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 nurse is reviewing percussion techniques with a newly graduated nurse. Which technique indicates that more review is needed?
A. Percussing once over each area
B. Quickly lifting the striking finger after each stroke
C. Striking with the fingertip, not the finger pad
D. Using the wrist to make the strikes, not the arm
Show answer and rationale
Correct answer: A — Percussing once over each area
Correct Answer: A
Rationale:
1. Percussing once over each area is incorrect because percussion should involve multiple strikes to accurately assess underlying structures.
2. Percussion requires a series of light and rapid strikes to elicit different sounds based on tissue density.
3. By percussing only once, the nurse may miss subtle differences in sound pitch and quality, leading to inaccurate assessments.
4. Therefore, more review is needed to ensure the nurse understands the importance of multiple percussion strikes for proper assessment.
Summary of other choices:
B. Quickly lifting the striking finger after each stroke is a correct technique to enhance the accuracy of percussion.
C. Striking with the fingertip, not the finger pad, is important to produce clear sounds during percussion.
D. Using the wrist to make the strikes, not the arm, is the correct technique to achieve controlled and precise percussion strikes.
Question 2
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
Show answer and rationale
Correct answer: D — Radial pulse, brachial pulse
When assessing a patient for peripheral vascular disease in the arms, it is important to examine the pulses in the upper extremities. The pulses to be assessed in this context include the radial pulse (located on the wrist at the base of the thumb) and the brachial pulse (located in the upper arm near the elbow). These pulses provide important information about blood flow and circulation in the arms. Changes in the strength, regularity, or absence of these pulses can indicate potential issues related to peripheral vascular disease. While the femoral and popliteal pulses (Choice A) are important for assessing the lower extremities, and the dorsalis pedis and posterior tibial pulses (Choice B) are also crucial for evaluating peripheral vascular disease in the legs, the radial and brachial pulses are specifically relevant for assessing the arms. The carotid pulse (Choice C) is important for evaluating the vascular status of
Question 3
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
Show answer and rationale
Correct answer: C — a focus on the health of the community
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.
Question 4
Blood and fluid loss from frequent diarrhea may cause hypovolemia and you can quickly assess volume depletion in Miss CC by:
A. Measuring the quantity and specific gravity of her urine output
B. Taking her blood pressure
C. Comparing the patient’s present weight with her last weight
D. Administering the oral water test
Show answer and rationale
Correct answer: C — Comparing the patient’s present weight with her last weight
The correct answer is C: Comparing the patient’s present weight with her last weight. This is the most direct and reliable method to assess volume depletion due to fluid loss. By comparing the patient's current weight with her last weight, you can easily determine if there has been a significant decrease in weight indicating fluid loss and potential hypovolemia.
Explanation of why other choices are incorrect:
A: Measuring the quantity and specific gravity of her urine output - This method may provide some information about hydration status, but it is not as direct or reliable as comparing weight changes.
B: Taking her blood pressure - While blood pressure can indicate hypovolemia, it may not provide immediate insight into volume depletion caused by diarrhea.
D: Administering the oral water test - This test is not commonly used to assess volume depletion and may not be as effective or quick as comparing weight changes.
Question 5
You are evaluating a trauma patient who may have sustained a spinal cord injury. Which of the following would you expect to see in a trauma patient with a spinal cord injury with autonomic nervous system involvement?
A. Bradycardia, hypotension, and a loss of sweating or shivering ability
B. Bradycardia, hypertension, warm, dry skin, and numbness of fingertips
C. Tachycardia, hypertension, one-sided paralysis, and amnesia
D. Tachycardia, hypotension, diaphoresis, cool, and clammy skin
Show answer and rationale
Correct answer: A — Bradycardia, hypotension, and a loss of sweating or shivering ability
The correct answer is A. In spinal cord injury with autonomic nervous system involvement, there is disruption of sympathetic and parasympathetic control. This leads to bradycardia due to loss of sympathetic tone, hypotension due to disrupted baroreceptor reflexes, and loss of sweating or shivering ability due to impaired temperature regulation.
Choice B is incorrect because hypertension and warm, dry skin are more indicative of sympathetic overactivity, not autonomic dysfunction. Numbness of fingertips is not a typical feature of autonomic involvement.
Choice C is incorrect as tachycardia and hypertension are more suggestive of sympathetic overactivity, and one-sided paralysis and amnesia are not specific to autonomic dysfunction.
Choice D is incorrect as tachycardia and diaphoresis suggest sympathetic overactivity, while cool and clammy skin is more indicative of hypovolemia rather than autonomic dysfunction.
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Question 6
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.
Correct answer:
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.
