RN exams medical-surgical practice questions, set 5
RN exams · medical-surgical
RN exams medical-surgical practice questionsset 5
You practice adult health stems across systems, then name the action that changes the outcome. 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 medical-surgical questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
The healthcare provider prescribes an indwelling urinary catheter for a client with urinary retention. Which intervention, along with strict aseptic technique, will decrease the risk of infection for this procedure?
A. Irrigating the catheter with sterile saline on a daily basis
B. Instructing the client to void around the catheter
C. Using an anesthetic lubricating gel during insertion
D. Inflating the balloon while the catheter is in the urethra
Show answer and rationale
Correct answer: C — Using an anesthetic lubricating gel during insertion
Correct Answer: C - Using an anesthetic lubricating gel during insertion
Rationale: Using an anesthetic lubricating gel during catheter insertion helps to reduce discomfort and trauma to the urethral mucosa, decreasing the risk of infection. This gel also helps to facilitate a smoother insertion process, reducing the chances of introducing pathogens into the urethra. Strict aseptic technique is important to prevent infection but using the lubricating gel specifically addresses the risk of trauma and discomfort during catheterization.
Incorrect Choices:
A: Irrigating the catheter with sterile saline on a daily basis - While irrigation with sterile saline is important for maintaining catheter patency, it does not directly decrease the risk of infection during catheter insertion.
B: Instructing the client to void around the catheter - This does not address the risk of infection during catheter insertion; it is important for proper catheter care post-insertion.
D: Inflating the balloon while the catheter is in
Question 2
The nurse writes the diagnosis"risk for injury related to impaired balance"Â for the client diagnosed with vertigo. Which nursing intervention should be included in the plan of care?
A. Provide information about vertigo and its treatment.
B. Assess for level and type of diversional activity.
C. Assess for visual acuity and proprioceptive deficits.
D. Refer the client to a support group and counseling.
Show answer and rationale
Correct answer: C — Assess for visual acuity and proprioceptive deficits.
The correct answer is C because assessing for visual acuity and proprioceptive deficits is essential in managing a client with vertigo to identify potential factors contributing to impaired balance. Visual acuity helps determine if vision issues are exacerbating vertigo symptoms, while proprioceptive deficits affect body awareness and balance. By assessing these factors, the nurse can tailor interventions to address specific needs, such as recommending corrective measures for vision problems or implementing balance exercises.
A: Providing information about vertigo is important but does not directly address the specific issue of assessing visual acuity and proprioceptive deficits.
B: Assessing for diversional activities is important for overall client well-being but does not directly address the balance issues related to vertigo.
D: Referring the client to a support group and counseling may be beneficial for emotional support but does not directly address the physical factors contributing to impaired balance.
Question 3
As charge nurse in a long-term-care (LTC) facility, you are developing a care plan for a client with a stage 3 pressure ulcer located over the sacrum. Which nursing intervention is most appropriate to delegate to an LPN who works as a team leader in the facility?
A. Choose the type of dressing to be used on the ulcer.
B. Use the Norton scale to assess for pressure ulcer risk factors.
C. Assist the client to change position at frequent intervals.
D. Inspect and document the appearance of the ulcer daily.
Show answer and rationale
Correct answer: D — Inspect and document the appearance of the ulcer daily.
The correct answer is D: Inspect and document the appearance of the ulcer daily. Delegating this task to an LPN is appropriate as it involves routine monitoring and documentation of the pressure ulcer, which is within the scope of practice for an LPN. By inspecting and documenting the ulcer daily, the LPN can track any changes in the ulcer's appearance, such as signs of infection or healing progress, and report this information to the charge nurse or healthcare provider. This helps in ensuring proper wound care and timely intervention.
Choice A (Choosing the type of dressing) involves making a clinical decision that requires a higher level of assessment and expertise, typically done by an RN or wound care specialist. Choice B (Using the Norton scale for assessment) involves a comprehensive assessment of risk factors, which is more suitable for an RN. Choice C (Assisting the client to change position) involves direct client care and should be done by a nursing assistant under the supervision of an RN or LPN.
Question 4
Following a severe traumatic brain injury, a patient is experiencing alterations in consciousness characterized by periods of wakefulness but with no meaningful interaction with the environment. Which term best describes this state?
