RN exams clinical judgment practice questions, set 86
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 86
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
A couple is scheduled to have a Huhner test for infertility. In preparation for the test, the nurse will instruct the couple about
A. being sedated during the procedure
B. determining the estimated time of ovulation.
C. experiencing shoulder pain after the procedure.
D. refraining from intercourse before the appointment.
Show answer and rationale
Correct answer: B — determining the estimated time of ovulation.
The correct answer is B because the Huhner test is used to assess the quality of cervical mucus and its ability to support sperm survival and movement. Therefore, determining the estimated time of ovulation is crucial as it ensures that the test is performed during the most fertile period of the woman's cycle. This increases the chances of obtaining accurate and relevant results.
A: Being sedated during the procedure is unnecessary as the Huhner test is a simple and non-invasive procedure that does not require sedation.
C: Experiencing shoulder pain after the procedure is not a common side effect of the Huhner test and is not a significant aspect to focus on during preparation.
D: Refraining from intercourse before the appointment is not specifically required for the Huhner test, as the purpose of the test is to evaluate the quality of cervical mucus rather than the presence of sperm.
Question 2
Several patients with similar complaints came to the doctor. They all present with weakness, pain in the intestines, indigestion. Feces analysis revealed the need for urgent hospitalization of the patient, who had microbial cysts with four nuclei detected in his samples. Such cysts are characteristic of the following protozoon:
A. Entamoeba histolytica.
B. Entamoeba coli.
C. Balantidium.
D. Trichomonad.
Show answer and rationale
Correct answer: A — Entamoeba histolytica.
The correct answer is A: Entamoeba histolytica. This protozoon is known to cause amoebic dysentery, presenting symptoms of weakness, intestinal pain, and indigestion. The presence of microbial cysts with four nuclei in fecal samples is characteristic of Entamoeba histolytica. These cysts are the infective form of the parasite and can cause severe invasive disease in the intestines.
Incorrect choices:
B: Entamoeba coli does not typically cause invasive disease or severe symptoms like those described in the question.
C: Balantidium is a ciliated protozoan that causes balantidiasis, which presents differently from the symptoms described in the question.
D: Trichomonad is a flagellated protozoan that typically infects the urogenital tract, not the intestine, and does not form cysts with four nuclei.
In summary, the key clues in the question were the symptoms of weakness, intestinal pain,
Question 3
You are on-scene with a 40-year-old patient with an extensive cardiac history for his age. Today, he is complaining of chest pain that radiates to his jaw and left arm. His vital signs are stable; however, once on the cardiac monitor, he exhibits ST elevation in leads II, III, and aVf. With the EKG finding, which of the following should you suspect?
A. A possible aortic dissection
B. An inferior wall myocardial infarction
C. A possible pulmonary embolus
D. A septal wall myocardial infarction
Show answer and rationale
Correct answer: B — An inferior wall myocardial infarction
The correct answer is B: An inferior wall myocardial infarction. The EKG findings of ST elevation in leads II, III, and aVf indicate an inferior wall MI. Leads II, III, and aVf correspond to the inferior wall of the heart supplied by the right coronary artery. This pattern of ST elevation is indicative of myocardial ischemia or infarction in this region. The symptoms of chest pain radiating to the jaw and left arm are also classic for a heart attack.
A: A possible aortic dissection is unlikely in this case as the EKG findings specifically point towards a myocardial infarction rather than aortic pathology.
C: A possible pulmonary embolus is less likely as the EKG findings are more consistent with a myocardial infarction, and pulmonary embolism typically presents with symptoms such as shortness of breath and chest pain.
D: A septal wall myocardial infarction is not supported by the
Question 4
What is a key characteristic of Illness Anxiety Disorder?
A. Excessive focus on minor symptoms without medical evidence of illness
B. The need for consistent reassurance from healthcare professionals
C. Compulsive behavior to avoid physical illness
D. Development of avoidance behaviors to reduce anxiety
Show answer and rationale
Correct answer: A — Excessive focus on minor symptoms without medical evidence of illness
The correct answer is A: "Excessive focus on minor symptoms without medical evidence of illness." Illness Anxiety Disorder, formerly known as hypochondriasis, is characterized by a preoccupation with having a serious illness despite no medical evidence to support the presence of an illness. Individuals with this disorder often interpret normal bodily sensations as signs of severe illness. Choice B is incorrect because while individuals with Illness Anxiety Disorder may seek reassurance from healthcare professionals, the excessive focus on minor symptoms is the key characteristic. Choice C is incorrect as compulsive behaviors to avoid physical illness are more characteristic of illnesses like Obsessive-Compulsive Disorder. Choice D is incorrect as the development of avoidance behaviors to reduce anxiety is more commonly seen in conditions like specific phobias or social anxiety disorder.