Pericardial tamponade and hemorrhagic shock present very similarly in the pre-hospital environment. What is the best way, of those listed, to distinguish between the two diagnoses?
A. Pericardial tamponade presents with jugular vein distension, and hemorrhagic shock normally does not cause jugular vein distension
B. Pericardial tamponade patients present with cyanosis to the face, neck, and upper chest while hemorrhagic shock presents with core cyanosis
C. Hemorrhagic shock presents with hypotension, and pericardial tamponade presents with hypertension
D. The presence of narrow complex tachycardia with hemorrhagic shock and wide complex tachycardia with pericardial tamponade
Correct answer:
The correct answer is A because pericardial tamponade can lead to jugular vein distension due to the increased pressure in the pericardium, which can impede blood flow back to the heart. Hemorrhagic shock, on the other hand, does not typically cause jugular vein distension. This difference in jugular vein distension is a key clinical finding to differentiate between the two conditions.
Choice B is incorrect because cyanosis to the face, neck, and upper chest can be present in both pericardial tamponade and hemorrhagic shock, making it less specific for distinguishing between the two.
Choice C is incorrect because pericardial tamponade can also lead to hypotension due to decreased cardiac output, while hemorrhagic shock can sometimes lead to compensatory hypertension in its early stages.
Choice D is incorrect because the type of tachycardia (narrow vs. wide complex) is not a reliable or consistent finding to
Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree?
A. providing direct physical care
B. using research findings to improve practice
C. administering medications as prescribed
D. collaborating with other healthcare providers
Correct answer:
The correct answer is B because using research findings to improve practice is a key component of a nurse with a baccalaureate degree. Baccalaureate-prepared nurses are expected to integrate evidence-based practice into their care delivery. This involves critically analyzing research findings to enhance patient outcomes and implement best practices. Nurses with a baccalaureate degree have a deeper understanding of research methodologies and the importance of evidence-based practice.
Choice A (providing direct physical care) is not specific to a baccalaureate degree level and can be performed by nurses at various educational levels. Choice C (administering medications as prescribed) is a basic nursing responsibility that does not require a baccalaureate degree specifically. Choice D (collaborating with other healthcare providers) is important in nursing practice but is not exclusive to baccalaureate-prepared nurses.
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
You are monitoring the cardiac rhythm of your 60-year-old female patient with shortness of breath when you note the presence of a possible first-degree atrioventricular block in lead II on the EKG. Which of the following electrocardiogram abnormalities makes you think there is a first-degree AV block present?
A. There are more than one P wave for each QRS complex
B. A P-R interval greater than five small boxes (0.20 seconds) wide on the electrocardiogram tracing
C. The P-R intervals become progressively longer until a QRS complex is dropped altogether
D. The P waves are present but bear no relationship to the QRS complexes
Correct answer:
The correct answer is B: A P-R interval greater than five small boxes (0.20 seconds) wide on the electrocardiogram tracing. In first-degree AV block, there is a delay in the conduction of the electrical impulse from the atria to the ventricles, resulting in a prolonged P-R interval. This delay causes the P-R interval to be longer than usual, typically greater than 0.20 seconds. This is indicative of the conduction abnormality seen in first-degree AV block.
Incorrect Choices:
A: There are more than one P wave for each QRS complex - This describes a condition known as atrial fibrillation where multiple P waves are present without a consistent relationship to the QRS complexes.
C: The P-R intervals become progressively longer until a QRS complex is dropped altogether - This describes a Mobitz type II second-degree AV block where there is a sudden drop of a QRS complex without a prior lengthening of the P-R interval.
A woman is leaving on a trip to Hawaii and has come in for a checkup. During the examination the nurse learns that she has diabetes and takes oral hypoglycemic agents. The patient needs to be concerned about which possible effect of her medications?
A. Increased possibility of bruising
B. Skin sensitivity as a result of exposure to salt water
C. Lack of availability of glucose-monitoring supplies
D. Importance of sunscreen and avoiding direct sunlight
Correct answer:
The correct answer is D: Importance of sunscreen and avoiding direct sunlight.
Rationale:
1. Oral hypoglycemic agents can increase sensitivity to sunlight, leading to sunburn or skin damage.
2. Diabetic patients are at higher risk of skin complications, so protecting the skin from sunlight is crucial.
3. Sun exposure can also affect blood sugar levels, potentially causing fluctuations in glucose levels.
4. Use of sunscreen and avoiding direct sunlight can help prevent skin issues and maintain overall health for a diabetic patient.
Summary:
A: Increased possibility of bruising - Not directly related to diabetes or oral hypoglycemic agents.
