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
Which of these statements are true regarding disinfection and cleaning? (Select all that apply.)
A. Proper cleaning requires mechanical removal of all soil from an object or area.
B. Routine environmental cleaning is an example of medical asepsis.
C. When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound.
D. Cleaning in a direction from the least to the most contaminated area helps reduce infections.
Show answer and rationale
Correct answer: B — Routine environmental cleaning is an example of medical asepsis.
The correct answer is B: Routine environmental cleaning is an example of medical asepsis. Medical asepsis refers to practices that help reduce the transmission of pathogenic microorganisms. Routine environmental cleaning, such as cleaning surfaces in healthcare settings, is a key component of maintaining a clean and safe environment to prevent the spread of infections. This practice helps to eliminate or reduce the number of microorganisms present on surfaces, thereby decreasing the risk of contamination and infection.
Choices A, C, and D are incorrect:
A: Proper cleaning requires mechanical removal of all soil from an object or area. This statement is true, but it does not specifically pertain to medical asepsis.
C: When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound. This statement is incorrect as the correct technique is to clean from the center outward to avoid contaminating the wound.
D: Cleaning in a direction from the least to the most contaminated area helps
Question 2
A client has a neurological deficit involving the limbic system. Specific to this type of deficit, the nurse would document which of the following information related to the client's behavior?
A. Is disoriented to person, place, and time.
B. Affect is flat, with periods of emotional lability.
C. Cannot recall what was eaten for breakfast today.
D. Demonstrates inability to add and subtract; does not know who is president.
Show answer and rationale
Correct answer: B — Affect is flat, with periods of emotional lability.
The correct answer is B: Affect is flat, with periods of emotional lability. This is because the limbic system is responsible for regulating emotions and behavior. A deficit in this area can lead to flat affect (lack of emotional expression) and emotional lability (rapid changes in emotions).
A: Disorientation to person, place, and time is more indicative of a deficit in cognitive function, commonly associated with the temporal lobe rather than the limbic system.
C: Difficulty recalling recent events like what was eaten for breakfast is related to memory impairment, typically associated with the hippocampus rather than the limbic system.
D: Inability to perform tasks like adding and subtracting or knowing the current president is more related to executive functioning and memory, associated with the frontal lobe rather than the limbic system.
In summary, the correct answer is B because it directly relates to the emotional and behavioral aspects affected by deficits in the limbic system, while the other choices are more
Question 3
Which of the following is the major goal of ambulatory care facilities?
A. to save money by not paying hospital rates
B. to provide care to patients capable of self-care at home
C. to perform major surgery in a community setting
D. to perform tests prior to being admitted to the hospital
Show answer and rationale
Correct answer: B — to provide care to patients capable of self-care at home
The correct answer is B: to provide care to patients capable of self-care at home. Ambulatory care facilities focus on providing medical services to patients who do not require overnight hospitalization and can manage their care at home. This includes services such as outpatient surgeries, diagnostic tests, treatments, and follow-up care. By choosing option B, it aligns with the primary goal of ambulatory care facilities, which is to offer convenient and cost-effective care to patients who can safely recover at home.
Explanation of other choices:
A: to save money by not paying hospital rates - Incorrect. While cost-effectiveness is a benefit of ambulatory care facilities, it is not the major goal.
C: to perform major surgery in a community setting - Incorrect. Ambulatory care facilities typically focus on minor surgeries and procedures, not major surgeries.
D: to perform tests prior to being admitted to the hospital - Incorrect. This goal is more related to pre-admission testing rather than the primary goal of ambulatory care
Question 4
A child has been admitted to the burn unit after pulling a pan of hot water off the stove. Given the fact that there is primarily second- and third-degree burns, the health care worker should prioritize care to focus on which of the following? Select all that apply.
A. Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments.
B. Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality.
C. Maintain sterile field when doing dressing changes and debridement.
D. Withhold foods/nutrition since the GI tract may have slowed down in response to stress.
Show answer and rationale
Correct answer: A — Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments.