A. Coma
B. Vegetative state
C. Minimally conscious state
D. Locked-in syndrome
Show answer and rationale
Correct answer: B — Vegetative state
A vegetative state, now more commonly referred to as unresponsive wakefulness syndrome, describes a condition where the patient is awake but with no awareness of themselves or their surroundings. This state usually follows a severe brain injury, such as traumatic brain injury. Patients in a vegetative state may have sleep-wake cycles, open their eyes, and even exhibit reflex movements, but they do not demonstrate any meaningful interaction with the environment. Differentiating between coma and vegetative state is important, as coma implies a complete lack of consciousness, while patients in a vegetative state have preserved wakefulness without awareness. Minimally conscious state (choice C) refers to a condition where there are some minimal signs of awareness or purposeful interaction, making it a different state than the one described in the scenario. Locked-in syndrome (choice D) is a condition where the patient is conscious and aware but unable to move or communicate due to paralysis, which is not consistent
Question 5
Fingerprint patterns are established prenatally during development of the:
A. stratum corneum
B. dermal papillary layer
C. stratum germinativum
D. dermal reticular layer
Show answer and rationale
Correct answer: B — dermal papillary layer
Fingerprints are unique patterns formed by ridges on the skin's surface, established during fetal development between the 10th and 16th weeks of gestation. These ridges arise from the dermal papillary layer, the superficial part of the dermis, which interfaces with the epidermis. The epidermis molds over these dermal papillae, creating the visible patterns. The stratum corneum, the outermost layer, is a dead, keratinized layer that does not determine ridge formation. The stratum germinativum, while critical for epidermal cell production, follows the dermal template rather than initiating it. The dermal reticular layer, deeper in the dermis, provides structural support but is not directly involved in fingerprint patterning. Genetic factors influence the ridge patterns, but their physical basis lies in the papillary layer's undulations. This prenatal process ensures fingerprints are permanent and unique, a feature exploited in identification sciences, making the dermal papillary layer the key developmental site.
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Question 6
What is the difference between a first-degree burn and a second-degree burn?
A. A first-degree burn affects only the epidermis, while a second-degree burn affects both the epidermis and the dermis.
B. A first-degree burn is characterized by redness and pain, while a second-degree burn is characterized by blisters and swelling.
C. A first-degree burn heals within a few days, while a second-degree burn may take several weeks to heal.
D. All of the above.
Correct answer:
The correct answer is D because it encompasses all the key differences between first-degree and second-degree burns.
A: A first-degree burn affects only the epidermis, while a second-degree burn affects both the epidermis and the dermis. This is correct as first-degree burns are superficial, affecting only the outer layer of the skin, while second-degree burns penetrate deeper into the dermis.
B: A first-degree burn is characterized by redness and pain, while a second-degree burn is characterized by blisters and swelling. This is accurate as first-degree burns typically result in redness and pain, whereas second-degree burns involve blister formation and swelling due to damage to deeper skin layers.
C: A first-degree burn heals within a few days, while a second-degree burn may take several weeks to heal. This is true as first-degree burns are minor and usually heal quickly, whereas second-degree burns require more time to heal due to the deeper tissue damage.
Therefore, by considering all the distinctions
Fingerprint patterns are established prenatally during development of the:
A. stratum corneum
B. dermal papillary layer
C. stratum germinativum
D. dermal reticular layer
Correct answer:
Fingerprints are unique patterns formed by ridges on the skin's surface, established during fetal development between the 10th and 16th weeks of gestation. These ridges arise from the dermal papillary layer, the superficial part of the dermis, which interfaces with the epidermis. The epidermis molds over these dermal papillae, creating the visible patterns. The stratum corneum, the outermost layer, is a dead, keratinized layer that does not determine ridge formation. The stratum germinativum, while critical for epidermal cell production, follows the dermal template rather than initiating it. The dermal reticular layer, deeper in the dermis, provides structural support but is not directly involved in fingerprint patterning. Genetic factors influence the ridge patterns, but their physical basis lies in the papillary layer's undulations. This prenatal process ensures fingerprints are permanent and unique, a feature exploited in identification sciences, making the dermal papillary layer the key developmental site.
Fingerprint patterns are established prenatally during development of the:
A. stratum corneum
B. dermal papillary layer
C. stratum germinativum
D. dermal reticular layer
Correct answer:
Fingerprints are unique patterns formed by ridges on the skin's surface, established during fetal development between the 10th and 16th weeks of gestation. These ridges arise from the dermal papillary layer, the superficial part of the dermis, which interfaces with the epidermis. The epidermis molds over these dermal papillae, creating the visible patterns. The stratum corneum, the outermost layer, is a dead, keratinized layer that does not determine ridge formation. The stratum germinativum, while critical for epidermal cell production, follows the dermal template rather than initiating it. The dermal reticular layer, deeper in the dermis, provides structural support but is not directly involved in fingerprint patterning. Genetic factors influence the ridge patterns, but their physical basis lies in the papillary layer's undulations. This prenatal process ensures fingerprints are permanent and unique, a feature exploited in identification sciences, making the dermal papillary layer the key developmental site.
