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
You are called to assist a 20-year-old male for a severe headache. On-scene, you learn the patient was involved in an accident that caused a potential closed head injury. However, at the time of the accident, the patient refused EMS care, stating he felt fine. Today, he is experiencing headache, confusion, and visual disturbances. Which of the following injuries is most likely to cause this type presentation?
A. Coup-contra-coup injury
B. Diffuse axonal injury
C. Subdural hematoma
D. Epidural hematoma
Show answer and rationale
Correct answer: C — Subdural hematoma
Rationale: The correct answer is C: Subdural hematoma. Subdural hematoma is a collection of blood between the dura mater and arachnoid mater of the brain, often caused by head trauma. Symptoms include headache, confusion, and visual disturbances, which align with the patient's presentation. Subdural hematomas can develop gradually after a head injury, leading to delayed symptoms.
Other choices:
A: Coup-contra-coup injury - This injury involves the brain hitting the skull on both sides due to acceleration-deceleration forces, but it typically presents with focal neurological deficits rather than the diffuse symptoms described.
B: Diffuse axonal injury - This injury involves widespread damage to nerve fibers in the brain, leading to coma or altered consciousness rather than confusion and visual disturbances.
D: Epidural hematoma - This injury is a collection of blood between the skull and dura mater, typically causing rapid deterioration in mental status and focal neurological deficits, not confusion
Question 2
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 3
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
Show answer and rationale
Correct answer: C — Blood transfusion can be delivered through an intraosseous access
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
Question 4
A nurse is working in a nursing home when there is a fire in the kitchen and cafeteria area. Which of the following is the first priority for the nurse in this situation?
A. Ensure that all patients are moved out of harm’s way.
B. Remove all flammable materials from the area and evacuate to allow firefighters to extinguish the fire.
C. Evacuate all patients from the building immediately.
D. Report to the area of the fire and take measures to extinguish and/or contain it, if possible.
Show answer and rationale
Correct answer: A — Ensure that all patients are moved out of harm’s way.
Step 1: Ensure safety of patients: The first priority of the nurse is to ensure the safety and well-being of the patients in the nursing home.
Step 2: Moving patients out of harm's way: Ensuring all patients are moved out of harm's way is crucial to prevent injuries or casualties.
Step 3: Avoid direct involvement in firefighting: Nurses are not trained firefighters and should not directly engage in extinguishing fires.
Step 4: Wait for firefighters: The nurse should focus on safe evacuation and wait for professional firefighters to handle the fire.
Step 5: Prioritize patient safety over containing the fire: Patient safety is the primary concern, and containing the fire comes after ensuring everyone is safe.
Summary:
- Choice A is correct as it prioritizes patient safety.
- Choice B is incorrect as nurses should not remove flammable materials or engage in firefighting.
- Choice C is incorrect as immediate evacuation without ensuring safety could lead to chaos.
- Choice D is incorrect as nurses
Question 5
You are on the scene of a vehicle accident with entrapment. Why is it so important to ensure the battery has been disconnected before attempting to enter the vehicle or extricate the driver?
A. To make sure the vehicle is not capable of moving during the extrication process and injuring anyone involved
B. To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved
C. To make sure that no one in contact with the vehicle gets electrocuted
D. To prevent the possibility of a fire starting in the passenger compartment during the extrication process
Show answer and rationale
Correct answer: B — To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved
The correct answer is B: To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved. When a vehicle's battery is not disconnected before attempting to enter or extricate a driver, there is a risk that any undeployed airbags may still be active and could suddenly inflate, potentially causing harm to the patient or anyone involved in the extrication process. Disconnecting the battery eliminates the power source for the airbags, reducing the risk of unintended deployment.
Choice A is incorrect because disconnecting the battery is not primarily done to prevent the vehicle from moving during extrication; other safety measures are in place for that purpose. Choice C is incorrect as the risk of electrocution is minimal if proper extrication procedures are followed. Choice D is incorrect because while a fire is a concern in vehicle accidents, disconnecting the battery is not specifically related to preventing fires in the passenger compartment during extrication.
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Question 6
A nurse who works in an outpatient surgical center develops a new respiratory illness. She has atypical symptoms and is not responding to conventional therapies. Her work history includes spending considerable amounts of time in her facility’s central supply and equipment sterilization areas. Her treating physician suspects her illness is linked to a workplace exposure. Where is the best place for the nurse to obtain information regarding her potential workplace exposures?
