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
Your client has an allergy to both penicillin and latex. Which of these pathophysiological facts should you apply when you are providing to this client?
A. The sensitizing dose of penicillin can lead to anaphylaxis.
B. The second dose of penicillin can lead to distributive shock.
C. You should be aware of the fact that about 10% of the population has an allergy to both penicillin and latex.
D. You should be aware of the fact that about 20% of the population has an allergy to both penicillin and latex.
Show answer and rationale
Correct answer: A — The sensitizing dose of penicillin can lead to anaphylaxis.
The correct answer is A. When a client has an allergy to both penicillin and latex, it is important to consider the risk of anaphylaxis from the sensitizing dose of penicillin. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur upon exposure to an allergen. In this case, the client's history of allergies indicates a heightened risk for anaphylaxis with penicillin. This pathophysiological fact is crucial to consider when providing care to this client.
Choices B, C, and D are incorrect because they do not directly address the specific risk associated with the client's allergy to both penicillin and latex. Choice B refers to distributive shock, which is not the primary concern in this scenario. Choices C and D provide statistics about the prevalence of allergies to penicillin and latex in the population, but these do not directly impact the care of a client with allergies to both substances.
Question 2
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
Show answer and rationale
Correct answer: D — Mechanical low back pain
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
Question 3
Which of the following best describes the general survey component of the physical examination?
A. It assesses the patient's chief complaint.
B. It includes observations about the patient's appearance, behavior, and mobility.
C. It documents findings from a review of systems.
D. It evaluates the patient's vital signs.
Show answer and rationale
Correct answer: B — It includes observations about the patient's appearance, behavior, and mobility.
The correct answer is B because the general survey component of the physical examination focuses on observations related to the patient's appearance, behavior, and mobility. This step is crucial in gathering initial information about the patient's overall health status and can provide important clues for further evaluation. Assessing the patient's appearance can reveal signs of distress, nutritional status, or hygiene. Observing behavior can indicate mental status or emotional state. Mobility assessment can identify physical limitations or abnormalities.
A, C, and D are incorrect:
A: Assessing the patient's chief complaint is part of the focused history taking, not the general survey component.
C: Documenting findings from a review of systems is part of the comprehensive history taking, not the general survey.
D: Evaluating vital signs is a separate component of the physical examination and not part of the general survey.
Question 4
Your client has an allergy to both penicillin and latex. Which of these pathophysiological facts should you apply when you are providing to this client?
A. The sensitizing dose of penicillin can lead to anaphylaxis.
B. The second dose of penicillin can lead to distributive shock.
C. You should be aware of the fact that about 10% of the population has an allergy to both penicillin and latex.
D. You should be aware of the fact that about 20% of the population has an allergy to both penicillin and latex.
Show answer and rationale
Correct answer: A — The sensitizing dose of penicillin can lead to anaphylaxis.
The correct answer is A. When a client has an allergy to both penicillin and latex, it is important to consider the risk of anaphylaxis from the sensitizing dose of penicillin. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur upon exposure to an allergen. In this case, the client's history of allergies indicates a heightened risk for anaphylaxis with penicillin. This pathophysiological fact is crucial to consider when providing care to this client.
Choices B, C, and D are incorrect because they do not directly address the specific risk associated with the client's allergy to both penicillin and latex. Choice B refers to distributive shock, which is not the primary concern in this scenario. Choices C and D provide statistics about the prevalence of allergies to penicillin and latex in the population, but these do not directly impact the care of a client with allergies to both substances.
Question 5
After the blood transfusion, you assessed the client for blood transfusion reactions. The following assessments were noted: HR: 120 bpm, Pulse: +4 in quality, presence of fine, short, high pitched crackling at base. Which of the following is your FIRST action?
A. Maintain bed rest with legs elevated.
B. Place the client in high-Fowler's position.
C. Increase the rate of infusion of intravenous fluids.
D. Consult with the primary health care provider (PHCP) regarding initiation of oxygen therapy.
Show answer and rationale
Correct answer: D — Consult with the primary health care provider (PHCP) regarding initiation of oxygen therapy.
