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
A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume of a television or radio. The most likely cause of his hearing loss is:
A. Otosclerosis.
B. Presbycusis.
C. Trauma to the bones.
D. Frequent ear infections.
Show answer and rationale
Correct answer: A — Otosclerosis.
The correct answer is A: Otosclerosis. Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, specifically the stapes bone. This abnormal bone growth can lead to conductive hearing loss, which may result in the patient experiencing progressive hearing loss. In this case, the patient's symptoms of hearing improvement with louder sounds or increased volume suggest a conductive hearing loss, which is common in otosclerosis.
Choice B: Presbycusis, is age-related hearing loss and typically presents as a gradual decline in hearing over time, not necessarily with a sudden progressive loss as described in the scenario.
Choice C: Trauma to the bones would likely result in a more sudden onset of hearing loss, not a progressive loss as described in the scenario.
Choice D: Frequent ear infections may lead to temporary hearing loss due to fluid buildup or damage to the ear structures, but the symptoms described in the scenario are more indicative of a chronic condition like otosclerosis.
Question 2
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 because administering oxytocin infusion is the most appropriate intervention for postpartum hemorrhage due to uterine atony, which is a common cause of excessive bleeding after delivery. Oxytocin helps to stimulate uterine contractions, which will help control the bleeding by reducing the size of the blood vessels at the placental site. This intervention is evidence-based and recommended in postpartum hemorrhage management protocols. Other choices are incorrect because:
A: Packing the vagina is not indicated unless there is active vaginal bleeding that cannot be controlled by other methods.
B: Administering lactated Ringer's solution at a rapid rate is not the first-line treatment for postpartum hemorrhage.
C: Trendelenburg position and a fluid bolus of normal saline are not recommended as they can increase the risk of fluid overload and do not address the underlying cause of the bleeding.
In summary, administering oxytocin infusion is the most appropriate intervention to manage post
Question 3
The infection control nurse has asked the staff to work on reducing the number of iatrogenic infections on the unit. Which of the following actions on the nurses’ part would contribute to reducing health care–acquired infections? (Select all that apply.)
A. Teaching correct handwashing to assigned patients
B. Using correct procedures in starting and caring for an intravenous infusion
C. Providing perineal care to a patient with an indwelling urinary catheter
D. Isolating a patient on antibiotics who has been having loose stool for 24 hours
Show answer and rationale
Correct answer: C — Providing perineal care to a patient with an indwelling urinary catheter
Correct Answer: C
Rationale:
1. Providing perineal care to a patient with an indwelling urinary catheter is essential in preventing infections as it helps maintain proper hygiene and reduces the risk of urinary tract infections.
2. Proper perineal care also helps in preventing catheter-associated urinary tract infections (CAUTIs), which are common iatrogenic infections in healthcare settings.
3. This action aligns with evidence-based practice guidelines for reducing healthcare-acquired infections.
Summary:
- Choice A (Teaching correct handwashing): While important for overall infection control, this choice does not directly address reducing iatrogenic infections.
- Choice B (Using correct procedures for IV care): While important for preventing bloodstream infections, it does not specifically target iatrogenic infections.
- Choice D (Isolating a patient on antibiotics with loose stool): Isolation helps with preventing the spread of infectious diseases but does not directly address iatrogenic infections.
Question 4
When caring for an immobile client, what nursing diagnosis has the highest priority?
A. Risk for fluid volume deficit.
B. Impaired gas exchange.
C. Risk for impaired skin integrity.
D. Altered tissue perfusion.
Show answer and rationale
Correct answer: B — Impaired gas exchange.
When caring for an immobile client, the nursing diagnosis with the highest priority is impaired gas exchange. This is because impaired gas exchange implies difficulty with breathing, which is essential for sustaining life. Adequate oxygenation is crucial for all bodily functions, and any impairment in gas exchange can lead to serious complications, making it the priority nursing diagnosis to address in an immobile client. Choices A, C, and D are important considerations as well when caring for an immobile client, but they are secondary to impaired gas exchange. Risk for fluid volume deficit may occur due to immobility, but ensuring proper gas exchange takes precedence as it directly impacts the client's immediate survival. Risk for impaired skin integrity is a concern in immobile clients but does not pose an immediate threat to life like impaired gas exchange. Altered tissue perfusion is also critical but is usually a consequence of impaired gas exchange, reinforcing the priority of addressing gas exchange first.
Question 5
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
Show answer and rationale
Correct answer: C — Locking the stretcher and bed wheels before transferring
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
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
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.
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
A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume of a television or radio. The most likely cause of his hearing loss is:
A. Otosclerosis.
B. Presbycusis.
C. Trauma to the bones.
D. Frequent ear infections.
Correct answer:
The correct answer is A: Otosclerosis. Otosclerosis is a condition characterized by abnormal bone growth in the middle ear, specifically the stapes bone. This abnormal bone growth can lead to conductive hearing loss, which may result in the patient experiencing progressive hearing loss. In this case, the patient's symptoms of hearing improvement with louder sounds or increased volume suggest a conductive hearing loss, which is common in otosclerosis.
Choice B: Presbycusis, is age-related hearing loss and typically presents as a gradual decline in hearing over time, not necessarily with a sudden progressive loss as described in the scenario.
Choice C: Trauma to the bones would likely result in a more sudden onset of hearing loss, not a progressive loss as described in the scenario.
Choice D: Frequent ear infections may lead to temporary hearing loss due to fluid buildup or damage to the ear structures, but the symptoms described in the scenario are more indicative of a chronic condition like otosclerosis.
