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
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
Show answer and rationale
Correct answer: B — Pulmonary embolism
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.
Question 2
A nurse is admitting a patient to the hospital for surgery. Which of the following pieces of information must be obtained from the patient? Select all that apply.
A. address
B. date of birth
C. admitting physician
D. symptoms experienced
Show answer and rationale
Correct answer: B — date of birth
The correct answer is B: date of birth. It is essential to obtain the patient's date of birth for accurate identification and to ensure the correct patient receives the appropriate care. This information is crucial for confirming the patient's identity and preventing medical errors.
Explanation for Incorrect Choices:
A: Address - While obtaining the patient's address is important for communication and follow-up purposes, it is not a critical piece of information that must be obtained during the admission process.
C: Admitting physician - Knowing the admitting physician is important for coordination of care, but it is not crucial information that must be obtained directly from the patient.
D: Symptoms experienced - While knowing the symptoms experienced by the patient is important for medical history and assessment, it is not a piece of information that must be obtained directly from the patient during the admission process.
Question 3
A patient whose cancer has been staged at T4 N2 M2 has been assigned for care. What is the best interpretation of this staging information in planning care for this patient?
A. The primary tumor has shrunk, although some lymph nodes remain involved. Teach the patient that this is good news.
B. The primary tumor has now responded to a combination of chemotherapy and radiation. The patient should now receive much less analgesic medication.
C. The primary tumor is quite large and has extended to lymph glands and distant areas. Gentle touch and therapeutic listening will be especially helpful.
D. After the series of radiation treatments, the distant metastases are still present. Prepare the patient to accept only the cure of the primary tumor.
Show answer and rationale
Correct answer: C — The primary tumor is quite large and has extended to lymph glands and distant areas. Gentle touch and therapeutic listening will be especially helpful.
The correct answer is C because the staging T4 N2 M2 indicates an advanced stage of cancer where the primary tumor is large (T4), multiple lymph nodes are involved (N2), and distant metastases are present (M2). This means the cancer has spread extensively beyond its original site, requiring comprehensive treatment. Gentle touch and therapeutic listening can be beneficial in providing comfort and support for the patient dealing with such advanced disease.
Choice A is incorrect because the presence of lymph node involvement and distant metastases indicate a poor prognosis, not necessarily good news. Choice B is incorrect as it suggests the primary tumor has responded well to treatment, which is inconsistent with the staging information provided. Choice D is incorrect as it oversimplifies the situation by focusing only on the primary tumor, disregarding the importance of addressing the metastases for effective care planning.
Question 4
Which of the following statements is true of a living will?
A. A living will goes into effect when a resident dies and leaves a large estate that needs to be distributed.
B. A living will is an important part of a resident's wishes regarding his inheritance.
C. A living will is a document that states the medical care a resident wants or does not want if he becomes unable to make those decisions.
D. A living will helps a resident decide who will manage his financial affairs when he is no longer able to do that.
Show answer and rationale
Correct answer: C — A living will is a document that states the medical care a resident wants or does not want if he becomes unable to make those decisions.
Step 1: A living will is a legal document that outlines a person's preferences for medical treatment in case they are unable to communicate their wishes.
Step 2: Choice C states that a living will states the medical care a resident wants or does not want if they become unable to make decisions, which aligns with the definition.
Step 3: Choice A is incorrect because a living will does not pertain to the distribution of a large estate upon death.
Step 4: Choice B is incorrect as a living will is not related to a resident's inheritance wishes but rather their medical care preferences.
Step 5: Choice D is incorrect as a living will does not address financial affairs but focuses solely on medical treatment preferences.
Summary: The correct answer, Choice C, accurately describes the purpose of a living will in outlining medical care preferences, making it distinct from the other choices that are unrelated to its intended use.
Question 5
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.
Show answer and rationale
Correct answer: C — Blood can flow into the left side of the heart through an opening in the atrial septum.
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.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
A patient whose cancer has been staged at T4 N2 M2 has been assigned for care. What is the best interpretation of this staging information in planning care for this patient?
A. The primary tumor has shrunk, although some lymph nodes remain involved. Teach the patient that this is good news.
B. The primary tumor has now responded to a combination of chemotherapy and radiation. The patient should now receive much less analgesic medication.
C. The primary tumor is quite large and has extended to lymph glands and distant areas. Gentle touch and therapeutic listening will be especially helpful.
D. After the series of radiation treatments, the distant metastases are still present. Prepare the patient to accept only the cure of the primary tumor.
Correct answer:
The correct answer is C because the staging T4 N2 M2 indicates an advanced stage of cancer where the primary tumor is large (T4), multiple lymph nodes are involved (N2), and distant metastases are present (M2). This means the cancer has spread extensively beyond its original site, requiring comprehensive treatment. Gentle touch and therapeutic listening can be beneficial in providing comfort and support for the patient dealing with such advanced disease.
Choice A is incorrect because the presence of lymph node involvement and distant metastases indicate a poor prognosis, not necessarily good news. Choice B is incorrect as it suggests the primary tumor has responded well to treatment, which is inconsistent with the staging information provided. Choice D is incorrect as it oversimplifies the situation by focusing only on the primary tumor, disregarding the importance of addressing the metastases for effective care planning.
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.
Correct answer:
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.
