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
The amount that Medicare and Medicaid will pay long-term care facilities for services is based on
A. The resident's background
B. The resident's need upon admission and throughout his stay
C. The size of the facility
D. The financial contributions from the resident's family
Show answer and rationale
Correct answer: B — The resident's need upon admission and throughout his stay
The correct answer is B because Medicare and Medicaid reimburse long-term care facilities based on the resident's need for services upon admission and throughout their stay. This is determined through assessments of the resident's health condition, functional status, and care requirements. The reimbursement is directly tied to the level of care provided to ensure that residents receive appropriate services.
Choice A (The resident's background) is incorrect because reimbursement is not based on the resident's personal history but on their current health and care needs. Choice C (The size of the facility) is incorrect as reimbursement is not determined by the facility's size but by the individual resident's care requirements. Choice D (The financial contributions from the resident's family) is incorrect as Medicare and Medicaid payments are not influenced by the resident's family contributions but are solely based on the resident's care needs.
Question 2
M.J., age 85, has been diagnosed with terminal lung cancer. During report you were told that the family does not want her to know the diagnosis. M.J. asks you, "Am I going to die?" Which of the following is the best therapeutic response from you, the nurse?
A. "Tell me what prompted that question."
B. "I will ask your physician to discuss this matter with you."
C. "Let's take each day as it comes."
D. "I think you should discuss that with your family."
Show answer and rationale
Correct answer: A — "Tell me what prompted that question."
The correct answer is A: "Tell me what prompted that question." This response shows empathy, encourages open communication, and allows M.J. to express her concerns. By asking for clarification, the nurse can assess M.J.'s understanding and emotional state, providing an opportunity to address her fears and offer support. This approach respects M.J.'s autonomy and allows her to share her feelings.
Choice B: "I will ask your physician to discuss this matter with you." This response avoids addressing M.J.'s concerns directly and may not respect her preferences for communication.
Choice C: "Let's take each day as it comes." This response does not directly address M.J.'s question and may come across as dismissive of her concerns.
Choice D: "I think you should discuss that with your family." This response does not acknowledge M.J.'s feelings or provide direct support, potentially undermining the therapeutic relationship between the nurse and M.J.
Question 3
You are on the scene of a vehicle accident with entrapment. Why is it so important to ensure the battery has been disconnected before attempting to enter the vehicle or extricate the driver?
A. To make sure the vehicle is not capable of moving during the extrication process and injuring anyone involved
B. To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved
C. To make sure that no one in contact with the vehicle gets electrocuted
D. To prevent the possibility of a fire starting in the passenger compartment during the extrication process
Show answer and rationale
Correct answer: B — To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved
The correct answer is B: To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved. It is important to disconnect the battery before attempting to enter the vehicle or extricate the driver because doing so can prevent any undeployed airbags from suddenly deploying during the extrication process. Deploying airbags can cause serious injuries to the patient or rescuers due to the force and speed at which they inflate. Disconnecting the battery helps to eliminate this risk and ensures a safer extrication process.
Choice A is incorrect because the main concern is not about the vehicle moving during extrication. Choice C is incorrect as electrocution risk is more related to high-voltage components in hybrid or electric vehicles, not just the standard battery. Choice D is incorrect as the battery disconnection is primarily to prevent airbag deployment, not to prevent fires in the passenger compartment.
Question 4
A nurse is designing a teaching program for individuals who have recently immigrated to the United States from Iraq. Which of the following considerations is necessary for culturally competent patient teaching?
A. Use materials developed previously for U.S. citizens.
B. Use all visual materials when teaching content.
C. Use a lecture format to teach content with few questions.
D. Develop written materials in the patient's native language.
Show answer and rationale
Correct answer: D — Develop written materials in the patient's native language.
The correct answer is D: Develop written materials in the patient's native language. This is necessary for culturally competent patient teaching as it ensures that the information is accessible and understandable to the individuals who have recently immigrated from Iraq. By providing materials in their native language, it enhances their comprehension and engagement with the content. This approach shows respect for their cultural background and helps to bridge any language barriers.
A: Using materials developed previously for U.S. citizens may not be effective as they may not be culturally relevant or easily understood by individuals from Iraq.
B: Using all visual materials may be helpful, but it is not sufficient on its own to ensure cultural competence in patient teaching.
