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RN exams clinical judgment practice questions, set 81

RN exams · clinical judgment

RN exams clinical judgment practice questions set 81

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

In the scenario where parents at Central Elementary School responded to a multiple-choice questionnaire regarding the most important activity they do with their child, this is an example of a __________.

  1. A. structured interview
  2. B. clinical interview
  3. C. naturalistic observation
  4. D. structured observation
Show answer and rationale

Correct answer: A — structured interview

A structured interview involves asking individuals a predetermined set of questions in a set order. In this scenario, parents at Central Elementary School were given a multiple-choice questionnaire, which indicates that the questions were predetermined and likely asked in a specific order. This method allows for standardized data collection and comparison across participants. Choice B, clinical interview, involves in-depth questioning aimed at understanding an individual's thoughts, feelings, and behaviors related to psychological issues, which is not the case here. Choice C, naturalistic observation, involves observing individuals in their natural environment without interference, which is not applicable to a questionnaire scenario. Choice D, structured observation, involves systematically observing behavior in predefined ways, not relevant to the given scenario of questionnaire responses.

Question 2

A patient was admitted to the mental health unit after arguing with co-workers and threatening to kill them. He is diagnosed with paranoid schizophrenia. On the unit he is aloof and suspicious. He mentioned that two physicians he saw talking were plotting to kill him. On the basis of data gathered at this point, which two primary nursing diagnoses should the nurse consider?

  1. A. Disturbed thought processes and Risk for other-directed violence
  2. B. Spiritual distress and Social isolation
  3. C. Risk for loneliness and Knowledge deficit
  4. D. Disturbed personal identity and Nonadherence
Show answer and rationale

Correct answer: A — Disturbed thought processes and Risk for other-directed violence

The correct answer is A: Disturbed thought processes and Risk for other-directed violence. 1. Disturbed thought processes: The patient's delusion of being plotted against by the physicians indicates impaired thought processes typical of paranoid schizophrenia. 2. Risk for other-directed violence: The patient's threatening behavior towards co-workers suggests a potential for violent acts towards others due to his paranoid beliefs. Summary of why other choices are incorrect: B: Spiritual distress and Social isolation are not primary concerns given the patient's acute symptoms of paranoia and risk for violence. C: Risk for loneliness and Knowledge deficit are not crucial at this point as the patient's primary issues are related to paranoia and violence. D: Disturbed personal identity and Nonadherence are not relevant to the immediate safety and mental health concerns presented by the patient.

Question 3

A patient in the emergency department shows a variety of psychiatric symptoms, including restlessness and anxiety. The patient says, "I feel sad because evil spirits have overtaken my mind." Which worldview is most applicable to this individual?

  1. A. Eastern/balance
  2. B. Southern/holistic
  3. C. Western/scientific
  4. D. Indigenous/harmony
Show answer and rationale

Correct answer: D — Indigenous/harmony

The correct answer is D: Indigenous/harmony. This worldview is most applicable because the patient's belief in evil spirits aligns with many indigenous cultures that attribute mental health issues to spiritual causes. In indigenous communities, maintaining harmony with nature and spiritual beings is essential for well-being. The patient's symptoms and explanation indicate a belief in the influence of spiritual forces on mental health. A: Eastern/balance focuses on achieving harmony within oneself and with the environment, but the patient's explanation is more about external evil spirits. B: Southern/holistic emphasizes interconnectedness of mind, body, and spirit, but the patient's belief in evil spirits is more specific to indigenous perspectives. C: Western/scientific relies on empirical evidence and medical explanations, which are not in line with the patient's spiritual explanation.

Question 4

A patient who has a history of chronic obstructive pulmonary disease (COPD) was hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels of 89% to 90%). In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching?

  1. A. Have the patient repeat the instructions immediately after teaching.
  2. B. Accomplish the patient teaching just before the scheduled discharge.
  3. C. Arrange for the patient's caregiver to be present during the teaching.
  4. D. Start giving the patient discharge teaching during the admission process.
Show answer and rationale

Correct answer: C — Arrange for the patient's caregiver to be present during the teaching.

The correct answer is C: Arrange for the patient's caregiver to be present during the teaching. Rationale: 1. Involving the patient's caregiver promotes better understanding and support for the patient's care at home. 2. Caregivers can assist in reinforcing teaching, ensuring the patient follows instructions. 3. Caregivers can help monitor the patient for any signs of worsening condition or noncompliance. 4. This approach is effective in addressing potential barriers to compliance and continuity of care. Summary of other choices: A: Having the patient repeat instructions may not guarantee understanding or retention of information. B: Teaching just before discharge may not allow enough time for the patient and caregiver to fully grasp and prepare for home care. D: Starting teaching during admission may overwhelm the patient and may not address the need for ongoing support at home.

