion or misunderstanding.
Which assessment finding for Mr. L (tracheostomy and partial laryngectomy) would be of greatest concern?
A. Pulsation of the tracheostomy tube in synchrony with the heartbeat
B. Increased secretions in and around the tracheostomy
C. Increased coughing, with difficulty in expectorating secretions
D. Presence of food particles in tracheal secretions
Correct answer:
The correct answer is A because pulsation of the tracheostomy tube in synchrony with the heartbeat indicates a potential risk of arterial bleeding, a serious complication that requires immediate intervention. This finding suggests that there may be a nearby major blood vessel that is pulsating due to arterial bleed. Immediate action is needed to prevent further bleeding and ensure patient safety.
Choice B is incorrect because increased secretions in and around the tracheostomy, while concerning, do not represent an immediate life-threatening situation like arterial bleeding.
Choice C is incorrect as increased coughing with difficulty in expectorating secretions could be indicative of respiratory issues but is not as urgent as arterial bleeding.
Choice D is incorrect as the presence of food particles in tracheal secretions may indicate aspiration or improper swallowing, but it is not as immediately life-threatening as arterial bleeding.
RN exams clinical judgment practice questions, set 47 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the RN exams exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
