You practice vitals, infection control, documentation, and the first nursing action when a patient is unstable. 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 fundamentals 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 would be an early sign of a possible aortic dissection?
A. A narrowing pulse pressure and tachycardia
B. A sudden rise in systolic blood pressure and fall in diastolic blood pressure
C. Blood pressure difference of 20 mmHg or more in the upper extremities
D. A reddish-blue discoloration of the skin above the shoulders
Show answer and rationale
Correct answer: C — Blood pressure difference of 20 mmHg or more in the upper extremities
Step-by-step rationale for answer C: An early sign of a possible aortic dissection is a blood pressure difference of 20 mmHg or more in the upper extremities due to impaired blood flow. This discrepancy occurs because the dissection can obstruct blood flow to one of the brachial arteries, leading to a difference in blood pressure readings between the arms. This sign is a result of the aortic dissection affecting the arterial blood supply to the upper extremities.
Summary of incorrect choices:
A: A narrowing pulse pressure and tachycardia - These symptoms are more commonly associated with conditions like shock or dehydration, not specifically indicative of aortic dissection.
B: A sudden rise in systolic blood pressure and fall in diastolic blood pressure - While changes in blood pressure can occur in aortic dissection, the specific pattern described here is not a typical early sign.
D: A reddish-blue discoloration of the skin above the shoulders - Skin discolor
Question 2
Which of the following tasks could be delegated to unlicensed assistive personnel?
A. an initial assessment of a patient
B. determination of a nursing diagnosis
C. evaluation of patient progress with the nursing care plan
D. assisting patients with hygiene
Show answer and rationale
Correct answer: D — assisting patients with hygiene
The correct answer is D because assisting patients with hygiene is a task that can be safely and appropriately delegated to unlicensed assistive personnel (UAP). UAP are trained to provide basic care such as bathing, grooming, and toileting under the supervision of licensed nurses. This task does not require complex critical thinking skills or clinical judgment.
Choice A is incorrect because an initial assessment of a patient requires a licensed healthcare provider due to the need for comprehensive clinical knowledge and critical thinking skills.
Choice B is incorrect because determining a nursing diagnosis involves analyzing assessment data and formulating a plan of care, which requires specialized nursing education and training.
Choice C is incorrect because evaluating patient progress with the nursing care plan involves interpreting data, making clinical judgments, and modifying the plan of care as needed, which are responsibilities of licensed nurses.
Question 3
You are on-scene with a patient in cardiac arrest. You turn the monitor/defibrillator on and attach the pads to the patient. When it begins to analyze the patient's cardiac rhythm, it signals 'low battery' and then shuts off. You have no other batteries available, and an electrical plug is not available. The patient subsequently dies despite adequate CPR and advanced airway and ventilation during transport. Which of the following could result?
A. Manslaughter charges could be brought against the paramedic in charge of the unit
B. Negligence charges could be brought against the paramedic in charge of the unit
C. Battery charges could be brought against the entire service
D. Defamation charges could be brought against the entire crew on scene
Show answer and rationale
Correct answer: B — Negligence charges could be brought against the paramedic in charge of the unit
The correct answer is B: Negligence charges could be brought against the paramedic in charge of the unit.
Rationale:
1. Negligence is the failure to exercise the standard of care that a reasonably prudent person would have in a similar situation.
2. In this scenario, the paramedic in charge failed to ensure the equipment was adequately charged or had backup batteries, leading to the device shutting off during a critical moment.
3. This failure to provide proper equipment falls below the standard of care expected in the field of emergency medical services.
4. As a result, the patient's death could be attributed to the paramedic's negligence in ensuring equipment readiness.
Summary:
A: Manslaughter charges require a higher level of intent and causation, not applicable here.
C: Battery charges refer to physical harm, not applicable in this context.
D: Defamation charges involve false statements damaging a person's reputation, not relevant to the situation described.
Question 4
A nurse cares for a patient who tests positive for alpha1-antitrypsin (AAT) deficiency. The patient asks, “What does this mean?” How would the nurse respond?
A. “Your children will be at high risk for the development of chronic obstructive pulmonary disease.”
B. “I will contact a genetic counselor to discuss your condition.”
C. “Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke.”
D. “This is a recessive gene and would have no impact on your health.”
Show answer and rationale
Correct answer: C — “Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke.”
