You protect comfort, dignity, and the family conversation the exam expects you to start. 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 end-of-life questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Nurse Margareth is revising a client's care plan. During which step of the nursing process does such revision take place?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
Show answer and rationale
Correct answer: D — Evaluation
The nursing process is a dynamic, cyclical framework guiding patient care, and revision of a care plan occurs during the evaluation step (Choice D). In evaluation, the nurse assesses whether the established goals (set during planning) were met, partially met, or unmet, using outcome criteria. If goals aren't achievede.g., a patient's pain remains uncontrolledthe nurse revises the plan, adjusting interventions or goals based on new data. Assessment (Choice A) is data collection, not revision, though it informs the process. Planning (Choice B) involves creating the initial care plan, not modifying it. Implementation (Choice C) is executing the plan, not evaluating or revising it. For example, if a wound isn't healing despite dressings, evaluation reveals the need for a new approach (e.g., different dressings), prompting revision. This step ensures care remains patient-centered and effective, adapting to changes in condition. Thus, Choice D, evaluation, is where revision occurs, making it the correct answer.
Question 2
Nurse Margareth is revising a client's care plan. During which step of the nursing process does such revision take place?
A. Assessment
B. Planning
C. Implementation
D. Evaluation
Show answer and rationale
Correct answer: D — Evaluation
The nursing process is a dynamic, cyclical framework guiding patient care, and revision of a care plan occurs during the evaluation step (Choice D). In evaluation, the nurse assesses whether the established goals (set during planning) were met, partially met, or unmet, using outcome criteria. If goals aren't achievede.g., a patient's pain remains uncontrolledthe nurse revises the plan, adjusting interventions or goals based on new data. Assessment (Choice A) is data collection, not revision, though it informs the process. Planning (Choice B) involves creating the initial care plan, not modifying it. Implementation (Choice C) is executing the plan, not evaluating or revising it. For example, if a wound isn't healing despite dressings, evaluation reveals the need for a new approach (e.g., different dressings), prompting revision. This step ensures care remains patient-centered and effective, adapting to changes in condition. Thus, Choice D, evaluation, is where revision occurs, making it the correct answer.
Question 3
How does chronic pain differ from acute pain in terms of duration?
A. Chronic pain lasts less than 1 month
B. Chronic pain lasts longer than 6 months
C. Chronic pain resolves with treatment
D. Chronic pain is always less severe
Show answer and rationale
Correct answer: B — Chronic pain lasts longer than 6 months
Chronic pain differs from acute pain primarily in its duration, persisting beyond six months, often without a clear end even after the initial cause has healed. Acute pain, by contrast, is short-lived, typically resolving within days to weeks as the body recovers from injury or surgery. Choice A is incorrect because pain lasting less than one month aligns with acute pain, not chronic. Choice C, suggesting chronic pain resolves with treatment, is misleadingwhile manageable, chronic pain often persists despite interventions, unlike acute pain, which usually subsides with healing. Choice D, claiming chronic pain is always less severe, is false; its intensity varies widely and can be debilitating, unlike acute pain's typically sharp but temporary nature. Choice B correctly highlights the key distinctionchronic pain's extended duration over six monthsmaking it a critical factor in nursing care, requiring long-term strategies like pain management and emotional support rather than just acute symptom relief.
Question 4
How does chronic pain differ from acute pain in terms of duration?
A. Chronic pain lasts less than 1 month
B. Chronic pain lasts longer than 6 months
C. Chronic pain resolves with treatment
D. Chronic pain is always less severe
Show answer and rationale
Correct answer: B — Chronic pain lasts longer than 6 months
Chronic pain differs from acute pain primarily in its duration, persisting beyond six months, often without a clear end even after the initial cause has healed. Acute pain, by contrast, is short-lived, typically resolving within days to weeks as the body recovers from injury or surgery. Choice A is incorrect because pain lasting less than one month aligns with acute pain, not chronic. Choice C, suggesting chronic pain resolves with treatment, is misleadingwhile manageable, chronic pain often persists despite interventions, unlike acute pain, which usually subsides with healing. Choice D, claiming chronic pain is always less severe, is false; its intensity varies widely and can be debilitating, unlike acute pain's typically sharp but temporary nature. Choice B correctly highlights the key distinctionchronic pain's extended duration over six monthsmaking it a critical factor in nursing care, requiring long-term strategies like pain management and emotional support rather than just acute symptom relief.
