Proctored Assessment: Critical Thinking Assessment: Entrance

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Sample questions from Proctored Assessment: Critical Thinking Assessment: Entrance

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical unit, a nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client 1 day after surgery who reports incisional pain of 7 out of 10
   • B.A client with pneumonia who has a temperature of 38.1 C
   • C.A client with heart failure who has new confusion and an SpO2 of 86% on room air
   • D.A client with diabetes whose premeal glucose is 248 mg/dL

   Rationale: New confusion with hypoxemia may indicate inadequate oxygenation and requires immediate assessment and intervention. Pain, elevated glucose, and fever need care, but none takes priority over a possible airway or breathing problem. Use the ABC framework when prioritizing acute findings.

2. 2.In a rehabilitation unit, an RN is planning assignments for a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which task is appropriate to delegate to the UAP?

   • A.Assess a new admission's swallowing ability
   • B.Teach a client how to use a walker after hip surgery
   • C.Evaluate whether a prescribed analgesic relieved pain
   • D.Obtain routine vital signs for a stable client

   Rationale: Obtaining routine vital signs for a stable client is a predictable task that can be delegated to UAP. Teaching, assessment, and evaluation require nursing judgment and remain the RN's responsibility. The RN must communicate parameters for reporting abnormal findings.

3. 3.In the emergency department, a 3-year-old with vomiting and diarrhea is lethargic, has dry mucous membranes, and has capillary refill of 4 seconds. Refer to the client's chart. Which actions should the nurse take? Select all that apply.

   • A.Reassess perfusion and mental status frequently
   • B.Establish IV access and anticipate isotonic fluid resuscitation as prescribed
   • C.Offer a large volume of plain water to drink immediately
   • D.Obtain a current weight and monitor intake and output
   • E.Delay escalation until the child has produced urine

   Rationale: Delayed capillary refill, lethargy, and dry mucosa indicate significant dehydration; isotonic IV fluid may be prescribed, and frequent reassessment is essential. A weight and intake/output measurements help evaluate fluid status. A large oral volume may not be tolerated in a lethargic child, and waiting for urine delays treatment of poor perfusion.

4. 4.A charge nurse on a surgical unit is making assignments. Which client is most appropriate for an LPN to care for?

   • A.A stable client requiring a scheduled oral antibiotic and routine wound dressing change
   • B.A client with a new tracheostomy who needs initial teaching
   • C.A client newly admitted with chest pain awaiting diagnostic results
   • D.A client with a sudden change in level of consciousness

   Answer and rationale are in the full material.

5. 5.A provider prescribes a medication dose that is three times the dose listed in the client's medication history. The client is stable and due for the medication now. What should the nurse do first?

   • A.Ask the client whether the larger dose is familiar
   • B.Hold the dose and clarify the prescription with the provider
   • C.Administer the prescribed dose because it is a current order
   • D.Request that another nurse administer the dose

   Answer and rationale are in the full material.