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
One important thing for the nursing assistant to check when a resident is being discharged is
A. Whether the resident will have enough food and drink for the trip home
B. Whether the resident or his family knows the address of his physician
C. Whether the resident has had all of his tubes and dressings removed by the nurse
D. Whether the resident or his family has paid his bill in full
Show answer and rationale
Correct answer: C — Whether the resident has had all of his tubes and dressings removed by the nurse
The correct answer is C because it is crucial for the nursing assistant to ensure that all tubes and dressings have been removed by the nurse before the resident is discharged. This is important for the resident's safety and well-being to prevent any complications or infections post-discharge. Checking for this ensures that the resident is ready to leave the healthcare facility in a stable condition.
A: Whether the resident will have enough food and drink for the trip home - While important, this is not the nursing assistant's primary responsibility at discharge.
B: Whether the resident or his family knows the address of his physician - Important for follow-up care, but not the nursing assistant's immediate concern at discharge.
D: Whether the resident or his family has paid his bill in full - Financial matters are not typically within the nursing assistant's scope of responsibilities.
Question 2
You are conducting a pupillary examination on a 34-year-old man. You note that both pupils dilate slightly. Both are noted to constrict briskly when the light is placed on the right eye. What is the most likely problem?
A. Optic nerve damage on the right
B. Optic nerve damage on the left
C. Efferent nerve damage on the right
D. Efferent nerve damage on the left
Show answer and rationale
Correct answer: B — Optic nerve damage on the left
The correct answer is B: Optic nerve damage on the left. When both pupils dilate slightly but the right pupil constricts briskly when light is shone on it, it indicates an afferent defect in the left eye. The optic nerve carries afferent (sensory) signals from the eye to the brain. Since the left optic nerve is damaged, the afferent signal from the left eye is not transmitted properly, resulting in the dilated pupils. The brisk constriction of the right pupil in response to light indicates that the efferent (motor) pathway is intact on the right side. Therefore, the problem is likely on the afferent pathway of the left optic nerve.
Incorrect choices:
A: Optic nerve damage on the right - Incorrect because the brisk constriction of the right pupil indicates the efferent pathway on the right is intact.
C: Efferent nerve damage on the right - Incorrect because the brisk constriction of the
Question 3
When assessing a child who complains of abdominal pain, what is the most appropriate nursing action?
A. Palpate the most painful area first.
B. Palpate for rebound tenderness.
C. Avoid painful areas until the end of the assessment.
D. Use deep palpation for abdominal tenderness.
Show answer and rationale
Correct answer: C — Avoid painful areas until the end of the assessment.
The most appropriate nursing action when assessing a child complaining of abdominal pain is to avoid painful areas until the end of the assessment (Choice C). This approach helps prevent causing unnecessary discomfort or distress to the child. By starting with non-painful areas, the nurse can establish rapport, gather important information, and assess the child's overall condition before addressing the painful areas. This ensures a thorough and sensitive assessment process.
Choice A is incorrect because palpating the most painful area first can cause distress and may not provide a comprehensive assessment. Choice B, palpating for rebound tenderness, is not appropriate as it is more specific to assessing for peritonitis in adults. Choice D, using deep palpation for abdominal tenderness, can be uncomfortable for the child and should be avoided until other assessments have been completed.
Question 4
You are caring for a patient who was recently diagnosed with type 1 diabetes. She is learning to manage her diabetes and will need support after discharge. Her knowledge deficit is considered a _____ priority problem & will require a collaborative effort with health care professionals.
A. First-level
B. Second-level
C. Third-level
Show answer and rationale
Correct answer: B — Second-level
The correct answer is B: Second-level. In the nursing process, addressing a knowledge deficit for a patient with a new diagnosis like type 1 diabetes falls under second-level priority. This is because it is essential for the patient's immediate well-being and safety, but it does not pose a direct threat to their life or physiological stability. Collaborative effort with healthcare professionals is crucial to ensure the patient receives comprehensive education and support.
Choice A: First-level priorities are for life-threatening issues requiring immediate attention, such as airway obstruction or cardiac arrest, which do not apply in this scenario.