The correct first action is D: Consult with the primary health care provider (PHCP) regarding initiation of oxygen therapy. This is because the client is showing signs of a potential transfusion reaction, likely a pulmonary embolism. The client's rapid heart rate, bounding pulse, and crackling sound at the base suggest a possible pulmonary issue. Oxygen therapy is crucial to improve oxygenation and stabilize the client's condition. Consulting with the PHCP ensures timely intervention and appropriate management.
A: Maintaining bed rest with legs elevated would not address the potential respiratory distress the client is experiencing.
B: Placing the client in high-Fowler's position may help improve oxygenation, but consulting the PHCP for oxygen therapy is the priority.
C: Increasing the rate of IV fluids is not the priority when the client is showing signs of a potential serious complication like a pulmonary embolism.
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Question 6
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 when a person is confused or disoriented, they may not be able to cooperate in holding the thermometer properly or keeping their mouth closed during the reading, leading to inaccurate results. Therefore, it is crucial not to take an oral temperature in such cases to ensure the accuracy of the measurement.
Choice A (The person has influenza) is not a valid reason to avoid taking an oral temperature. Influenza itself does not prevent the accurate measurement of oral temperature.
Choice B (The person almost certainly has a fever) does not necessarily indicate that an oral temperature should not be taken. It is still important to assess the person's temperature accurately to confirm the presence of a fever.
Choice C (The person is over six years old) is irrelevant to the decision of not taking an oral temperature. Age alone does not impact the ability to take an oral temperature accurately.
The nurse is caring for a patient who has a bloodborne pathogen. The nurse splashes blood above the glove to intact skin while discontinuing an intravenous (IV) infusion. Which step(s) will the nurse take next?
A. Obtain an alcohol swab, remove the blood with an alcohol swab, and continue care.
B. Immediately wash the site with soap and running water, and seek guidance from the manager.
C. Do nothing; accidentally getting splashed with blood happens frequently and is part of the job.
D. Delay washing of the site until the nurse is finished providing care to the patient.
Correct answer:
The correct answer is B. Immediately washing the site with soap and running water is essential to reduce the risk of transmission of bloodborne pathogens. This step helps to remove any potentially infectious material and decreases the likelihood of infection. Seeking guidance from the manager is also important as they can provide support and further instructions on reporting the incident.
Choice A is incorrect because using an alcohol swab alone may not effectively remove all bloodborne pathogens, and continuing care without proper cleaning increases the risk of transmission.
Choice C is incorrect as ignoring a blood splashing incident can lead to serious health consequences for both the nurse and the patient. It is not acceptable to consider it a normal part of the job.
Choice D is incorrect because delaying washing the site can allow pathogens to enter the body through breaks in the skin, increasing the risk of infection.
An 18 y/o man presents with paralysis in both legs and arms after a motorcycle crash. His BP is 60/40 and pulse 140 bpm. He should:
A. "Undergo exploratory celiotomy"
B. Be treated for neurogenic shock
C. Be treated for hypovolemic shock
D. Undergo immediate nasotracheal intubation
Correct answer:
The correct answer is C: Be treated for hypovolemic shock.
Rationale:
1. The patient's low blood pressure (60/40) and high pulse rate (140 bpm) indicate hypovolemic shock due to significant blood loss from the crash.
2. Treatment for hypovolemic shock involves restoring intravascular volume with intravenous fluids to improve perfusion and stabilize the patient's condition.
3. Initiating treatment for hypovolemic shock is crucial to prevent further complications and improve the patient's chances of survival.
Summary:
- Choice A (Undergo exploratory celiotomy) is incorrect as it involves abdominal surgery and is not indicated based on the presented symptoms.
- Choice B (Be treated for neurogenic shock) is incorrect as the symptoms are more indicative of hypovolemic shock.
