RN exams clinical judgment practice questions set 54

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The correct answer is B. Tube feedings until the client eats 90% of all meals for 1 day. This intervention is appropriate for a client with anorexia nervosa who is refusing to eat. Tube feedings ensure adequate nutrition while also encouraging the client to resume eating orally. It is a gradual approach that aims to transition the client back to regular eating habits. Explanation for why other choices are incorrect: A: IV infusions are not the first-line intervention for a client with anorexia nervosa refusing to eat. This choice does not address the underlying issue of the client's refusal to eat. C: Placing the client on suicide precautions and one-to-one observation is not indicated solely based on refusal to eat. This choice does not address the nutritional needs of the client. D: Limiting peer group visitors for 2 weeks does not address the client's refusal to eat and is not a relevant intervention in this situation.

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The correct answer is B: Referral for biofeedback training in pelvic muscle exercise. Biofeedback training helps Ms. J improve her pelvic muscle control, which can address her urinary leakage issue. It is specifically tailored to strengthen the pelvic floor muscles, which can help with urinary incontinence. This option is appropriate for Ms. J as she has already tried Kegel exercises without success. Option A: Bladder training focuses on scheduling toilet trips and gradually increasing the time between trips. It may not be as effective for Ms. J's specific issue with leakage during physical activity. Option C: Solifenacin is a medication for overactive bladder symptoms, which may not be the best approach for Ms. J who has stress urinary incontinence. Option D: Topical estrogen is used for menopausal symptoms and genitourinary atrophy, which may not directly address Ms. J's issue with urinary leakage during physical activity.

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Mrs. Fletcher's symptoms of unilateral pain during chewing, which is chronic, without facial tenderness or tenderness of the scalp are more suggestive of temporomandibular joint (TMJ) syndrome rather than other conditions listed. TMJ syndrome is characterized by pain and dysfunction of the jaw muscles and the joints that connect the jaw to the skull. The pain is often worsened by chewing or opening the mouth widely. In this case, the absence of facial tenderness or signs of temporal arteritis makes these conditions less likely. Trigeminal neuralgia typically presents with sudden, severe facial pain in the distribution of the trigeminal nerve. Tumor of the mandible would likely present with other symptoms such as swelling, bone destruction, or difficulty with mouth opening and chewing. Temporal arteritis usually presents with symptoms such as headache, scalp tenderness, and visual disturbances. Given Mrs. Fletcher's presentation,

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The most effective action the nurse leader can take will be the one that encourages the group to solve its own problem. Pointing out changes in the group and asking members to respond to them lays the foundation for a discussion of group dynamics. Asking members to respond to the talkative patient puts that patient in an awkward position, likely increasing her anxiety. As anxiety increases, monopolizing behavior tends to increase as well, so this response would be self-defeating. Asking members what is going on is a broader opening and might lead to responses unrelated to the issue that bears addressing; narrowing the focus to the group process more directly addresses what is occurring in the group. Focusing on the talkative patient would be less effective and involves the leader addressing the issue instead of members first attempting to do so themselves (giving them a chance to practice skills such as assertive communication).

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The correct answer is C: “I will have blood drawn at 1 hour after I drink the glucose solution.” This statement demonstrates understanding of the GCT procedure. The glucose challenge test involves drinking a sugary solution, followed by blood drawn 1 hour later to measure blood glucose levels. This timing is crucial for assessing the body's ability to metabolize glucose, which helps in diagnosing gestational diabetes. Explanation of why the other choices are incorrect: A: “I have to fast the night before the test.” - This is incorrect as fasting is not required for the GCT. B: “I will drink a sugary solution containing 100 g of glucose.” - This is incorrect as the GCT typically involves drinking a solution with a standardized amount of glucose, usually 50 g, not 100 g. D: “I should keep track of my baby’s movements between now and the test.” - This is unrelated to the GCT procedure and does not demonstrate understanding of the