A. the equipment manufacturer’s service center and help desk
B. the Occupational Safety and Health Administration (OSHA) website
C. the Safety Data Sheets/SDS (formerly referred to as Material Safety Data Sheets/MSDS) at her facility
D. the Centers for Disease Control and Prevention’s (CDC) reportable illness hotline
Correct answer:
The correct answer is C: the Safety Data Sheets/SDS at her facility. This is the best place for the nurse to obtain information regarding her potential workplace exposures because SDS provide detailed information about hazardous chemicals in the workplace, including health effects, protective measures, and exposure control. The nurse can review the SDS for the chemicals used in the central supply and equipment sterilization areas to identify any potential exposures that may be linked to her illness.
Choice A (the equipment manufacturer’s service center and help desk) is incorrect because they may not have specific information on workplace exposures. Choice B (OSHA website) is incorrect because while OSHA provides general workplace safety guidelines, it may not have specific information on the nurse’s workplace exposures. Choice D (CDC’s reportable illness hotline) is incorrect because it is more focused on reporting and tracking infectious diseases, rather than identifying workplace exposures.
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.
You are on the scene of a vehicle accident with entrapment. Why is it so important to ensure the battery has been disconnected before attempting to enter the vehicle or extricate the driver?
A. To make sure the vehicle is not capable of moving during the extrication process and injuring anyone involved
B. To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved
C. To make sure that no one in contact with the vehicle gets electrocuted
D. To prevent the possibility of a fire starting in the passenger compartment during the extrication process
Correct answer:
The correct answer is B: To ensure any undeployed airbags do not discharge and cause an injury to the patient or anyone involved. When a vehicle's battery is not disconnected before attempting to enter or extricate a driver, there is a risk that any undeployed airbags may still be active and could suddenly inflate, potentially causing harm to the patient or anyone involved in the extrication process. Disconnecting the battery eliminates the power source for the airbags, reducing the risk of unintended deployment.
Choice A is incorrect because disconnecting the battery is not primarily done to prevent the vehicle from moving during extrication; other safety measures are in place for that purpose. Choice C is incorrect as the risk of electrocution is minimal if proper extrication procedures are followed. Choice D is incorrect because while a fire is a concern in vehicle accidents, disconnecting the battery is not specifically related to preventing fires in the passenger compartment during extrication.
The nurse is caring for a patient in an intensive care unit who needs a bath. Which priority action will the nurse take to decrease the potential for a health care–associated infection?
A. Use local anesthetic on reddened areas.
B. Use nonallergenic tape on dressings.
C. Use a chlorhexidine wash.
D. Use filtered water.
Correct answer:
The correct answer is C: Use a chlorhexidine wash. This is the priority action to decrease the potential for healthcare-associated infections in an ICU setting. Chlorhexidine is an effective antiseptic that can reduce the risk of infection by killing a wide range of microorganisms on the skin. It is specifically chosen for its ability to provide prolonged antimicrobial activity, making it an essential component in infection prevention protocols. Using a chlorhexidine wash before a bath can significantly reduce the microbial load on the patient's skin, decreasing the risk of infections.
Choice A, using local anesthetic on reddened areas, is not directly related to infection prevention. Choice B, using nonallergenic tape on dressings, is important for preventing allergic reactions but does not address the overall risk of healthcare-associated infections. Choice D, using filtered water, is important for certain procedures but does not target the broader goal of infection prevention in this scenario.
What role does the nurse assume when given a position of authority within a formal organization?
A. Manager.
B. Advocate.
C. Leader.
D. Teacher.
Correct answer:
The correct answer is A: Manager. When a nurse assumes a position of authority within a formal organization, they are responsible for overseeing operations, resources, and staff to achieve organizational goals. As a manager, the nurse will be involved in decision-making, planning, organizing, and controlling activities within the organization. This role requires skills in delegation, problem-solving, and communication to effectively lead the team.
Incorrect choices:
B: Advocate - While advocacy is an important aspect of nursing, assuming a position of authority typically involves broader responsibilities beyond advocacy.
C: Leader - Leadership qualities are essential for a nurse in a managerial position, but leadership alone does not encompass all the responsibilities of a manager.
D: Teacher - Although teaching may be part of a nurse's role, assuming a position of authority within a formal organization usually entails managerial duties rather than solely focusing on teaching responsibilities.
A 70-year-old man presents with a complaint of difficulty walking. He has a history of Parkinson's disease and is currently taking levodopa. On examination, he has rigidity, bradykinesia, and a shuffling gait. Which of the following is the most likely cause of his symptoms?
A. Parkinson's disease progression
B. Normal aging
C. Cerebellar ataxia
D. Spinal cord compression
Correct answer:
The correct answer is A: Parkinson's disease progression. This is the most likely cause of the patient's symptoms due to his history of Parkinson's disease and the presence of typical Parkinsonian features such as rigidity, bradykinesia, and shuffling gait. Levodopa is a common medication used to manage symptoms of Parkinson's disease. The progression of Parkinson's disease can lead to worsening motor symptoms over time, including difficulty walking.
