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
A 24-year-old travel agent comes to your clinic, complaining of pain and swelling in her vulvar area. She states that 2 days earlier she could feel a small tender spot on the left side of her vagina but now it is larger and extremely tender. Her last period was 1 year ago and she is sexually active. She uses the Depo-Provera shot for contraception. She denies any nausea, vomiting, constipation, diarrhea, pain with urination, or fever. Her past medical history is significant for ankle surgery. Her mother is healthy and her father has type 2 diabetes. On examination she appears her stated age and is standing up. She states she cannot sit down without excruciating pain. Her blood pressure, temperature, and pulse are unremarkable. On visualization of her perineum, a large, red, tense swelling is seen to the left of her introitus. Palpation of the mass causes a great deal of pain. What disorder of the vulva is most likely causing her problems?
A. Bartholin's gland infection
B. Vulvar carcinoma
C. Secondary syphilis
D. Condylomata acuminata
Show answer and rationale
Correct answer: A — Bartholin's gland infection
The correct answer is A: Bartholin's gland infection. The patient's symptoms of pain, swelling, tenderness, and the presence of a red, tense swelling to the left of her introitus are classic signs of Bartholin's gland infection. The Bartholin's gland is located at the entrance to the vagina and can become infected, leading to the formation of a painful abscess. The patient's age, sexual activity, and use of contraception are all risk factors for developing this condition. The absence of systemic symptoms such as fever, along with the localized nature of the swelling, further support this diagnosis.
The other choices are incorrect because:
B: Vulvar carcinoma typically presents with different symptoms such as persistent itching, bleeding, or changes in the appearance of the skin.
C: Secondary syphilis would present with systemic symptoms like rash, fever, and lymphadenopathy, which are absent in this case.
D: Condylomata acuminata (genital warts) usually
Question 2
When performing a physical exam on an infant, the nurse should:
A. Conduct the exam in a head-to-toe manner.
B. Begin with invasive procedures like ear examination.
C. Start with less distressing areas such as the abdomen.
D. Wait for the infant to wake up before starting the exam.
Show answer and rationale
Correct answer: C — Start with less distressing areas such as the abdomen.
Rationale for choice C: Starting with less distressing areas such as the abdomen is recommended when performing a physical exam on an infant. This approach helps build rapport and trust with the infant, allowing them to feel more comfortable during the exam. It also helps prevent unnecessary stress and agitation, leading to a smoother and more successful examination process. By starting with non-invasive areas, the nurse can gradually progress to more sensitive areas without causing undue distress to the infant.
Summary of why other choices are incorrect:
A: Conducting the exam in a head-to-toe manner may overwhelm the infant and increase stress levels.
B: Beginning with invasive procedures like ear examination can cause discomfort and lead to resistance from the infant.
D: Waiting for the infant to wake up before starting the exam is not practical as the nurse should take advantage of the infant's calm state during sleep to perform the exam efficiently.
Question 3
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.
Show answer and rationale
Correct answer: C — Presence of bronchovesicular breath sounds in the peripheral lung fields.
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
Question 4
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
Show answer and rationale
Correct answer: C — Remove the BVM from tube #1 and ventilate through tube #2
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
Question 5
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
Show answer and rationale
Correct answer: C — Asthma
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
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Question 6
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.
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
Correct answer:
The correct answer is B: Negligence charges could be brought against the paramedic in charge of the unit.
Rationale:
1. Negligence: In this scenario, the paramedic failed to ensure the equipment was properly charged, leading to the death of the patient.
2. Duty of Care: The paramedic had a duty to ensure the equipment was functional to provide appropriate care to the patient.
3. Breach of Duty: By not ensuring the defibrillator had adequate battery power, the paramedic breached their duty of care.
4. Proximate Cause: The lack of functioning equipment directly contributed to the patient's death.
5. Legal Liability: Negligence in providing care can result in legal charges being brought against the individual responsible for the patient's care.
Summary:
A: Manslaughter charges are not applicable as there was no intent to harm the patient.
C: Battery charges are not relevant as it refers to physical harm, not the lack of battery power in equipment
A 75-year-old man is being discharged to his home following a fall in his kitchen that resulted in a fractured pelvis. The home health nurse makes a home assessment that will be used to design interventions to meet which priority need?
A. sleep and rest
B. support from family members
C. protection from potential harm
D. feeling a sense of accomplishment
Correct answer:
The correct answer is C: protection from potential harm. Following a fractured pelvis from a fall, the priority need is ensuring the patient's safety at home to prevent further harm. The home assessment will focus on identifying and addressing potential hazards that could lead to additional falls or injuries. This includes assessing the home environment for safety modifications, such as installing grab bars in the bathroom or removing tripping hazards. Ensuring protection from potential harm is essential for the patient's recovery and overall well-being.