C: Using a lecture format with few questions may not be engaging or interactive enough for individuals from Iraq, and it may not cater to their preferred learning style.
Question 5
How do you measure for leg length discrepancy?
A. Anterior superior iliac spine (ASIS) to lateral malleolus
B. Posterior superior iliac spine (PSIS) to lateral malleolus
C. ASIS to medial malleolus
D. PSIS to medial malleolus
Show answer and rationale
Correct answer: C — ASIS to medial malleolus
To measure for leg length discrepancy accurately, you should measure from the Anterior Superior Iliac Spine (ASIS) to the Medial Malleolus. This is because the ASIS is a reliable and consistent bony landmark for measurement, and the medial malleolus is a stable reference point at the ankle joint. Measuring from ASIS to Medial Malleolus ensures that the entire length of the leg is accounted for, providing an accurate assessment of any potential length difference between the two legs. This measurement technique is commonly used in clinical practice and research studies to assess leg length inequality.
Summary:
A: Incorrect - Does not account for the full length of the leg.
B: Incorrect - PSIS is not commonly used as a reference point for leg length measurement.
C: Correct - ASIS to Medial Malleolus provides an accurate measurement of leg length discrepancy.
D: Incorrect - PSIS is not commonly used for measuring leg length, and measuring
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Question 6
The patient experienced a surgical procedure, and Betadine was utilized as the surgical prep. Two days postoperatively, the nurse’s assessment indicates that the incision is red and has a small amount of purulent drainage. The patient reports tenderness at the incision site. The patient’s temperature is 100.5° F, and the WBC is 10,500/mm3. Which action should the nurse take first?
A. Plan to change the surgical dressing during the shift.
B. Utilize SBAR to notify the primary health care provider.
C. Reevaluate the temperature and white blood cell count in 4 hours.
D. Check to see what solution was used for skin preparation in surgery.
Correct answer:
The correct answer is B: Utilize SBAR to notify the primary health care provider. This is the first action the nurse should take because the patient is exhibiting signs of a surgical site infection (redness, purulent drainage, tenderness, elevated temperature, and increased WBC count), which requires immediate attention from the healthcare provider for further evaluation and management. Notifying the provider promptly allows for timely intervention to prevent complications.
Choices A, C, and D are incorrect:
A: Planning to change the surgical dressing during the shift is not the priority as the patient's symptoms indicate a potential infection that needs immediate attention.
C: Reevaluating the temperature and WBC count in 4 hours delays necessary intervention for a suspected infection.
D: Checking the solution used for skin preparation in surgery is not urgent compared to notifying the provider about the concerning signs of infection.
An examiner is using an ophthalmoscope to examine a patient's eyes. Which technique indicates that the examination is being correctly performed?
A. Using the large full circle of light when assessing pupils that are not dilated.
B. Rotating the lens selector dial to the black numbers to compensate for astigmatism.
C. Using the grid on the lens aperture dial to visualize the external structures of the eye.
D. Rotating the lens selector dial to the red numbers to compensate for myopia.
Correct answer:
The correct answer is D: Rotating the lens selector dial to the red numbers to compensate for myopia. This is the correct technique because red numbers on the lens selector dial indicate the adjustment for nearsightedness (myopia) by adding concave lenses. This adjustment helps in achieving a clear view of the retina in myopic patients.
A: Using the large full circle of light when assessing pupils that are not dilated is incorrect because a smaller circle of light is preferred for assessing undilated pupils to reduce glare.
B: Rotating the lens selector dial to the black numbers to compensate for astigmatism is incorrect because astigmatism is corrected by adjusting the cylindrical power, not by using black numbers on the lens selector dial.
C: Using the grid on the lens aperture dial to visualize the external structures of the eye is incorrect as the grid is typically used for focusing and not for visualizing external structures.
His head, eyes, ears, nose, and throat examinations are unremarkable. His lungs have normal breath sounds and there are no abnormalities with percussion and palpation of the chest. His heart has a normal S and S and no S or S . Further workup is pending. 1 2 3 4 Which disorder of the chest best describes these symptoms?
