NCLEX-PN clinical judgment practice questions, set 37
NCLEX-PN · clinical judgment
NCLEX-PN clinical judgment practice questionsset 37
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
Which of the following viruses is most likely to be acquired through casual contact with an infected individual?
A. influenza virus
B. herpes virus
C. cytomegalovirus (CMV)
D. human immunodeficiency virus (HIV)
Show answer and rationale
Correct answer: A — influenza virus
The correct answer is influenza virus. Influenza virus is most likely to be acquired through casual contact with an infected individual as it is transmitted through respiratory droplets. Herpes virus is primarily transmitted by direct contact, such as skin-to-skin contact, making it less likely to be acquired through casual contact. HIV is mainly transmitted through blood and body fluids like semen and vaginal fluids, not through casual contact. Cytomegalovirus (CMV) is an opportunistic infection commonly affecting immunocompromised individuals and is usually transmitted through close personal contact, not casual contact.
Question 2
A nurse calls a health care provider to question a prescription written for a higher-than-normal dosage of morphine sulfate. The health care provider changes the prescription to a dosage within the normal range, and the nurse documents the new telephone prescription in accordance with the agency's guidelines in the client's record. Which other statement does the nurse document in the nursing notes?
A. The health care provider made a mistake in the written prescription for morphine sulfate.
B. An inaccurate dosage of morphine sulfate was prescribed and the health care provider was informed.
C. The health care provider was contacted to correct a mistake in the dosage of morphine sulfate.
D. The health care provider was contacted to clarify the prescription for morphine sulfate
Show answer and rationale
Correct answer: D — The health care provider was contacted to clarify the prescription for morphine sulfate
The nurse needs to document a factual, descriptive, and objective statement that does not include words indicating that an individual made a mistake or performed an incorrect action or procedure. If a health care provider's prescription must be questioned, the nurse should record that clarification regarding the prescription was sought. Therefore, the correct statement to document is that the health care provider was contacted to clarify the prescription for morphine sulfate. Choices A, B, and C imply errors or mistakes on the part of the health care provider, which is not the focus of the documentation in this scenario.
Question 3
The client is going for surgery and mentions their religious objection to blood transfusions. Which of the following responses would be most appropriate?
A. "I can ask pastoral care to send someone to speak with you about this concern since it would not be safe to refuse a blood transfusion."?
B. "I understand, and you have the right to refuse blood transfusions."?
C. "While I understand, if there is excessive bleeding during surgery, we may need to transfuse blood to stabilize you."?
D. "I have received a blood transfusion before, and I do not think you understand the risks versus the benefits of refusing this."?
Show answer and rationale
Correct answer: B — "I understand, and you have the right to refuse blood transfusions."?
The most appropriate response is, '"I understand, and you have the right to refuse blood transfusions."? This answer shows respect for the client's autonomy and religious beliefs. It is crucial for healthcare providers to acknowledge and support a patient's decision-making regarding their care, even if it conflicts with medical advice. Option A is not ideal as it might seem dismissive of the client's beliefs. Option C introduces a potential negative outcome of refusing a blood transfusion, which could induce fear or coercion. Option D is inappropriate because it implies judgment and does not uphold the client's autonomy.
Question 4
Which of the following terms refers to soft tissue injury caused by blunt force?
A. contusion
B. strain
C. sprain
D. dislocation
Show answer and rationale
Correct answer: A — contusion
A contusion is a soft tissue injury caused by blunt force. It is an injury that does not break the skin, caused by a blow, and characterized by swelling, discoloration, and pain. The immediate application of cold might limit the development of a contusion. A strain is a muscle pull from overuse, overstretching, or excessive stress. A sprain is caused by a wrenching or twisting motion. A dislocation is a condition where the articular surfaces of the bones forming a joint are no longer in anatomical contact. Therefore, the correct answer is 'contusion' as it specifically relates to soft tissue injury caused by blunt force.
Question 5
What is the best position for a client immediately following a bilateral salpingooophorectomy?
