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
After graduation from an accredited program in nursing and successfully passing the NCLEX, what gives the nurse a legal right to practice?
A. enrolling in an advanced degree program
B. filing NCLEX results in the county of residence
C. being licensed by the State Board of Nursing
D. having a signed letter confirming graduation
Show answer and rationale
Correct answer: C — being licensed by the State Board of Nursing
The correct answer is C because being licensed by the State Board of Nursing is the legal requirement to practice as a nurse. The State Board of Nursing grants the license after confirming the candidate's qualifications, including graduation from an accredited program and passing the NCLEX. This license signifies that the nurse has met the necessary standards to practice safely and competently.
A: Enrolling in an advanced degree program is not relevant to the legal right to practice as a nurse.
B: Filing NCLEX results in the county of residence is a procedural step and does not grant the legal right to practice.
D: Having a signed letter confirming graduation is not sufficient to practice as a nurse; licensure by the State Board of Nursing is the key requirement.
Question 2
The nurse recognizes that the bell of the stethoscope is used to detect which type of sounds?
A. High-pitched sounds like breath sounds.
B. Low-pitched sounds like heart murmurs.
C. Sounds over a large surface area.
D. Sounds with a high amplitude.
Show answer and rationale
Correct answer: B — Low-pitched sounds like heart murmurs.
The correct answer is B because low-pitched sounds like heart murmurs are best detected using the bell of the stethoscope. The bell is designed to pick up low-frequency sounds with more clarity and resonance due to its shape and size. Heart murmurs typically fall into the category of low-pitched sounds, making the bell ideal for their detection.
Choice A is incorrect because high-pitched sounds like breath sounds are better detected using the diaphragm of the stethoscope, not the bell. Choice C is incorrect as sounds over a large surface area would be better detected using the diaphragm as well. Choice D is incorrect because the amplitude of the sound does not determine whether the bell or diaphragm is used; it is more about the frequency or pitch of the sound.
Question 3
Which of the following correctly describes phonophoresis?
A. Using ultrasound to drive topical medications into tissue
B. Using electric current to drive medications into tissue
C. Using massage to drive topical medications into tissue
D. Using cold spray to numb a painful area
Show answer and rationale
Correct answer: A — Using ultrasound to drive topical medications into tissue
The correct answer is A because phonophoresis involves using ultrasound to drive topical medications into tissue. Ultrasound waves help enhance the penetration of medications through the skin and into deeper tissues. This method is effective for localized pain management and inflammation.
Choice B is incorrect because using electric current to drive medications into tissue is known as iontophoresis, not phonophoresis.
Choice C is incorrect as massage alone cannot drive topical medications into tissue.
Choice D is incorrect because using cold spray to numb a painful area is a form of cryotherapy, not phonophoresis.
In summary, phonophoresis involves ultrasound to enhance medication penetration, differing from iontophoresis, massage, and cryotherapy.
Question 4
Which of the following is part of caring for a resident within an isolation unit?
A. The NA should limit reading materials because they can become contaminated.
B. The NA should never enter the isolation unit.
C. The NA should make sure that nobody talks to the resident until the isolation period has ended.
D. The NA should disinfect surfaces often.
Show answer and rationale
Correct answer: D — The NA should disinfect surfaces often.
Correct Answer: D - The NA should disinfect surfaces often.
Rationale:
1. Disinfecting surfaces helps prevent the spread of infections within the isolation unit.
2. Regular disinfection maintains a clean and safe environment for the resident.
3. It is a crucial part of infection control protocols to reduce the risk of cross-contamination.
4. Proper disinfection practices promote the well-being and recovery of the isolated resident.
Summary:
A: Incorrect - Limiting reading materials is not directly related to infection control within the isolation unit.
B: Incorrect - Completely avoiding entry may hinder necessary care for the resident.
C: Incorrect - Isolating the resident from social interaction is not a standard practice and may impact their mental well-being.
Question 5
Alternate communication methods for a resident with an artificial airway include
A. Playing charades
B. Shouting at the resident
C. Asking the resident's family what they think he wants
D. Using communication boards
Show answer and rationale
Correct answer: D — Using communication boards
The correct answer is D: Using communication boards. This method is appropriate as it allows the resident to visually communicate by pointing to or indicating words or symbols on the board. It ensures clear and accurate communication, especially for individuals with artificial airways who may have difficulty speaking.
A: Playing charades may not be effective for residents with artificial airways as it relies on physical gestures and may not always be clear or understood.
B: Shouting at the resident is not appropriate and can be distressing for them. It does not consider the resident's comfort or dignity.
C: Asking the resident's family what they think he wants may not always be reliable and may not accurately reflect the resident's own preferences and needs.