Question 5
A nurse is caring for a patient who is sleeping for abnormally long periods of time. This condition may be caused by injury to which of the following body structures?
A. spinal cord
B. pancreas
C. hypothalamus
D. thyroid
Show answer and rationale
Correct answer: C — hypothalamus
Excessive sleep, or hypersomnia, often stems from central nervous system dysfunction, particularly the hypothalamus , which regulates sleep-wake cycles via the suprachiasmatic nucleus (SCN) and orexin neurons. Injury heree.g., from trauma or tumordisrupts circadian rhythm and arousal, causing prolonged sleep, as seen in conditions like narcolepsy or post-traumatic hypersomnia. The spinal cord conducts signals but doesn't control sleep; injury might cause paralysis, not hypersomnia. The pancreas manages glucose, and while hypoglycemia can induce fatigue, it doesn't directly govern sleep duration. The thyroid influences metabolism; hypothyroidism causes lethargy, but not abnormally long sleep periods distinct from fatigue. For example, a hypothalamic lesion might reduce orexin, a wake-promoting neurotransmitter, leading to 16-hour sleep days versus a normal 7-9. Nursing assessments would note this brain region's role in sleep homeostasis, per Taylor's text, confirming Choice C as the correct answer.
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Question 6
A nurse is caring for a patient who is sleeping for abnormally long periods of time. This condition may be caused by injury to which of the following body structures?
A. spinal cord
B. pancreas
C. hypothalamus
D. thyroid
Correct answer:
Excessive sleep, or hypersomnia, often stems from central nervous system dysfunction, particularly the hypothalamus , which regulates sleep-wake cycles via the suprachiasmatic nucleus (SCN) and orexin neurons. Injury heree.g., from trauma or tumordisrupts circadian rhythm and arousal, causing prolonged sleep, as seen in conditions like narcolepsy or post-traumatic hypersomnia. The spinal cord conducts signals but doesn't control sleep; injury might cause paralysis, not hypersomnia. The pancreas manages glucose, and while hypoglycemia can induce fatigue, it doesn't directly govern sleep duration. The thyroid influences metabolism; hypothyroidism causes lethargy, but not abnormally long sleep periods distinct from fatigue. For example, a hypothalamic lesion might reduce orexin, a wake-promoting neurotransmitter, leading to 16-hour sleep days versus a normal 7-9. Nursing assessments would note this brain region's role in sleep homeostasis, per Taylor's text, confirming Choice C as the correct answer.
The nurse is caring for a client who reports chronic pain. Which statement by the client indicates a need for further education?
A. I take my pain medication as prescribed.'
B. I use relaxation techniques to help with my pain.'
C. I only take my pain medication when I can't stand the pain anymore.'
D. I've been keeping a pain diary to track my symptoms.'
Correct answer:
The statement I only take my pain medication when I can't stand the pain anymore' indicates a need for further education, as it suggests the client delays medication until pain peaks, undermining chronic pain management. Effective control requires consistent dosing to maintain steady relief, preventing escalation that's harder to reverse. Choice A, taking medication as prescribed, shows adherence to a regimen, not a gap in understanding. Choice B, using relaxation techniques, reflects a proactive, educated approach to complement medication. Choice D, keeping a pain diary, demonstrates awareness and engagement in tracking pain patterns, aiding treatment adjustments. Choice C is correct, highlighting a misconceptionwaiting until pain is unbearable can increase suffering and medication needs. Nurses should educate on scheduled dosing, explaining how proactive management stabilizes pain levels, reduces flare-ups, and improves function, contrasting with reactive use that perpetuates a pain cycle.
The nurse is caring for a client who reports chronic pain. Which statement by the client indicates a need for further education?
A. I take my pain medication as prescribed.'
B. I use relaxation techniques to help with my pain.'
C. I only take my pain medication when I can't stand the pain anymore.'
D. I've been keeping a pain diary to track my symptoms.'
Correct answer:
The statement I only take my pain medication when I can't stand the pain anymore' indicates a need for further education, as it suggests the client delays medication until pain peaks, undermining chronic pain management. Effective control requires consistent dosing to maintain steady relief, preventing escalation that's harder to reverse. Choice A, taking medication as prescribed, shows adherence to a regimen, not a gap in understanding. Choice B, using relaxation techniques, reflects a proactive, educated approach to complement medication. Choice D, keeping a pain diary, demonstrates awareness and engagement in tracking pain patterns, aiding treatment adjustments. Choice C is correct, highlighting a misconceptionwaiting until pain is unbearable can increase suffering and medication needs. Nurses should educate on scheduled dosing, explaining how proactive management stabilizes pain levels, reduces flare-ups, and improves function, contrasting with reactive use that perpetuates a pain cycle.