As charge nurse in a long-term-care (LTC) facility, you are developing a care plan for a client with a stage 3 pressure ulcer located over the sacrum. Which nursing intervention is most appropriate to delegate to an LPN who works as a team leader in the facility?
A. Choose the type of dressing to be used on the ulcer.
B. Use the Norton scale to assess for pressure ulcer risk factors.
C. Assist the client to change position at frequent intervals.
D. Inspect and document the appearance of the ulcer daily.
Correct answer:
The correct answer is D: Inspect and document the appearance of the ulcer daily. Delegating this task to an LPN is appropriate as it involves routine monitoring and documentation of the pressure ulcer, which is within the scope of practice for an LPN. By inspecting and documenting the ulcer daily, the LPN can track any changes in the ulcer's appearance, such as signs of infection or healing progress, and report this information to the charge nurse or healthcare provider. This helps in ensuring proper wound care and timely intervention.
Choice A (Choosing the type of dressing) involves making a clinical decision that requires a higher level of assessment and expertise, typically done by an RN or wound care specialist. Choice B (Using the Norton scale for assessment) involves a comprehensive assessment of risk factors, which is more suitable for an RN. Choice C (Assisting the client to change position) involves direct client care and should be done by a nursing assistant under the supervision of an RN or LPN.
The healthcare provider prescribes an indwelling urinary catheter for a client with urinary retention. Which intervention, along with strict aseptic technique, will decrease the risk of infection for this procedure?
A. Irrigating the catheter with sterile saline on a daily basis
B. Instructing the client to void around the catheter
C. Using an anesthetic lubricating gel during insertion
D. Inflating the balloon while the catheter is in the urethra
Correct answer:
Correct Answer: C - Using an anesthetic lubricating gel during insertion
Rationale: Using an anesthetic lubricating gel during catheter insertion helps to reduce discomfort and trauma to the urethral mucosa, decreasing the risk of infection. This gel also helps to facilitate a smoother insertion process, reducing the chances of introducing pathogens into the urethra. Strict aseptic technique is important to prevent infection but using the lubricating gel specifically addresses the risk of trauma and discomfort during catheterization.
Incorrect Choices:
A: Irrigating the catheter with sterile saline on a daily basis - While irrigation with sterile saline is important for maintaining catheter patency, it does not directly decrease the risk of infection during catheter insertion.
B: Instructing the client to void around the catheter - This does not address the risk of infection during catheter insertion; it is important for proper catheter care post-insertion.
D: Inflating the balloon while the catheter is in
What is the benefit of inducing mild hypothermia to a post-arrest patient who has a return of spontaneous circulation?
A. Hypothermia reduces the body's need for stored energy (sugar) to maintain homeostasis
B. Hypothermia increases blood flow to the brain and heart while reducing blood flow to the peripheral tissues
C. It reduces intracranial pressure, the cerebral metabolic rate, and the brain's demand for oxygen
D. It reduces the amount of oxygen and blood circulation needed to supply the tissues of the periphery
Correct answer:
The correct answer is C because inducing mild hypothermia in a post-arrest patient with a return of spontaneous circulation helps reduce intracranial pressure, cerebral metabolic rate, and the brain's demand for oxygen. This is crucial in preventing secondary brain injury and improving neurological outcomes.
Explanation:
1. Reduced intracranial pressure: Hypothermia causes vasoconstriction, reducing cerebral blood flow and lowering intracranial pressure.
2. Decreased cerebral metabolic rate: Hypothermia slows down cellular metabolism, decreasing the brain's oxygen and energy requirements.
3. Lowered brain's demand for oxygen: With reduced metabolic rate and blood flow, the brain requires less oxygen.
Summary of other choices:
A: Hypothermia does not directly reduce the body's need for stored energy (sugar) but rather decreases metabolic rate.
B: Hypothermia may alter blood flow distribution but does not specifically increase blood flow to the brain and heart.
D: Hypothermia primarily affects the
The male client diagnosed with a stage 4 pressure ulcer on the coccyx area is being treated with an autolytic medication for debridement and an occlusive dressing. The wife asks about a foul odor. Which statement is the nurse's best response?
