RN exams clinical judgment practice questions, set 98
RN exams · clinical judgment
RN exams clinical judgment practice questionsset 98
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
Which of the following types of hearing loss does the nurse understand is most improved with the use of a hearing aid?
A. Conductive
B. Mixed
C. Sensorineural
D. Central
Show answer and rationale
Correct answer: C — Sensorineural
The correct answer is C: Sensorineural hearing loss. Hearing aids are most effective for sensorineural hearing loss as they amplify sound signals to compensate for damage to the inner ear hair cells or auditory nerve. This type of hearing loss is due to problems in the inner ear or auditory nerve, which can be partially compensated for by using hearing aids. The other choices, A: Conductive, B: Mixed, and D: Central, are not as effectively improved by hearing aids. Conductive hearing loss is usually due to problems in the outer or middle ear, which can often be treated with medical or surgical interventions. Mixed hearing loss involves a combination of conductive and sensorineural components, and may require a combination of interventions. Central hearing loss is due to problems in the central auditory pathways in the brain, and is not typically improved by hearing aids.
Question 2
A married couple applied to the genetic consultation in order to consult about their child with multiple abnormalities (microcephaly, idiocy etc). The woman has had an illnesses during her pregnancy but she didn't take any teratogens or mutagens. The parents' and the child's karyotype is normal. Anamnesis study revealed that the family kept a cat. What gravidic disease caused the child's abnormalities?
A. Toxoplasmosis
B. Leishmaniasis
C. Dysentery
D. Balantidiasis
Show answer and rationale
Correct answer: A — Toxoplasmosis
The correct answer is A: Toxoplasmosis. Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii, which can be transmitted to humans through contact with infected cat feces. During pregnancy, Toxoplasma infection can result in severe birth defects such as microcephaly and mental retardation in the child. In this case, the presence of a cat in the family and the child's abnormalities suggest a possible link to Toxoplasmosis.
Other choices are incorrect because:
B: Leishmaniasis is a parasitic disease transmitted by sandflies and does not typically cause the specific birth defects mentioned in the scenario.
C: Dysentery is a bacterial infection that primarily affects the intestines and does not cause the neurological abnormalities described.
D: Balantidiasis is a parasitic infection caused by Balantidium coli, a ciliated protozoan, but it is not associated with
Question 3
A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?
A. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
B. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
C. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
D. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
Show answer and rationale
Correct answer: D — Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
The correct answer is D because it provides the most direct and hands-on assistance to ensure completion of the shower. By walking her to the shower, assisting with undressing, starting the water, and providing necessary supplies and instructions, the patient is guided through each step of the showering process. This approach is essential for someone with significant apraxia and poor hygiene due to Alzheimer's disease.
Choice A is incorrect because simply reminding the patient every 30 minutes may not address the physical assistance needed for shower completion. Choice B is also incorrect as discussing the importance of showers may not be enough to overcome the challenges of apraxia and poor hygiene. Choice C is not as effective as choice D as occasional reminders may not provide the comprehensive assistance required for the patient to successfully complete the shower.
Question 4
The nurse performs an intervention for a collaborative problem. Which type of intervention did the nurse perform?
A. Dependent NursingStoreRN
B. Independent
C. Interdependent
D. Physician-initiated
Show answer and rationale
Correct answer: C — Interdependent
The correct answer is C: Interdependent. In this scenario, the nurse performed an intervention for a collaborative problem, which involves working together with other healthcare professionals to address the issue. Interdependent interventions require collaboration and communication among healthcare team members to achieve the best outcomes for the patient.
Choice A (Dependent Nursing) refers to interventions that require an order from a healthcare provider.
Choice B (Independent) involves nursing actions that the nurse can initiate without the need for a healthcare provider's order.
Choice D (Physician-initiated) specifically denotes interventions initiated by a physician without direct involvement from the nurse.
In this case, the nurse's intervention for a collaborative problem aligns with the definition of interdependent intervention, making it the correct choice.
Question 5
Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self-care, the nurse should address which of the following topics? Select all that apply.