A. Angina pectoris
B. Pericarditis
C. Dissecting aortic aneurysm
D. Pleural pain
Correct answer:
The symptoms described in the scenario point towards pleural pain. The examination findings of normal breath sounds, no abnormalities with percussion and palpation of the chest, and a normal heart sound (S1 and S2) suggest that the issue is more likely related to the pleura rather than the heart or major blood vessels. Pleural pain is typically sharp and worsens with deep breathing or coughing. This differs from angina pectoris, which is chest pain caused by reduced blood flow to the heart muscles due to coronary artery disease. Pericarditis involves inflammation of the pericardium, the membrane surrounding the heart, and usually presents with chest pain that is relieved by sitting up and leaning forward. Dissecting aortic aneurysm is a life-threatening condition characterized by severe, tearing chest pain that can radiate to the back. In this case, the lack of significant abnormalities on cardiac and vascular examination points towards ple
One way for a nursing assistant to communicate effectively with a resident who has a visual impairment is to
A. Wait until the resident speaks to her before identifying herself
B. Touch the resident on the arm before identifying herself to let her know the NA is there
C. Speak as little as possible while providing care
D. Use the face of an imaginary clock to explain the position of objects
Correct answer:
The correct answer is B: Touch the resident on the arm before identifying herself to let her know the NA is there. This approach is effective because it helps the visually impaired resident to be aware of the nursing assistant's presence before verbal communication. By gently touching the resident's arm, the nursing assistant establishes physical contact and ensures the resident is prepared for interaction. This gesture shows respect for the resident's personal space and helps build trust and rapport.
A: Waiting until the resident speaks is not proactive and may lead to confusion or frustration for the visually impaired resident.
C: Speaking as little as possible is not helpful as communication is essential for providing care and addressing the resident's needs.
D: Using the face of an imaginary clock may be confusing and unnecessary for the resident, as simple and direct communication through touch and verbal cues is more effective.
The Omnibus Budget Reconciliation Act (OBRA) was passed as a response to
A. Lack of funding for long-term care facilities
B. Reports of abuse and poor care in long-term care facilities
C. Complaints from long-term care facility staff about resident behavior
D. Nursing assistants being unable to pass competency examinations
Correct answer:
The correct answer is B. The Omnibus Budget Reconciliation Act (OBRA) was passed in response to reports of abuse and poor care in long-term care facilities. This legislation aimed to improve the quality of care in nursing homes by setting standards for training and competency of staff, ensuring residents' rights, and enhancing the quality of life for residents.
Incorrect choices:
A: Lack of funding for long-term care facilities - While funding issues may impact the quality of care, OBRA was primarily focused on addressing abuse and poor care.
C: Complaints from long-term care facility staff about resident behavior - Staff complaints about resident behavior were not the primary reason for the passage of OBRA.
D: Nursing assistants being unable to pass competency examinations - While this could be a concern, OBRA was more about setting standards and regulations to improve care quality, not solely about the competency of nursing assistants.
The nurse is preparing to conduct a mental status examination. Which statement is true regarding the mental status examination?
A. A patient's family is the best resource for information about the patient's coping skills
B. Gathering mental status information during the health history interview is usually sufficient
C. Integrating the mental status examination into the health history interview takes an enormous amount of extra time
D. To get a good idea of the patient's level of functioning, performing a complete mental status examination is usually necessary
Correct answer:
Rationale: Option B is correct because gathering mental status information during the health history interview is a crucial and efficient way to assess a patient's mental state. Here's the rationale:
1. Mental status assessment during the health history interview allows for a comprehensive evaluation of the patient's current mental state.
2. It helps in identifying any immediate concerns or issues that may impact the patient's overall health and well-being.
3. Gathering mental status information early on can guide further assessment and interventions.
4. Conducting a separate mental status examination may be necessary in some cases, but integrating it into the health history interview streamlines the assessment process.
In summary, option B is correct as it emphasizes the importance and efficiency of gathering mental status information during the health history interview, while the other choices provide inaccurate or irrelevant statements.
When assessing a patient's pulse, the nurse notes that the amplitude is weaker during inspiration and stronger during expiration. When the nurse measures the blood pressure, the reading decreases 20 mm Hg during inspiration and increases with expiration. This patient is experiencing pulsus:
A. Alternans.
B. Bisferiens.
C. Bigeminus.
D. Paradoxus.
Correct answer:
Step-by-step rationale for why the correct answer is D (Paradoxus):
1. Pulsus paradoxus is characterized by a decrease in pulse strength during inspiration and an increase during expiration, as seen in the patient's pulse assessment.