Step-by-step rationale for why Option C is correct:
1. Alpha1-antitrypsin deficiency predisposes individuals to develop chronic obstructive pulmonary disease (COPD).
2. Smoking exacerbates the risk of COPD in individuals with AAT deficiency.
3. By stating, "Your risk for COPD is higher, especially if you smoke," the nurse addresses the patient's concern and provides relevant information.
4. This response acknowledges the connection between AAT deficiency, COPD risk, and smoking, empowering the patient to make informed decisions about their health.
Summary of why the other choices are incorrect:
A. Incorrect. AAT deficiency does not directly impact the children's risk for COPD; it is the individual who has the deficiency who is at risk.
B. Incorrect. While genetic counseling may be beneficial, it does not directly answer the patient's question about the implications of AAT deficiency.
D. Incorrect. AAT deficiency can impact the individual's health, especially their
Question 5
A patient in her first trimester of pregnancy is diagnosed with rubella. Which of these statements is correct regarding the significance of this in relation to the infant's hearing?
A. Rubella may affect the mother's hearing but not the infant's.
B. Rubella can damage the infant's organ of Corti, which will impair hearing.
C. Rubella is only dangerous to the infant in the second trimester of pregnancy.
D. Rubella can impair the development of CN VIII and thus affect hearing.
Show answer and rationale
Correct answer: B — Rubella can damage the infant's organ of Corti, which will impair hearing.
The correct answer is B: Rubella can damage the infant's organ of Corti, which will impair hearing. Rubella virus can cross the placenta and infect the developing fetus, leading to congenital rubella syndrome. This syndrome can cause damage to various organs including the organ of Corti in the inner ear, leading to hearing impairment. This occurs mainly when the infection happens during the first trimester when the organ systems are developing.
Incorrect choices:
A: Rubella may affect the mother's hearing but not the infant's - This is incorrect as rubella can indeed affect the infant's hearing through congenital rubella syndrome.
C: Rubella is only dangerous to the infant in the second trimester of pregnancy - This is incorrect as rubella can harm the infant's hearing in the first trimester as well.
D: Rubella can impair the development of CN VIII and thus affect hearing - While rubella can affect hearing, it primarily does so by damaging the organ of Corti
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Question 6
You are working a respiratory arrest patient and have just successfully placed a combi-tube in your apneic patient. What should you do if the chest fails to rise appropriately and gastric sounds are present?
A. Secure tube, and ventilate through tube #1
B. Confirm placement with CO2 detector before ventilating through tube #1
C. Remove the BVM from tube #1 and ventilate through tube #2
D. Pull the combi-tube back approximately 2 cm and reassess
Correct answer:
The correct answer is C: Remove the BVM from tube #1 and ventilate through tube #2. If gastric sounds are present along with inadequate chest rise, it indicates that the tube may be in the esophagus rather than the trachea. By removing the BVM from tube #1 and ventilating through tube #2, you can provide ventilation directly to the lungs and avoid insufflating air into the stomach. This step ensures proper oxygenation and ventilation while preventing complications from gastric insufflation. It is essential to act promptly to optimize patient outcomes.
Incorrect answers:
A: Securing the tube and ventilating through tube #1 would continue to insufflate air into the stomach, worsening the situation.
B: Confirming placement with a CO2 detector before ventilating through tube #1 may delay appropriate intervention, risking patient harm.
D: Pulling the combi-tube back approximately 2 cm without addressing the issue of gastric sounds and inadequate chest rise would
Under which of the following conditions should a nursing assistant not take an oral temperature on a person?
A. The person has influenza.
B. The person almost certainly has a fever.
C. The person is over six years old.
D. The person is confused or disoriented.
Correct answer:
The correct answer is D because taking an oral temperature on a person who is confused or disoriented could lead to inaccurate results. A person who is confused may not be able to cooperate or keep the thermometer in their mouth properly, affecting the reading. It is crucial to ensure the person is alert and able to follow instructions for an accurate oral temperature.
Choice A (The person has influenza): This is not a valid reason to avoid taking an oral temperature as having influenza does not necessarily impact the accuracy of the reading.
Choice B (The person almost certainly has a fever): While the person likely has a fever, it does not directly affect the process of taking an oral temperature if the person is alert and can follow instructions.
Choice C (The person is over six years old): Age alone does not determine whether a person should not have their oral temperature taken. It is the person's ability to cooperate and follow instructions that matters.
When assessing the respiratory system of a 4-year-old child, which of these findings would the nurse expect?