A. Use of condoms to prevent infecting others
B. Appropriate use of antibiotics
C. Taking measures to prevent pregnancy
D. The need for a Pap smear every 3 months E) The importance of weight loss in preventing symptoms
Show answer and rationale
Correct answer: A — Use of condoms to prevent infecting others
The correct answer is A: Use of condoms to prevent infecting others. This is important because PID is a sexually transmitted infection and using condoms can help prevent transmission to sexual partners. It is crucial to address this topic to ensure the patient understands the importance of safe sex practices.
The other choices are incorrect:
B: Appropriate use of antibiotics - While antibiotics are used to treat PID, this choice does not address self-care education for prevention.
C: Taking measures to prevent pregnancy - While important for overall health, preventing pregnancy is not directly related to self-care for PID.
D: The need for a Pap smear every 3 months - Pap smears are not directly related to PID management or prevention.
E: The importance of weight loss in preventing symptoms - Weight loss is not a direct self-care measure for managing or preventing PID.
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Question 6
A patient who was pregnant had a spontaneous abortion at approximately 4 weeks' gestation. At the time of the miscarriage, it was thought that all products of conception were expelled. Two weeks later, the patient presents at the clinic office complaining of “crampy†abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100°F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/minute (bpm), and respirations, 20 breaths per minute. Based on this assessment data, what does the nurse anticipate as a clinical diagnosis?
A. Ectopic pregnancy
B. Uterine infection
C. Gestational trophoblastic disease
D. Endometriosis
Correct answer:
The correct answer is B: Uterine infection. The patient's presentation with crampy abdominal pain, scant serosanguineous vaginal drainage, negative pregnancy test, and vital signs indicating fever, hypotension, and tachycardia are indicative of a uterine infection, most likely post-miscarriage. The timing of symptoms 2 weeks after miscarriage aligns with the typical onset of infection. The absence of products of conception being expelled completely could have led to retained tissue causing infection. Ectopic pregnancy (A) would typically present with severe abdominal pain, vaginal bleeding, and positive pregnancy test. Gestational trophoblastic disease (C) would present with irregular vaginal bleeding and elevated hCG levels. Endometriosis (D) is a chronic condition characterized by pelvic pain and abnormal menstrual bleeding, not an acute post-miscarriage complication.
A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on passage of the bill?
A. Explain the rationale for the bill to the school board.
B. Contact the elected representative's office by telephone to request support for the bill.
C. Support a health advocate to run for election as state representative.
D. Tell all students about the bill.
Correct answer:
The correct answer is B: Contact the elected representative's office by telephone to request support for the bill. This action is the most direct and effective way to influence the passage of the bill. By directly contacting the elected representative, the nurse can advocate for the importance of the bill and provide relevant information to garner their support. This direct communication with the decision-maker holds significant weight in influencing their vote on the bill.
A: Explaining the rationale to the school board may be informative, but the school board may not have direct influence on the state legislature.
C: Supporting a health advocate to run for election is a long-term strategy and may not have an immediate impact on the passage of the bill.
D: Telling all students about the bill may raise awareness but may not directly influence the lawmakers' decisions.
The nurse is assessing a 3-year-old who has been brought to the clinic for"drainage from the nose." On assessment, it is found that there is a purulent, malodorous drainage from the left naris but no drainage from the right naris. The child is afebrile and has no other symptoms. What should the nurse do next?
A. Refer the child to a physician for an antibiotic prescription.
B. Have the mother bring the child back in 1 week.
C. Perform an otoscopic examination of the left naris.
D. Tell the mother that this is normal for children of this age.
Correct answer:
The correct answer is C: Perform an otoscopic examination of the left naris. The rationale for this is that the child presenting with purulent, malodorous drainage from one naris may indicate a foreign body lodged in the left naris causing infection. By performing an otoscopic examination, the nurse can visualize inside the naris to identify any foreign body or signs of infection. This step is crucial for determining the appropriate treatment plan.