B: Skin sensitivity as a result of exposure to salt water - Not a common concern for diabetic patients on oral hypoglycemic agents.
C: Lack of availability of glucose-monitoring supplies - Important but not directly related to the side effects of oral hypoglycemic agents.
The nurse is assessing a patient in the hospital who has received numerous antibiotics and notices that his tongue appears to be black and hairy. In response to his concern, what would the nurse say?
A. "We will need to get a biopsy to determine the cause."
B. "This is an overgrowth of hair and will go away in a few days."
C. "Black, hairy tongue is a fungal infection caused by all the antibiotics you have received."
D. "This is probably caused by the same bacteria you had in your lungs."
Correct answer:
The correct answer is C: "Black, hairy tongue is a fungal infection caused by all the antibiotics you have received."
Rationale:
1. Black, hairy tongue is a known side effect of prolonged antibiotic use, leading to fungal overgrowth.
2. Antibiotics can disrupt the natural balance of bacteria in the mouth, allowing fungi to overgrow.
3. Fungal infections can manifest as a black, hairy appearance on the tongue.
4. Biopsy is not typically needed for the diagnosis of black, hairy tongue.
5. Overgrowth of hair is not a plausible explanation for this condition.
6. The black, hairy tongue is not caused by the same bacteria the patient had in his lungs.
Summary:
Choice C is correct as it accurately links the patient's antibiotic use to the fungal infection causing black, hairy tongue. Choices A, B, and D are incorrect as they do not address the specific cause of this condition and provide inaccurate information.
When a patient's intracranial pressure (ICP) is being monitored with an intraventricular catheter, which information obtained by the nurse is most important to communicate to the health care provider?
A. Oral temperature 102° F
B. Apical pulse 102 beats/min
C. Intracranial pressure 18 mm Hg
D. Mean arterial pressure 90 mm Hg
Correct answer:
The correct answer is C: Intracranial pressure 18 mm Hg. This is the most important information to communicate because changes in ICP can indicate increasing intracranial pressure, which can lead to serious complications such as brain herniation. Monitoring and promptly communicating any changes in ICP to the healthcare provider is crucial for timely intervention and prevention of further damage.
Choice A: Oral temperature 102°F is important for assessing for signs of infection or inflammation, but it is not directly related to the intracranial pressure monitoring.
Choice B: Apical pulse 102 beats/min is important for assessing cardiac function, but it is not directly related to intracranial pressure monitoring.
Choice D: Mean arterial pressure 90 mm Hg is important for assessing perfusion to the brain, but it is not as directly relevant to intracranial pressure monitoring as the actual ICP reading itself.
Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree?
A. providing direct physical care
B. using research findings to improve practice
C. administering medications as prescribed
D. collaborating with other healthcare providers
Correct answer:
The correct answer is B because using research findings to improve practice is a key component of a nurse with a baccalaureate degree. Baccalaureate-prepared nurses are expected to integrate evidence-based practice into their care delivery. This involves critically analyzing research findings to enhance patient outcomes and implement best practices. Nurses with a baccalaureate degree have a deeper understanding of research methodologies and the importance of evidence-based practice.
Choice A (providing direct physical care) is not specific to a baccalaureate degree level and can be performed by nurses at various educational levels. Choice C (administering medications as prescribed) is a basic nursing responsibility that does not require a baccalaureate degree specifically. Choice D (collaborating with other healthcare providers) is important in nursing practice but is not exclusive to baccalaureate-prepared nurses.
A patient referred to physical therapy with chronic low back pain has failed to make any progress toward meeting established goals in over three weeks of treatment. The physical therapist has employed a variety of treatment techniques but has yet to observe improvement. What is the most appropriate next step?
A. Transfer the patient to another therapist's schedule.
B. Re-examine the patient and establish new goals.
C. Continue to modify the patient's treatment plan.
D. Alert the referring physician to the patient's status.
Correct answer:
The correct answer is B: Re-examine the patient and establish new goals. This is the most appropriate next step because if the patient has not shown progress in over three weeks, it indicates a need to reassess the current treatment plan and goals. By re-examining the patient, the therapist can identify any factors hindering progress and adjust the treatment plan accordingly. This proactive approach ensures the patient receives the most effective care.
Choice A: Transferring the patient to another therapist does not address the root cause of the lack of progress and may disrupt continuity of care.
Choice C: Simply continuing to modify the treatment plan without re-evaluating the patient may not lead to improved outcomes.
Choice D: Alerting the referring physician should be done after reassessment and establishing new goals, as the physician may require updated information but is not the immediate next step.
RN exams fundamentals practice questions, set 20 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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