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
Her abdominal examination reveals a gravid uterus but is otherwise unremarkable. On visualization of the anus there is a slight red, moist- appearing protrusion from the anus. As you have her bear down, the protrusion grows larger. On digital rectal examination you can feel an enlarged tender area on the posterior side. There is some blood on the glove after the examination. What disorder of the anus or rectum best fits this presentation?
A. Anal fissure
B. External hemorrhoids
C. Internal hemorrhoids
D. Anorectal fistula
Show answer and rationale
Correct answer: C — Internal hemorrhoids
The described clinical presentation is consistent with internal hemorrhoids. The typical symptoms of internal hemorrhoids include painless rectal bleeding, protrusion from the anus during straining, and a feeling of incomplete evacuation. In this case, the protrusion is observed to be red, moist, and enlarges with bearing down, all indicative of internal hemorrhoids. The enlarged tender area felt on digital rectal examination supports the diagnosis. Additionally, the presence of blood on the glove after the examination is also suggestive of internal hemorrhoids causing bleeding. Anal fissures typically present with sharp pain during defecation and may have visible tears in the anal mucosa. External hemorrhoids are usually more painful and can be felt as a lump around the anus. Anorectal fistulas have different signs and symptoms, including discharge of pus and recurrent infections.
Question 2
One way for a nursing assistant to communicate effectively with a resident who has a visual impairment is to
A. Wait until the resident speaks to her before identifying herself
B. Touch the resident on the arm before identifying herself to let her know the NA is there
C. Speak as little as possible while providing care
D. Use the face of an imaginary clock to explain the position of objects
Show answer and rationale
Correct answer: B — Touch the resident on the arm before identifying herself to let her know the NA is there
The correct answer is B. By touching the resident on the arm before identifying herself, the nursing assistant can provide a physical cue to alert the resident of her presence. This gesture is important for someone with visual impairment as it helps establish trust and a connection before communication begins. It also respects the resident's personal space and avoids startling them.
Choice A is incorrect because waiting for the resident to speak may lead to confusion and frustration, especially if the resident is not aware of the assistant's presence.
Choice C is incorrect as it does not promote effective communication and may make the resident feel neglected or isolated.
Choice D is incorrect as using an imaginary clock face to explain the position of objects may be confusing and not as effective in establishing immediate communication and connection with the resident.
Question 3
The ANA, which is committed to monitoring the regulation, education, and use of NAPs, recommends adherence to which one of the following principles:
A. It is the nursing profession that determines the scope of nursing practice.
B. It is the RN who defines and supervises the education, training, and use of any unlicensed assistant roles.
C. It is the assigned NAP who is responsible and accountable for his or her nursing practice.
D. It is the purpose of the RN to work in a supportive role to the assistive personnel.
Show answer and rationale
Correct answer: A — It is the nursing profession that determines the scope of nursing practice.
The correct answer is A because the American Nurses Association (ANA) believes that it is the nursing profession itself that should have the authority to determine the scope of nursing practice. This principle emphasizes the importance of nursing professionals being actively involved in defining and regulating their own practice.
Choice B is incorrect because while RNs may have a role in supervising unlicensed assistive personnel, it is not solely the responsibility of the RN to define and supervise the education and training of NAPs.
Choice C is incorrect because ultimate responsibility and accountability for nursing practice lies with the licensed nurse, not the unlicensed NAP.
Choice D is incorrect because the purpose of the RN is not just to work in a supportive role to assistive personnel; rather, it is to provide comprehensive nursing care and lead the nursing team.
Question 4
A tumor that is not cancerous is called a
A. Nonspecific tumor
B. Malignant tumor
C. Septic tumor
D. Benign tumor
Show answer and rationale
Correct answer: D — Benign tumor
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.
Question 5
The nurse is reviewing the characteristics of breath sounds. Which statement about bronchovesicular breath sounds is true? Bronchovesicular breath sounds are:
A. Musical in quality.
B. Usually caused by a pathologic disease.
C. Expected near the major airways.
D. Similar to bronchial sounds except shorter in duration.
Show answer and rationale
Correct answer: C — Expected near the major airways.
