RN exams clinical judgment practice questions, set 84
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 84
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
The parents of an infant have just been told that their infant has physiological anemia of infancy. Which serves as an important rationale to support why this occurred?
A. Gestational diabetes in the mother leading to LGA in the infant
B. Hypervolemia as a result of maternal bleeding, which accumulates in the fetal circulation
C. Red blood cell death, which occurs every 15 days in the infant
D. Decline in fetal erythrocytes around 2 months of age
Show answer and rationale
Correct answer: D — Decline in fetal erythrocytes around 2 months of age
The correct answer is D: Decline in fetal erythrocytes around 2 months of age. Physiological anemia of infancy occurs around 2-3 months of age due to a natural decline in fetal erythrocytes. This decline is a normal process as the infant's body adjusts to extrauterine life.
A: Gestational diabetes leading to LGA in the infant is unrelated to physiological anemia.
B: Hypervolemia from maternal bleeding is not a known cause of physiological anemia in infants.
C: Red blood cell death every 15 days is not a recognized physiological process leading to anemia in infants.
In summary, the correct answer is D because it directly addresses the natural decline in fetal erythrocytes that occurs around 2 months of age, leading to physiological anemia of infancy. The other choices are incorrect as they do not provide a relevant explanation for the occurrence of physiological anemia in infants.
Question 2
A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, "I wish I were dead! I'm just a burden on everybody." Based on this information, which nursing diagnosis is most appropriate?
A. Complicated grieving related to expectation of death
B. Chronic low self-esteem related to physical dependence
C. Ineffective coping related to unknown outcome of illness
D. Deficient knowledge related to lack of education about COPD
Show answer and rationale
Correct answer: C — Ineffective coping related to unknown outcome of illness
The most appropriate nursing diagnosis is "Ineffective coping related to unknown outcome of illness" (Choice C). This is because the patient's expression of feeling like a burden and wishing to be dead indicates difficulty coping with the uncertainties and challenges of their COPD. The patient's emotional distress and sense of hopelessness suggest ineffective coping mechanisms in dealing with their illness.
Choice A (Complicated grieving) is incorrect because the patient's statement does not indicate grief over an actual loss, but rather a sense of burden and hopelessness. Choice B (Chronic low self-esteem) is incorrect as the patient's statement is more related to the impact of the illness on others rather than self-esteem issues. Choice D (Deficient knowledge) is not the most appropriate as the patient's statement reflects emotional distress rather than a lack of knowledge about COPD.
Question 3
In the morning a patient had nausea, abdominal discomfort, single vomiting, dry mouth. In the evening, the patient presented with the increasing general weakness, double vision, difficult swallowing of solid food. Objectively: ptosis, mydriasis, anisocoria, absence of gag and pharyngeal reflex, dry mucous membranes. The previous evening the patient had dinner with canned food and alcohol. What is the presumptive diagnosis?
A. Botulism
B. Poliomyelitis
C. Food toxicoinfection
D. Acute ischemic stroke
Show answer and rationale
Correct answer: A — Botulism
The correct answer is A: Botulism. The symptoms described, such as ptosis, mydriasis, anisocoria, dry mouth, and absent gag reflex, are classic signs of botulism. Botulism is caused by the bacterium Clostridium botulinum, commonly found in improperly preserved canned foods. The progression from gastrointestinal symptoms to neurological symptoms, like double vision and difficulty swallowing, is characteristic of botulism due to the toxin's effect on neuromuscular transmission. Poliomyelitis primarily affects the motor neurons and presents with different symptoms. Food toxicoinfection typically involves gastrointestinal symptoms and does not manifest with the neurological findings seen in this case. Acute ischemic stroke presents with sudden onset neurological deficits due to impaired blood flow to the brain, which is not consistent with the gradual progression of symptoms in this scenario.
Question 4
A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify?
A. Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels
B. Low levels of urine constituents normally excreted in the urine
C. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
D. Electrolyte imbalance that could affect the blood’s ability to coagulate properly
Show answer and rationale
Correct answer: C — Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
Rationale for Correct Answer (C): A complete blood count (CBC) is used to identify abnormalities in red blood cells, white blood cells, and platelets. Hematocrit (HCT) and hemoglobin (Hb) levels are part of a CBC and indicate the oxygen-carrying capacity of the blood. Abnormally low HCT and Hb levels can signify conditions like anemia, which can impact a client's ability to undergo surgery due to potential complications related to oxygen delivery.
Summary of Incorrect Choices:
A: Potential hepatic dysfunction is not directly related to a CBC, and BUN/creatinine levels are markers for kidney function, not liver function.
B: Low levels of urine constituents are not assessed in a CBC, which focuses on blood components.
D: Electrolyte imbalance is not specifically tested in a CBC; it is usually evaluated through separate blood tests. Coagulation factors are not directly measured in a CBC.
Question 5
Which strategy is important to addressing issues associated with the aging workforce? (Select all that apply.)
