RN exams clinical judgment practice questions, set 8
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 8
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 81-year-old patient who has been in the intensive care unit (ICU) for a week is now stable, and transfer to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset confusion. The nurse will plan to:
A. Give PRN lorazepam (Ativan) and cancel the transfer.
B. Inform the receiving nurse and then transfer the patient.
C. Notify the health care provider and postpone the transfer.
D. Obtain an order for restraints as needed and transfer the patient.
Show answer and rationale
Correct answer: C — Notify the health care provider and postpone the transfer.
The correct answer is C: Notify the health care provider and postpone the transfer. The new onset confusion in an elderly patient in the ICU can be a sign of delirium, which is a serious condition that requires prompt evaluation and management. By notifying the healthcare provider, they can assess the patient's condition, order appropriate tests, and adjust the treatment plan as needed. Postponing the transfer allows for further observation and intervention to address the underlying cause of the confusion.
Choice A (Give PRN lorazepam and cancel the transfer) is incorrect because administering lorazepam may worsen the confusion in an elderly patient and should not be done without proper evaluation.
Choice B (Inform the receiving nurse and then transfer the patient) is incorrect because transferring the patient without addressing the new onset confusion can lead to potential complications and delay in appropriate management.
Choice D (Obtain an order for restraints as needed and transfer the patient) is incorrect because using restraints should only be considered as a
Question 2
A nurse is caring for a postpartum person who is breastfeeding. What is the most important action to support successful breastfeeding?
A. educate the person on proper latch
B. support skin-to-skin contact
C. promote frequent feeding
D. educate on postpartum care
Show answer and rationale
Correct answer: B — support skin-to-skin contact
The correct answer is B: support skin-to-skin contact. Skin-to-skin contact immediately after birth helps regulate the baby's body temperature, promotes bonding, and enhances breastfeeding success by stimulating the baby's natural instincts to latch on and feed. This action establishes a strong foundation for successful breastfeeding.
Rationale:
1. Skin-to-skin contact promotes bonding and attachment between the parent and baby, creating a supportive environment for breastfeeding.
2. It helps regulate the baby's body temperature, ensuring they are comfortable and more willing to breastfeed effectively.
3. Skin-to-skin contact triggers the baby's natural feeding reflexes, making it easier for them to latch on properly.
4. This action fosters a positive breastfeeding experience for both the parent and baby, setting the stage for successful breastfeeding.
Summary:
- Choice A: educating on proper latch is important, but skin-to-skin contact is more crucial for establishing successful breastfeeding.
- Choice C: promoting frequent feeding is beneficial, but skin-to
Question 3
Which of the following nursing activities demonstrates im plementation of the AACN Standards of Professional Performance? (Select all that ap ply.)
A. Attending a meeting of the local chapter of the Americ an Association of Critical-Care Nurses in which a continuing education program on sepsis is being taught
B. Collaborating with a pastoral services colleague to assist in meeting spiritual needs of the patient and family
C. Participating on the unit’s nurse practice council
D. Posting an article from Critical Care Nurse on manage ment of venous thromboembolism for your colleagues to read
Show answer and rationale
Correct answer: C — Participating on the unit’s nurse practice council
The correct answer is C because participating on the unit's nurse practice council demonstrates adherence to the AACN Standards of Professional Performance, specifically the standard related to quality of practice. By actively engaging in the nurse practice council, the nurse contributes to the development and implementation of policies and procedures that promote quality patient care. This activity also involves collaboration, leadership, and advocacy, which are essential components of professional nursing practice.
The other choices are incorrect because:
A: Attending a meeting and receiving continuing education on sepsis is important for professional development but does not directly align with the AACN Standards of Professional Performance.
B: Collaborating with a pastoral services colleague is essential for holistic patient care but does not specifically address the standards set by the AACN.
D: Posting an article for colleagues to read is beneficial for knowledge sharing but does not directly demonstrate adherence to the AACN Standards of Professional Performance.
Question 4
In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on the principle of:
A. veracity.
B. values.
C. utilitarianism.
D. autonomy.
Show answer and rationale
Correct answer: C — utilitarianism.
The correct answer is C: utilitarianism. Utilitarianism is the ethical principle that actions should be chosen based on their ability to maximize overall happiness or well-being. In this scenario, implementing hypertension screening and treatment for a community where most residents are hypertensive aligns with utilitarianism as it aims to benefit the greatest number of people by improving their health outcomes. This decision focuses on the overall good of the community, making it the most ethical choice.
Rationale for why other choices are incorrect:
A: Veracity is the principle of truthfulness. While honesty is important in healthcare decision-making, it is not the primary factor in this scenario.
B: Values refer to personal beliefs and principles. While values may influence decision-making, the primary focus in this scenario is on maximizing community health outcomes.
