RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
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RN Comprehensive Predictor Exam Study Notes
Question 177 of 180: Client in Active Labor with Ruptured Membranes
● Scenario: A nurse is caring for a client at 38 weeks of gestation, in active
labor, with ruptured membranes.
● Action to Take: The priority action for the nurse is to apply a fetal heart rate
monitor.
○ Rationale: After rupture of membranes, there is an increased risk of
umbilical cord prolapse or compression, which can lead to fetal distress.
Continuous fetal heart rate monitoring is crucial to assess fetal well-
being and identify any potential complications immediately.
○ Other considerations: While other interventions might be relevant later
(e.g., initiating oxytocin infusion, inserting an indwelling urinary
catheter, or initiating fundal massage post-delivery), immediate fetal
heart rate monitoring is the most critical action after membrane
rupture to ensure fetal safety.
Question 1 of 180 (Cystic Fibrosis Medications - Select All That Apply)
● Scenario: A school-age child with cystic fibrosis (diagnosed with failure to
thrive and pulmonary disease) presents with wheezing, rhonchi, paroxysmal
cough, dyspnea, and reports large, frothy, foul-smelling stools. The child also
has deficient levels of vitamins A, D, E, and K. The nurse is reviewing the
child's medical record and needs to identify which medications the provider is
expected to prescribe.
● Expected Medications for Cystic Fibrosis Management:
○ Pancreatic Enzymes: Essential to aid in the digestion and absorption of
fats, proteins, and carbohydrates due to pancreatic insufficiency,
which is common in cystic fibrosis and causes the foul-smelling,
frothy stools.
○ Vitamins (Fat-Soluble: A, D, E, K): Due to malabsorption caused by
pancreatic insufficiency, clients with cystic fibrosis often have
deficiencies in fat-soluble vitamins, requiring supplementation.
○ Albuterol: A bronchodilator used to manage respiratory symptoms like
wheezing and dyspnea by opening the airways.
○ Dornase Alfa: A mucolytic agent that helps thin respiratory secretions,
making them easier to clear, which is crucial for managing the thick
mucus associated with cystic fibrosis pulmonary disease.
○ Pirate: (Note: The provided text has a typo, this likely refers to a
medication that starts with "Pi" and is used in CF treatment, e.g.,
inhaled antibiotics like tobramycin which might be prescribed to
manage recurrent pulmonary infections, but "Pirate" itself is not a
medication).
○ Mesamenopilen: (Note: This appears to be a transcription error from
the source image. It's unclear what medication this refers to).
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
, RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
Question 106 of 180: Minimizing Pesticide Exposure for Farmworkers
● Scenario: A nurse is teaching farmworkers about minimizing pesticide
exposure.
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
, RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
● Key Information for Teaching:
○ Change clothes after working in the field: This is crucial to prevent
continued skin exposure to pesticide residues.
○ Do NOT apply petroleum jelly to nostrils: Petroleum jelly can trap
pesticides and should not be used.
○ Do NOT wipe fruits/vegetables with a dry cloth: This does not
adequately remove pesticides; thorough washing with water is
necessary.
○ Do NOT take a hot shower immediately after work: A hot shower can
increase skin absorption of pesticides. A cool or lukewarm shower is
preferable, or a thorough wash with soap and water after removing
contaminated clothing.
Question 3 of 180: 3-Year-Old with Respiratory Symptoms
● Scenario: A 3-year-old child presents to the emergency department with a
low-grade fever, coughing, and restlessness. Assessment findings include
agitation, hoarse cry, audible inspiratory stridor, and a barking, non-
productive cough. The nurse needs to determine if these findings are
consistent with acute laryngotracheobronchitis (Croup) or pneumonia.
● Assessment Findings Analysis:
○ Hoarse cry, inspiratory stridor, barking cough: These are hallmark signs of
acute laryngotracheobronchitis (Croup), an inflammation of the larynx,
trachea, and bronchi, typically caused by a viral infection.
○ Agitation, restlessness, low-grade fever, non-productive cough:
These symptoms can be present in both Croup and pneumonia.
○ Pneumonia vs. Croup: Pneumonia typically presents with findings such as
crackles, rhonchi, high fever, and a productive cough, which are not
explicitly stated as primary findings for this child.
● Conclusion: The findings strongly indicate acute laryngotracheobronchitis
(Croup).
Question 12 of 180: Client in Emergency Department with Respiratory Distress
● Scenario: A client in the emergency department reports shortness of breath,
difficulty sleeping, fatigue, nausea, intermittent chest tightness, productive
cough, irregular breathing, crackles, and wheezing. The client has a 35-year
history of smoking one pack of cigarettes per day but no clubbing of fingers,
and appears anxious. They have received albuterol and oxygen, and were
instructed on pursed-lip breathing.
● Interventions to Include in Plan of Care (Select All That Apply - based on markings):
○ Administer albuterol and oxygen: Already administered and should be
continued as prescribed to manage respiratory symptoms.
○ Instruct on pursed-lip breathing: This technique helps clients with
obstructive airway diseases to prolong exhalation, prevent airway
collapse, and improve gas exchange.
○ Monitor SpO2: Crucial for assessing the client's oxygenation status,
especially with reported respiratory distress.
○ Assess respiratory rate and effort: Important to monitor the
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
, RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
effectiveness of interventions and detect worsening respiratory
status.
○ Auscultate lung sounds frequently: To assess for changes in crackles,
wheezing, and overall air movement, indicating improvement or
deterioration.
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
Questions & Answers Latest Update.
.
