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 assessing a patient's mental status and asks the patient to recall three words. What is the nurse testing?
A. Recent memory.
B. Long-term memory.
C. Abstract reasoning.
D. Orientation.
Show answer and rationale
Correct answer: A — Recent memory.
The correct answer is A: Recent memory. By asking the patient to recall three words, the nurse is assessing the patient's ability to remember information that was just presented to them, which falls under recent memory. This test helps evaluate the patient's immediate memory function and can provide insights into cognitive impairments or memory deficits.
Incorrect choices:
B: Long-term memory - This choice is incorrect because the nurse is assessing the patient's ability to recall information presented in the immediate past, not from a long time ago.
C: Abstract reasoning - This choice is incorrect as assessing abstract reasoning involves tasks that require logical thinking and problem-solving, not simply recalling words.
D: Orientation - This choice is incorrect because orientation refers to awareness of person, place, time, and situation, which is not being tested by asking the patient to recall three words.
Question 2
Mrs. Sales also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?
A. Inhibition of the parasympathetic reflex
B. Esophageal emptying hastens
C. Loss of tone of the smooth muscles of the colon
D. Decreased ability to absorb fluids in the lower intestines
Show answer and rationale
Correct answer: C — Loss of tone of the smooth muscles of the colon
The correct answer is C: Loss of tone of the smooth muscles of the colon. As individuals age, the smooth muscles of the colon can lose their tone, resulting in slower peristalsis and decreased bowel movements, leading to constipation. This physical change is a common factor contributing to constipation in older adults.
A: Inhibition of the parasympathetic reflex is not directly related to constipation in aging individuals. Parasympathetic stimulation usually promotes bowel movements.
B: Esophageal emptying hastening is not relevant to constipation. Esophageal emptying refers to the movement of food from the esophagus into the stomach, not the colon.
D: Decreased ability to absorb fluids in the lower intestines is not a typical physical change associated with aging that predisposes individuals to constipation. Constipation is more commonly linked to issues with colonic motility rather than fluid absorption.
Question 3
A patient has had a 'terrible itch' for several months that he has been continuously scratching. On examination, the nurse might expect to find:
A. A keloid.
B. A fissure.
C. Keratosis.
D. Lichenification.
Show answer and rationale
Correct answer: D — Lichenification.
The correct answer is D: Lichenification. Lichenification is a skin condition characterized by thickening and hardening of the skin due to chronic irritation or scratching. In this case, the patient's continuous scratching of the itch has led to lichenification. This is evident by the rough and leathery texture of the skin upon examination.
A: A keloid is an overgrowth of scar tissue that can occur after a wound heals, not typically associated with chronic scratching.
B: A fissure is a small, painful crack in the skin that can occur due to dryness or trauma, not a result of continuous scratching.
C: Keratosis refers to various skin conditions characterized by thickening of the skin, but it is not specifically associated with chronic scratching like lichenification.
In summary, lichenification is the most likely finding in this scenario due to the chronic scratching leading to skin thickening and hardening.
Question 4
Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethically relevant consideration is important to the nurse as an advocate for these patients?
A. balance between benefits and harms in patient care
B. norms of family life
C. considerations of power
D. cost-effectiveness and allocation
Show answer and rationale
Correct answer: C — considerations of power
The correct answer is C: considerations of power. In this scenario, the nurse needs to consider the power dynamics at play due to the social status of the children's families. The child of a famous sports figure may have more influence and resources, potentially leading to unfair advantages in accessing healthcare compared to the child from a low-income family. By being aware of these power dynamics, the nurse can advocate for equal treatment and fair allocation of resources.
A: Balance between benefits and harms in patient care is important but not as relevant in this context as considering power dynamics.
B: Norms of family life may be important in some situations but do not directly address the ethical consideration of power in this scenario.
D: Cost-effectiveness and allocation are important factors but do not directly address the ethical consideration of power dynamics between the two children's families.
Question 5
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
Show answer and rationale
Correct answer: B — A P-R interval greater than five small boxes (0.20 seconds) wide on the electrocardiogram tracing
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.
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Question 6
You are serving as the supervisory nurse for a home healthcare agency in the community. You are doing an admission assessment for a 76 year old male client who resides with his elderly wife. Which of the following assessments would indicate that the couple needs some education relating to home safety?