D: Autonomy is the principle of respecting individuals' right to make their own decisions. While autonomy is important in healthcare, it is not the guiding principle in this scenario where the focus is
Question 5
The nurse is discussing legal issues surrounding OB nursing. What statement might that nurse make?
A. Legal issues are the concern of the OB.'
B. I'm glad that people understand that all childbirth carries risk.'
C. Medical malpractice insurance is cheap.'
D. OB nurses are held to a standard of care and can be sued if proper care is not provided.'
Show answer and rationale
Correct answer: D — OB nurses are held to a standard of care and can be sued if proper care is not provided.'
The correct answer is D because OB nurses are indeed held to a standard of care and can be sued if proper care is not provided. OB nurses have a duty to ensure the safety and well-being of both the mother and the baby during childbirth. Failure to meet this standard of care can result in legal consequences such as being sued for medical malpractice.
Choice A is incorrect because legal issues surrounding OB nursing are not solely the concern of the OB, but rather a shared responsibility among all healthcare providers involved in the care of the mother and baby.
Choice B is incorrect as it does not directly address legal issues surrounding OB nursing, but rather focuses on the general understanding of childbirth risks.
Choice C is incorrect as medical malpractice insurance is not necessarily cheap, and the cost can vary depending on factors such as the nurse's experience, the hospital's history of malpractice claims, and the specific coverage needed.
In summary, choice D is the correct answer as it directly addresses the legal responsibilities and potential
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Question 6
The nurse learns about cultural issues involvedin the patient’s health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?
A. Marginalized groups
B. Health care disparity
C. Transcultural nursing
D. Culturally congruent care
Correct answer:
The correct answer is D: Culturally congruent care. This concept refers to providing care that aligns with the patient's cultural beliefs and practices. By learning about cultural issues and enabling patients to receive care that is meaningful and supportive within their cultural context, the nurse is demonstrating culturally congruent care.
A: Marginalized groups - This refers to groups in society who are disadvantaged and face discrimination. While understanding cultural issues may be important when caring for marginalized groups, it is not the main concept demonstrated in this scenario.
B: Health care disparity - This refers to differences in access to healthcare and health outcomes among different populations. While cultural competence can help address healthcare disparities, it is not the concept being demonstrated here.
C: Transcultural nursing - This refers to providing care across different cultures. While related, it does not specifically address the nurse's role in understanding and enabling culturally appropriate care for individual patients and families.
A pregnant patient is at 24 weeks gestation and reports feeling nauseous after eating. What is the most appropriate recommendation for the nurse to make?
A. Instruct the patient to take over-the-counter anti-nausea medications.
B. Encourage the patient to eat smaller, more frequent meals and avoid greasy foods.
C. Recommend the patient rest in bed to alleviate symptoms.
D. Advise the patient to reduce fluid intake to prevent nausea.
Correct answer:
The correct answer is B: Encourage the patient to eat smaller, more frequent meals and avoid greasy foods. This recommendation helps manage nausea during pregnancy by preventing the stomach from becoming too full, which can exacerbate symptoms. Eating smaller, more frequent meals helps maintain stable blood sugar levels and prevents hunger, which can trigger nausea. Avoiding greasy foods reduces the likelihood of indigestion and discomfort.
Explanation of why the other choices are incorrect:
A: Instructing the patient to take over-the-counter anti-nausea medications may not be suitable during pregnancy without consulting a healthcare provider due to potential risks to the fetus.
C: Recommending the patient to rest in bed may provide temporary relief but does not address the underlying cause of nausea and may not be practical for managing symptoms throughout the day.
D: Advising the patient to reduce fluid intake may lead to dehydration, which is particularly concerning during pregnancy. Adequate hydration is important for both the mother and the developing fetus.
The nurse leading an educational session is describing self-examination of the breast. The nurse tells the womens group to raise their arms and inspect their breasts in a mirror. A member of the womens group asks the nurse why raising her arms is necessary. What is the nurses best response?
A. It helps to spread out the fat that makes up your breast.
B. It allows you to simultaneously assess for pain.
C. It will help to observe for dimpling more closely.
D. This is what the American Cancer Society recommends.
Correct answer:
The correct answer is A: It helps to spread out the fat that makes up your breast. Raising the arms during breast self-examination stretches the breast tissue, making it easier to detect any lumps or abnormalities. This action also helps to distribute the breast tissue evenly, providing a clearer view of the entire breast. This method ensures a more thorough examination and increases the chances of detecting any changes in the breast tissue early on.
Summary of incorrect choices:
B: It allows you to simultaneously assess for pain - Although assessing for pain is important, raising the arms specifically helps with spreading out the breast tissue, not necessarily for assessing pain.