A. Crepitus palpated at the costochondral junctions.
B. No diaphragmatic excursion as a result of a child's decreased inspiratory volume.
C. Presence of bronchovesicular breath sounds in the peripheral lung fields.
D. Irregular respiratory pattern and a respiratory rate of 40 breaths per minute at rest.
Correct answer:
The correct answer is C because bronchovesicular breath sounds in the peripheral lung fields are an expected finding in a 4-year-old child. This is due to the normal anatomy and physiology of a child's respiratory system at that age. Bronchovesicular breath sounds are commonly heard in children and are a combination of bronchial and vesicular sounds. These sounds are normal in children up to the age of 5 and are typically heard in the peripheral lung fields.
Choice A is incorrect because crepitus palpated at the costochondral junctions is not an expected finding in a 4-year-old child's respiratory assessment. Crepitus may indicate air or gas under the skin and is not a normal finding in a respiratory assessment.
Choice B is incorrect because no diaphragmatic excursion due to decreased inspiratory volume is not a typical finding in a 4-year-old child. Children of this age should have adequate diaphragmatic excursion, and a lack of it may indicate respiratory
A nurse is helping at a health fair at a local mall. When taking blood pressures on a variety of people, the nurse keeps in mind that:
A. After menopause, blood pressure readings in women are usually lower than those in men.
B. The blood pressure of a Black adult is usually higher than that of a White adult of the same age.
C. Blood pressure measurements in people who are overweight should be the same as those of people who are at a normal weight.
D. A teenager's blood pressure reading will be lower than that of an adult.
Correct answer:
The correct answer is B because research has shown that on average, Black adults tend to have higher blood pressure compared to White adults of the same age. This is due to a combination of genetic, lifestyle, and environmental factors. It is important for healthcare professionals to be aware of these differences to provide appropriate care and interventions.
Choice A is incorrect because blood pressure readings in women after menopause actually tend to increase due to hormonal changes.
Choice C is incorrect because being overweight is a risk factor for high blood pressure, so individuals who are overweight are more likely to have higher blood pressure readings compared to those at a normal weight.
Choice D is incorrect because a teenager's blood pressure reading can vary, but it is not always lower than that of an adult. Teenagers can also have high blood pressure, especially if they have risk factors such as obesity or a family history of hypertension.
A 25-year-old woman in her fifth month of pregnancy has a blood pressure of 100/70 mm Hg. In reviewing her previous examination, the nurse notes that her blood pressure in her second month was 124/80 mm Hg. In evaluating this change, what does the nurse know to be true?
A. This decline in blood pressure is the result of peripheral vasodilatation and is an expected change.
B. This decline in blood pressure is the result of the parasympathetic effect of hormones secreted during pregnancy and is an expected change.
C. This change in blood pressure is not an expected finding because it means a decrease in cardiac output.
D. This decline in blood pressure means a decrease in circulating blood volume, which is dangerous for the fetus.
Correct answer:
Step-by-step rationale:
1. During pregnancy, blood pressure tends to decrease due to hormonal and physiological changes.
2. The decline in blood pressure is attributed to peripheral vasodilatation, allowing for increased blood flow to the placenta.
3. This vasodilatation is a normal adaptive response to support the growing fetus.
4. The parasympathetic effect of pregnancy hormones contributes to the vasodilatation and helps regulate blood pressure.
5. Therefore, choice A is correct as it aligns with the physiological changes expected during pregnancy.
Summary of other choices:
- Choice B incorrectly attributes the decline solely to the parasympathetic effect, ignoring the role of vasodilatation.
- Choice C is incorrect as a decrease in blood pressure does not necessarily mean a decrease in cardiac output during pregnancy.
- Choice D is incorrect as a decrease in blood pressure does not always indicate a dangerous decrease in blood volume for the fetus.
A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies. On examination, auscultation of her chest shows decreased air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
Correct answer:
The correct answer is C: Asthma. The key clues in the scenario are the patient's age, nocturnal cough, continuous shortness of breath, history of seasonal allergies, and physical exam findings of wheezing on expiration in all lobes. These are classic signs of asthma. Asthma is a chronic inflammatory condition of the airways characterized by reversible airflow obstruction, leading to symptoms such as cough, shortness of breath, and wheezing. The patient's history of seasonal allergies further supports the diagnosis of asthma, as allergies are a common trigger for asthma exacerbations.
Now, let's discuss why the other choices are incorrect:
A: Spontaneous pneumothorax typically presents with sudden-onset chest pain and shortness of breath, not a gradual onset as described in the scenario.