Choice C: Third-level priorities are important for long-term health outcomes but not immediate concerns like knowledge deficit in a newly diagnosed patient.
Choice D: This option is likely incomplete and cannot be considered a valid choice.
Question 5
Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend?
A. Continue fundal massage, and pack the vagina with sterile ABD or trauma pads
B. Administer lactated Ringer's solution run wide open using macro-drip tubing under pressure
C. Administer a fluid bolus of 1,000 mL of normal saline, and transport the patient in the Trendelenburg position
D. Administer oxytocin infusion (1 unit per 100 mL of lactated Ringer's solution) at 20 to 30 gtts/min (micro-drip tubing) depending on bleeding severity
Show answer and rationale
Correct answer: D — Administer oxytocin infusion (1 unit per 100 mL of lactated Ringer's solution) at 20 to 30 gtts/min (micro-drip tubing) depending on bleeding severity
The correct answer is D: Administer oxytocin infusion at 20 to 30 gtts/min depending on bleeding severity. Oxytocin is a uterotonic agent that helps control postpartum hemorrhage by causing uterine contractions, which can help stop the bleeding. In this scenario, the mother is experiencing postpartum hemorrhage despite initial interventions. Administering oxytocin can help control the bleeding and prevent further complications.
Choice A is incorrect because packing the vagina with pads is not the recommended first-line treatment for postpartum hemorrhage. Choice B is incorrect because administering lactated Ringer's solution under pressure is not the appropriate intervention for postpartum hemorrhage. Choice C is incorrect because Trendelenburg position is not recommended for managing postpartum hemorrhage and can potentially worsen the situation by increasing blood flow to the head.
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Question 6
Which of the following would be an early sign of a possible aortic dissection?
A. A narrowing pulse pressure and tachycardia
B. A sudden rise in systolic blood pressure and fall in diastolic blood pressure
C. Blood pressure difference of 20 mmHg or more in the upper extremities
D. A reddish-blue discoloration of the skin above the shoulders
Correct answer:
Rationale for Correct Answer (C): An early sign of a possible aortic dissection is a blood pressure difference of 20 mmHg or more in the upper extremities. This is due to the unequal blood pressure distribution resulting from the dissection affecting the aorta. The pressure gradient occurs because the false lumen of the aorta created by the dissection leads to different blood pressures in the upper extremities. Monitoring blood pressure in both arms helps detect this discrepancy.
Summary of Incorrect Choices:
A: A narrowing pulse pressure and tachycardia - Not specific to aortic dissection.
B: A sudden rise in systolic blood pressure and fall in diastolic blood pressure - More commonly seen in aortic rupture than dissection.
D: A reddish-blue discoloration of the skin above the shoulders - Typically associated with different conditions and not a characteristic sign of aortic dissection.
The nurse assesses a patient with chronic obstructive pulmonary disease (COPD) who has been admitted with increasing dyspnea over the past 3 days. Which finding is important for the nurse to report to the health care provider?
A. Respirations are 36 breaths/min.
B. Anterior-posterior chest ratio is 1:1.
C. Lung expansion is decreased bilaterally.
D. Hyperresonance to percussion is present.
Correct answer:
The correct answer is A because an increased respiratory rate of 36 breaths/min in a patient with COPD and worsening dyspnea can indicate respiratory distress or impending respiratory failure. This finding is crucial to report promptly to the healthcare provider for further evaluation and intervention.
Choice B is incorrect because an anterior-posterior chest ratio of 1:1 is within normal limits and not directly related to the patient's current respiratory distress.
Choice C is incorrect as decreased lung expansion bilaterally can be expected in a patient with COPD and may not necessarily warrant immediate concern unless it is significantly asymmetric or accompanied by other concerning signs.
Choice D is incorrect as hyperresonance to percussion may be a typical finding in COPD due to increased lung volumes and is not an immediate priority compared to the elevated respiratory rate.
The correct answer is D: Benign tumor. Benign tumors are noncancerous growths that do not invade nearby tissues or spread to other parts of the body. They are typically localized and do not pose a significant threat to health. The term "benign" indicates that the tumor is not harmful and tends to have a slow growth rate.