- Choice D (Undergo immediate nasotracheal intubation) is incorrect as airway management is not the primary concern in this scenario, addressing hypov
The nurse is performing an assessment on a patient who will begin taking propranolol (Inderal) to treat hypertension. The nurse learns that the patient has a history of asthma and diabetes. The nurse will take which action?
A. Administer the medication and monitor the patient's serum glucose.
B. Contact the provider to discuss another type antihypertensive medication.
C. Request an order for renal function tests prior to administering this drug.
D. Teach the patient about the risks of combining herbal medications with this drug.
Correct answer:
Step 1: Identify contraindications - Propranolol is contraindicated in patients with asthma due to its potential to exacerbate bronchospasm.
Step 2: Recognize patient history - The patient has a history of asthma.
Step 3: Assess for comorbidities - The patient also has diabetes, which is another consideration in selecting appropriate antihypertensive medication.
Step 4: Consider safer alternatives - Given the contraindications and comorbidities, contacting the provider to discuss an alternative antihypertensive medication is the best course of action.
Step 5: Monitor for adverse effects - Administering the medication without addressing the contraindications could lead to serious complications.
Summary: Option B is correct as it addresses the contraindications and comorbidities, ensuring patient safety. Options A, C, and D are incorrect as they do not address the potential risks associated with propranolol in this specific
A client requires minor surgery for removal of a basal cell tumor. The anesthesiologist administers the anesthetic ketamine hydrochloride (Ketalar), 60g IV. After Ketamine administration, the nurse should monitor the client for:
A. Muscle rigidity and spasms
B. Hiccups
C. Extrapyramidal reactions
D. Respiratory depression
Correct answer:
The correct answer is A: Muscle rigidity and spasms. Ketamine can cause muscle rigidity and spasms as a side effect. The anesthesiologist should monitor the client for this adverse reaction. Muscle rigidity and spasms are common with ketamine administration and can affect the client's comfort and safety during the procedure. It is important for the nurse to promptly address any signs of muscle rigidity or spasms to prevent complications.
Summary of why other choices are incorrect:
B: Hiccups - Ketamine can cause hiccups, but it is not the primary side effect to monitor for in this scenario.
C: Extrapyramidal reactions - Ketamine does not typically cause extrapyramidal reactions.
D: Respiratory depression - Ketamine is known for its minimal effect on respiratory depression compared to other anesthetics. Monitoring respiratory depression is still important, but not the primary concern with ketamine administration in this case.
A nurse teaches a client who is at risk for hyponatremia. Which statement does the nurse include in this client’s teaching?
A. “Have you spouse watch you for irritability and anxiety.â€
B. “Notify the clinic if you notice muscle twitching.â€
C. “Call your primary health care provider for diarrhea.â€
D. “Bake or grill your meat rather than frying it.â€
Correct answer:
The correct answer is B: “Notify the clinic if you notice muscle twitching.†Muscle twitching can be a symptom of hyponatremia, which is a condition characterized by low sodium levels in the blood. The nurse should include this statement in the client’s teaching because it is important for the client to recognize and report this symptom promptly to prevent potential complications. Muscle twitching can indicate worsening hyponatremia and requires medical attention.
Incorrect choices:
A: “Have your spouse watch you for irritability and anxiety.†This choice focuses on emotional symptoms rather than physical symptoms of hyponatremia.
C: “Call your primary health care provider for diarrhea.†Diarrhea is not a common symptom of hyponatremia; this choice is unrelated to the condition.
D: “Bake or grill your meat rather than frying it.†This choice is unrelated to the prevention or management of hyponatremia.
A focus of healthcare today is community-based care. What is community-based care?
A. care provided to patients within a defined geographic area
B. a focus on providing appropriate care for mental health
C. a focus on the health of the community
D. an emphasis on population-based care
Correct answer:
The correct answer is C: a focus on the health of the community. Community-based care emphasizes promoting health and wellness within the community, addressing the specific needs and challenges of the population. This approach involves collaboration with community members, organizations, and resources to improve overall health outcomes. This choice directly aligns with the concept of community-based care, reflecting a comprehensive and holistic approach to healthcare.