B: Chronic obstructive pulmonary disease (COPD) is more common in older individuals with a history of smoking. The absence of smoking history and the patient's age make COPD
When planning care for a client with an indwelling urinary catheter, which nursing diagnosis has the highest priority?
A. Self-care deficit
B. Functional incontinence
C. Fluid volume deficit
D. High risk for infection
Correct answer:
The highest priority nursing diagnosis when planning care for a client with an indwelling urinary catheter is 'High risk for infection.' Indwelling urinary catheters pose a significant risk of infection due to their direct contact with the urinary system. Preventing and managing infections is crucial in the care of these clients. Monitoring for signs of infection, following proper catheter care protocols, and maintaining aseptic technique during catheter maintenance are essential steps to prevent complications associated with catheter-related infections.
Choices A, B, and C are not the highest priority because in this case, the immediate concern is the risk of infection associated with the presence of the urinary catheter. While self-care deficit, functional incontinence, and fluid volume deficit are important considerations in overall patient care, they are not as critical as preventing potentially serious infections related to the indwelling urinary catheter.
Which of the following would be an early sign of a possible aortic dissection?
A. A narrowing pulse pressure and tachycardia
B. A sudden rise in systolic blood pressure and fall in diastolic blood pressure
C. Blood pressure difference of 20 mmHg or more in the upper extremities
D. A reddish-blue discoloration of the skin above the shoulders
Correct answer:
Step-by-step rationale for answer C: An early sign of a possible aortic dissection is a blood pressure difference of 20 mmHg or more in the upper extremities due to impaired blood flow. This discrepancy occurs because the dissection can obstruct blood flow to one of the brachial arteries, leading to a difference in blood pressure readings between the arms. This sign is a result of the aortic dissection affecting the arterial blood supply to the upper extremities.
Summary of incorrect choices:
A: A narrowing pulse pressure and tachycardia - These symptoms are more commonly associated with conditions like shock or dehydration, not specifically indicative of aortic dissection.
B: A sudden rise in systolic blood pressure and fall in diastolic blood pressure - While changes in blood pressure can occur in aortic dissection, the specific pattern described here is not a typical early sign.
D: A reddish-blue discoloration of the skin above the shoulders - Skin discolor
Which of the following tasks could be delegated to unlicensed assistive personnel?
A. an initial assessment of a patient
B. determination of a nursing diagnosis
C. evaluation of patient progress with the nursing care plan
D. assisting patients with hygiene
Correct answer:
The correct answer is D because assisting patients with hygiene is a task that can be safely and appropriately delegated to unlicensed assistive personnel (UAP). UAP are trained to provide basic care such as bathing, grooming, and toileting under the supervision of licensed nurses. This task does not require complex critical thinking skills or clinical judgment.
Choice A is incorrect because an initial assessment of a patient requires a licensed healthcare provider due to the need for comprehensive clinical knowledge and critical thinking skills.
Choice B is incorrect because determining a nursing diagnosis involves analyzing assessment data and formulating a plan of care, which requires specialized nursing education and training.
Choice C is incorrect because evaluating patient progress with the nursing care plan involves interpreting data, making clinical judgments, and modifying the plan of care as needed, which are responsibilities of licensed nurses.
A patient in her first trimester of pregnancy is diagnosed with rubella. Which of these statements is correct regarding the significance of this in relation to the infant's hearing?
A. Rubella may affect the mother's hearing but not the infant's.
B. Rubella can damage the infant's organ of Corti, which will impair hearing.
C. Rubella is only dangerous to the infant in the second trimester of pregnancy.
D. Rubella can impair the development of CN VIII and thus affect hearing.
Correct answer:
The correct answer is B: Rubella can damage the infant's organ of Corti, which will impair hearing. Rubella virus can cross the placenta and infect the developing fetus, leading to congenital rubella syndrome. This syndrome can cause damage to various organs including the organ of Corti in the inner ear, leading to hearing impairment. This occurs mainly when the infection happens during the first trimester when the organ systems are developing.
Incorrect choices:
A: Rubella may affect the mother's hearing but not the infant's - This is incorrect as rubella can indeed affect the infant's hearing through congenital rubella syndrome.
C: Rubella is only dangerous to the infant in the second trimester of pregnancy - This is incorrect as rubella can harm the infant's hearing in the first trimester as well.
D: Rubella can impair the development of CN VIII and thus affect hearing - While rubella can affect hearing, it primarily does so by damaging the organ of Corti
RN exams fundamentals practice questions, set 12 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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