A. Allowing nurses to work flexible shift durations
B. Encouraging older nurses to transfer to an outpatient se tting that is less stressful
C. Hiring nurse technicians that are available to assist wit h patient care, such as turning the patient
D. Developing a staffing model that accurately reflects th e unit’s needs.
Show answer and rationale
Correct answer: A — Allowing nurses to work flexible shift durations
The correct answer is A: Allowing nurses to work flexible shift durations. This strategy is important in addressing issues associated with the aging workforce because it acknowledges the changing needs and preferences of older nurses. By offering flexible shift durations, older nurses can better manage their work-life balance, reduce physical strain, and continue contributing to the workforce effectively.
Choices B, C, and D are incorrect because they do not directly address the specific needs of the aging workforce. Encouraging older nurses to transfer to a less stressful outpatient setting may not align with their career goals. Hiring nurse technicians to assist with patient care may not address the unique experience and expertise of older nurses. Developing a staffing model, while important, does not specifically cater to the needs of aging nurses in terms of flexibility and support.
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 with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
A. Psychoanalytic group
B. Psychoeducational group
C. Individual counseling
D. Family therapy
Correct answer:
The correct answer is B: Psychoeducational group. This option is most beneficial as it provides education and information to the family about the patient's illness, treatment options, and ways they can support his recovery. It helps them understand the challenges the patient faces and equips them with practical strategies to assist in his recovery process.
A: Psychoanalytic group focuses on exploring unconscious patterns of behavior and may not provide the necessary education and tools for the family to support the patient effectively.
C: Individual counseling is focused on the patient and may not involve the family members in understanding the illness and their role in the patient's recovery.
D: Family therapy involves the whole family in therapy sessions, but may not specifically focus on educating them about schizophrenia and its treatment, which is crucial for their support.
This is an example of stretch reflex stimulated by passive muscle movement
A. patellar reflex
B. tendon reflex
C. flexor reflex
D. ipsilateral reflex
Correct answer:
A stretch reflex occurs when a muscle is passively stretched, triggering a rapid contraction to resist the stretch, mediated by muscle spindles and a monosynaptic reflex arc. The classic example is the knee-jerk response, where tapping the patellar tendon stretches the quadriceps, causing an immediate kick. This reflex tests spinal nerve function and is widely recognized in clinical settings. A tendon reflex, while related to tension, typically involves Golgi tendon organs inhibiting contraction, not initiating it. A flexor reflex is a polysynaptic withdrawal response to pain, not passive stretch. An ipsilateral reflex occurs on the same side but isn't specific to stretch. The knee-jerk response perfectly exemplifies a stretch reflex due to its simplicity and direct muscle activation, making it the best fit, as it's a foundational concept in neurophysiology for assessing reflex integrity.
An infected client was on an airplane traveling home and it was shedding a virus that can directly
A. Which form of transmission is being described
B. Agent
C. Direct
D. Environment
Correct answer:
The correct answer is C: Direct. In this scenario, the virus is being transmitted directly from the infected client to others on the airplane without any intermediary. The term "direct transmission" refers to the immediate transfer of an infectious agent from an infected individual to a susceptible host. This aligns with the situation described in the question where the virus is being shed by the infected client and directly transmitted to others on the plane.
Choice A (Which form of transmission is being described) is incorrect as it does not provide a specific answer to the type of transmission discussed in the scenario. Choice B (Agent) is incorrect as it refers to the infectious microorganism itself rather than the mode of transmission. Choice D (Environment) is incorrect as it does not directly address the method of transmission from the infected client to others on the airplane.
Which is an expected characteristic of amniotic fluid?
A. Deep yellow color
B. Clear, with small white particles
C. Nitrazine test: acidic result
D. Absence of ferning
Correct answer:
The correct answer is B: Clear, with small white particles. Amniotic fluid is typically clear with small white particles, representing vernix caseosa. Vernix caseosa is a white, cheese-like substance that covers the skin of the fetus. It helps protect the skin and regulate body temperature. The presence of vernix particles in amniotic fluid is a normal and expected characteristic.
Incorrect choices:
A: Deep yellow color - Amniotic fluid is usually clear or slightly straw-colored. A deep yellow color may indicate the presence of meconium, which suggests fetal distress.
C: Nitrazine test: acidic result - Amniotic fluid is normally alkaline, not acidic. An acidic result may indicate infection.
D: Absence of ferning - Ferning is a characteristic pattern seen under a microscope in dried cervical mucus, not amniotic fluid. Absence of ferning in amniotic fluid is not a relevant characteristic.
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?
A. Eastern/balance
B. Southern/holistic
C. Western/scientific
D. Indigenous/harmony
Correct answer:
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.
When children are research participants, __________.