RN Comprehensive Predictor Exam Study Notes
Question 177 of 180: Client in Active Labor with Ruptured Membranes
● Scenario: A nurse is caring for a client at 38 weeks of gestation, in active
labor, with ruptured membranes.
● Action to Take: The priority action for the nurse is to apply a fetal heart rate
monitor.
○ Rationale: After rupture of membranes, there is an increased risk of
umbilical cord prolapse or compression, which can lead to fetal distress.
Continuous fetal heart rate monitoring is crucial to assess fetal well-
being and identify any potential complications immediately.
○ Other considerations: While other interventions might be relevant later
(e.g., initiating oxytocin infusion, inserting an indwelling urinary
catheter, or initiating fundal massage post-delivery), immediate fetal
heart rate monitoring is the most critical action after membrane
rupture to ensure fetal safety.
Question 1 of 180 (Cystic Fibrosis Medications - Select All That Apply)
● Scenario: A school-age child with cystic fibrosis (diagnosed with failure to
thrive and pulmonary disease) presents with wheezing, rhonchi, paroxysmal
cough, dyspnea, and reports large, frothy, foul-smelling stools. The child also
has deficient levels of vitamins A, D, E, and K. The nurse is reviewing the
child's medical record and needs to identify which medications the provider is
expected to prescribe.
● Expected Medications for Cystic Fibrosis Management:
○ Pancreatic Enzymes: Essential to aid in the digestion and absorption of
fats, proteins, and carbohydrates due to pancreatic insufficiency,
which is common in cystic fibrosis and causes the foul-smelling,
frothy stools.
○ Vitamins (Fat-Soluble: A, D, E, K): Due to malabsorption caused by
pancreatic insufficiency, clients with cystic fibrosis often have
deficiencies in fat-soluble vitamins, requiring supplementation.
○ Albuterol: A bronchodilator used to manage respiratory symptoms like
wheezing and dyspnea by opening the airways.
○ Dornase Alfa: A mucolytic agent that helps thin respiratory secretions,
making them easier to clear, which is crucial for managing the thick
mucus associated with cystic fibrosis pulmonary disease.
○ Pirate: (Note: The provided text has a typo, this likely refers to a
medication that starts with "Pi" and is used in CF treatment, e.g.,
inhaled antibiotics like tobramycin which might be prescribed to
manage recurrent pulmonary infections, but "Pirate" itself is not a
medication).
○ Mesamenopilen: (Note: This appears to be a transcription error from
the source image. It's unclear what medication this refers to).
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
, RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
Question 106 of 180: Minimizing Pesticide Exposure for Farmworkers
● Scenario: A nurse is teaching farmworkers about minimizing pesticide
exposure.
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
, RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
● Key Information for Teaching:
○ Change clothes after working in the field: This is crucial to prevent
continued skin exposure to pesticide residues.
○ Do NOT apply petroleum jelly to nostrils: Petroleum jelly can trap
pesticides and should not be used.
○ Do NOT wipe fruits/vegetables with a dry cloth: This does not
adequately remove pesticides; thorough washing with water is
necessary.
○ Do NOT take a hot shower immediately after work: A hot shower can
increase skin absorption of pesticides. A cool or lukewarm shower is
preferable, or a thorough wash with soap and water after removing
contaminated clothing.
Question 3 of 180: 3-Year-Old with Respiratory Symptoms
● Scenario: A 3-year-old child presents to the emergency department with a
low-grade fever, coughing, and restlessness. Assessment findings include
agitation, hoarse cry, audible inspiratory stridor, and a barking, non-
productive cough. The nurse needs to determine if these findings are
consistent with acute laryngotracheobronchitis (Croup) or pneumonia.
● Assessment Findings Analysis:
○ Hoarse cry, inspiratory stridor, barking cough: These are hallmark signs of
acute laryngotracheobronchitis (Croup), an inflammation of the larynx,
trachea, and bronchi, typically caused by a viral infection.
○ Agitation, restlessness, low-grade fever, non-productive cough:
These symptoms can be present in both Croup and pneumonia.
○ Pneumonia vs. Croup: Pneumonia typically presents with findings such as
crackles, rhonchi, high fever, and a productive cough, which are not
explicitly stated as primary findings for this child.
● Conclusion: The findings strongly indicate acute laryngotracheobronchitis
(Croup).
Question 12 of 180: Client in Emergency Department with Respiratory Distress
● Scenario: A client in the emergency department reports shortness of breath,
difficulty sleeping, fatigue, nausea, intermittent chest tightness, productive
cough, irregular breathing, crackles, and wheezing. The client has a 35-year
history of smoking one pack of cigarettes per day but no clubbing of fingers,
and appears anxious. They have received albuterol and oxygen, and were
instructed on pursed-lip breathing.
● Interventions to Include in Plan of Care (Select All That Apply - based on markings):
○ Administer albuterol and oxygen: Already administered and should be
continued as prescribed to manage respiratory symptoms.
○ Instruct on pursed-lip breathing: This technique helps clients with
obstructive airway diseases to prolong exhalation, prevent airway
collapse, and improve gas exchange.
○ Monitor SpO2: Crucial for assessing the client's oxygenation status,
especially with reported respiratory distress.
○ Assess respiratory rate and effort: Important to monitor the
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
, RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios
Questions & Answers Latest Update.
effectiveness of interventions and detect worsening respiratory
status.
○ Auscultate lung sounds frequently: To assess for changes in crackles,
wheezing, and overall air movement, indicating improvement or
deterioration.
RN Comprehensive Predictor Exam Study Notes: Key Nursing Scenarios Questions &
Answers Latest Update.
