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
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
Show answer and rationale
Correct answer: D — Edema, redness, tenderness, and loss of function
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
Question 2
A cross-table lateral x-ray of the cervical spine:
A. Must precede endotracheal intubation
B. Excludes serious cervical spine injury
C. Is unacceptable unless 7 cervical vertebrae and the C-7 to T-1 relationship are visualize
D. Is not necessary for unconscious patients with penetrating cervical injuries
Show answer and rationale
Correct answer: C — Is unacceptable unless 7 cervical vertebrae and the C-7 to T-1 relationship are visualize
Step-by-step rationale for why choice C is correct:
1. A cross-table lateral x-ray of the cervical spine is crucial for evaluating cervical spine injuries.
2. It allows visualization of all 7 cervical vertebrae and the C-7 to T-1 relationship.
3. This comprehensive view helps in identifying any fractures or dislocations accurately.
4. Missing any part of the cervical spine can lead to overlooking potential injuries.
5. Therefore, ensuring visualization of all 7 vertebrae and the C-7 to T-1 relationship is essential for an accurate assessment.
Summary of why other choices are incorrect:
- Choice A is incorrect because obtaining the x-ray does not necessarily have to precede endotracheal intubation.
- Choice B is incorrect because a cross-table lateral x-ray does not always exclude serious cervical spine injuries; it helps in identifying them.
- Choice D is incorrect because even unconscious patients with penetrating cervical injuries may require a cross-table lateral x-ray for accurate
Question 3
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
Show answer and rationale
Correct answer: C — the Safety Data Sheets/SDS (formerly referred to as Material Safety Data Sheets/MSDS) at her facility
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.
Question 4
What role does the nurse assume when given a position of authority within a formal organization?
A. Manager.
B. Advocate.
C. Leader.
D. Teacher.
Show answer and rationale
Correct answer: A — Manager.
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.
Question 5
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
Show answer and rationale
Correct answer: A — Parkinson's disease progression
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.
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Question 6
A 40-year-old woman presents with a complaint of frequent urination and increased thirst. She reports that these symptoms have been present for several weeks. She has a family history of diabetes mellitus. What is the most likely diagnosis?
A. Diabetes mellitus
B. Urinary tract infection
C. Hypercalcemia
D. Cystitis
Correct answer:
The most likely diagnosis for the 40-year-old woman presenting with frequent urination, increased thirst, and a family history of diabetes mellitus is diabetes mellitus (Choice A).
1. Symptoms of frequent urination and increased thirst are classic signs of diabetes mellitus.
2. Family history of diabetes increases the likelihood of developing the condition.
3. Other choices are less likely:
- Urinary tract infection (Choice B) typically presents with symptoms such as pain or burning sensation during urination, fever, and cloudy urine.
- Hypercalcemia (Choice C) is characterized by elevated levels of calcium in the blood and is not directly related to the symptoms described.
- Cystitis (Choice D) is inflammation of the bladder and usually presents with symptoms like pain or discomfort in the pelvic area, frequent urination, and urgency to urinate.
In summary, based on the patient's symptoms and family history, diabetes mellitus is the most likely diagnosis, while the other choices
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.
Correct answer:
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
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
Which of the following is an appropriate nursing intervention for a client wearing anti-embolic stockings?
A. Measure the legs before applying stockings to assure proper fit
B. Applying the stockings while the client is sitting in a chair
C. Massage the legs when removing the stockings
D. Leave the stockings in place for one week intervals
Correct answer:
Correct Answer: A - Measure the legs before applying stockings to assure proper fit.
Rationale: Proper fit is crucial for the effectiveness of anti-embolic stockings. Measuring the legs ensures a snug but not too tight fit, promoting circulation without causing discomfort or complications. This step helps prevent skin breakdown, nerve compression, and circulation issues.
Summary of Incorrect Choices:
B: Applying the stockings while the client is sitting in a chair - This is incorrect as stockings should be applied when the client is lying down with legs elevated to reduce swelling and make application easier.