A. The client has refrigerated foods labelled with an expiration date.
B. You assess that the home is free of scatter rugs that many use to protect the feet against hard floors.
C. The client uses the FIFO method for insuring food safety.
D. The client assures you that the smoke alarm batteries are replaced annually to insure that they work.
Correct answer:
Step 1: The correct answer is D because ensuring that smoke alarm batteries are replaced annually is crucial for home safety, especially for elderly individuals who may have decreased mobility or sensory perception.
Step 2: Smoke alarms are essential for early detection of fires, which is crucial for elderly individuals who may have difficulty escaping quickly.
Step 3: By replacing the batteries annually, the client demonstrates proactive measures to protect themselves and their spouse from potential fire hazards.
Step 4: Choices A, B, and C are not indicators of needing education on home safety as they all reflect positive practices related to food storage, fall prevention, and food safety.
Summary: Option D is the correct answer as it directly relates to fire safety, a critical aspect of home safety for elderly individuals. Options A, B, and C are not relevant to home safety education in this context.
The electrical stimulus of the cardiac cycle follows which sequence?
A. AV node → SA node → bundle of His
B. Bundle of His → AV node → SA node
C. SA node → AV node → bundle of His → bundle branches
D. AV node → SA node → bundle of His → bundle branches
Correct answer:
The correct sequence of the electrical stimulus in the cardiac cycle is SA node → AV node → bundle of His → bundle branches. The rationale is as follows:
1. The SA node initiates the electrical impulse in the heart.
2. The impulse travels to the AV node, which serves as a delay mechanism to ensure proper coordination of atrial and ventricular contractions.
3. From the AV node, the impulse then travels to the bundle of His, which conducts the impulse to the bundle branches.
4. Finally, the impulse is transmitted through the bundle branches to the Purkinje fibers, which then distribute the impulse throughout the ventricles for coordinated contraction.
Therefore, choice C is correct as it accurately represents the sequential pathway of the electrical stimulus in the cardiac cycle. Choices A, B, and D are incorrect as they do not follow the physiologically accurate sequence of the cardiac conduction system.
Which of the following statements regarding patients with thoracic spine injuries is TRUE?
A. Log-rolling may be destabilizing to fractures from T12 to L1
B. Adequate immobilization can be accomplished with the scoop stretcher
C. Spinal cord injury below T10 usually spares bowel and bladder function
D. Hyperflexion fractures in the upper thoracic spine are inherently unstable
Correct answer:
The correct answer is A: Log-rolling may be destabilizing to fractures from T12 to L1. Log-rolling involves moving a patient as a unit to prevent further spinal cord injury. In patients with thoracic spine injuries at T12 to L1, log-rolling can cause disruption or misalignment of the fractured vertebrae, leading to potential neurological damage or increased spinal instability. Therefore, avoiding log-rolling in these cases is crucial to prevent further harm.
Choice B is incorrect because the scoop stretcher may not provide adequate immobilization for thoracic spine injuries due to its limitations in maintaining proper spinal alignment. Choice C is incorrect as spinal cord injuries below T10 can affect bowel and bladder function due to the involvement of the sacral segments. Choice D is incorrect because hyperflexion fractures in the upper thoracic spine are generally considered stable, not inherently unstable.
During auscultation of the lungs, the nurse expects decreased breath sounds to be heard in which situation?
A. When the bronchial tree is obstructed.
B. When adventitious sounds are present.
C. In conjunction with whispered pectoriloquy.
D. In conditions of consolidation, such as pneumonia.
Correct answer:
The correct answer is A: When the bronchial tree is obstructed. Decreased breath sounds are expected in situations where airflow is obstructed, leading to diminished sound transmission. When there is an obstruction in the bronchial tree, such as in asthma or bronchitis, breath sounds become decreased due to the restricted airflow.
The other choices are incorrect because:
B: When adventitious sounds are present - Adventitious sounds like crackles or wheezes indicate abnormal lung sounds but do not necessarily result in decreased breath sounds.
C: In conjunction with whispered pectoriloquy - Whispered pectoriloquy is a finding where whispering is heard clearly through the stethoscope, indicating lung consolidation rather than decreased breath sounds.