A. Investigators need to seek the opinion of others if in doubt about the harmful effects of research.
B. They have the right to concealment of their identity on information collected in the course of research.
C. There is a need to inform them or their parents of the results of the research.
D. Informed consent of their parents as well as others who act on their behalf should be obtained.
Correct answer:
When children are research participants, it is essential to obtain informed consent from their parents or others who act on their behalf. This is to ensure that the child's rights and well-being are protected during the research process. Informed consent is a fundamental ethical principle in research involving children, as they may not have the capacity to fully understand the implications of their participation. Choice A is incorrect because seeking the opinion of others when in doubt about harmful effects is not a substitute for informed consent. Choice B is incorrect because children do not have an absolute right to conceal their identity in research, especially when it comes to ensuring their safety and well-being. Choice C is incorrect as it is important to inform children or their parents about the results of the research to maintain transparency and respect for their participation.
While administering normal saline to an adult patient experiencing hypovolemia, the medical command physician recommends the administration of warm normal saline, even though it is not a cold environment. Why would a physician (MCP) recommend warmed normal saline be administered to an adult hypovolemia patient?
A. Warm saline has a better affinity to oxygen transport to the cells
B. To help maintain a normal body temperature during hypovolemia
C. Warm saline will require less energy to enter the systemic circulation
D. It will increase the amount of cardiac output more rapidly
Correct answer:
The correct answer is B: To help maintain a normal body temperature during hypovolemia.
Rationale:
1. When a patient is experiencing hypovolemia, their body is already under stress, potentially leading to a decrease in body temperature.
2. Administering warm normal saline helps prevent further cooling of the body and aids in maintaining a normal body temperature.
3. Maintaining normal body temperature is crucial for proper physiological functions and overall patient well-being during hypovolemia.
Summary of other choices:
A: Warm saline's temperature does not affect its affinity for oxygen transport.
C: The energy required for warm saline to enter circulation is not significantly different from room temperature saline.
D: Warm saline may slightly affect cardiac output due to temperature, but the primary reason for warming saline is to maintain body temperature in hypovolemia.
The nurse is caring for a client with pneumonia. Which intervention is most effective in preventing hospital-acquired pneumonia?
A. Administering antibiotics as prescribed.
B. Encouraging ambulation several times daily.
C. Performing frequent oral care.
D. Providing a high-calorie, high-protein diet.
Correct answer:
Rationale for Correct Answer C: Performing frequent oral care is the most effective intervention in preventing hospital-acquired pneumonia. This is because oral care helps to reduce the risk of oral bacteria being aspirated into the lungs, which can lead to pneumonia. By keeping the mouth clean and free of harmful bacteria, the risk of pneumonia is significantly reduced.
Summary of Incorrect Choices:
A: Administering antibiotics as prescribed may be necessary for treating pneumonia, but it does not directly prevent hospital-acquired pneumonia.
B: Encouraging ambulation several times daily is important for preventing complications like deep vein thrombosis in hospitalized patients, but it does not directly prevent pneumonia.
D: Providing a high-calorie, high-protein diet is important for overall nutrition and immune function, but it does not directly prevent hospital-acquired pneumonia.
A nurse is gathering information about a patients habits and lifestyle patterns. Which method of data collection will the nurse use that will best obtain this information?
A. Carefully review lab results.
B. Conduct the physical assessment.
C. Perform a thorough nursing health history.
D. Prolong the termination phase of the interview.
Correct answer:
The correct answer is C: Perform a thorough nursing health history. This method is the best for gathering information about a patient's habits and lifestyle patterns because it involves asking specific questions related to the patient's daily routines, habits, and lifestyle choices. By obtaining a comprehensive health history, the nurse can gather valuable information about the patient's diet, exercise habits, sleep patterns, stress levels, substance use, and other lifestyle factors that may impact their health. Reviewing lab results (A) may provide some information but not specifically about habits and lifestyle. Conducting a physical assessment (B) focuses more on the patient's physical condition rather than lifestyle. Prolonging the termination phase of the interview (D) is not a method of data collection and does not focus on gathering information about habits and lifestyle patterns.
The client is admitted to the emergency department complaining of acute epigastric pain and reports vomiting a large amount of bright red blood at home. Which interventions should the nurse implement?
A. Assess the client's vital signs
B. Start an IV with an 18-gauge needle
C. Begin iced saline lavage
D. A, B
Correct answer:
In this scenario, the client's presentation of acute epigastric pain and vomiting bright red blood indicates a potential gastrointestinal bleeding emergency. Assessing the client's vital signs is essential to monitor their hemodynamic status. Starting an IV with an 18-gauge needle is crucial to establish access for potential fluid resuscitation or blood transfusion. Beginning iced saline lavage is not appropriate in this situation and could potentially delay necessary interventions. Therefore, the correct interventions for the nurse to implement are to assess the client's vital signs and start an IV, making option D the most appropriate choice. Options A and B are correct because they are essential initial steps in managing gastrointestinal bleeding. Option C is incorrect as iced saline lavage is not indicated and may not address the urgent needs of the client in this critical situation.
RN exams clinical judgment practice questions, set 84 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.