A. Fowler's
B. Modified Sims
C. Side lying
D. Flat supine
Show answer and rationale
Correct answer: C — Side lying
The best position for a client immediately following a bilateral salpingooophorectomy is side lying. This position promotes comfort with the knees flexed and ensures proper airway management. Fowler's position (Choice A) would not be ideal as it involves sitting at a 90-degree angle, potentially causing discomfort after this procedure. Modified Sims position (Choice B) is typically used for rectal examinations, not for post-surgical management. Flat supine (Choice D) may not be the best choice immediately after surgery as it does not provide the same level of comfort and airway protection as side lying with knees flexed.
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Question 6
Which of the following roommates would be best for the client newly admitted with gastric resection?
A. A client with Crohn's disease
B. A client with pneumonia
C. A client with gastritis
D. A client with phlebitis
Correct answer:
The most suitable roommate for the client newly admitted with gastric resection is the client with phlebitis. Phlebitis is an inflammation of the blood vessel and is not infectious, making it a safer option for the surgical client. Crohn's disease clients (choice A) have frequent stools that might spread infections to the surgical client, posing a risk. A client with pneumonia (choice B) is coughing, which can disturb the gastric client's recovery. Additionally, a client with gastritis (choice C) who is vomiting and experiencing diarrhea would also not be an ideal roommate for a client recovering from gastric resection.
A high school nurse observes a 14-year-old female rubbing her scalp excessively in the gym. What is the most appropriate course of action for the nurse?
A. Request the female’s parents for a private evaluation of her scalp
B. Contact the female’s parents regarding the observations
C. Observe the hairline and scalp for possible signs of lice
D. Inform the student’s physician about the situation
Correct answer:
The most appropriate course of action for the nurse is to observe the hairline and scalp for possible signs of lice. The student's behavior of excessively rubbing her scalp raises concerns about a potential infestation, making it necessary to look for signs firsthand. Contacting the parents or the physician should be considered after observing for signs of lice to provide more information and take appropriate action. Requesting a private evaluation from the parents may not be required initially, as lice infestation is a common concern among children and observing for signs is the immediate step to address the situation.
A wrong committed by one person against another (or against the property of another) that might result in a civil trial is:
A. a tort
B. a crime
C. a misdemeanor
D. a felony
Correct answer:
A tort is a civil wrong committed by one person against another person (or against the property of another) that might result in civil trials. Unlike crimes, which are considered wrongs against the public, torts are personal wrongs. Misdemeanors are crimes punishable with fines or imprisonment for less than one year, whereas felonies are serious crimes punishable by imprisonment for more than one year in a State or Federal penitentiary. Therefore, the correct answer is a tort as it aligns with the definition of a civil wrong that leads to potential civil trials, distinguishing it from crimes, misdemeanors, and felonies.
A twenty-one-year-old man suffered a concussion, and the MD ordered an MRI. The patient asks, 'Will they allow me to sit up during the MRI?' The correct response by the nurse should be:
A. "I will have to talk to the doctor about letting you sit upright during the test."?
B. "You will be positioned in the reverse Trendelenburg position to maximize the view of the brain."?
C. "The radiologist will let you know."?
D. "You will have to lie down on your back during the test."?
Correct answer:
The correct answer is to inform the patient that they will have to lie down on their back during the MRI. This positioning is necessary for the scan to obtain accurate images of the brain. Choice A is incorrect because the decision on the positioning during the MRI is typically determined by the imaging protocol and not subject to negotiation during the test. Choice B is incorrect as the reverse Trendelenburg position is not commonly used during MRI scans. Choice C is incorrect because the radiologist does not usually make decisions on patient positioning during the MRI; it is predetermined by the imaging requirements.
Which hormone is responsible for amenorrhea in the pregnant woman?
A. Progesterone
B. Estrogen
C. Follicle-stimulating hormone (FSH)
D. Human chorionic gonadotropin (hCG)
Correct answer:
Correct! Progesterone is the hormone responsible for amenorrhea in pregnant women. Progesterone plays a crucial role in maintaining the uterine lining for implantation and supporting early pregnancy. High levels of progesterone during pregnancy suppress the normal menstrual cycle, leading to amenorrhea. Estrogen, FSH, and hCG do not directly cause amenorrhea in pregnant women. Estrogen is involved in the development of female secondary sexual characteristics, FSH is involved in the growth and maturation of ovarian follicles, and hCG is produced by the placenta to support the production of progesterone during pregnancy.