While examining a client's leg, the nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressings is most appropriate for the nurse in charge to apply?
A. Dry sterile dressing
B. Sterile petroleum gauze
C. Moist, sterile saline gauze
D. Povidone-iodine-soaked gauze
Correct answer:
Granulation tissue in an open wound indicates healing, with new, red, vascular tissue forming. Moist, sterile saline gauze (Choice C) is most appropriate because it maintains a moist environment, promoting cell migration and preventing desiccation of granulation tissue, which could halt healing. Dry sterile dressing (Choice A) adheres to the wound, damaging granulation tissue upon removal and delaying healing. Sterile petroleum gauze (Choice B) supports healing but is costlier and less practical for interim use, often reserved for specific wounds like burns. Povidone-iodine-soaked gauze (Choice D) is cytotoxic to healing cells, irritating granulation tissue and slowing repair, making it unsuitable. Research supports moist wound healing (e.g., Winter's 1962 study), showing faster epithelialization with moisture. Until the specialist arrives, moist saline gauze balances efficacy, availability, and safety, protecting the delicate healing process. Thus, Choice C is the correct dressing choice.
While examining a client's leg, the nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressings is most appropriate for the nurse in charge to apply?
A. Dry sterile dressing
B. Sterile petroleum gauze
C. Moist, sterile saline gauze
D. Povidone-iodine-soaked gauze
Correct answer:
Granulation tissue in an open wound indicates healing, with new, red, vascular tissue forming. Moist, sterile saline gauze (Choice C) is most appropriate because it maintains a moist environment, promoting cell migration and preventing desiccation of granulation tissue, which could halt healing. Dry sterile dressing (Choice A) adheres to the wound, damaging granulation tissue upon removal and delaying healing. Sterile petroleum gauze (Choice B) supports healing but is costlier and less practical for interim use, often reserved for specific wounds like burns. Povidone-iodine-soaked gauze (Choice D) is cytotoxic to healing cells, irritating granulation tissue and slowing repair, making it unsuitable. Research supports moist wound healing (e.g., Winter's 1962 study), showing faster epithelialization with moisture. Until the specialist arrives, moist saline gauze balances efficacy, availability, and safety, protecting the delicate healing process. Thus, Choice C is the correct dressing choice.
A nurse assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he's impotent and says that he's concerned about its effect on his marriage. In planning this client's care, the most appropriate intervention would be to:
A. Encourage the client to ask questions about personal sexuality
B. Provide time for privacy
C. Provide support for the spouse or significant other
D. Suggest referral to a sex counselor or other appropriate professional
Correct answer:
For a postoperative diabetic client reporting impotence and marital concerns, the most appropriate intervention is suggesting referral to a sex counselor or professional (Choice D). Diabetes and surgery can cause erectile dysfunction (ED) via neuropathy, vascular damage, or psychological stress, requiring specialized expertise beyond general nursing. Encouraging questions (Choice A) fosters discussion but doesn't address the issue's complexity. Providing privacy (Choice B) supports dignity but doesn't resolve ED or marital strain. Supporting the spouse (Choice C) is secondary without addressing the client's primary concern. A sex counselor can assess physical and emotional factors, offer tailored therapies (e.g., medication, counseling), and involve the spouse, aligning with holistic care. Nurses facilitate referrals when issues exceed their scope, ensuring comprehensive management. Choice D directly tackles the client's stated worry, making it the correct and most effective intervention.