C: Massage the legs when removing the stockings - Massaging the legs can dislodge blood clots, which is dangerous for clients wearing anti-embolic stockings.
D: Leave the stockings in place for one week intervals - Stockings should be regularly removed and washed to maintain hygiene and prevent skin irritation or infections. Leaving them on for a week can lead to complications.
A 40-year-old woman presents with a complaint of frequent urination and increased thirst. She reports that these symptoms have been present for several weeks. She has a family history of diabetes mellitus. What is the most likely diagnosis?
A. Diabetes mellitus
B. Urinary tract infection
C. Hypercalcemia
D. Cystitis
Correct answer:
The most likely diagnosis for the 40-year-old woman presenting with frequent urination, increased thirst, and a family history of diabetes mellitus is diabetes mellitus (Choice A).
1. Symptoms of frequent urination and increased thirst are classic signs of diabetes mellitus.
2. Family history of diabetes increases the likelihood of developing the condition.
3. Other choices are less likely:
- Urinary tract infection (Choice B) typically presents with symptoms such as pain or burning sensation during urination, fever, and cloudy urine.
- Hypercalcemia (Choice C) is characterized by elevated levels of calcium in the blood and is not directly related to the symptoms described.
- Cystitis (Choice D) is inflammation of the bladder and usually presents with symptoms like pain or discomfort in the pelvic area, frequent urination, and urgency to urinate.
In summary, based on the patient's symptoms and family history, diabetes mellitus is the most likely diagnosis, while the other choices
The nurse is assessing a patient's skin during an office visit. What part of the hand and technique should be used to best assess the patient's skin temperature?
A. Fingertips; they are more sensitive to small changes in temperature.
B. Dorsal surface of the hand; the skin is thinner on this surface than on the palms.
C. Ulnar portion of the hand; increased blood supply in this area enhances temperature sensitivity.
D. Palmar surface of the hand; this surface is the most sensitive to temperature variations because of its increased nerve supply in this area.
Correct answer:
The correct answer is B: Dorsal surface of the hand; the skin is thinner on this surface than on the palms.
Rationale:
1. The dorsal surface of the hand has thinner skin compared to the thicker skin on the palmar surface, making it more sensitive to temperature changes.
2. Thinner skin allows for better detection of subtle temperature variations, making it ideal for accurately assessing the patient's skin temperature.
3. The fingertips (choice A) may be more sensitive to touch, but for temperature assessment, the dorsal surface is more reliable due to its thinner skin.
4. The ulnar portion of the hand (choice C) having increased blood supply does not necessarily enhance temperature sensitivity; it is more related to vascular function.
5. The palmar surface (choice D) may have increased nerve supply, but its thickness can dampen the sensitivity to detect subtle temperature changes.
In summary, the correct choice (B) is supported by the anatomical characteristics of the dorsal hand
You are working at the desk in your hospital when another employee of the hospital asks for information about a patient who was admitted last night with a pulmonary embolus secondary to cancer. You know the details of the case. The person requesting the information states that he is a close friend and co-worker of your patient. He shows you proper identification proving he really is a co-worker of your patient who also works in the hospital. Which of the following is the most appropriate response to this request?
A. Give him the information on the patient.
B. Give him the information only if he is a relative of the patient.
C. Inform him that you are not at liberty to give details regarding the patient without the patient's permission.
D. Have him sign a release or consent form before revealing the information.
Correct answer:
Confidentiality is a fundamental right of all patients. As part of maintaining the patient's autonomy in revealing information only to those they wish to be informed of their condition you must refuse to release any specific information of the patient's medical history or current medical problems without direct permission from the patient. Respect this right even if the person asking is, indeed, a co-worker-or even their superior. You have no idea if medical information may be used to discriminate against the patient. Separate from this, third parties have no automatic right to a patient's medical information unless they are directly involved in the care of the patient. This would hold true even if the person seeking information is a health-care worker if they are not directly involved in the care of the patient. Have the patient- not the person requesting the information-sign the consent form for release of information confirming that they are giving you permission to release information.