Question 5

Epinephrine is effective in helping reverse the adverse effects of anaphylaxis. It is the drug of choice because it causes bronchodilation and vasoconstriction to improve respiratory effort and improve blood pressure. What other effect does epinephrine have on the patient's body during an anaphylactic reaction?

  1. A. It reduces the release of chemical mediators from the mast cells
  2. B. It is effective in reducing the inflammatory response of the reaction
  3. C. Increases the heart rate to improve peripheral perfusion
  4. D. It causes peripheral vasoconstriction to reduce the itching associated with the reaction
Show answer and rationale

Correct answer: A — It reduces the release of chemical mediators from the mast cells

The correct answer is A: It reduces the release of chemical mediators from the mast cells. Epinephrine acts on adrenergic receptors to inhibit mast cell degranulation, reducing the release of histamine and other inflammatory mediators that contribute to anaphylaxis. This helps to prevent further systemic allergic reactions and stabilize the patient. Choice B is incorrect because while epinephrine does help reduce the overall inflammatory response by stabilizing mast cells, it is not the primary mechanism of action. Choice C is incorrect as epinephrine primarily causes an increase in heart rate through its positive inotropic and chronotropic effects on the heart, rather than peripheral vasoconstriction. Choice D is incorrect as while epinephrine does cause vasoconstriction, it is mainly focused on improving blood pressure and systemic vascular resistance rather than reducing itching.

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Question 6

A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?

  1. A. Due to my weight, there is a possibility that I may develop gestational diabetes.
  2. B. I am not overweight, but I am still at risk for gestational diabetes.
  3. C. My mother had preeclampsia during one of her pregnancies.
  4. D. I will need to do a glucose tolerance test in my second trimester.
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Question 7

An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?

  1. A. There is no supervision, because at times the LPN/LVN is not with the RN.
  2. B. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care.
  3. C. Continual supervision is being provided until the RN determines competency.
  4. D. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.
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Question 8

About the vascularization of the uterus we can state the following:

  1. A. the arteries branch off the common iliac artery;
  2. B. the arteries are branches off the abdominal aorta;
  3. C. the veins open in the inferior vena cava;
  4. D. the arteries are branches off the internal iliac artery;
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Question 9

You have an HIV-positive patient in the office. You ask her if she has informed her partner that she is HIV-positive. She has repeatedly resisted your attempts to have her inform the partner. She is pregnant with his child. The partner is in the waiting room and you have met him many times. What should you do?

  1. A. Inform the partner now.
  2. B. Respect her confidentiality.
  3. C. Refer your patient to another physician who is comfortable with her wishes.
  4. D. Tell the partner to practice safe sex from now on but don't tell him her HIV status.
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Question 10

A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?

  1. A. Genital herpes
  2. B. Condylomata acuminata
  3. C. Syphilitic chancre
  4. D. Epidermoid cyst
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Question 11

Which statement most accurately describes substance dependence?

  1. A. It is a lack of control over use. Tolerance and withdrawal symptoms occur when intake is reduced or stopped.
  2. B. It occurs when psychoactive drug use interferes with the work of competing neurotransmitters.
  3. C. Symptoms occur when two or more drugs that affect the central nervous system (CNS) have additive effects.
  4. D. It involves taking a combination of substances to weaken or inhibit the effect of another drug.
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Question 12

The nurse is caring for a pregnant patient who is 26 weeks gestation and has a history of gestational diabetes. Which of the following actions is most important for the nurse to monitor during this pregnancy?

  1. A. Blood glucose levels and fetal growth
  2. B. Urine protein levels and blood pressure
  3. C. Maternal weight gain and diet
  4. D. Fetal heart rate and activity patterns
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Question 13

You have an HIV-positive patient in the office. You ask her if she has informed her partner that she is HIV-positive. She has repeatedly resisted your attempts to have her inform the partner. She is pregnant with his child. The partner is in the waiting room and you have met him many times. What should you do?

  1. A. Inform the partner now.
  2. B. Respect her confidentiality.
  3. C. Refer your patient to another physician who is comfortable with her wishes.
  4. D. Tell the partner to practice safe sex from now on but don't tell him her HIV status.
Answer and rationale unlock in the Nursier study hub. Unlock answers

Question 14

The fluidlike portion of a cell is referred to as:

  1. A. cytosol
  2. B. nucleoplasm
  3. C. cytoplasmic membrane
  4. D. inclusion
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Question 15

The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, “I don’t believe this is happening to us. We were so careful during pregnancy.” The nurse associates the parents’ comments with which stage of grief?

  1. A. Disbelief
  2. B. Depression
  3. C. Denial of reality
  4. D. Anger with each other
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About these RN exams clinical judgment questions

RN exams clinical judgment practice questions, set 81 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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