The correct answer is A: Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. In burn injuries, there is a significant loss of fluids due to damage to the skin barrier. Prioritizing fluid replacement helps prevent hypovolemic shock and maintains adequate tissue perfusion. This is crucial in managing burn patients to prevent complications like organ failure.
Choices B, C, and D are incorrect:
B: Assessing for airway compromise is important but not the top priority in this scenario. Fluid resuscitation takes precedence in managing burn injuries.
C: Maintaining a sterile field is important for infection prevention but is not the immediate priority over fluid replacement.
D: Withholding nutrition is not recommended as burn injuries increase the body's metabolic demands. Providing adequate nutrition supports healing and recovery, so withholding food can be detrimental.
In summary, fluid replacement is prioritized in burn injuries to prevent shock and maintain tissue perfusion.
Question 5
An 18-year-old college freshman comes to your clinic, complaining of severe left-sided lower abdominal pain and a foul yellow discharge. The pain began last night while she was having intercourse with her boyfriend. Afterward the pain became more severe and the discharge started. By this morning she had a fever of 101 degrees and walking was making the pain worse. Only lying very still makes the pain better. She has tried ibuprofen and acetaminophen without any improvement. She denies any nausea, vomiting, diarrhea, or constipation. Her past medical history is unremarkable. She has had two past sexual partners. She uses the birth control patch instead of condoms. She smokes a half pack of cigarettes a day and drinks four to five beers per weekend night. She denies any illegal drug use. Her parents are both healthy. On examination you find a young woman who appears ill. Her temperature is 102 degrees and her pulse is elevated at 110. She is tender in the left lower quadrant but has no guarding or rebound. Speculum examination reveals yellow purulent drainage from the os. On palpation there is cervical motion tenderness and the left adnexa is swollen and tender. A urine analysis is unremarkable and the urine pregnancy test is pending. What is the best choice of diagnosis for this adnexal swelling?
A. Ovarian cyst
B. Tubal pregnancy
C. Pelvic inflammatory disease
Show answer and rationale
Correct answer: C — Pelvic inflammatory disease
The correct diagnosis is C: Pelvic inflammatory disease (PID). The patient's symptoms of severe left-sided lower abdominal pain, foul yellow discharge, fever, tenderness in the left lower quadrant, cervical motion tenderness, and swollen/tender left adnexa are indicative of PID. The history of recent intercourse, multiple sexual partners, and use of birth control patch instead of condoms increase the risk of sexually transmitted infections, leading to PID. The key findings on examination, such as purulent drainage, cervical motion tenderness, and adnexal tenderness, support the diagnosis. PID is a serious infection that can lead to complications like infertility and ectopic pregnancy if not treated promptly.
Incorrect choices:
A: Ovarian cyst - Unlikely as symptoms are more indicative of an infectious process rather than a simple cyst.
B: Tubal pregnancy - While a tubal pregnancy can present with lower abdominal pain and a positive pregnancy test, the presence of purulent discharge and cervical motion tenderness suggests
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Question 6
Which of these statements are true regarding disinfection and cleaning? (Select all that apply.)
A. Proper cleaning requires mechanical removal of all soil from an object or area.
B. Routine environmental cleaning is an example of medical asepsis.
C. When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound.
D. Cleaning in a direction from the least to the most contaminated area helps reduce infections.
Correct answer:
The correct answer is B: Routine environmental cleaning is an example of medical asepsis. Medical asepsis refers to practices that help reduce the transmission of pathogenic microorganisms. Routine environmental cleaning, such as cleaning surfaces in healthcare settings, is a key component of maintaining a clean and safe environment to prevent the spread of infections. This practice helps to eliminate or reduce the number of microorganisms present on surfaces, thereby decreasing the risk of contamination and infection.
Choices A, C, and D are incorrect:
A: Proper cleaning requires mechanical removal of all soil from an object or area. This statement is true, but it does not specifically pertain to medical asepsis.