D: In conditions of consolidation, such as pneumonia - Consolidation leads to increased breath sounds due to the denser lung tissue, not decreased breath sounds.
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
Correct answer:
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.
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
During the cardiac auscultation, the nurse hears a sound immediately occurring after the S2 at the second left intercostal space. To further assess this sound, what should the nurse do?
A. Have the patient turn to the left side while the nurse listens with the bell of the stethoscope.
B. Ask the patient to hold his or her breath while the nurse listens again.
C. No further assessment is needed because the nurse knows this sound is an S3.
D. Watch the patient's respirations while listening for the effect on the sound.
Correct answer:
The correct answer is D because watching the patient's respirations while listening for the effect on the sound can help differentiate between an S3 and an opening snap or ejection sound. Observing how the sound changes with the respiratory cycle can provide valuable information about the origin and nature of the sound.
Choice A is incorrect because having the patient turn to the left side with the bell of the stethoscope is typically done to enhance the detection of a mitral murmur, not to assess a sound immediately after S2.
Choice B is incorrect because asking the patient to hold their breath is more relevant in assessing for a pericardial friction rub, not in differentiating between heart sounds.
Choice C is incorrect because assuming the sound is an S3 without further assessment can lead to a misdiagnosis. It is essential to confirm the nature of the sound through appropriate assessment techniques.
Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethically relevant consideration is important to the nurse as an advocate for these patients?
A. balance between benefits and harms in patient care
B. norms of family life
C. considerations of power
D. cost-effectiveness and allocation
Correct answer:
The correct answer is C: considerations of power. In this scenario, the nurse needs to consider the power dynamics at play due to the social status of the children's families. The child of a famous sports figure may have more influence and resources, potentially leading to unfair advantages in accessing healthcare compared to the child from a low-income family. By being aware of these power dynamics, the nurse can advocate for equal treatment and fair allocation of resources.
A: Balance between benefits and harms in patient care is important but not as relevant in this context as considering power dynamics.
B: Norms of family life may be important in some situations but do not directly address the ethical consideration of power in this scenario.
D: Cost-effectiveness and allocation are important factors but do not directly address the ethical consideration of power dynamics between the two children's families.
Which of the following statements regarding patients with thoracic spine injuries is TRUE?
A. Log-rolling may be destabilizing to fractures from T12 to L1
B. Adequate immobilization can be accomplished with the scoop stretcher
C. Spinal cord injury below T10 usually spares bowel and bladder function
D. Hyperflexion fractures in the upper thoracic spine are inherently unstable
Correct answer:
The correct answer is A: Log-rolling may be destabilizing to fractures from T12 to L1. Log-rolling involves moving a patient as a unit to prevent further spinal cord injury. In patients with thoracic spine injuries at T12 to L1, log-rolling can cause disruption or misalignment of the fractured vertebrae, leading to potential neurological damage or increased spinal instability. Therefore, avoiding log-rolling in these cases is crucial to prevent further harm.
Choice B is incorrect because the scoop stretcher may not provide adequate immobilization for thoracic spine injuries due to its limitations in maintaining proper spinal alignment. Choice C is incorrect as spinal cord injuries below T10 can affect bowel and bladder function due to the involvement of the sacral segments. Choice D is incorrect because hyperflexion fractures in the upper thoracic spine are generally considered stable, not inherently unstable.
The nurse is assessing a patient's mental status and asks the patient to recall three words. What is the nurse testing?
A. Recent memory.
B. Long-term memory.
C. Abstract reasoning.
D. Orientation.
Correct answer:
The correct answer is A: Recent memory. By asking the patient to recall three words, the nurse is assessing the patient's ability to remember information that was just presented to them, which falls under recent memory. This test helps evaluate the patient's immediate memory function and can provide insights into cognitive impairments or memory deficits.
Incorrect choices:
B: Long-term memory - This choice is incorrect because the nurse is assessing the patient's ability to recall information presented in the immediate past, not from a long time ago.
C: Abstract reasoning - This choice is incorrect as assessing abstract reasoning involves tasks that require logical thinking and problem-solving, not simply recalling words.
D: Orientation - This choice is incorrect because orientation refers to awareness of person, place, time, and situation, which is not being tested by asking the patient to recall three words.
RN exams fundamentals practice questions, set 21 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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