2. The blood pressure reading decreasing by 20 mm Hg during inspiration is indicative of pulsus paradoxus, as it reflects an exaggeration of the normal inspiratory drop in blood pressure.
3. Pulsus paradoxus is commonly associated with conditions like cardiac tamponade and severe asthma, which can cause this paradoxical pulse and blood pressure pattern.
Summary of why the other choices are incorrect:
A. Alternans: Alternating strong and weak pulse amplitudes, not related to the respiratory cycle.
B. Bisferiens: Pulse with double systolic peaks, not related to respiratory cycle changes.
C. Bigeminus: A pattern of every other heartbeat occurring prematurely, not related to respiratory cycle influences.
The patient experienced a surgical procedure, and Betadine was utilized as the surgical prep. Two days postoperatively, the nurse’s assessment indicates that the incision is red and has a small amount of purulent drainage. The patient reports tenderness at the incision site. The patient’s temperature is 100.5° F, and the WBC is 10,500/mm3. Which action should the nurse take first?
A. Plan to change the surgical dressing during the shift.
B. Utilize SBAR to notify the primary health care provider.
C. Reevaluate the temperature and white blood cell count in 4 hours.
D. Check to see what solution was used for skin preparation in surgery.
Correct answer:
The correct answer is B: Utilize SBAR to notify the primary health care provider. This is the first action the nurse should take because the patient is exhibiting signs of a surgical site infection (redness, purulent drainage, tenderness, elevated temperature, and increased WBC count), which requires immediate attention from the healthcare provider for further evaluation and management. Notifying the provider promptly allows for timely intervention to prevent complications.
Choices A, C, and D are incorrect:
A: Planning to change the surgical dressing during the shift is not the priority as the patient's symptoms indicate a potential infection that needs immediate attention.
C: Reevaluating the temperature and WBC count in 4 hours delays necessary intervention for a suspected infection.
D: Checking the solution used for skin preparation in surgery is not urgent compared to notifying the provider about the concerning signs of infection.
A 45-year-old woman presents with a complaint of chronic back pain. She describes the pain as dull, aching, and constant, with no radiation. She has a history of rheumatoid arthritis and takes nonsteroidal anti-inflammatory drugs. On examination, she has tenderness over the lower lumbar spine. Which of the following is the most likely diagnosis?
A. Osteoporotic fracture
B. Herniated disc
C. Spinal stenosis
D. Mechanical low back pain
Correct answer:
The most likely diagnosis for the 45-year-old woman with chronic back pain, tenderness over the lower lumbar spine, and a history of rheumatoid arthritis is mechanical low back pain (Choice D).
1. Chronic dull, aching, constant pain with no radiation is characteristic of mechanical low back pain.
2. Presence of tenderness over the lower lumbar spine suggests a musculoskeletal origin, consistent with mechanical low back pain.
3. History of rheumatoid arthritis increases the likelihood of musculoskeletal issues like mechanical low back pain.
Summary:
- A: Osteoporotic fracture is less likely due to absence of acute onset, severe pain, and risk factors like advanced age or prolonged corticosteroid use.
- B: Herniated disc typically presents with radicular pain (radiating pain down the leg), which is not described in this case.
- C: Spinal stenosis usually presents with neurogenic claudication (pain with walking) and neurological
A client is having a lumbar puncture performed. The nurse would plan to place the client in which position?
A. Side-lying, with a pillow under the hip.
B. Prone, with a pillow under the abdomen.
C. Prone, in slight-Trendelenburg's position.
D. Side-lying, with the legs pulled up and head bent down onto chest.
Correct answer:
The correct answer is D. During a lumbar puncture, the client should be positioned in a side-lying position with the legs pulled up and head bent down onto the chest. This position helps to open up the spaces between the vertebrae, making it easier for the healthcare provider to access the lumbar area. Placing the legs up also helps to widen the spaces between the vertebrae, making it easier to insert the needle without damaging the spinal cord. The head bent down onto the chest helps to round the back, further increasing the space between the vertebrae.
Choice A is incorrect because placing a pillow under the hip does not provide the necessary positioning for a lumbar puncture. Choice B is incorrect as the prone position with a pillow under the abdomen would not facilitate access to the lumbar area. Choice C is incorrect as the Trendelenburg's position is not recommended for lumbar punctures as it can increase intracranial pressure.
RN exams fundamentals practice questions, set 16 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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