C: When cleaning a wound, wipe around the wound edge first and then clean inward toward the center of the wound. This statement is incorrect as the correct technique is to clean from the center outward to avoid contaminating the wound.
D: Cleaning in a direction from the least to the most contaminated area helps
An 18-year-old college freshman comes to your clinic, complaining of severe left-sided lower abdominal pain and a foul yellow discharge. The pain began last night while she was having intercourse with her boyfriend. Afterward the pain became more severe and the discharge started. By this morning she had a fever of 101 degrees and walking was making the pain worse. Only lying very still makes the pain better. She has tried ibuprofen and acetaminophen without any improvement. She denies any nausea, vomiting, diarrhea, or constipation. Her past medical history is unremarkable. She has had two past sexual partners. She uses the birth control patch instead of condoms. She smokes a half pack of cigarettes a day and drinks four to five beers per weekend night. She denies any illegal drug use. Her parents are both healthy. On examination you find a young woman who appears ill. Her temperature is 102 degrees and her pulse is elevated at 110. She is tender in the left lower quadrant but has no guarding or rebound. Speculum examination reveals yellow purulent drainage from the os. On palpation there is cervical motion tenderness and the left adnexa is swollen and tender. A urine analysis is unremarkable and the urine pregnancy test is pending. What is the best choice of diagnosis for this adnexal swelling?
A. Ovarian cyst
B. Tubal pregnancy
C. Pelvic inflammatory disease
Correct answer:
The correct diagnosis is C: Pelvic inflammatory disease (PID). The patient's symptoms of severe left-sided lower abdominal pain, foul yellow discharge, fever, tenderness in the left lower quadrant, cervical motion tenderness, and swollen/tender left adnexa are indicative of PID. The history of recent intercourse, multiple sexual partners, and use of birth control patch instead of condoms increase the risk of sexually transmitted infections, leading to PID. The key findings on examination, such as purulent drainage, cervical motion tenderness, and adnexal tenderness, support the diagnosis. PID is a serious infection that can lead to complications like infertility and ectopic pregnancy if not treated promptly.
Incorrect choices:
A: Ovarian cyst - Unlikely as symptoms are more indicative of an infectious process rather than a simple cyst.
B: Tubal pregnancy - While a tubal pregnancy can present with lower abdominal pain and a positive pregnancy test, the presence of purulent discharge and cervical motion tenderness suggests
What is an important safety measure when a nursing assistant transfers a resident to a surgical bed?
A. Ensuring that the linen is tightly tucked all along the top and bottom of the bed
B. Having the bed and stretcher elevated to the highest position
C. Locking the stretcher and bed wheels before transferring
D. Positioning the bed and stretcher about six inches apart before transferring
Correct answer:
The correct answer is C: Locking the stretcher and bed wheels before transferring. This is important for safety to prevent any movement of the bed or stretcher during the transfer, which could potentially lead to accidents or injuries. By locking the wheels, the surfaces will remain stable and secure, ensuring a smooth and safe transfer process.
Explanation:
1. Locking the wheels ensures stability and prevents unintended movement during the transfer.
2. Prevents the bed or stretcher from rolling or shifting, reducing the risk of falls or accidents.
3. Secures the positioning of the surfaces, making it easier and safer for the nursing assistant to transfer the resident without any unexpected movements.
Summary:
A: Ensuring that the linen is tightly tucked is not directly related to the safety of the transfer process.
B: Elevating the bed and stretcher to the highest position may not be necessary and does not address the safety measure of locking the wheels.
D: Positioning the bed and stretcher six inches apart
A client has a neurological deficit involving the limbic system. Specific to this type of deficit, the nurse would document which of the following information related to the client's behavior?