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 because administering oxytocin infusion is the most appropriate intervention for postpartum hemorrhage due to uterine atony, which is a common cause of excessive bleeding after delivery. Oxytocin helps to stimulate uterine contractions, which will help control the bleeding by reducing the size of the blood vessels at the placental site. This intervention is evidence-based and recommended in postpartum hemorrhage management protocols. Other choices are incorrect because:
A: Packing the vagina is not indicated unless there is active vaginal bleeding that cannot be controlled by other methods.
B: Administering lactated Ringer's solution at a rapid rate is not the first-line treatment for postpartum hemorrhage.
C: Trendelenburg position and a fluid bolus of normal saline are not recommended as they can increase the risk of fluid overload and do not address the underlying cause of the bleeding.
In summary, administering oxytocin infusion is the most appropriate intervention to manage post
Which one of the following statements is true regarding access in pediatric resuscitation?
A. "Intraosseous access should only be considered after five percutaneous attempts"
B. Cut down at the ankle is a preferred initial access technique
C. Blood transfusion can be delivered through an intraosseous access
D. Internal jugular cannulation is the next preferred option when percutaneous venous access fails
Correct answer:
The correct answer is C: Blood transfusion can be delivered through an intraosseous access. In pediatric resuscitation, intraosseous access is commonly used for rapid vascular access when peripheral IV access is difficult. This route allows for the delivery of fluids, medications, and even blood products such as transfusions. It is a reliable and effective alternative in emergency situations.
Explanation for why other choices are incorrect:
A: "Intraosseous access should only be considered after five percutaneous attempts" - This statement is incorrect as intraosseous access is often the preferred route in pediatric resuscitation when peripheral IV access is difficult.
B: Cut down at the ankle is a preferred initial access technique - This statement is incorrect as intraosseous access is typically preferred over cut down procedures in pediatric resuscitation.
D: Internal jugular cannulation is the next preferred option when percutaneous venous access fails - This statement is incorrect as intraosseous
A nurse has seen several clients at a community health center. Which of the clients would be most at risk for developing an infection?
A. An older adult with several chronic illnesses
B. An infant who has just received first immunizations
C. An adolescent who had a basketball physical
D. A middle-aged adult with joint pain and stiffness
Correct answer:
The correct answer is A: An older adult with several chronic illnesses. This client is most at risk for developing an infection due to a weakened immune system associated with aging and chronic illnesses, making them more vulnerable to infections. Older adults often have decreased immune function, making them more susceptible to infections. Additionally, chronic illnesses can further compromise the immune system.
Summary of other choices:
B: An infant who has just received first immunizations - While infants may experience mild side effects from immunizations, they are not at increased risk for developing infections.
C: An adolescent who had a basketball physical - Adolescents are generally healthy and active, and having a physical exam does not increase their risk of developing an infection.
D: A middle-aged adult with joint pain and stiffness - Joint pain and stiffness do not directly increase the risk of developing an infection unless there are underlying conditions compromising the immune system.
S.Q. was just admitted because of cellulitis of her lower extremity due to a cat scratch. She was previously treated outpatient but missed multiple appointments and did not take her medication. As you complete the health history, she shares that she is sleeping on her sister's couch because she lost her job. She lives in an area of town considered a food desert and often eats whatever she can find from a local gas station or fast-food restaurant. She missed her last two follow-up visits for her leg due to inadequate transportation and could not afford to purchase the expensive medication. Which of the following statements best describes the impact of social determinants of health on S.Q.'s well-being?
A. S.Q. is not motivated to be compliant with health care provider recommendations. She should make sure she attends all appointments.
B. Social determinants of health, including lack of economic stability and an environment that lacks nutritious food options, are negatively impacting S.Q.
C. Social determinants of health are important, but she can overcome these barriers if she tries hard enough.
D. S.Q. should work harder to get a new job so she has improved economic stability and may be able to become self-sufficient.
Correct answer:
The correct answer is B. Social determinants of health, such as lack of economic stability and limited access to nutritious food options, are negatively impacting S.Q.'s well-being. This choice is correct because it directly addresses the root causes of S.Q.'s health issues, including her living situation, financial struggles, and food insecurity. These factors significantly contribute to her inability to adhere to medical recommendations and access necessary healthcare.
Incorrect answers:
A: This choice incorrectly attributes S.Q.'s non-compliance to lack of motivation, ignoring the systemic barriers she faces.
C: This choice implies that overcoming social determinants of health is solely dependent on individual effort, disregarding the structural factors that perpetuate disparities.
D: This choice oversimplifies the situation by suggesting that S.Q. can improve her well-being solely through obtaining a new job, without acknowledging the complex interplay of social determinants impacting her health.
The nurse is caring for a school-aged child who has injured the right leg after a bicycle accident. Which signs and symptoms will the nurse assess for to determine if the child is experiencing a localized inflammatory response?
A. Malaise, anorexia, enlarged lymph nodes, and increased white blood cells
B. Chest pain, shortness of breath, and nausea and vomiting
C. Dizziness and disorientation to time, date, and place
D. Edema, redness, tenderness, and loss of function
Correct answer:
The correct answer is D. In this scenario, the child has injured the right leg, indicating a localized injury. Signs of a localized inflammatory response include edema (swelling), redness, tenderness, and loss of function in the affected area. Edema and redness occur due to increased blood flow and fluid accumulation at the site of injury. Tenderness is a result of irritation of nerve endings, and loss of function can occur due to pain and swelling limiting movement.
Choice A is incorrect because malaise, anorexia, enlarged lymph nodes, and increased white blood cells are more indicative of a systemic inflammatory response rather than a localized one.
Choice B is incorrect as chest pain, shortness of breath, nausea, and vomiting are not typical signs of a localized inflammatory response.
Choice C is incorrect as dizziness and disorientation are not specific signs of inflammation in a localized area.
In summary, the signs and symptoms in choice D align with a localized inflammatory response
RN exams fundamentals practice questions, set 6 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.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