A nurse assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he's impotent and says that he's concerned about its effect on his marriage. In planning this client's care, the most appropriate intervention would be to:
A. Encourage the client to ask questions about personal sexuality
B. Provide time for privacy
C. Provide support for the spouse or significant other
D. Suggest referral to a sex counselor or other appropriate professional
Correct answer:
For a postoperative diabetic client reporting impotence and marital concerns, the most appropriate intervention is suggesting referral to a sex counselor or professional (Choice D). Diabetes and surgery can cause erectile dysfunction (ED) via neuropathy, vascular damage, or psychological stress, requiring specialized expertise beyond general nursing. Encouraging questions (Choice A) fosters discussion but doesn't address the issue's complexity. Providing privacy (Choice B) supports dignity but doesn't resolve ED or marital strain. Supporting the spouse (Choice C) is secondary without addressing the client's primary concern. A sex counselor can assess physical and emotional factors, offer tailored therapies (e.g., medication, counseling), and involve the spouse, aligning with holistic care. Nurses facilitate referrals when issues exceed their scope, ensuring comprehensive management. Choice D directly tackles the client's stated worry, making it the correct and most effective intervention.
A nurse teaches a young couple to put their newborn on his back to sleep. What is the rationale for this information?
A. prone position increases the risk for sudden infant death syndrome
B. prone position decreases the risk for sudden infant death syndrome
C. supine position may alter the size and shape of the infants head
D. supine position makes changing diapers and feeding difficult
Correct answer:
Teaching parents to place a newborn supine (on the back) aims to reduce sudden infant death syndrome (SIDS), a leading cause of infant mortality. 'Prone position increases the risk for sudden infant death syndrome' is correct; studies (e.g., AAP guidelines since 1992's 'Back to Sleep' campaign) show prone sleeping raises SIDS risk 2-13 times, possibly via airway obstruction or rebreathing CO2-rich air. Choice B, 'prone position decreases the risk,' is false, contradicting evidence. Choice C, 'supine position may alter the size and shape of the infant's head,' notes positional plagiocephaly (flat head), but this cosmetic issue is manageable (e.g., tummy time) and less critical than SIDS. Choice D, 'supine position makes changing diapers and feeding difficult,' is impractical and unfounded; supine is standard for sleep, not care tasks. For example, SIDS rates dropped 50% post-campaign, prioritizing safety over minor concerns. Choice A reflects this life-saving rationale, making it correct.
A nurse teaches a young couple to put their newborn on his back to sleep. What is the rationale for this information?
A. prone position increases the risk for sudden infant death syndrome
B. prone position decreases the risk for sudden infant death syndrome
C. supine position may alter the size and shape of the infants head
D. supine position makes changing diapers and feeding difficult
Correct answer:
Teaching parents to place a newborn supine (on the back) aims to reduce sudden infant death syndrome (SIDS), a leading cause of infant mortality. 'Prone position increases the risk for sudden infant death syndrome' is correct; studies (e.g., AAP guidelines since 1992's 'Back to Sleep' campaign) show prone sleeping raises SIDS risk 2-13 times, possibly via airway obstruction or rebreathing CO2-rich air. Choice B, 'prone position decreases the risk,' is false, contradicting evidence. Choice C, 'supine position may alter the size and shape of the infant's head,' notes positional plagiocephaly (flat head), but this cosmetic issue is manageable (e.g., tummy time) and less critical than SIDS. Choice D, 'supine position makes changing diapers and feeding difficult,' is impractical and unfounded; supine is standard for sleep, not care tasks. For example, SIDS rates dropped 50% post-campaign, prioritizing safety over minor concerns. Choice A reflects this life-saving rationale, making it correct.
The nurse is assessing a client with fibromyalgia who reports disturbed sleep and fatigue. What additional symptom does the nurse anticipate?
A. Increased appetite
B. Widespread pain
C. Headache
D. Bradycardia
Correct answer:
The nurse anticipates widespread pain in a client with fibromyalgia reporting disturbed sleep and fatigue, as it's a hallmark symptom of the condition. Fibromyalgia involves chronic, diffuse musculoskeletal pain across multiple body regions, often exacerbated by poor sleep and fatigue, which disrupt pain modulation in the central nervous system. Increased appetite (Choice A) isn't typicalfatigue might reduce appetite due to low energy, not increase it. Headache (Choice C) can occur but isn't a core feature; fibromyalgia's pain is broader, not localized to the head. Bradycardia (Choice D), a slow heart rate, has no direct link to fibromyalgia, which doesn't typically affect cardiac rhythm. Widespread pain (Choice B) aligns with diagnostic criteria, making it the expected finding. Nurses assess this to tailor interventions like pain management, sleep aids, or stress reduction, addressing the triad of pain, sleep issues, and fatigue that defines fibromyalgia's impact on quality of life.
RN exams end-of-life practice questions, set 3 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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