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NCLEX-PN clinical judgment practice questions, set 28

NCLEX-PN · clinical judgment

NCLEX-PN clinical judgment practice questions set 28

You notice cues, form a hypothesis, act, and evaluate — the same loop Next Generation items reward. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the NCLEX-PN exam guide or more NCLEX-PN practice questions.

Five clinical judgment questions with answers

Cover the key. Write the first action. Then open the rationale and name why the other choices fail.

Question 1

Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except:

  1. A. tolerance.
  2. B. constipation.
  3. C. sedation.
  4. D. addiction.
Show answer and rationale

Correct answer: D — addiction.

The correct answer is 'addiction.' When caring for clients with cancer who are taking opioids, nurses need to assess for tolerance, constipation, and sedation as these are common side effects of opioid use. Addiction is not a primary concern when managing pain in terminally ill clients, as the goal is effective pain management rather than addiction prevention. Tolerance refers to the body's adaptation to the opioid over time, requiring higher doses for the same effect. Constipation and sedation are common side effects of opioids that nurses need to monitor and manage. Addiction is not a major concern in this population as the focus is on providing comfort and pain relief.

Question 2

Quality is defined as a combination of all of the following except:

  1. A. conforming to standards.
  2. B. performing at the minimally acceptable level.
  3. C. meeting or exceeding customer requirements.
  4. D. exceeding customer expectations.
Show answer and rationale

Correct answer: B — performing at the minimally acceptable level.

The correct answer is 'performing at the minimally acceptable level.' Quality is about meeting or exceeding customer requirements and expectations, as well as conforming to standards. The term 'performing at the minimally acceptable level' implies just meeting the minimum requirements, which falls short of the comprehensive definition of quality in terms of customer satisfaction and excellence. Therefore, this choice is the exception when defining quality. Choices A, C, and D align with the definition of quality as they all involve meeting or surpassing certain criteria for customer satisfaction and product excellence, which are essential components of quality management.

Question 3

The nurse is preparing to administer IV Vancomycin to a client. Which of the following nursing actions should be taken first?

  1. A. Performing a physical assessment prior to administration
  2. B. Obtaining the most recent lab values regarding renal function
  3. C. Reviewing peaks and troughs for the past few days
  4. D. Ensuring the client is not allergic to the medication
Show answer and rationale

Correct answer: D — Ensuring the client is not allergic to the medication

Before administering any medication, including IV Vancomycin, it is crucial to ensure that the client is not allergic to the medication. This is the most critical action to prevent any potential allergic reactions. While performing a physical assessment is important, it may not be as time-sensitive as checking for allergies. Obtaining lab values related to renal function is also significant with Vancomycin due to its potential nephrotoxicity, but ensuring the client's safety by checking for allergies takes precedence. Reviewing peaks and troughs is important for monitoring drug levels, but it is a secondary step compared to checking for allergies prior to administration.

Question 4

A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:

  1. A. naloxone (Narcan)
  2. B. labetalol (Normodyne)
  3. C. neostigmine (Prostigmin)
  4. D. thiothixene (Navane)
Show answer and rationale

Correct answer: A — naloxone (Narcan)

The correct answer is naloxone (Narcan). Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression and somnolence. In this scenario, the client's extreme somnolence and respiratory depression suggest an opioid overdose, making naloxone the appropriate choice to counteract these effects. Labetalol (Normodyne) is a nonselective beta-blocker used to treat hypertension, not opioid overdose. Neostigmine (Prostigmin) is a cholinesterase inhibitor used to reverse neuromuscular blockade, not opioid-induced respiratory depression. Thiothixene (Navane) is an antipsychotic medication used to treat schizophrenia and is not indicated for opioid overdose.

Question 5

A 14-year-old boy has been admitted to a mental health unit for observation and treatment. The boy becomes agitated and starts yelling at nursing staff members. What should the nurse's first response be?

  1. A. Create an atmosphere of seclusion for the boy according to procedures.
  2. B. Remove other patients from the area for added safety.
  3. C. Ask the patient, "What is making you mad?"?
  4. D. Ask the patient, "Why are you behaving this way? Have you thought about what may help you calm down?"?
Show answer and rationale

Correct answer: A — Create an atmosphere of seclusion for the boy according to procedures.

In a situation where a patient is agitated and yelling, the first response should be to create an atmosphere of seclusion for the safety of the patient and others. Seclusion is a standard procedure to help manage aggressive behaviors and prevent harm. Options B, C, and D are not appropriate in this scenario. Removing other patients may not address the immediate safety concern, asking the patient what is making them mad can escalate the situation, and questioning why the patient is behaving that way may not help in managing the current agitation. Therefore, seclusion is the recommended course of action in this scenario to ensure the safety and well-being of all involved.

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Question 6

The client asks the nurse not to tell anyone outside of the care team about his positive HIV diagnosis. What response is most appropriate?

  1. A. "I have to inform all clients on the unit of your diagnosis as it is transmissible."?
  2. B. "I will not communicate your diagnosis to anyone without your permission."?
  3. C. "Because this is a communicable disease, it may need to be reported to the CDC."?
  4. D. "You should not be concerned with who I share your diagnosis with."?
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Question 7

Which of the following factors can impact an individual's ability to give informed consent?

  1. A. IQ
  2. B. educational level
  3. C. pain medications
  4. D. financial status
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Question 8

A 45-year-old client with type I diabetes is in need of support services upon discharge from a skilled rehabilitation unit. Which of the following services is an example of a skilled support service?

  1. A. shopping for groceries
  2. B. house cleaning
  3. C. transportation to physician's visits
  4. D. medication instruction
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Question 9

A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?

  1. A. a radiologist
  2. B. a gynecologist
  3. C. a physiatrist
  4. D. an oncologist
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Question 10

A nurse is caring for a patient in the step-down unit. The patient has signs of increased intracranial pressure. Which of the following is not a sign of increased intracranial pressure?

  1. A. Bradycardia
  2. B. Increased pupil size bilaterally
  3. C. Change in LOC
  4. D. Vomiting
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Question 11

A client who has a known history of cardiac problems and is still smoking enters the clinic complaining of sudden onset of sharp, stabbing pain that intensifies with a deep breath. The pain is occurring on only one side and can be isolated upon general assessment. The nurse concludes that this description is most likely caused by:

  1. A. pleurisy.
  2. B. pleural effusion.
  3. C. atelectasis.
  4. D. tuberculosis.
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Question 12

A nurse observes a nursing assistant communicating with a hearing-impaired client in later adulthood. The nurse should intervene if the nursing assistant performs which action?

  1. A. Uses short sentences
  2. B. Speaks at a normal rate and volume
  3. C. Uses facial expressions or gestures
  4. D. Overarticulates words
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Question 13

The physician has ordered a culture for the client with suspected gonorrhea. The nurse should obtain which type of culture?

  1. A. Blood
  2. B. Nasopharyngeal secretions
  3. C. Stool
  4. D. Genital secretions
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Question 14

Which of the following ethnic groups is at highest risk in the United States for pesticide-related injuries?

  1. A. Native American
  2. B. Asian-Pacific
  3. C. Norwegian
  4. D. Hispanic
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Question 15

What ethical obligations do professional nurses have according to the ANA Code of Ethics for Nurses?

  1. A. patients.
  2. B. the nursing profession.
  3. C. provide high-quality care.
  4. D. all of the above
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About these NCLEX-PN clinical judgment questions

NCLEX-PN clinical judgment practice questions, set 28 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

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The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.

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