Choices A, B, and D are incorrect because they do not address the immediate safety concerns associated with the patient's fractured pelvis. While sleep and rest, support from family members, and feeling a sense of accomplishment are important aspects of care, they are not the priority in this scenario where the main focus should be on preventing further injury and ensuring the patient's safety at home.
A 55-year-old secretary with a recent history of breast cancer, for which she underwent surgery and radiation therapy, and a history of hypertension comes to your office for a routine checkup. Which of the following aspects of the physical are important to note when assessing the patient for peripheral vascular disease in the arms?
A. Femoral pulse, popliteal pulse
B. Dorsalis pedis pulse, posterior tibial pulse
C. Carotid pulse
D. Radial pulse, brachial pulse
Correct answer:
The correct answer is D: Radial pulse, brachial pulse. When assessing for peripheral vascular disease in the arms, it is important to check the radial and brachial pulses. The radial pulse is located at the wrist and is an indicator of arterial flow to the hand, while the brachial pulse is located in the upper arm and is important for assessing arterial flow to the forearm. In this patient with a history of breast cancer and hypertension, checking these pulses can provide valuable information about blood flow to the arms, especially after surgery and radiation therapy.
Choices A, B, and C are incorrect because:
A: Femoral and popliteal pulses are located in the lower extremities and are not relevant for assessing peripheral vascular disease in the arms.
B: Dorsalis pedis and posterior tibial pulses are also located in the lower extremities and do not provide information about arterial flow to the arms.
C: Carotid pulse is located in the neck and is
When performing a physical exam on an infant, the nurse should:
A. Conduct the exam in a head-to-toe manner.
B. Begin with invasive procedures like ear examination.
C. Start with less distressing areas such as the abdomen.
D. Wait for the infant to wake up before starting the exam.
Correct answer:
Rationale for choice C: Starting with less distressing areas such as the abdomen is recommended when performing a physical exam on an infant. This approach helps build rapport and trust with the infant, allowing them to feel more comfortable during the exam. It also helps prevent unnecessary stress and agitation, leading to a smoother and more successful examination process. By starting with non-invasive areas, the nurse can gradually progress to more sensitive areas without causing undue distress to the infant.
Summary of why other choices are incorrect:
A: Conducting the exam in a head-to-toe manner may overwhelm the infant and increase stress levels.
B: Beginning with invasive procedures like ear examination can cause discomfort and lead to resistance from the infant.
D: Waiting for the infant to wake up before starting the exam is not practical as the nurse should take advantage of the infant's calm state during sleep to perform the exam efficiently.
A 24-year-old travel agent comes to your clinic, complaining of pain and swelling in her vulvar area. She states that 2 days earlier she could feel a small tender spot on the left side of her vagina but now it is larger and extremely tender. Her last period was 1 year ago and she is sexually active. She uses the Depo-Provera shot for contraception. She denies any nausea, vomiting, constipation, diarrhea, pain with urination, or fever. Her past medical history is significant for ankle surgery. Her mother is healthy and her father has type 2 diabetes. On examination she appears her stated age and is standing up. She states she cannot sit down without excruciating pain. Her blood pressure, temperature, and pulse are unremarkable. On visualization of her perineum, a large, red, tense swelling is seen to the left of her introitus. Palpation of the mass causes a great deal of pain. What disorder of the vulva is most likely causing her problems?
A. Bartholin's gland infection
B. Vulvar carcinoma
C. Secondary syphilis
D. Condylomata acuminata
Correct answer:
The correct answer is A: Bartholin's gland infection. The patient's symptoms of pain, swelling, tenderness, and the presence of a red, tense swelling to the left of her introitus are classic signs of Bartholin's gland infection. The Bartholin's gland is located at the entrance to the vagina and can become infected, leading to the formation of a painful abscess. The patient's age, sexual activity, and use of contraception are all risk factors for developing this condition. The absence of systemic symptoms such as fever, along with the localized nature of the swelling, further support this diagnosis.
The other choices are incorrect because:
B: Vulvar carcinoma typically presents with different symptoms such as persistent itching, bleeding, or changes in the appearance of the skin.
C: Secondary syphilis would present with systemic symptoms like rash, fever, and lymphadenopathy, which are absent in this case.
D: Condylomata acuminata (genital warts) usually
A client is admitted to a cardiac care unit for chronic hypertension. The client has been struggling to take their medications appropriately and acute management was required to gain control of the client’s hypertension. The client had recently been having several high blood pressures in the morning and was prescribed amlodipine (Norvasc®) 5 mg PO daily. Prior to the first administration of the amlodipine (Norvasc), the client’s vitals read: heart rate 80, respiratory rate 10, 100%, and blood pressure 80/50. Which action by the nurse is most appropriate?