C: It will help to observe for dimpling more closely - While observing for dimpling is important, raising the arms is primarily for spreading out the breast tissue, not for observing dimpling.
D: This is what the American Cancer Society recommends - While recommendations from reputable sources are important, the rationale behind raising the arms during breast self-examination is not solely
The nurse is caring for a pregnant patient who is experiencing frequent contractions. The patient asks the nurse if the contractions are normal. Which response by the nurse is most appropriate?
A. Contractions are common at this stage and are usually harmless.
B. Frequent contractions are always a sign of labor starting.
C. Frequent contractions may be a sign of preterm labor, and further evaluation is needed.
D. You should drink more water to stop the contractions from happening.
Correct answer:
The correct answer is C: Frequent contractions may be a sign of preterm labor, and further evaluation is needed. This response is appropriate because frequent contractions in a pregnant patient can indicate preterm labor, which requires immediate medical attention to prevent potential complications for both the mother and the baby. It is crucial to evaluate the situation to determine the cause of the contractions and take appropriate actions.
Explanation for other choices:
A: Contractions are common at this stage and are usually harmless - This is inaccurate as frequent contractions, especially in a pregnant patient, should not be dismissed as harmless without proper evaluation.
B: Frequent contractions are always a sign of labor starting - This is incorrect because frequent contractions do not always indicate the onset of labor, especially in the case of preterm labor.
D: You should drink more water to stop the contractions from happening - This is not an appropriate response as hydration may not necessarily stop contractions, especially if they are due to pre
A nurse is developing a plan of care for a 16-year-old female client experiencing her first outbreak of genital herpes. The client states that she contracted the disease by holding hands with someone who has syphilis. Which nursing diagnosis should the nurse identify as the priority?
A. Acute pain related to the development of genital lesions
B. Lack of knowledge about the disease and its transmission
C. Ineffective coping related to the increased stress associated with the infection
D. Noncompliance with treatment related to age of the client
Correct answer:
The correct answer is B: Lack of knowledge about the disease and its transmission. This is the priority nursing diagnosis because the client's statement about contracting herpes by holding hands with someone who has syphilis indicates a lack of understanding about how genital herpes is transmitted. The nurse should prioritize educating the client about the disease, its transmission, and prevention to empower the client to make informed decisions about her health.
Choices A, C, and D are incorrect:
A: Acute pain may be a symptom of genital herpes, but addressing the lack of knowledge about the disease and its transmission is more essential for the client's well-being.
C: While coping with the stress of the infection is important, addressing the lack of knowledge should take precedence to prevent further transmission and help the client manage the condition effectively.
D: Noncompliance with treatment may be a concern, but addressing the client's lack of knowledge about the disease and its transmission is crucial in promoting understanding and adherence to treatment.
A hospice nurse who has become close to a terminally ill patient is present in the home when the patient dies and feels saddened and tearful as the family members begin to cry. Which action should the nurse take at this time?
A. Contact a grief counselor as soon as possible.
B. Cry along with the patient’s family members.
C. Leave the home as soon as possible to allow the family to grieve privately.
D. Consider whether working in hospice is desirable because patient losses are common.
Correct answer:
The correct answer is B: Cry along with the patient’s family members. This action demonstrates empathy and support for the family's grief, showing that the nurse acknowledges and shares their feelings. It can help the family feel understood and supported during a difficult time. By crying with the family, the nurse can validate their emotions and provide comfort without intruding on their personal space. This approach fosters a sense of connection and trust between the nurse and the family, enhancing the quality of care provided.
Incorrect Choices:
A: Contact a grief counselor as soon as possible - This choice may be premature and could come across as impersonal or distancing in the immediate aftermath of the patient’s death.
C: Leave the home as soon as possible - This choice would be insensitive and could make the family feel abandoned in their time of need.
D: Consider whether working in hospice is desirable because patient losses are common - This choice is inappropriate as it suggests the nurse should reconsider their career choice based on emotional reactions,
A nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction?
A. "Let's talk only about one movie you recently watched."
B. "I like to know about department store sales, but we need to get through this report, so let's talk about sales as we walk between patient rooms."
C. "I know your shift has been busy. What went wrong?"
D. "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."
Correct answer:
The correct answer is D because it directly addresses the issue of time management during shift report by focusing on the essential tasks that need to be discussed. By starting with revisions to the plan of care and scheduled activities for the next shift, the nurse ensures that the most critical information is covered efficiently. This approach helps prioritize the discussion and prevent unnecessary time spent on non-essential topics.
Option A is incorrect because limiting the discussion to just one movie does not address the overall time management issue during shift report. Option B is incorrect because discussing department store sales while walking between patient rooms may still lead to distractions and inefficiencies in the report.