Rationale:
1. A: Nonspecific tumor - This term does not accurately describe the nature of a noncancerous tumor. Nonspecific typically refers to something that is not clearly defined or specific.
2. B: Malignant tumor - Malignant tumors are cancerous growths that can invade nearby tissues and spread to other parts of the body. This choice is incorrect as it describes a type of tumor that is harmful and poses a serious health risk.
3. C: Septic tumor - The term "septic" refers to an infection caused by bacteria, which is not related to the classification of tumors.
A nurse is caring for a patient who has had a total knee replacement. The patient is complaining of severe pain. What is the priority intervention?
A. Administer analgesics.
B. Administer antibiotics.
C. Administer insulin therapy.
D. Administer an oral anticoagulant.
Correct answer:
The correct answer is D: Administer an oral anticoagulant. The priority intervention for a patient who has had a total knee replacement and is experiencing severe pain is to administer an oral anticoagulant. This is because after surgery, there is an increased risk of blood clots forming in the legs due to immobility, which can lead to serious complications like pulmonary embolism. Administering an oral anticoagulant helps prevent the formation of blood clots and reduces the risk of these complications.
Summary:
- Option A (Administer analgesics): While controlling pain is important, in this case, preventing blood clots is the priority.
- Option B (Administer antibiotics): Antibiotics are not indicated unless there is an infection present.
- Option C (Administer insulin therapy): Insulin therapy is not relevant in this scenario unless the patient has diabetes that requires management.
In performing a breast examination, the nurse knows that examining the upper outer quadrant of the breast is especially important. The reason for this is that the upper outer quadrant is:
A. The largest quadrant of the breast.
B. The location of most breast tumors.
C. Where most of the suspensory ligaments attach.
D. More prone to injury and calcifications than other locations in the breast.
Correct answer:
The correct answer is B: The location of most breast tumors. This is because statistically, the upper outer quadrant of the breast is where the majority of breast tumors are found. This area is more glandular and has more breast tissue, making it a common site for tumors to develop. It is important to focus on this area during a breast examination to detect any abnormalities early.
A: The largest quadrant of the breast - This is not the reason why examining the upper outer quadrant is important for detecting breast tumors.
C: Where most of the suspensory ligaments attach - While true, this is not the primary reason for focusing on the upper outer quadrant during a breast examination.
D: More prone to injury and calcifications than other locations in the breast - While calcifications can occur in this area, it is not the primary reason for its importance in detecting breast tumors.
Immediately after birth, the nurse is unable to suction the nares of a newborn. An attempt is made to pass a catheter through both nasal cavities with no success. What should the nurse do next?
A. Attempt to suction again with a bulb syringe.
B. Recognize that this situation requires immediate intervention.
C. Contact the physician to schedule an appointment for the infant at his or her next hospital visit.
D. N/A
Correct answer:
The correct answer is B: Recognize that this situation requires immediate intervention. If the nurse is unable to suction the nares and pass a catheter through, it suggests a potential blockage or obstruction in the nasal passages, which could lead to respiratory distress. Immediate intervention is crucial to ensure the newborn's airway is clear and breathing is not compromised. Contacting the physician or seeking further medical assistance promptly is necessary to address the issue.
Choice A is incorrect because simply attempting to suction again may not resolve the underlying obstruction, and delaying necessary intervention could be harmful. Choice C is incorrect as scheduling an appointment for the infant at a later time is not appropriate when immediate intervention is required. Choice D is not applicable as it does not provide any solution or guidance for the current situation.
The nurse is caring for a patient who will undergo a removal of a lung lobe. Which level of care will the patient require immediately post procedure?
A. Acute care"”medical-surgical unit
B. Acute care"”intensive care unit
C. Ambulatory surgery
D. Ambulatory surgery"”extended stay
Correct answer:
The correct answer is B: Acute care - intensive care unit. Post lung lobe removal, the patient may require close monitoring of vital signs, respiratory status, pain management, and potential complications like bleeding or respiratory distress. The intensive care unit provides specialized care and continuous monitoring by healthcare professionals to manage any postoperative complications promptly.
Choice A (Acute care - medical-surgical unit) may not provide the level of monitoring and specialized care that an intensive care unit offers for a patient undergoing major surgery like lung lobe removal.