A. Administer the amlodipine (Norvasc®).
B. Chart that the client refused the medication.
C. Hold the amlodipine (Norvasc®) and notify the provider.
D. Hold the amlodipine (Norvasc®) for 30 minutes and then administer the medication.
Correct answer:
The correct answer is C: Hold the amlodipine (Norvasc®) and notify the provider. The client's blood pressure of 80/50 is significantly low, indicating hypotension. Amlodipine is a calcium channel blocker that can further lower blood pressure. Therefore, administering amlodipine in this situation could worsen the hypotension and lead to potential complications such as dizziness, fainting, or even shock. By holding the medication and notifying the provider, the nurse ensures that the provider can assess the situation and determine the appropriate course of action, which may include adjusting the medication dosage or considering alternative treatments. This approach prioritizes patient safety and prevents harm.
Summary of other choices:
A: Administering the amlodipine could worsen the hypotension, leading to potential complications.
B: Charting that the client refused the medication does not address the critical issue of the client's hypotension.
D:
The nurse is performing an assessment on a patient brought to the emergency department for treatment for dehydration. The nurse assesses a respiratory rate of 26 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 86/50 mm Hg, and a temperature of 39.5 C. The patient becomes dizzy when transferred from the wheelchair to a bed. The nurse notes cool, clammy skin. Which diagnosis does the nurse suspect?
A. Fluid volume deficit (FVD)
B. Fluid volume excess (FVE)
C. Mild extracellular fluid (ECF) deficit
D. Renal failure
Correct answer:
The correct diagnosis is A: Fluid volume deficit (FVD). The patient's vital signs and symptoms indicate hypovolemia. A respiratory rate of 26 breaths/minute, heart rate of 110 beats/minute, low blood pressure, high temperature, dizziness upon position change, and cool, clammy skin are all indicative of FVD. The increased respiratory and heart rates are compensatory mechanisms to maintain oxygen delivery in response to decreased circulating volume. The low blood pressure and cool, clammy skin suggest poor perfusion due to decreased fluid volume. These findings align with the clinical presentation of dehydration.
Summary of other choices:
B: Fluid volume excess (FVE) - Contradicted by the patient's low blood pressure, cool, clammy skin, and symptoms of dehydration.
C: Mild extracellular fluid (ECF) deficit - Symptoms and vital signs are indicative of severe rather than mild fluid deficit.
D: Renal failure - Not supported by the information provided;
Your adult patient sustained a right index finger amputation at work. On arrival, first responders have the bleeding controlled with sterile dressings, and the patient is conscious, alert, and oriented. What is the best way to manage the patient's amputated finger during transport to the hospital?
A. Do not wrap the finger. Gently place it in a sealed plastic bag, and place it on a towel in ice.
B. Wrap the finger in gauze (moistened with normal saline), and seal the finger in a plastic bag before placing it on ice
C. Rinse the gauze-wrapped finger using water, and place it in a plastic bag with ice
D. Wrap it in gauze, and place the finger in close proximity to the patient's core to maintain the appropriate body temperature for re-attachment
Correct answer:
The correct answer is B: Wrap the finger in gauze (moistened with normal saline), and seal the finger in a plastic bag before placing it on ice. This method helps preserve the amputated part by keeping it moist and cool, which can improve the chances of successful reattachment. Here's a step-by-step rationale:
1. Moistening the gauze with normal saline helps prevent the tissue from drying out, maintaining its viability.
2. Sealing the finger in a plastic bag helps protect it from contamination and further damage during transport.
3. Placing the sealed finger on ice helps keep it cool, which slows down metabolic processes and reduces tissue damage.
4. Avoiding direct contact of the finger with ice prevents frostbite and tissue damage from extreme cold.
In summary, option B is the best choice as it optimally preserves the amputated finger for potential reattachment. Option A does not maintain moisture, leading to tissue damage. Option C's use of water
The nurse is performing a musculoskeletal assessment and notes that the patient has a decreased range of motion in the shoulder with pain on movement. What is the most likely cause of this finding?
A. Osteoarthritis.
B. Frozen shoulder (adhesive capsulitis).
C. Rheumatoid arthritis.
D. Bursitis.
Correct answer:
The correct answer is B: Frozen shoulder (adhesive capsulitis). Frozen shoulder is characterized by decreased range of motion in the shoulder joint with pain on movement. This is due to inflammation and thickening of the shoulder joint capsule, leading to adhesions that restrict movement. Other choices are incorrect because:
A: Osteoarthritis primarily affects the joints, causing pain and stiffness but typically doesn't lead to severe restriction of range of motion like in frozen shoulder.
C: Rheumatoid arthritis is a systemic autoimmune disorder that can affect multiple joints, causing inflammation and deformities, but it doesn't typically present with the characteristic pattern of restricted movement seen in frozen shoulder.
D: Bursitis involves inflammation of the bursae (fluid-filled sacs) around joints, leading to pain and swelling, but it doesn't typically result in the severe restriction of movement and pain on movement seen in frozen shoulder.
RN exams fundamentals practice questions, set 13 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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