Question 5
The home health nurse cares for a patient who is diagnosed with chronic obstructive pulmonary disease. Which response(s) and behavior(s) by the nurse would indicate that bonding between nurse and patient has occurred? (Select all that apply)
A. Expects the patient to meet the goals for exercise as determined by the nurse.
B. Listens to the patient describe the feelings of anxiety related to severe dyspnea.
C. Develops teaching plan based on the learning preferences of the patient.
D. Refrains from touching the patient unless performing physical assessment techniques.
Show answer and rationale
Correct answer: B — Listens to the patient describe the feelings of anxiety related to severe dyspnea.
The correct answer is B because listening to the patient describe their feelings of anxiety related to severe dyspnea indicates empathy, active listening, and emotional support, which are essential for building a strong nurse-patient bond. By actively listening to the patient's concerns, the nurse shows genuine care and understanding, fostering trust and connection.
Choices A, C, and D are incorrect:
A: Expects the patient to meet exercise goals - This choice emphasizes a more authoritative approach and does not necessarily indicate a strong bond.
C: Develops teaching plan based on learning preferences - While important for effective teaching, this choice focuses on education rather than emotional connection.
D: Refrains from touching the patient - Touch can be a comforting gesture and important for physical assessment, but avoiding it altogether may not necessarily indicate bonding.
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Question 6
Which of the following is a care guideline for visual impairments?
A. Use the face of an imaginary clock to explain object positions.
B. Keep the room as dark as possible.
C. Walk behind the resident while touching his back.
D. Touch the resident before identifying yourself.
Correct answer:
The correct answer is A because using the face of an imaginary clock to explain object positions is a helpful technique for individuals with visual impairments to understand spatial relationships. This method is clear and easy to visualize, making it effective in communication. It promotes independence and enhances the person's understanding of their surroundings.
Explanation of why other choices are incorrect:
B: Keeping the room dark can further hinder the individual's ability to see and navigate their environment.
C: Walking behind the resident and touching their back can startle or make them uncomfortable. It's important to offer support from the side to maintain their sense of safety.
D: Touching the resident before identifying yourself can be alarming and invade their personal space. It's crucial to introduce yourself first to establish trust and ensure clear communication.
The specific prevention (by vaccination) of the disease gas gangrene (caused by Clostridium perfringens) is based on:
A. Killed whole cell vaccine
B. Anatoxin
C. There is no specific prevention by vaccination
D. Alive attenuated vaccine
Correct answer:
The correct answer is B: Anatoxin. An anatoxin is a toxin that has been rendered harmless while retaining its ability to stimulate an immune response. Gas gangrene is caused by the toxins produced by Clostridium perfringens, not the bacteria itself. Therefore, vaccination with an anatoxin can trigger the immune system to produce antibodies against the toxin, providing immunity against the disease.
A: Killed whole cell vaccine - Gas gangrene is caused by toxins, not the whole bacterium. This type of vaccine may not be effective in preventing the disease.
C: There is no specific prevention by vaccination - This is incorrect, as vaccination with an anatoxin can prevent gas gangrene.
D: Alive attenuated vaccine - Attenuated vaccines contain live, weakened forms of the pathogen. However, for gas gangrene prevention, targeting the specific toxin with an anatoxin vaccine is more appropriate.
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?
A. It reduces the release of chemical mediators from the mast cells
B. It is effective in reducing the inflammatory response of the reaction
C. Increases the heart rate to improve peripheral perfusion
D. It causes peripheral vasoconstriction to reduce the itching associated with the reaction
Correct answer:
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.
A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?
A. Administer pain relief medication.
B. Obtain a stat head CT scan.
C. Administer antihypertensive medications as prescribed.
D. Call the healthcare provider immediately.
Correct answer:
The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.
A 55-yr-old patient with increasing dyspnea is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease (COPD). When teaching a patient about pulmonary spirometry for this condition, what is the most important question the nurse should ask?
A. Are you claustrophobic?
B. Have you taken any bronchodilators today?
C. Have you had frequent streptococcal throat infections?
D. Do you use antihistamines for upper airway congestion?
Correct answer:
The correct answer is C: Have you had frequent streptococcal throat infections? This is the most important question to ask because repeated streptococcal throat infections can lead to bronchiectasis, which is a risk factor for COPD. Bronchiectasis causes permanent dilation of the bronchi, leading to airflow obstruction. It is crucial to assess this history as it can provide valuable information on the patient's risk for developing COPD.
A: Are you claustrophobic? - This question is not directly related to the assessment for COPD through pulmonary spirometry.
B: Have you taken any bronchodilators today? - While important for assessing current medication use, it is not as crucial as determining the history of streptococcal throat infections.
D: Do you use antihistamines for upper airway congestion? - Antihistamine use may not be directly linked to the risk factors for COPD development.