A. I will contact your husband's doctor when he makes rounds.'
B. The odor is secondary to an infection and he is taking antibiotics.'
C. The odor is an expected reaction to the pressure dressing.'
D. I am sorry the odor bothers you. We will bathe your husband.'
Correct answer:
The correct answer is C: 'The odor is an expected reaction to the pressure dressing.' The rationale is that in the scenario provided, the male client is being treated with an occlusive dressing for the pressure ulcer. Occlusive dressings can sometimes lead to a foul odor due to the accumulation of exudate and bacteria under the dressing, which is a normal part of the healing process. The nurse's response should reassure the wife that the odor is expected and not necessarily indicative of an infection.
Option A: 'I will contact your husband's doctor when he makes rounds.' This response does not address the wife's concern about the foul odor and delays providing necessary information.
Option B: 'The odor is secondary to an infection and he is taking antibiotics.' This response assumes an infection without proper assessment and may mislead the wife about the cause of the odor.
Option D: 'I am sorry the odor bothers you. We will bathe your husband.' This response does not address the underlying cause
A client with diabetes mellitus has a diabetic foot ulcer on the left heel. The nurse is preparing to apply a hydrocolloid dressing to the wound. What is an advantage of using this type of dressing?
A. It provides a moist environment for wound healing
B. It absorbs large amounts of exudate from the wound
C. It allows frequent inspection of the wound without removal
D. It stimulates autolytic debridement of necrotic tissue in the wound
Correct answer:
as hydrocolloid dressings stimulate autolytic debridement of necrotic tissue, a key advantage for a diabetic foot ulcer. These dressings are occlusive, forming a gel-like layer over the wound that traps moisture and enzymes, naturally breaking down dead tissue without mechanical intervention. This process is gentle, reducing trauma to surrounding healthy tissue, which is crucial for diabetic patients prone to slow healing. While providing a moist environment is true, it's not unique to hydrocolloids other dressings like hydrogels also do this making it less specific. Absorbing large amounts of exudate is incorrect, as hydrocolloids handle only minimal to moderate drainage, unlike alginates, and can leak if overwhelmed. Allowing frequent inspection is false; hydrocolloids are opaque and typically left in place for days, not designed for regular viewing. Autolytic debridement stands out as the distinct benefit, supporting healing in chronic wounds like diabetic ulcers by clearing necrotic debris efficiently.
The nurse is preparing a patient to receive immunosuppressant drugs on an outpatient basis. What is the priority for the nurse to arrange for this patient in the home environment?
A. A caregiver who is skilled in cardiopulmonary resuscitation (CPR)
B. A caregiver who will provide adequate nutrition
C. Supportive care and comfort measures
D. Arrange for a home care nurse to administer injections
Correct answer:
Rationale for correct answer (C): Providing supportive care and comfort measures is the priority for the nurse preparing a patient for immunosuppressant drugs at home. This is crucial to monitor the patient's well-being, manage side effects, and ensure the patient's comfort during treatment. Supportive care includes monitoring vital signs, managing symptoms, and addressing any concerns the patient may have, which are essential for the patient's safety and well-being.
Summary of incorrect choices:
A: A caregiver skilled in CPR is important but not the priority. CPR may be needed in emergencies, but ensuring ongoing supportive care and comfort measures take precedence.
B: Adequate nutrition is important for overall health but not the immediate priority when preparing a patient for immunosuppressant drugs.
D: Having a home care nurse administer injections may be helpful, but it is not the priority. Providing supportive care and comfort measures can be managed by the patient themselves or the caregiver.
When assessing a new patient at the outpatient clinic, the nurse notes dry, scaly skin; thin hair; and thick, brittle nails. What is the nurse’s most important action?
A. Instruct the patient about the importance of nutrition for skin health.
B. Make a referral to a podiatrist so that the nails can be safely trimmed.
C. Consult with the health care provider about the need for further diagnostic testing.
D. Teach the patient about using moisturizing creams and lotions to decrease dry skin.
Correct answer:
The correct answer is C: Consult with the health care provider about the need for further diagnostic testing. The nurse's most important action is to investigate the underlying cause of the patient's symptoms, as dry, scaly skin; thin hair; and thick, brittle nails can be indicative of various underlying health conditions such as thyroid disorders, nutritional deficiencies, or skin disorders. By consulting with the health care provider for further diagnostic testing, the nurse can determine the root cause of the symptoms and develop an appropriate treatment plan.
Choice A is incorrect because while nutrition is important for skin health, the patient's symptoms may be indicative of a more serious underlying health issue that needs to be addressed first. Choice B is incorrect as referring to a podiatrist for nail trimming does not address the underlying cause of the symptoms. Choice D is incorrect as using moisturizing creams may provide temporary relief but does not address the root cause of the issue.
RN exams medical-surgical 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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