Step 1: Bronchovesicular breath sounds are expected near the major airways.
Step 2: Bronchovesicular sounds are heard over the 1st and 2nd intercostal spaces along the sternal border at the front and between the scapulae on the back.
Step 3: The sounds are a combination of bronchial (heard over trachea and major bronchi) and vesicular (heard over peripheral lung fields) sounds.
Step 4: The characteristics include moderate pitch and intensity, with equal inspiration and expiration.
Step 5: Choice C is the correct answer as it accurately describes the expected location of bronchovesicular breath sounds near the major airways.
Summary:
A: Incorrect - Bronchovesicular breath sounds are not musical in quality.
B: Incorrect - Bronchovesicular breath sounds are not usually caused by a pathologic disease.
D: Incorrect - Bronchovesicular breath sounds are a combination of bronchial
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Question 6
Which of the following nursing groups provides a definition and scope of practice for nursing?
A. ICN
B. AAN
C. ANA
D. The Joint Commission
Correct answer:
The correct answer is C: ANA. The American Nurses Association (ANA) provides a comprehensive definition and scope of practice for nursing in the United States. ANA establishes standards, guidelines, and policies to guide nursing practice and ensure quality patient care.
Incorrect choices:
A: ICN - The International Council of Nurses (ICN) is a global organization that represents nurses worldwide, but it does not specifically define the scope of nursing practice in the U.S.
B: AAN - The American Academy of Nursing (AAN) is an organization that focuses on recognizing nursing excellence and leadership, but it does not set standards for nursing practice.
D: The Joint Commission - The Joint Commission is a healthcare accreditation organization that focuses on patient safety and quality improvement, but it does not provide a specific definition and scope of practice for nursing.
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. **Stop magnesium infusion**: Magnesium toxicity can cause hypotension, bradycardia, and high-degree nodal block, hence stopping the infusion is crucial.
2. **Administer calcium chloride**: Calcium is the antidote for magnesium toxicity as it competes with magnesium for binding sites, reversing its effects.
3. **Corrects adverse effects**: Calcium chloride helps in counteracting the negative effects of magnesium on the cardiovascular system.
Summary:
- **Option A**: Increasing magnesium and giving saline won't address magnesium toxicity.
- **Option C**: Potassium won't counteract magnesium toxicity.
- **Option D**: Reducing infusion and giving dextrose won't correct magnesium toxicity.
A 19-year-old female comes to your office, complaining of a clear discharge from her right breast for 2 months. She states that she noticed it when she and her boyfriend were 'messing around' and he squeezed her nipple. She continues to have this discharge anytime she squeezes that nipple. She denies any trauma to her breasts. Her past medical history is unremarkable. She denies any pregnancies. Both of her parents are healthy. She denies using tobacco or illegal drugs and drinks three to four beers a week. On examination her breasts are symmetric with no skin changes. You are able to express clear discharge from her right nipple. You feel no discrete masses and her axillae are normal. The remainder of her heart, lung, abdominal, and pelvic examinations are unremarkable. A urine pregnancy test is negative. What cause of nipple discharge is the most likely in her circumstance?
A. Benign breast abnormality
B. Breast cancer
C. Nonpuerperal galactorrhea
Correct answer:
The most likely cause of nipple discharge in this 19-year-old female is a benign breast abnormality. This is supported by her age, absence of skin changes, negative pregnancy test, and lack of other significant findings on examination. The clear discharge that she experiences specifically upon squeezing the nipple is consistent with a benign etiology such as intraductal papilloma or duct ectasia. Breast cancer is less likely due to her young age and absence of risk factors. Nonpuerperal galactorrhea typically presents with milky discharge and is usually associated with hormonal imbalances, which are not evident in this case. Other systemic causes like thyroid disorders or medications are not suggested based on the given information. Therefore, based on her clinical presentation and examination findings, a benign breast abnormality is the most likely cause of her nipple discharge.
A client with bronchitis is experiencing increased mucus production. Which intervention is most effective in promoting mucus clearance?