The nurse is aware that positioning and range-of-motion (ROM) exercises most help the immobilized patient to prevent:
A. increased pain
B. contractures
C. pressure ulcers
D. compromised circulation
Correct answer:
For an immobilized patient, maintaining joint and muscle function is a priority, and contractures permanent shortening of muscles or tendons due to prolonged immobility are a significant risk. Positioning and ROM exercises keep joints flexible and muscles stretched, counteracting the tendency for tissues to stiffen and shorten when unused. Increased pain might occur with immobility, but ROM exercises primarily address stiffness rather than pain itself. Pressure ulcers result from prolonged pressure on skin, prevented more by repositioning than ROM alone. Compromised circulation can occur with immobility, but it's more directly managed by elevation or compression, not ROM exercises. Contractures are the most relevant outcome these interventions target, as they can lead to permanent disability if not addressed early, making this the primary focus of such care in immobilization scenarios.
Which of the following adverse effects is most likely to occur during the therapy?
A. Macrocytic anemia
B. Hallucinations
C. Liver cirrhosis
D. Pancreatitis
Correct answer:
The correct answer is D: Pancreatitis. During therapy, certain medications can cause pancreatitis due to their toxic effects on the pancreas. This can lead to inflammation of the pancreas, resulting in symptoms such as severe abdominal pain, nausea, and vomiting. Pancreatitis is a serious condition that requires immediate medical attention.
Rationale:
- A (Macrocytic anemia): This adverse effect is more commonly associated with deficiencies in vitamin B12 or folic acid, not typically caused by medications during therapy.
- B (Hallucinations): Hallucinations are more likely to occur as a side effect of certain psychiatric medications or in cases of substance abuse, rather than during general therapy.
- C (Liver cirrhosis): Liver cirrhosis is a long-term consequence of chronic liver damage, often due to alcohol abuse or viral hepatitis, not typically a direct adverse effect of therapy.
The nurse is planning to assess new memory with a patient. The best way to do this would be to:
A. Administer the FACT test.
B. Ask him to describe his first job to you.
C. Give him the Four Unrelated Words Test.
D. Ask him to describe the last TV show he watched before coming to the clinic.
Correct answer:
The correct answer is C: Give him the Four Unrelated Words Test. This is the best way to assess new memory because it is a standardized test specifically designed to evaluate a patient's ability to form new memories. The test involves presenting the patient with four unrelated words and then asking them to recall those words after a delay. This test is reliable, valid, and widely used in clinical settings to assess new memory formation.
Other choices are incorrect because:
A: Administering the FACT test is not the best way to assess new memory as it is not specifically designed for this purpose.
B: Asking the patient to describe his first job does not directly evaluate new memory formation and may not provide a standardized assessment.
D: Asking the patient to describe the last TV show he watched does not focus on new memory and is not a standardized way to assess memory function.
The human body regulates homeostasis by communicating at the cellular level through the nervous and endocrine systems. Which of the following is responsible for serving as the command and control center for linking the systems together?
A. Hypothalamus
B. Adrenal gland
C. Thyroid gland
D. Pituitary gland
Correct answer:
The correct answer is A: Hypothalamus. The hypothalamus serves as the command and control center for linking the nervous and endocrine systems. It regulates body temperature, thirst, hunger, and other vital functions.
Rationale:
1. The hypothalamus is located in the brain and plays a crucial role in maintaining homeostasis by regulating hormone secretion from the pituitary gland.
2. It receives input from the nervous system and sends signals to the pituitary gland to release hormones that control various bodily functions.
3. The hypothalamus also controls the autonomic nervous system, which regulates involuntary processes such as heart rate and digestion.
4. The adrenal gland (B), thyroid gland (C), and pituitary gland (D) are important components of the endocrine system, but they do not serve as the central command center for linking the nervous and endocrine systems together.
A patient is to undergo an ultrasound-guided core biopsy. The patient tells the nurse that a friend of hers had a stereotactic core biopsy. She wants to understand the differences between the two procedures.What would be the nurses best response?
A. An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation.
B. An ultrasound-guided core biopsy is a little more expensive, but it doesnt use radiation and it is faster.
C. An ultrasound-guided core biopsy is a little more expensive, and it also uses radiation but it is faster.
D. An ultrasound-guided core biopsy takes more time, and it also uses radiation, but it is less expensive.
Correct answer:
The correct answer is A because an ultrasound-guided core biopsy is indeed faster, less expensive, and does not use radiation.
- "Faster": Ultrasound-guided biopsies are typically quicker compared to stereotactic biopsies, as they are performed in real-time using ultrasound imaging.
- "Less expensive": Ultrasound-guided biopsies are generally more cost-effective than stereotactic biopsies due to the equipment and resources required.
- "Does not use radiation": Unlike stereotactic biopsies which involve the use of X-rays for guidance, ultrasound-guided biopsies do not expose the patient to radiation, making them safer in that aspect.
The other choices are incorrect because they either inaccurately state that ultrasound-guided biopsies use radiation (C), take more time (D), or imply a slight increase in cost without highlighting the key advantages of speed and lack of radiation (B).
RN exams clinical judgment practice questions, set 86 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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