August RN Exit Study Guide

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Sample questions from August RN Exit Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.The RN receives reports on four clients. Which client should the RN assess first?

   • A.A client with chronic heart failure who gained 1 lb over three days and denies dyspnea
   • B.A client with a healing leg fracture requesting prescribed pain medication
   • C.A client two hours after thyroidectomy who has new inspiratory stridor
   • D.A client with stable diabetes who needs discharge instruction

   Rationale: B is correct because new stridor indicates potential upper airway obstruction after neck surgery. A requires follow-up but has no immediate respiratory compromise. C needs timely pain care but is lower priority than an airway threat. D is important planned teaching that can wait until the unstable client is addressed.

2. 2.Which task is most appropriate for the RN to delegate to trained assistive personnel?

   • A.Measure and record urine output for a stable client with an established plan
   • B.Evaluate whether a newly confused client is developing sepsis
   • C.Determine whether a postoperative client's pain treatment is effective
   • D.Teach a client how to use a new insulin pen

   Rationale: C is a predictable measurement task for a stable client, with instructions to report concerning findings. A requires assessment interpretation. B involves initial teaching. D requires nursing evaluation rather than simple collection of a pain rating. Scope and institutional policy still govern the delegation.

3. 3.Ten minutes after a packed red blood cell transfusion begins, a client reports chills and back pain and develops hypotension. What should the nurse do first?

   • A.Reduce the infusion rate by half
   • B.Stop the transfusion
   • C.Give an antipyretic and reassess in 30 minutes
   • D.Obtain a urine specimen before interrupting the infusion

   Rationale: A immediately limits exposure to a potentially harmful blood product. The nurse then supports the client, maintains access with new tubing and normal saline according to protocol, and notifies the appropriate team. B continues exposure. C delays the protective action. D does not address the possible life-threatening reaction.

4. 4.An adult with DKA has a potassium level of 3.1 mEq/L. An insulin infusion is prescribed. Which action is most appropriate?

   • A.Start insulin and restrict all potassium intake
   • B.Start insulin because serum potassium always rises during treatment
   • C.Administer intravenous potassium by push
   • D.Clarify the insulin timing and begin prescribed potassium replacement according to protocol

   Answer and rationale are in the full material.

5. 5.A client is awake, diaphoretic, and able to swallow. The capillary glucose is 54 mg/dL. Which action is best?

   • A.Administer the scheduled rapid-acting insulin
   • B.Offer a high-fat meal and recheck glucose in two hours
   • C.Withhold treatment until a laboratory glucose result is available
   • D.Provide approximately 15 g of rapid-acting carbohydrate and recheck glucose in 15 minutes

   Answer and rationale are in the full material.