A test that can correctly identify those who do not have a given disease is:
A. specific.
B. sensitive.
C. negative culture.
D. marginal finding.
Correct answer:
The correct answer is 'specific.' A specific test correctly identifies individuals who do not have a particular disease. In this case, since the lab culture report is negative for the suspected infection, it means the test is good at ruling out the disease. 'Sensitive' (choice B) would be incorrect as sensitivity refers to a test's ability to correctly identify individuals who do have the disease. 'Negative culture' (choice C) is incorrect as it describes the result rather than the test's characteristic. 'Marginal finding' (choice D) is unrelated to the concept of correctly identifying individuals without the disease.
A mother brings her 13-month-old child with Down Syndrome to a pediatric clinic reporting muscle weakness and poor movement. The child's reflexes are noted to be diminished. Which action should the nurse take first?
A. Contact the physician immediately
B. Have the patient go for an X-ray for a c-spine work-up
C. Start an IV on the patient
D. Position the child's neck in a neutral position
Correct answer:
In a child with Down Syndrome presenting with muscle weakness and diminished reflexes, an atlanto-axial dislocation is a concern. The priority action is to position the child's neck in a neutral c-spine posture to prevent further injury. This should be done before any movement or manipulation. Contacting the physician should follow to ensure appropriate evaluation and management. Initiating an IV is not indicated unless specifically ordered for a medical reason. Ordering an X-ray for a c-spine work-up should not be the first action as it may involve movement that could exacerbate the condition if an injury is present.
Following the change of shift report, when can or should the nurse's plan be altered or modified during the shift?
A. halfway through the shift
B. at the end of the shift before the nurse reports off
C. when needs change
D. after the top-priority tasks have been completed
Correct answer:
The correct answer is 'when needs change.' It is crucial for the nurse to remain adaptable and adjust the plan promptly when the patient's needs or condition change. Choice A, 'halfway through the shift,' may not align with the timing of when needs actually change, making it less optimal for plan modifications. Choice B, 'at the end of the shift before the nurse reports off,' is too late to address evolving needs effectively. Choice D, 'after the top-priority tasks have been completed,' limits the nurse's ability to respond promptly to changing priorities, as needs may shift before all top-priority tasks are finished.
A client begins a regimen of chemotherapy. Her platelet count falls to 98,000. Which action is least likely to increase the risk of hemorrhage?
A. Test all excreta for occult blood.
B. Use a soft toothbrush or foam cleaner for oral hygiene.
C. Implement reverse isolation.
D. Avoid IM injections.
Correct answer:
The correct answer is to implement reverse isolation. Reverse isolation is a protective measure used to protect patients from infections, not to affect the risk of hemorrhage. Testing all excreta for occult blood (Choice A) is important to monitor for signs of internal bleeding. Using a soft toothbrush or foam cleaner for oral hygiene (Choice B) is recommended to prevent gum bleeding. Avoiding IM injections (Choice D) is crucial to reduce the risk of bleeding in a client with a low platelet count. Therefore, among the given options, implementing reverse isolation is the least likely to increase the risk of hemorrhage.
The mother of a newborn child is very upset. The child has a cleft lip and palate. The type of crisis this mother is experiencing is:
A. reactive.
B. maturational.
C. situational.
D. adventitious.
Correct answer:
The mother is experiencing a situational crisis as the unexpected birth of a child with a cleft lip and palate has placed her in a challenging situation she did not anticipate. This type of crisis is triggered by specific events and circumstances. Choice A, reactive, implies responding to a stressor after it has occurred, which is not the case here. Choice B, maturational, refers to stress related to developmental stages, not to external events like the child's condition. Choice D, adventitious, involves crises resulting from events outside one's control, such as natural disasters, which do not apply in this scenario.
NCLEX-PN clinical judgment practice questions, set 37 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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