A. Is disoriented to person, place, and time.
B. Affect is flat, with periods of emotional lability.
C. Cannot recall what was eaten for breakfast today.
D. Demonstrates inability to add and subtract; does not know who is president.
Correct answer:
The correct answer is B: Affect is flat, with periods of emotional lability. This is because the limbic system is responsible for regulating emotions and behavior. A deficit in this area can lead to flat affect (lack of emotional expression) and emotional lability (rapid changes in emotions).
A: Disorientation to person, place, and time is more indicative of a deficit in cognitive function, commonly associated with the temporal lobe rather than the limbic system.
C: Difficulty recalling recent events like what was eaten for breakfast is related to memory impairment, typically associated with the hippocampus rather than the limbic system.
D: Inability to perform tasks like adding and subtracting or knowing the current president is more related to executive functioning and memory, associated with the frontal lobe rather than the limbic system.
In summary, the correct answer is B because it directly relates to the emotional and behavioral aspects affected by deficits in the limbic system, while the other choices are more
During the precordial assessment on an patient who is 8 months pregnant, the nurse palpates the apical impulse at the fourth left intercostal space lateral to the midclavicular line. This finding would indicate:
A. Right ventricular hypertrophy.
B. Increased volume and size of the heart as a result of pregnancy.
C. Displacement of the heart from elevation of the diaphragm.
D. Increased blood flow through the internal mammary artery.
Correct answer:
The correct answer is C: Displacement of the heart from elevation of the diaphragm. During pregnancy, the growing uterus pushes the diaphragm upwards, causing the heart to be displaced upwards and laterally. This displacement results in the apical impulse being palpated at a higher position, such as the fourth left intercostal space lateral to the midclavicular line. This finding is a normal physiological change due to pregnancy and does not indicate any cardiac pathology.
Explanation of other choices:
A: Right ventricular hypertrophy - This is unlikely in a pregnant patient without underlying cardiac conditions.
B: Increased volume and size of the heart as a result of pregnancy - While the heart may undergo some changes during pregnancy, palpating the apical impulse at a higher position is specifically due to displacement of the heart by the elevated diaphragm, not increased heart size.
D: Increased blood flow through the internal mammary artery - This choice is unrelated to the displacement of the heart and the
Which of the following medication types are used to decrease the workload of the heart by blocking sympathetic stimulation of receptors that work on the SA node and myocardial cells, thus decreasing the force of myocardial contraction and directly reducing a patient's heart rate?
A. Alpha-adrenergic agents
B. Beta-blockers
C. Calcium-channel blockers
D. Sodium-channel blockers
Correct answer:
The correct answer is B: Beta-blockers. Beta-blockers decrease the workload of the heart by blocking the sympathetic stimulation of beta-adrenergic receptors in the heart. This action results in a decrease in heart rate and the force of myocardial contraction. By blocking these receptors, beta-blockers reduce the impact of adrenaline and other stress hormones on the heart, leading to a decrease in the heart's workload.
A: Alpha-adrenergic agents primarily work on alpha-adrenergic receptors and do not have the same effect on decreasing the workload of the heart.
C: Calcium-channel blockers work by blocking calcium channels in the heart and blood vessels, leading to vasodilation and decreased contractility of the heart. While they can reduce the heart's workload, they do not primarily target sympathetic stimulation of receptors working on the SA node and myocardial cells.
D: Sodium-channel blockers primarily affect the conduction of electrical impulses in the heart and are used for different purposes, such as
The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines, antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient would most likely include which drug or drug classes?
A. Vasodilators alone
B. ACE inhibitors alone
C. Calcium channel blockers with thiazide diuretics
D. Beta blockers with thiazide diuretics
Correct answer:
The correct answer is C: Calcium channel blockers with thiazide diuretics. According to JNC-8 guidelines, for African-American patients with hypertension, initial drug therapy should include calcium channel blockers or thiazide diuretics due to their proven efficacy in this population. Calcium channel blockers help relax blood vessels and improve blood flow, while thiazide diuretics help reduce fluid volume and blood pressure. This combination has shown better outcomes and reduced risk of adverse effects in African-American patients.
