RN Registered Nurse 3 — Questions and Answers
Question 1: A nurse is reviewing a patient's ABG results: pH 7.28, PaCO2 52 mmHg, HCO3 24 mEq/L. How should the nurse interpret these findings?
- Metabolic acidosis
- Respiratory alkalosis
- Respiratory acidosis (Correct answer)
- Metabolic alkalosis
Correct answer: Respiratory acidosis
A low pH with elevated PaCO2 and normal HCO3 indicates respiratory acidosis, caused by CO2 retention from hypoventilation.
Question 2: Which action by a nursing student requires the RN to intervene immediately?
- Checking the patient's ID band before administering medication
- Wearing gloves when emptying a urinary catheter bag
- Recapping a used needle before disposal (Correct answer)
- Performing hand hygiene before entering the patient's room
Correct answer: Recapping a used needle before disposal
Recapping used needles is a major cause of needlestick injuries and violates standard safety precautions; needles must be discarded uncapped into sharps containers.
Question 3: A patient is admitted with suspected meningitis. Which action should the nurse prioritize before antibiotics are administered?
- Obtain blood cultures and CSF specimen as ordered (Correct answer)
- Administer acetaminophen for fever reduction
- Place the patient in a private room on droplet precautions
- Insert a urinary catheter to monitor output
Correct answer: Obtain blood cultures and CSF specimen as ordered
Culture specimens must be collected before antibiotic administration to identify the causative organism; antibiotics can render cultures falsely negative.
Question 4: A nurse is caring for a patient receiving a blood transfusion who develops chills, flank pain, and dark-colored urine 30 minutes into the infusion. What is the priority action?
- Slow the transfusion rate and notify the provider
- Stop the transfusion and infuse normal saline (Correct answer)
- Administer diphenhydramine IV as ordered
- Obtain a urine culture to rule out infection
Correct answer: Stop the transfusion and infuse normal saline
These symptoms indicate an acute hemolytic transfusion reaction; the transfusion must be stopped immediately and NS infused to maintain kidney perfusion.
Question 5: A patient's serum sodium level is 122 mEq/L. Which clinical finding does the nurse anticipate?
- Extreme thirst and dry mucous membranes
- Seizures and altered mental status (Correct answer)
- Hypertension and bradycardia
- Peaked T-waves on ECG
Correct answer: Seizures and altered mental status
Severe hyponatremia causes cerebral edema, manifesting as neurological symptoms including confusion, seizures, and decreased level of consciousness.
Question 6: A nurse is assessing a patient with a suspected pulmonary embolism. Which clinical finding is most consistent with this diagnosis?
- Gradual onset of productive cough with low-grade fever
- Sudden onset of pleuritic chest pain and dyspnea (Correct answer)
- Bilateral wheezing relieved by bronchodilators
- Central chest pressure radiating to the left arm
Correct answer: Sudden onset of pleuritic chest pain and dyspnea
Pulmonary embolism classically presents with sudden-onset pleuritic chest pain (worse with inspiration), dyspnea, and tachycardia.
Question 7: Which intervention is most effective in preventing catheter-associated urinary tract infections (CAUTI)?
- Irrigating the catheter with antibiotic solution daily
- Maintaining a closed urinary drainage system (Correct answer)
- Changing the catheter every 72 hours
- Administering prophylactic antibiotics while catheterized
Correct answer: Maintaining a closed urinary drainage system
Maintaining a sterile, closed drainage system is the single most effective intervention to prevent CAUTI by preventing bacterial entry.
RN Registered Nurse 3
A nurse is reviewing a patient's ABG results: pH 7.28, PaCO2 52 mmHg, HCO3 24 mEq/L.
How should the nurse interpret these findings?