The nurse is obtaining a health history on a 3-month-old infant. During the interview, the mother states, "I think she is getting her first tooth because she has started drooling a lot." The nurse's best response would be:
A. "You're right, drooling is usually a sign of the first tooth."
B. "It would be unusual for a 3 month old to be getting her first tooth."
C. "This could be the sign of a problem with the salivary glands."
D. "She is just starting to salivate and hasn't learned to swallow the saliva."
Correct answer:
The correct response is D: "She is just starting to salivate and hasn't learned to swallow the saliva." At 3 months old, infants often start drooling due to increased salivation as their salivary glands develop. This response acknowledges normal infant development and provides an explanation for the observed behavior.
Choice A (You're right, drooling is usually a sign of the first tooth) is incorrect because while drooling can be associated with teething, it is not the primary reason for drooling in a 3-month-old.
Choice B (It would be unusual for a 3-month-old to be getting her first tooth) is incorrect because teething can start as early as 3 months, although it is more common around 6 months.
Choice C (This could be the sign of a problem with the salivary glands) is incorrect as it jumps to a less likely conclusion of a salivary gland issue without considering the normal developmental process of salivation in infants
A 35-year-old man is brought to the emergency department after a motorcycle accident. He is conscious but has pain in his chest. His vital signs are as follows: BP 100/60 mm Hg, pulse 120 bpm, and respiratory rate 22 breaths/min. Physical examination reveals bruising and tenderness over the left side of his chest. Which of the following is the most likely cause of his pain?
A. Rib fracture
B. Pneumothorax
C. Pericarditis
D. Myocardial infarction
Correct answer:
The correct answer is A: Rib fracture.
Rationale:
1. The patient's presentation with chest pain, tenderness, and bruising after a motorcycle accident is highly suggestive of a traumatic injury like a rib fracture.
2. Rib fractures are common in blunt chest trauma and can cause significant pain with breathing and movement.
3. Tenderness over the affected area and pain on palpation are typical findings in rib fractures.
4. The vital signs of a stable blood pressure and tachycardia are consistent with a rib fracture without significant hemodynamic instability.
Summary of incorrect choices:
B: Pneumothorax - Less likely in this case as there is no mention of decreased breath sounds or respiratory distress.
C: Pericarditis - Unlikely given the acute presentation after trauma and absence of classic pericarditis symptoms.
D: Myocardial infarction - Not likely in a young patient with trauma and no risk factors for heart disease.
You are transporting a 20-year-old pregnant female from a local hospital to a medical facility that specializes in high-risk pregnancies when you note the patient is experiencing unexplained hypotension and bradycardia. The patient has a patent IV and is being administered magnesium that was initiated by hospital staff. On the cardiac monitor, the patient presents with a lengthening PR interval and signs of an impending high-degree nodal block. Which of the following interventions would be most appropriate in this case?
A. Increase the magnesium sulfate infusion rate, and administer a 1,000 mL normal saline bolus to support the patient's blood pressure
B. Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity
C. Continue the infusion, but administer potassium chloride to counteract the adverse effects of the magnesium chloride administration
D. Reduce the infusion by half, and administer dextrose 50% to counteract the adverse cardiac effects caused by the magnesium chloride infusion
Correct answer:
The correct answer is B: Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity.
Rationale:
1. Magnesium toxicity can lead to hypotension, bradycardia, and cardiac conduction abnormalities.
2. Stopping the magnesium infusion is crucial to prevent further adverse effects.
3. Calcium chloride is the antidote for magnesium toxicity as it competes with magnesium for binding sites on cardiac cells, restoring normal cardiac function.
4. Administering a normal saline bolus (choice A) would not address the underlying cause of magnesium toxicity.
5. Administering potassium chloride (choice C) is not appropriate as it can exacerbate the cardiac effects of magnesium toxicity.
6. Reducing the magnesium infusion and administering dextrose 50% (choice D) would not address the magnesium toxicity and may not reverse the cardiac effects.
A patient who has been placed on Contact Precautions for Clostridium difficile (C. difficile) asks you to explain what he should know about this organism. Which statements made by the patient show an understanding of the patient teaching? (Select all that apply.)
A. “The organism is usually transmitted through the fecal-oral route.â€
B. “Hands should always be cleaned with soap and water rather than the alcohol-based hand sanitizer.â€
C. “Everyone coming into the room must wear a gown and gloves.â€
D. “While I am in Contact Precautions, I cannot leave the room.â€
Correct answer:
The correct answer is B: "Hands should always be cleaned with soap and water rather than the alcohol-based hand sanitizer."
Rationale:
1. C. difficile spores are not effectively killed by alcohol-based hand sanitizers.
2. Washing hands with soap and water is essential for removing spores.
3. Proper hand hygiene is crucial to prevent the spread of C. difficile.
4. This statement reflects understanding of the importance of hand hygiene in preventing transmission of C. difficile.
Incorrect Choices:
A: Incorrect. While C. difficile is transmitted through the fecal-oral route, this statement does not directly address patient teaching on prevention.
C: Incorrect. While gowns and gloves are necessary in Contact Precautions, this statement does not emphasize the importance of hand hygiene.
D: Incorrect. Patients on Contact Precautions may leave the room but should practice proper hand hygiene to prevent transmission.
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
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.
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.
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.
Correct answer:
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.
RN exams fundamentals practice questions, set 19 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the RN exams exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