Option C is incorrect as it focuses on what went wrong during the shift rather than addressing the need for efficient time management during the report. The correct answer, D, is the most effective choice as it directly tackles the issue of time wasted during shift report by emphasizing the essential tasks that need to be covered.
Critical illness often results in family conflicts. Which scenario is most likely to result in the greatest conflict?
A. A 21-year-old college student of divorced parents hosp italized with multiple trauma. She resides with her mother. The parents are amicable with each other and have similar values. The father blames the daughter’s b oyfriend for causing the accident.
B. A 36-year-old male admitted for a ruptured cerebral an eurysm. He has been living with his 34-year-old girlfriend for 8 years, and they have a 4-year-old daughter. He does not have written advance directives. His parents aarbriribv.ceo mfr/otemst out-of-state and are asked to make decisions about his health care. He h as not seen them in over a year.
C. A 58-year-old male admitted for coronary artery bypas s surgery. He has been living with his same-sex partner for 20 years in a committed relationship. He has designated his sister, a registered nurse, as his healthca re proxy in a written advance directive.
D. A 78-year-old female admitted with gastrointestinal blaebeirdbi.cnogm./ tHeset r hemoglobin is decreasing to a critical level. She is a Jehovah’s Witness and refuses the treatment of a blood transfusion. She is capable of making her ow n decisions and has a clearly written advance directive declining any transfu sions. Her son is upset with her and tells her she is “committing suicide.”
Correct answer:
The correct answer is D because it involves a conflict between the patient's autonomy and her son's beliefs. The patient, a Jehovah's Witness, has clearly stated her refusal of a blood transfusion in her advance directive, which aligns with her religious beliefs. Her son's disagreement with her decision creates a significant ethical dilemma and conflict. This scenario highlights the clash between respecting the patient's autonomy and the son's concerns for her well-being.
Choice A is less likely to result in the greatest conflict as both parents have similar values and are amicable, with the conflict being directed towards the daughter's boyfriend.
Choice B involves a conflict between the patient's girlfriend and parents, but the patient's lack of advance directives and estranged relationship with his parents do not present as significant a conflict as in the correct answer.
Choice C involves a designated healthcare proxy and a committed relationship, which are less likely to result in a conflict as compared to the clash of beliefs and autonomy seen in Choice D.
An89-year-oldmalepatientiswheelchairboundfollowingahemorrhagicstrokeandhasbeenlivingin N anursinghomesinceleavingthehospital.Hereturnstotheadjacentprimarycareclinicbywheelchair forfollow-upcareofhypertensionandotherhealthproblems.Thenursewouldmodifyhishealthhistory toincludewhichquestion?
A. Tell me about your medications: How do you usually get them each day?
B. Tell me about where you live: Do you feel your needs are being met, and do you feel safe?
C. What limitations are you dealing with related to your health and being in a wheelchair? Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 15e 91
D. How do you deal with that?
Correct answer:
The correct answer is C: "What limitations are you dealing with related to your health and being in a wheelchair?" This question is the most appropriate as it directly addresses the patient's current health status and the impact of being wheelchair-bound on his daily life. It shows a focus on assessing the patient's functional status and potential challenges he may be facing due to his condition.
Choice A is incorrect because while knowing about the patient's medications and how he obtains them is important, it does not directly address the impact of his current health status and wheelchair use.
Choice B is incorrect as it focuses on the patient's living situation rather than his health status and wheelchair limitations.
Choice D is incorrect as it is a vague and open-ended question that does not specifically address the patient's health status and the impact of being wheelchair-bound.
In summary, choice C is the correct answer as it directly addresses the patient's health and functional limitations, which are crucial for providing appropriate care and support.
In the past three to four decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has most contributed to this increased focus of care of the dying?
A. Increased incidence of infections and acute illnesses
B. Increased focus of health care providers on disease prevention
C. Larger numbers of people dying in hospital settings
D. Demographic changes in the population
Correct answer:
The correct answer is D: Demographic changes in the population. This is because as the population ages, there is a higher prevalence of chronic illnesses and an increased number of people facing end-of-life care needs. This has led to a greater demand for palliative and hospice care services, shifting the focus of nursing towards providing care for the dying.
A: Increased incidence of infections and acute illnesses is not the primary factor contributing to the increased focus on care for the dying. While these conditions do require nursing care, they do not directly explain the shift in focus.
B: Increased focus of health care providers on disease prevention is important but does not directly explain the increased attention on care for the dying. Disease prevention aims to reduce the incidence of illnesses, not necessarily address end-of-life care needs.
C: Larger numbers of people dying in hospital settings may be a consequence of the increased focus on care for the dying, but it is not the underlying phenomenon driving the shift in nursing care towards end-of
RN exams clinical judgment practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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