A. Encouraging fluid intake of at least 3 liters per day.
B. Administering prescribed antitussive medication.
C. Positioning the client in a high Fowler's position.
D. Limiting activity to conserve energy.
Correct answer:
The correct answer is A: Encouraging fluid intake of at least 3 liters per day. Increasing fluid intake helps to thin the mucus, making it easier to clear from the airways. Adequate hydration also helps to keep the mucus membranes moist, facilitating mucus clearance. This intervention promotes effective coughing and expectoration, ultimately aiding in clearing the excess mucus associated with bronchitis.
Choice B: Administering prescribed antitussive medication would not be effective in promoting mucus clearance as antitussives suppress coughing, which is needed to clear mucus.
Choice C: Positioning the client in a high Fowler's position may improve breathing but does not directly address mucus clearance.
Choice D: Limiting activity to conserve energy does not promote mucus clearance. In fact, some degree of activity can help mobilize mucus and facilitate its clearance.
When examining the nares of a 45-year-old patient who has complaints of rhinorrhea, itching of the nose and eyes, and sneezing, the nurse notices the following: pale turbinates, swelling of the turbinates, and clear rhinorrhea. Which of these conditions is most likely the cause?
A. Nasal polyps
B. Acute sinusitis
C. Allergic rhinitis
D. Acute rhinitis
Correct answer:
Correct Answer: C. Allergic rhinitis
Rationale: The patient's symptoms of itching, sneezing, and clear rhinorrhea are classic signs of allergic rhinitis. The pale and swollen turbinates also support this diagnosis, as they are common findings in allergic rhinitis due to inflammation from allergens.
Incorrect Choices:
A: Nasal polyps - Nasal polyps typically present with nasal congestion, loss of smell, and may be associated with asthma. They are not commonly associated with clear rhinorrhea and itching.
B: Acute sinusitis - Acute sinusitis is characterized by facial pain, pressure, purulent nasal discharge, and fever. The absence of these symptoms makes acute sinusitis less likely.
D: Acute rhinitis - Acute rhinitis, or the common cold, usually presents with thick nasal discharge, sore throat, and low-grade fever. The clear rhinorrhea and itching in this patient are more
A 19-year-old female comes to your office, complaining of a clear discharge from her right breast for 2 months. She states that she noticed it when she and her boyfriend were 'messing around' and he squeezed her nipple. She continues to have this discharge anytime she squeezes that nipple. She denies any trauma to her breasts. Her past medical history is unremarkable. She denies any pregnancies. Both of her parents are healthy. She denies using tobacco or illegal drugs and drinks three to four beers a week. On examination her breasts are symmetric with no skin changes. You are able to express clear discharge from her right nipple. You feel no discrete masses and her axillae are normal. The remainder of her heart, lung, abdominal, and pelvic examinations are unremarkable. A urine pregnancy test is negative. What cause of nipple discharge is the most likely in her circumstance?
A. Benign breast abnormality
B. Breast cancer
C. Nonpuerperal galactorrhea
Correct answer:
The most likely cause of nipple discharge in this 19-year-old female is a benign breast abnormality. This is supported by her age, absence of skin changes, negative pregnancy test, and lack of other significant findings on examination. The clear discharge that she experiences specifically upon squeezing the nipple is consistent with a benign etiology such as intraductal papilloma or duct ectasia. Breast cancer is less likely due to her young age and absence of risk factors. Nonpuerperal galactorrhea typically presents with milky discharge and is usually associated with hormonal imbalances, which are not evident in this case. Other systemic causes like thyroid disorders or medications are not suggested based on the given information. Therefore, based on her clinical presentation and examination findings, a benign breast abnormality is the most likely cause of her nipple discharge.
A 62-year-old construction worker presents with chronic cough and occasional shortness of breath for almost a year. He has smoked two packs a day for 45 years. On examination, his chest diameter seems enlarged. Breath sounds are decreased throughout all lobes. Rhonchi are heard over all lung fields.