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Question 6
While obtaining a health history, a patient tells the nurse that he has frequent nosebleeds and asks the best way to get them to stop. What would be the nurse's best response?
A. "While sitting up, place a cold compress over your nose."
B. "Sit up with your head tilted forward and pinch your nose."
C. "Just allow the bleeding to stop on its own, but don't blow your nose."
D. "Lie on your back with your head tilted back and pinch your nose."
Correct answer:
The correct answer is B because when a patient experiences a nosebleed, sitting up with the head tilted forward and pinching the nose helps to apply pressure to the bleeding area, promoting clotting and stopping the bleeding. This position also prevents blood from flowing down the throat, which can cause choking or swallowing blood. Placing a cold compress while sitting up (choice A) can help constrict blood vessels, but the key action of applying pressure by pinching the nose is missing. Allowing bleeding to stop on its own (choice C) without taking any immediate action could lead to excessive blood loss. Lying on the back with the head tilted back (choice D) is not recommended as it can cause blood to flow back into the throat and potentially lead to aspiration.
While obtaining a health history, a patient tells the nurse that he has frequent nosebleeds and asks the best way to get them to stop. What would be the nurse's best response?
A. "While sitting up, place a cold compress over your nose."
B. "Sit up with your head tilted forward and pinch your nose."
C. "Just allow the bleeding to stop on its own, but don't blow your nose."
D. "Lie on your back with your head tilted back and pinch your nose."
Correct answer:
The correct answer is B because when a patient experiences a nosebleed, sitting up with the head tilted forward and pinching the nose helps to apply pressure to the bleeding area, promoting clotting and stopping the bleeding. This position also prevents blood from flowing down the throat, which can cause choking or swallowing blood. Placing a cold compress while sitting up (choice A) can help constrict blood vessels, but the key action of applying pressure by pinching the nose is missing. Allowing bleeding to stop on its own (choice C) without taking any immediate action could lead to excessive blood loss. Lying on the back with the head tilted back (choice D) is not recommended as it can cause blood to flow back into the throat and potentially lead to aspiration.
A 20-year-old female client with a noticeable body odor has refused to shower for the last 3 days. She states, 'I have been told that it is harmful to bathe during my period.' Which action should the nurse take first?
A. Accept and document the client's wish to refrain from bathing.
B. Offer to give the client a bed bath, avoiding the perineal area.
C. Obtain written brochures about menstruation to give to the client.
D. Teach the importance of personal hygiene during menstruation to the client.
Correct answer:
The priority for the nurse is to educate the client on the importance of personal hygiene during menstruation. Although it's crucial to respect the client's beliefs, providing education ensures the client receives accurate information to make informed decisions about her hygiene practices. By offering teaching first, the nurse can address any misconceptions or concerns the client may have while promoting optimal hygiene practices for overall well-being. Choice A should not be the first action as it does not address the client's potential misinformation about hygiene. Choice B is not ideal as it only offers a temporary solution without addressing the underlying issue. Choice C is not the priority as the immediate concern is the client's personal hygiene practices.
Dakota is a 14-year-old boy who just noticed a rash at his ankles. There is no history of exposure to ill people or other agents in the environment. He has a slight fever in the office. The rash consists of small, bright red marks. When they are pressed, the red colour remains. What should you do?
A. Prescribe a steroid cream to decrease inflammation.
B. Consider admitting the patient to the hospital.
C. Reassure the parents and the patient that this should resolve within a week.
D. Tell him not to scratch them, and follow up in 3 days.
Correct answer:
Correct Answer: B (Consider admitting the patient to the hospital)
Rationale:
1. Dakota is a 14-year-old boy with a sudden rash, slight fever, and no known exposure.
2. The rash is non-blanching which indicates a serious underlying condition like meningococcal infection.
3. Meningococcal infection can progress rapidly, leading to life-threatening complications.
4. Hospital admission allows for close monitoring, diagnostic tests, and prompt treatment if needed.
Summary of other choices:
A: Steroid cream is not appropriate as the rash could be a sign of a serious infection, not just inflammation.
C: Relying on reassurance without proper evaluation can delay necessary treatment.
D: Following up in 3 days may be too late if the condition worsens rapidly.
A 26 y/o seat-belted driver presents with diffuse abdominal tenderness and free air on abdominal films. The patient should:
A. "Undergo peritoneal lavage"
B. Undergo prompt celiotomy
C. Have a contrast x-ray of her GI-tract
D. Be carefully observed for further evidence of intraabdominal injury
Correct answer:
The correct answer is B, "Undergo prompt celiotomy." This is because the presence of free air on abdominal films in a seat-belted driver with diffuse abdominal tenderness indicates a likely intra-abdominal injury requiring surgical intervention. Prompt celiotomy allows for exploration of the abdomen to identify and repair any internal injuries.