Choices C (Ambulatory surgery) and D (Ambulatory surgery - extended stay) are not appropriate postoperative care settings for a patient undergoing lung lobe removal, as this surgery is major and requires more intensive monitoring and care than what ambulatory surgery settings can provide.
A patient who has a history of chronic obstructive pulmonary disease (COPD) was hospitalized for increasing shortness of breath and chronic hypoxemia (SaO2 levels of 89% to 90%). In planning for discharge, which action by the nurse will be most effective in improving compliance with discharge teaching?
A. Have the patient repeat the instructions immediately after teaching.
B. Accomplish the patient teaching just before the scheduled discharge.
C. Arrange for the patient's caregiver to be present during the teaching.
D. Accomplish the patient teaching just before the scheduled discharge.
Correct answer:
The correct answer is C: Arrange for the patient's caregiver to be present during the teaching. Involving the caregiver in the teaching process increases the likelihood of proper understanding and adherence to the discharge instructions. The caregiver can provide additional support and reinforcement for the patient's education, especially in managing COPD symptoms at home. This collaborative approach promotes a more supportive environment for the patient post-discharge.
Choice A (Having the patient repeat instructions immediately after teaching) may not be as effective because the patient's understanding and retention of the information may still be limited. Choice B (Patient teaching just before discharge) may not allow enough time for the patient and caregiver to fully grasp and retain the information. Choice D is a duplicate of choice B and does not offer any additional benefit.
Your adult female postpartum patient delivered her newborn with the assistance of her husband five minutes prior to your arrival on the scene. The infant's Apgar score is 10, and the baby seems to be fine. However, the mother continues to bleed heavily after an adequate fundal massage and encouraging the infant to breastfeed. Her current heart rate is 125 bpm; her blood pressure is 108/60, and she is breathing 22 times a minute with an SpO2 of 97. After ensuring a second infant is not present, which of the following interventions would medical command most likely recommend?
A. Continue fundal massage, and pack the vagina with sterile ABD or trauma pads
B. Administer lactated Ringer's solution run wide open using macro-drip tubing under pressure
C. Administer a fluid bolus of 1,000 mL of normal saline, and transport the patient in the Trendelenburg position
D. Administer oxytocin infusion (1 unit per 100 mL of lactated Ringer's solution) at 20 to 30 gtts/min (micro-drip tubing) depending on bleeding severity
Correct answer:
The correct answer is D: Administer oxytocin infusion at 20 to 30 gtts/min depending on bleeding severity. Oxytocin is a uterotonic agent that helps control postpartum hemorrhage by causing uterine contractions, which can help stop the bleeding. In this scenario, the mother is experiencing postpartum hemorrhage despite initial interventions. Administering oxytocin can help control the bleeding and prevent further complications.
Choice A is incorrect because packing the vagina with pads is not the recommended first-line treatment for postpartum hemorrhage. Choice B is incorrect because administering lactated Ringer's solution under pressure is not the appropriate intervention for postpartum hemorrhage. Choice C is incorrect because Trendelenburg position is not recommended for managing postpartum hemorrhage and can potentially worsen the situation by increasing blood flow to the head.
During which type of contraction is a hamstring injury most likely to occur?
A. Concentric muscle contraction
B. Eccentric muscle contraction
C. Isometric contractions
D. Isotonic contractions
Correct answer:
The correct answer is B: Eccentric muscle contraction. During eccentric contractions, the muscle lengthens while generating force, placing greater stress on the muscle fibers and making them more susceptible to injury. In the case of the hamstring, which is commonly injured during activities involving sudden deceleration or slowing down, such as running downhill or stopping abruptly, the eccentric contraction plays a significant role. Choice A (Concentric muscle contraction) involves muscle shortening and is less likely to cause injury in the hamstring. Choice C (Isometric contractions) involve static muscle contractions with no change in muscle length, making them less likely to lead to hamstring injury. Choice D (Isotonic contractions) refers to muscle contractions with a constant load, which may or may not lead to hamstring injury depending on the specific exercise and load applied.
RN exams fundamentals practice questions, set 29 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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