Choices A, B, and D are incorrect:
A: Referring the child for an antibiotic prescription without further assessment is premature and may not address the underlying cause.
B: Having the mother bring the child back in 1 week delays the necessary examination and potential treatment.
D: Telling the mother that this is normal without proper assessment could lead to overlooking a potential health issue that requires intervention.
A patient who was pregnant had a spontaneous abortion at approximately 4 weeks' gestation. At the time of the miscarriage, it was thought that all products of conception were expelled. Two weeks later, the patient presents at the clinic office complaining of “crampy†abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100°F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/minute (bpm), and respirations, 20 breaths per minute. Based on this assessment data, what does the nurse anticipate as a clinical diagnosis?
A. Ectopic pregnancy
B. Uterine infection
C. Gestational trophoblastic disease
D. Endometriosis
Correct answer:
The correct answer is B: Uterine infection. The patient's presentation with crampy abdominal pain, scant serosanguineous vaginal drainage, negative pregnancy test, and vital signs indicating fever, hypotension, and tachycardia are indicative of a uterine infection, most likely post-miscarriage. The timing of symptoms 2 weeks after miscarriage aligns with the typical onset of infection. The absence of products of conception being expelled completely could have led to retained tissue causing infection. Ectopic pregnancy (A) would typically present with severe abdominal pain, vaginal bleeding, and positive pregnancy test. Gestational trophoblastic disease (C) would present with irregular vaginal bleeding and elevated hCG levels. Endometriosis (D) is a chronic condition characterized by pelvic pain and abnormal menstrual bleeding, not an acute post-miscarriage complication.
A nurse is concerned because novice nurses are having their orientation period shortened and are being placed in charge nurse positions. The nurse has documented unsafe care and decisions by these novice nurses. To be protected from retaliation by the employer, this nurse must "blow the whistle" by:
A. holding a public forum in the agency cafeteria to discuss concerns.
B. reporting concerns to state and/or national agencies regulating the agency.
C. calling coworkers outside the workplace to informally discuss wrongdoing.
D. contacting The Joint Commission to report unsafe conditions.
Correct answer:
Step-by-step rationale for why choice B is correct:
1. Reporting concerns to state and/or national agencies is a formal and official way to blow the whistle.
2. State and national agencies have the authority to investigate and take action on reported concerns.
3. Whistleblower protection laws often cover individuals who report to regulatory agencies.
4. This action ensures the concerns are addressed at a higher level and can protect the nurse from retaliation.
Summary of why the other choices are incorrect:
A. Holding a public forum may not provide the necessary confidentiality or protection for the nurse.
C. Informally discussing wrongdoing with coworkers may not result in formal actions to address the concerns.
D. Contacting The Joint Commission is a good option, but reporting concerns to state and/or national agencies is more direct and appropriate in this scenario.
A nurse is assessing a patient who is experiencing shortness of breath and a cough that produces thick, green sputum. Which of the following conditions should the nurse be most concerned about?
A. Asthma.
B. Bronchitis.
C. Pneumonia.
D. Pulmonary embolism.
Correct answer:
The correct answer is C: Pneumonia. The patient's symptoms of shortness of breath and cough with thick, green sputum suggest an acute infection in the lungs. Pneumonia is characterized by inflammation and infection of the lung tissue, leading to symptoms such as productive cough, shortness of breath, and sputum production. It is a serious condition that requires prompt treatment with antibiotics.
A: Asthma typically presents with wheezing, chest tightness, and shortness of breath triggered by certain stimuli, but not usually with thick, green sputum.
B: Bronchitis is inflammation of the bronchial tubes, characterized by cough with clear or slightly discolored sputum, not typically thick and green.
D: Pulmonary embolism is a blockage in the arteries of the lungs, causing sudden shortness of breath and chest pain, but not usually associated with green sputum production.
A nurse believes a new mouth care procedure (MCP) is causing more mouth problems than it
A. Which of the following must be present for the nurse to go to administration with confidence that the MCP is causing problems? (Select all that apply.)