Choice A, peritoneal lavage, is not recommended as it does not provide definitive treatment for the underlying intra-abdominal injury. Choice C, contrast x-ray of the GI-tract, is unnecessary and delays definitive management. Choice D, observation for further evidence of intraabdominal injury, is not appropriate given the already identified signs of a serious abdominal injury that require immediate surgical intervention.
Which of the following is a sign of approaching death?
A. Low blood pressure
B. Sharper vision
C. Warm
D. dry skin
Correct answer:
Step 1: Low blood pressure is a common sign of approaching death due to the body's decreased ability to maintain normal blood flow.
Step 2: As organs fail, blood pressure drops, leading to decreased perfusion and oxygen delivery.
Step 3: This can result in cold, clammy skin, confusion, and decreased consciousness as the body shuts down.
Step 4: Sharper vision (B), being warm (C), and having dry skin (D) are not specific signs of approaching death and do not directly relate to the body's physiological changes in the same way low blood pressure does.
Summary: Low blood pressure is a significant indicator of approaching death due to its direct impact on organ perfusion and oxygen delivery, unlike the other choices which lack this direct physiological connection.
Which of the following assessment findings is most concerning in a patient with a head injury?
A. Reactive pupils.
B. Decreased level of consciousness.
C. Mild headache.
D. Nausea and vomiting.
Correct answer:
The correct answer is B: Decreased level of consciousness. This is the most concerning assessment finding in a patient with a head injury because it indicates potential brain damage or swelling, which can lead to serious complications. Decreased consciousness may suggest increased intracranial pressure, requiring immediate medical intervention to prevent further damage.
A: Reactive pupils are generally a positive sign and indicate normal brain function.
C: Mild headache is a common symptom after a head injury and may not necessarily indicate a serious issue.
D: Nausea and vomiting can be common symptoms in head injuries, but they are not as concerning as a decreased level of consciousness, as they can also be caused by other factors such as pain or anxiety.
The nurse recognizes that the bell of the stethoscope is used to detect which type of sounds?
A. High-pitched sounds like breath sounds.
B. Low-pitched sounds like heart murmurs.
C. Sounds over a large surface area.
D. Sounds with a high amplitude.
Correct answer:
The correct answer is B because low-pitched sounds like heart murmurs are best detected using the bell of the stethoscope. The bell is designed to pick up low-frequency sounds with more clarity and resonance due to its shape and size. Heart murmurs typically fall into the category of low-pitched sounds, making the bell ideal for their detection.
Choice A is incorrect because high-pitched sounds like breath sounds are better detected using the diaphragm of the stethoscope, not the bell. Choice C is incorrect as sounds over a large surface area would be better detected using the diaphragm as well. Choice D is incorrect because the amplitude of the sound does not determine whether the bell or diaphragm is used; it is more about the frequency or pitch of the sound.
Which information will the nurse include in the teaching plan for a patient newly diagnosed with asthma?
A. Use the inhaled corticosteroid when shortness of breath occurs.
B. Inhale slowly and deeply when using the dry powder inhaler (DPI).
C. Hold your breath for 5 seconds after using the bronchodilator inhaler.
D. Tremors are an expected side effect of rapidly acting bronchodilators.
Correct answer:
Step 1: Tremors as a side effect of rapidly acting bronchodilators are common due to their impact on the sympathetic nervous system.
Step 2: Educating the patient about this side effect prepares them for what to expect and reduces anxiety.
Step 3: This knowledge helps the patient differentiate between expected side effects and potential adverse reactions.
Step 4: It is crucial for the patient to be informed about common side effects to ensure adherence to treatment.
Summary:
Choice D is correct because informing the patient about expected side effects like tremors is essential for treatment adherence. Choices A, B, and C are incorrect because they do not address crucial information related to side effects and proper inhaler technique for asthma management.
Which of the following is true of combative behavior?
A. The behavior is usually a reaction to a specific person.
B. The behavior is not a concern to staff or other residents.
C. The behavior may be caused by disease or medication.
D. The behavior does not need to be reported.
Correct answer:
Step-by-step rationale for why choice C is correct:
1. Combative behavior can be caused by underlying medical conditions.
2. Certain diseases or medications can lead to aggression or hostility.
3. Understanding the root cause is crucial for effective management.
4. Addressing the underlying issue can help improve behavior.
5. Reporting and addressing the cause of combative behavior is essential for the individual's well-being and safety.
Summary:
A: Incorrect - Combative behavior is not always directed towards a specific person.
B: Incorrect - Staff and residents should be concerned and take appropriate action.
C: Correct - Identifying medical causes is crucial for effective management.
D: Incorrect - Combative behavior should be reported and addressed promptly.
RN exams fundamentals practice questions, set 40 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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Keep going past these 15 questions
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