A patient expresses fear of going home and being alone. Vital signs are stable and the incision is nearly completely healed. What can the nurse infer from the subjective data?
A. The patient can now perform the dressing changes without help.
B. The patient can begin retaking all of the previous medications.
C. The patient is apprehensive about discharge.
D. The patient’s surgery was not successful.
Correct answer:
The correct answer is C: The patient is apprehensive about discharge. This is the correct answer because the patient's fear of going home and being alone indicates apprehension about discharge, which is a common feeling among patients transitioning from the hospital to home care. This subjective data suggests that the patient may need additional support and education prior to discharge to address their fears and concerns.
A: The patient can now perform the dressing changes without help - This is incorrect because the patient's fear of going home and being alone does not necessarily indicate their ability to perform dressing changes independently.
B: The patient can begin retaking all of the previous medications - This is incorrect as the fear expressed by the patient is related to being alone at home, not to medication management.
D: The patient’s surgery was not successful - This is incorrect as there is no indication in the subjective data provided that the surgery was not successful.
You are on-scene with an adult patient who was found with an extremely altered level of consciousness, and a small amount of blood noted on his lips. There are no other obvious signs of trauma during the primary assessment other than a small tongue laceration. After ensuring an adequate airway, you discover the patient's small tongue laceration appears consistent with biting his tongue. He also has obviously swollen gums that do not appear to be caused by trauma. His vital signs are found to be within normal limits, and his pupils react to light, but his level of consciousness continues to be decreased to painful stimuli only. With the limited findings, which of the following conditions is most likely to cause the patient presentation?
A. A diabetic seizure most likely caused the patient's presentation
B. A metabolic coma is likely the cause of the patient's presentation
C. An epileptic seizure is likely responsible for causing the patient's condition
D. A cerebrovascular accident is likely the cause of the patient's condition
Correct answer:
The correct answer is C: An epileptic seizure is likely responsible for causing the patient's condition. The rationale for this is as follows:
1. Tongue biting is a common occurrence during seizures, which is consistent with the small tongue laceration observed in the patient.
2. Swollen gums that are not caused by trauma can be a sign of oral injury during a seizure due to forceful clenching of the jaw.
3. The patient's decreased level of consciousness to painful stimuli is typical after a seizure, known as the postictal state.
4. Normal vital signs and reactive pupils suggest no immediate life-threatening emergency like a diabetic seizure, metabolic coma, or cerebrovascular accident.
Summary:
A: A diabetic seizure is unlikely due to the absence of associated signs such as altered blood sugar levels or diabetic history.
B: A metabolic coma is unlikely as vital signs are normal, and the presentation is more indicative of a seizure.
D: A cerebrovascular accident is unlikely as
A cross-table lateral x-ray of the cervical spine:
A. Must precede endotracheal intubation
B. Excludes serious cervical spine injury
C. Is unacceptable unless 7 cervical vertebrae and the C-7 to T-1 relationship are visualize
D. Is not necessary for unconscious patients with penetrating cervical injuries
Correct answer:
Step-by-step rationale for why choice C is correct:
1. A cross-table lateral x-ray of the cervical spine is crucial for evaluating cervical spine injuries.
2. It allows visualization of all 7 cervical vertebrae and the C-7 to T-1 relationship.
3. This comprehensive view helps in identifying any fractures or dislocations accurately.
4. Missing any part of the cervical spine can lead to overlooking potential injuries.
5. Therefore, ensuring visualization of all 7 vertebrae and the C-7 to T-1 relationship is essential for an accurate assessment.
Summary of why other choices are incorrect:
- Choice A is incorrect because obtaining the x-ray does not necessarily have to precede endotracheal intubation.
- Choice B is incorrect because a cross-table lateral x-ray does not always exclude serious cervical spine injuries; it helps in identifying them.
- Choice D is incorrect because even unconscious patients with penetrating cervical injuries may require a cross-table lateral x-ray for accurate
RN exams fundamentals practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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