Incorrect choices:
A: Vasodilators alone - Not recommended as initial therapy for newly diagnosed hypertensive African-American patients.
B: ACE inhibitors alone - While ACE inhibitors are effective in treating hypertension, they are not the first-line choice for African-American patients based on JNC-8 guidelines.
D: Beta blockers with thiazide diuretics - Beta blockers are not the preferred initial therapy for hypertensive African-American patients according to JNC-8 guidelines.
The correct answer is C: Nonspecific. At birth, infants possess nonspecific immunity, also known as innate immunity. This type of immunity provides immediate defense against a wide range of pathogens without prior exposure. It includes physical barriers like skin, chemical barriers like stomach acid, and cellular defenses like macrophages. This innate immunity is essential for protecting newborns from infections until their adaptive immune system develops.
Explanation of other choices:
A: Active immunity is acquired through exposure to antigens and the subsequent production of antibodies by the individual's own immune system. It is not present at birth.
B: Passive immunity is acquired through the transfer of pre-formed antibodies from another individual, such as through breast milk or placental transfer. It is not present at birth.
D: Specific immunity, also known as adaptive immunity, is developed over time through exposure to specific antigens and the production of memory cells. It is not present at birth.
During the precordial assessment on an patient who is 8 months pregnant, the nurse palpates the apical impulse at the fourth left intercostal space lateral to the midclavicular line. This finding would indicate:
A. Right ventricular hypertrophy.
B. Increased volume and size of the heart as a result of pregnancy.
C. Displacement of the heart from elevation of the diaphragm.
D. Increased blood flow through the internal mammary artery.
Correct answer:
The correct answer is C: Displacement of the heart from elevation of the diaphragm. During pregnancy, the growing uterus pushes the diaphragm upwards, causing the heart to be displaced upwards and laterally. This displacement results in the apical impulse being palpated at a higher position, such as the fourth left intercostal space lateral to the midclavicular line. This finding is a normal physiological change due to pregnancy and does not indicate any cardiac pathology.
Explanation of other choices:
A: Right ventricular hypertrophy - This is unlikely in a pregnant patient without underlying cardiac conditions.
B: Increased volume and size of the heart as a result of pregnancy - While the heart may undergo some changes during pregnancy, palpating the apical impulse at a higher position is specifically due to displacement of the heart by the elevated diaphragm, not increased heart size.
D: Increased blood flow through the internal mammary artery - This choice is unrelated to the displacement of the heart and the
A 70 year old suffers blunt chest trauma after being struck by a car. On presentation, his GCS is 15, BP is 145/90, HR is 72. RR is 24 and O2-sat on 5L is 91%. Chest x-ray demonstrates multiple right sided rib fractures. ECG demonstrates normal sinus rhythm with no conduction abnormalities. Management should include:
A. "Placement of a 22Fr right sided chest tube"
B. "Serial troponins and cardiac monitoring"
C. "Monitored i.v analgesia"
D. "Thoracic splinting
Correct answer:
The correct answer is C: "Monitored i.v analgesia." In this scenario, the patient has blunt chest trauma with rib fractures causing pain. The management should focus on controlling pain to improve respiratory effort and prevent complications like pneumonia. IV analgesia is recommended to provide effective pain relief and improve patient outcomes.
Choice A: "Placement of a 22Fr right sided chest tube" is incorrect because there is no indication for chest tube insertion based on the information provided. The patient's vital signs are stable and there are no signs of tension pneumothorax.
Choice B: "Serial troponins and cardiac monitoring" is incorrect because there are no indications of cardiac injury based on the normal ECG and the absence of cardiac symptoms. Troponins and cardiac monitoring are not necessary at this point.
Choice D: "Thoracic splinting" is incorrect because splinting is not typically recommended for rib fractures in elderly patients. It may restrict respiratory effort and cause more harm
RN exams fundamentals practice questions, set 5 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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