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
Correct answer:
The correct answer is B: Chronic obstructive pulmonary disease (COPD). Given the patient's history of smoking, chronic cough, shortness of breath, and decreased breath sounds, COPD is the most likely diagnosis. COPD is characterized by irreversible airflow obstruction due to chronic inflammation and damage to the lungs, commonly caused by smoking. The enlarged chest diameter and decreased breath sounds suggest hyperinflation and air trapping, which are typical in COPD. Rhonchi can be heard due to airway inflammation and mucus production.
Incorrect choices:
A: Spontaneous pneumothorax - Unlikely as there is no sudden onset of chest pain or breathlessness.
C: Asthma - Less likely in this case as asthma typically presents with wheezing and may have a history of allergies.
D: Pneumonia - Less likely given the chronic nature of the symptoms and absence of fever or focal chest signs.
A 28 year old male is brought to the E He was involved in a fight in which he was beaten with a wooden stick. His chest shows multiple severe bruises. His airway is clear, RR is 22, HR is 126 and systolic BP is 90mmHg. Which one of the following should be performed during the primary survey?
A. "GCS"
B. Cervical spine x-ray
C. TT-administration
D. Blood alcohol level
Correct answer:
The correct answer is A: "GCS" (Glasgow Coma Scale). During the primary survey in trauma, assessing the patient's level of consciousness using GCS is crucial to identify any potential brain injury. The patient's airway, breathing, and circulation are already assessed and stable based on the given information. GCS helps determine the severity of head injury and guides further management.
B: Cervical spine x-ray is not indicated during the primary survey unless there is suspicion of cervical spine injury based on mechanism of injury or physical exam findings.
C: TT-administration (tetanus toxoid) is important but is not a priority during the primary survey. It can be administered later in the secondary survey.
D: Blood alcohol level is not necessary during the primary survey for acute trauma management. It can be considered in the secondary survey for further evaluation.
A client becomes angry while waiting for a supervised break to smoke a cigarette outside and states, 'I want to go outside now and smoke. It takes forever to get anything done here!' Which intervention is best for the nurse to implement?
A. Encourage the client to use a nicotine patch.
B. Reassure the client that it is almost time for another break.
C. Have the client leave the unit with another staff member.
D. Review the schedule of outdoor breaks with the client.
Correct answer:
When a client becomes angry while waiting for a supervised break, it is essential to address their concerns effectively. Reviewing the schedule of outdoor breaks with the client provides concrete information, helps manage the client's expectations, and may alleviate their frustration. This intervention promotes transparency and empowers the client by clarifying the timing of their desired break, fostering a therapeutic and collaborative nurse-client relationship. Encouraging the client to use a nicotine patch (Choice A) does not address the client's immediate frustration with the break schedule. Reassuring the client about another break (Choice B) may temporarily placate them but does not address the underlying issue. Having the client leave the unit with another staff member (Choice C) may not be feasible or appropriate at that moment and does not address the client's concerns.
A hospitalized male client is receiving nasogastric tube feedings via a small-bore tube and a continuous pump infusion. He reports that he had a bad bout of severe coughing a few minutes ago but feels fine now. What action is best for the nurse to take?
A. Record the coughing incident. No further action is required at this time.
B. Stop the feeding, explain to the family why it is being stopped, and notify the healthcare provider.
C. After clearing the tube with 30 ml of air, check the pH of fluid withdrawn from the tube.
D. Inject 30 ml of air into the tube while auscultating the epigastrium for gurgling.
Correct answer:
Coughing, vomiting, and suctioning can precipitate displacement of the tip of the small-bore feeding tube upward into the esophagus, placing the client at increased risk for aspiration. Checking the sample of fluid withdrawn from the tube (after clearing the tube with 30 ml of air) for acidic (stomach) or alkaline (intestine) values is a more sensitive method for these tubes. The nurse should assess tube placement in this way before taking any other action to ensure the tube is still in the correct position and prevent potential complications. Choice A is incorrect because further assessment is needed due to the risk of tube displacement. Choice B is incorrect as stopping the feeding and involving the family is premature without confirming tube placement. Choice D is incorrect as injecting air and auscultating for gurgling is not the recommended method to confirm tube placement.
RN exams fundamentals practice questions, set 31 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.
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