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The correct answer is A: TRUE. Poxviruses are indeed the largest viruses known, ranging from 200-450 nm in size, which is close to the resolution limit of a light microscope. This makes them almost visible under a light microscope. Explanation: 1. Poxviruses have complex structures and are among the largest viruses. 2. Light microscopes have a resolution limit of around 200 nm. 3. Poxviruses fall within the size range that is close to the resolution limit of a light microscope. 4. Therefore, poxviruses are almost visible under a light microscope. Summary: Choice B is incorrect because poxviruses are indeed large enough to be almost visible under a light microscope. Choice C is incorrect as it implies uncertainty, but poxviruses are consistently close to the resolution limit of a light microscope. Choice D is incorrect as the size of poxviruses being almost visible under a light microscope is a factual statement, not dependent

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The patient's presentation with an enlarged chest diameter, decreased breath sounds throughout all lobes, and the presence of rhonchi over all lung fields is suggestive of a chronic condition that affects the entire respiratory system. These findings are classic for COPD, a progressive lung disease characterized by airflow limitation. The breath sounds are decreased due to airflow obstruction, and the presence of rhonchi indicates mucus production and airway inflammation commonly seen in COPD. In contrast, a spontaneous pneumothorax would typically present with sudden chest pain and shortness of breath, often in a younger patient with risk factors such as smoking. Asthma would present with wheezing, shortness of breath, and possibly a history of atopy or allergies. Pneumonia would typically present with fever, cough, and focal findings on chest examination, such as crackles or bronchial breath sounds over a consolidated area. In

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The correct answer is D: Cord blood gas. When the mother has Rh type O blood and the newborn's Apgar score is low, it indicates potential oxygenation issues during birth. Cord blood gas analysis is crucial to assess the newborn's oxygenation status and acid-base balance. A low Apgar score suggests the need to evaluate the newborn's respiratory and metabolic functions, which can be done through cord blood gas analysis. A: Cardiac enzymes - Not relevant in this scenario as the focus is on oxygenation and respiratory function, not cardiac issues. B: Blood glucose - Not directly related to the situation described, as low Apgar score and Rh blood type are more indicative of oxygenation and potential Rh incompatibility. C: Electrolyte panel - While electrolyte imbalance is important, cord blood gas analysis provides more immediate information on oxygenation and acid-base balance, which are crucial in low Apgar score situations.

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Correct Answer: D - Give acetaminophen (Tylenol) 650 mg per nasogastric tube. Rationale: LPNs/LVNs are trained to administer medications, including oral and nasogastric routes. Giving acetaminophen via nasogastric tube is within their scope of practice. LPNs/LVNs should have the knowledge and skills to safely administer this medication as part of the hypothermia protocol. Summary of other choices: A: Continuously monitor heart rhythm - This requires specialized training and skills typically within the scope of registered nurses or cardiac monitoring technicians. B: Check neurologic status every 2 hours - Assessing neurologic status requires critical thinking and clinical judgment, which are typically responsibilities of registered nurses. C: Place cooling blankets above and below the patient - Positioning and managing cooling devices may require specific training and should be done under the supervision of a registered nurse.

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The correct answer is C, a combination of stimulated sucking and receiving sucrose orally. Thakkar et al. (2016) found that this method effectively reduced pain response during heel sticks in neonates. Stimulated sucking triggers the release of endorphins, providing natural pain relief, while sucrose activates sweet taste receptors, further reducing pain perception. This dual approach addresses both physiological and psychological aspects of pain management in neonates. Choice A (anesthetic gel) may not be as effective for heel sticks as it takes time to work and may not provide comprehensive pain relief. Choice B (breastfeeding) may distract the neonate but does not directly address pain management. Choice D (en face positioning) may promote bonding but does not offer a specific pain management strategy. Overall, choice C is supported by research and provides a holistic approach to neonatal pain control during heel sticks.