Summary of other choices:
A: While care may be provided within a defined area in community-based care, the focus is not solely on geography but on the community's overall health.
B: Community-based care is not limited to mental health but encompasses all aspects of healthcare.
D: Population-based care is a broader concept that focuses on health outcomes at the population level, whereas community-based care is more specific to the community's health needs.
The nurse is caring for a patient in the operating suite who is experiencing hypercarbia, tachypnea, tachycardia, premature ventricular contractions, and muscle rigidity. Which condition does the nurse suspect the patient is experiencing?
A. Malignant hyperthermia
B. Fluid imbalance
C. Hemorrhage
D. Hypoxia
Correct answer:
The correct answer is A: Malignant hyperthermia. Hypercarbia, tachypnea, tachycardia, premature ventricular contractions, and muscle rigidity are characteristic signs of malignant hyperthermia, a rare but life-threatening reaction to certain anesthetics. This condition is triggered by an abnormal response to specific anesthetic agents, leading to increased muscle metabolism, hyperthermia, and potentially fatal complications. Prompt recognition and treatment, including discontinuation of triggering agents, administration of dantrolene, and supportive care, are crucial.
B: Fluid imbalance is incorrect because the symptoms described are not typically associated with fluid imbalance.
C: Hemorrhage is incorrect as it does not typically present with the combination of symptoms mentioned.
D: Hypoxia is incorrect as it usually presents with different clinical manifestations such as cyanosis, confusion, and respiratory distress.
You are called to a scene for a 48-year-old male presenting with sudden onset of severe shortness of breath, tachypnea, and a rapid pulse. He is alert and oriented, and physical exam reveals a swollen right calf with tenderness. Which condition is most likely causing his symptoms?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Tension pneumothorax
D. Severe asthma attack
Correct answer:
The correct answer is B: Pulmonary embolism. Given the sudden onset of severe shortness of breath, tachypnea, rapid pulse, and swollen right calf with tenderness, the most likely diagnosis is a pulmonary embolism. A pulmonary embolism occurs when a blood clot travels to the lungs, blocking blood flow. This leads to symptoms of shortness of breath, tachypnea, and rapid pulse. The swollen right calf with tenderness suggests a possible deep vein thrombosis, which can lead to a pulmonary embolism. The other choices are less likely because they do not fully encompass the patient's presentation and physical exam findings. A myocardial infarction typically presents with chest pain, not solely shortness of breath and calf swelling. Tension pneumothorax presents with respiratory distress and decreased breath sounds, not calf swelling. Severe asthma attack may cause shortness of breath but is less likely to present with a swollen calf.
When assessing a newborn infant who is 5 minutes old, the nurse knows which of these statements to be true?
A. The left ventricle is larger and weighs more than the right ventricle.
B. The circulation of a newborn is identical to that of an adult.
C. Blood can flow into the left side of the heart through an opening in the atrial septum.
D. The foramen ovale closes just minutes before birth, and the ductus arteriosus closes immediately after.
Correct answer:
The correct answer is C because at birth, the opening in the atrial septum known as the foramen ovale allows blood to bypass the lungs and flow from the right atrium to the left atrium. This is essential as the lungs are not functional until the baby takes its first breath. The closure of the foramen ovale typically occurs within minutes to hours after birth as the pressure changes in the heart and lungs.
Choice A is incorrect because the right ventricle is typically larger and weighs more than the left ventricle in a newborn due to the lower pressure needed to pump blood to the lungs. Choice B is incorrect as the circulation of a newborn is different from that of an adult, with shunts and openings that close or change soon after birth. Choice D is incorrect as the foramen ovale closes gradually over time after birth, not just minutes before, and the ductus arteriosus closes within a few days after birth, not immediately.
RN exams fundamentals practice questions, set 18 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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