Option B: Normal aging is incorrect because the patient's symptoms are not solely due to the aging process, but rather are consistent with the known condition of Parkinson's disease.
Option C: Cerebellar ataxia is unlikely as the patient's symptoms align more closely with Parkinsonian features rather than cerebellar dysfunction.
Option D: Spinal cord compression is not the most likely cause as the patient's symptoms are more characteristic of Parkinson's disease progression rather than symptoms typically associated with spinal cord compression.
You are called to assist a 20-year-old male for a severe headache. On-scene, you learn the patient was involved in an accident that caused a potential closed head injury. However, at the time of the accident, the patient refused EMS care, stating he felt fine. Today, he is experiencing headache, confusion, and visual disturbances. Which of the following injuries is most likely to cause this type presentation?
A. Coup-contra-coup injury
B. Diffuse axonal injury
C. Subdural hematoma
D. Epidural hematoma
Correct answer:
Rationale: The correct answer is C: Subdural hematoma. Subdural hematoma is a collection of blood between the dura mater and arachnoid mater of the brain, often caused by head trauma. Symptoms include headache, confusion, and visual disturbances, which align with the patient's presentation. Subdural hematomas can develop gradually after a head injury, leading to delayed symptoms.
Other choices:
A: Coup-contra-coup injury - This injury involves the brain hitting the skull on both sides due to acceleration-deceleration forces, but it typically presents with focal neurological deficits rather than the diffuse symptoms described.
B: Diffuse axonal injury - This injury involves widespread damage to nerve fibers in the brain, leading to coma or altered consciousness rather than confusion and visual disturbances.
D: Epidural hematoma - This injury is a collection of blood between the skull and dura mater, typically causing rapid deterioration in mental status and focal neurological deficits, not confusion
The nurse is caring for a patient in an intensive care unit who needs a bath. Which priority action will the nurse take to decrease the potential for a health care–associated infection?
A. Use local anesthetic on reddened areas.
B. Use nonallergenic tape on dressings.
C. Use a chlorhexidine wash.
D. Use filtered water.
Correct answer:
The correct answer is C: Use a chlorhexidine wash. This is the priority action to decrease the potential for healthcare-associated infections in an ICU setting. Chlorhexidine is an effective antiseptic that can reduce the risk of infection by killing a wide range of microorganisms on the skin. It is specifically chosen for its ability to provide prolonged antimicrobial activity, making it an essential component in infection prevention protocols. Using a chlorhexidine wash before a bath can significantly reduce the microbial load on the patient's skin, decreasing the risk of infections.
Choice A, using local anesthetic on reddened areas, is not directly related to infection prevention. Choice B, using nonallergenic tape on dressings, is important for preventing allergic reactions but does not address the overall risk of healthcare-associated infections. Choice D, using filtered water, is important for certain procedures but does not target the broader goal of infection prevention in this scenario.
You are called to assist a 55-year-old male who complains of sudden onset chest pain, dyspnea, and palpitations. On arrival, he is found semi-conscious with a pulse rate too fast to palpate and a blood pressure of 80 systolic. Once on the monitor, he is exhibiting an irregularly wide complex tachycardia, with a polymorphic QRS appearance, at nearly 200 per minute. Which of the following would be the most effective intervention for this patient?
A. Administer procainamide at 20 mg/min IV infusion, per protocol
B. Administer 6 mg of adenosine IVP, followed by 12 mg, twice for a total of 30 mg, per protocol
C. Administer defibrillation per protocol
D. Administer synchronized electrical cardioversion at 50-100 joules, per protocol
Correct answer:
The correct answer is C: Administer defibrillation per protocol. The patient is presenting with symptoms indicative of unstable ventricular tachycardia or ventricular fibrillation, which are life-threatening arrhythmias. Defibrillation is the immediate intervention to restore normal rhythm by delivering an electrical shock to the heart. In this scenario, the patient is hemodynamically unstable with a low blood pressure and loss of consciousness, making defibrillation the most appropriate and effective intervention to potentially save the patient's life.
Choice A (Administer procainamide) is not the most effective intervention as this patient is in a critical condition that requires immediate action, and procainamide infusion takes time to work.
Choice B (Administer adenosine) is typically used for supraventricular tachycardias and is not appropriate for wide complex tachycardias.
Choice D (Administer synchronized electrical cardioversion) is indicated for stable wide complex tachycardias
RN exams fundamentals practice questions, set 7 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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