B. A plausible explanation of how the new MCP could cause harm
C. A strong feeling that the MCP is the cause
D. Consistently seeing mouth inflammation in many of the patients who have received the MCP
Correct answer:
The correct answer is B because having a plausible explanation of how the new MCP could cause harm is essential to confidently present concerns to administration. This step involves understanding the potential mechanisms by which the MCP may be causing issues, providing a logical basis for the observed problems. Without a clear explanation, it would be challenging to convince administration of the causal link.
Choices A, C, and D are incorrect:
A: Merely having certain conditions present doesn't provide a solid foundation for presenting concerns without a plausible explanation.
C: Relying solely on feelings without concrete evidence or reasoning is not sufficient to support the claim.
D: While consistently seeing mouth inflammation is concerning, without understanding how the MCP could be causing it, it lacks a logical basis for presenting the issue to administration.
Maintaining the infusion rate of hyperalimentation solutions is a nursing responsibility. What side effects would you anticipate from too rapid infusion rate?
A. Cellular dehydration and potassium
B. Hypoglycemia and hypovolemia
C. Potassium excess and CHF
D. Circulatory overload and hypoglycemia SITUATION: In the recall of the fluids and electrolytes, the nurse should be able to understand the calculations and other conditions related to loss or retention.
Correct answer:
Rationale:
1. Rapid infusion of hyperalimentation solutions can lead to circulatory overload due to increased fluid volume in the circulatory system.
2. Circulatory overload can result in symptoms such as hypertension, tachycardia, and edema.
3. Hypoglycemia can occur as a result of excess insulin release due to the sudden increase in glucose from the hyperalimentation solution.
Summary:
A. Cellular dehydration and potassium: Incorrect. Rapid infusion would lead to fluid overload, not dehydration.
B. Hypoglycemia and hypovolemia: Incorrect. Hypovolemia is unlikely with rapid infusion, and hypoglycemia is a possible side effect.
C. Potassium excess and CHF: Incorrect. Rapid infusion may cause circulatory overload, not CHF, and potassium excess is not a common side effect.
D. Circulatory overload and hypoglycemia: Correct. These are the most likely side effects of rapid
In the preparedness phase for disasters, the community plans for a possible terrorist attack using anthrax as the weapon of destruction. What treatments and/or preparations would be needed?
A. Vaccines and Level B Personal Protection Equipment (PPE)
B. Treatment for burns, decontamination, and Level A PPE
C. Social distance determination, decontamination for radioactive fallout
D. Identify and detect incendiary devices, treatment for burns and propellants
Correct answer:
The correct answer is A: Vaccines and Level B Personal Protection Equipment (PPE). In the preparedness phase for a terrorist attack using anthrax, vaccines are crucial for prevention. Level B PPE provides respiratory protection and skin protection against anthrax spores. This is essential for healthcare workers and first responders.
Choice B is incorrect as it mentions treatment for burns, which is not relevant to anthrax exposure. Decontamination and Level A PPE are not specifically needed for anthrax. Choice C is incorrect as it mentions radioactive fallout, which is not relevant to anthrax. Social distancing is also not effective in preventing anthrax exposure. Choice D is incorrect as it mentions incendiary devices and treatment for burns, which are not related to anthrax exposure. Identifying and detecting propellants is also not relevant to anthrax preparedness.
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
A. Splitting
B. Projective identification
C. Isolation of affect
D. Dissociation
Correct answer:
The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things as all good or all bad, leading to extreme shifts in perception. In this case, the client initially viewed the psychiatrist as the best doctor but now hates him completely due to feeling abandoned. This sudden shift from idealization to devaluation is characteristic of splitting.
Choice B: Projective identification involves attributing one's own unacceptable feelings or traits onto another. This is not evident in the client's description.
Choice C: Isolation of affect refers to separating emotions from their source. The client is expressing strong emotions towards the psychiatrist, not isolating them.
Choice D: Dissociation involves a disruption in consciousness, memory, identity, or perception. The client is not displaying symptoms of dissociation in this scenario.
RN exams clinical judgment practice questions, set 98 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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