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NCLEX-PN clinical judgment practice questions, set 42

NCLEX-PN · clinical judgment

NCLEX-PN clinical judgment practice questions set 42

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

In an obstetrical emergency, which of the following actions should the nurse perform first after the baby delivers?

  1. A. Place extra padding under the mother to absorb blood from the delivery.
  2. B. Cut the umbilical cord using sterile scissors.
  3. C. Suction the baby's mouth and nose.
  4. D. Wrap the baby in a clean blanket to preserve warmth.
Show answer and rationale

Correct answer: C — Suction the baby's mouth and nose.

In an obstetrical emergency, the immediate action the nurse should take after the baby delivers is to suction the baby's mouth and nose to ensure the infant can breathe properly. This helps clear any potential obstructions and establish a clear airway. Cutting the umbilical cord (Choice B) and wrapping the baby in a clean blanket (Choice D) are important steps but should come after ensuring the baby's airway is clear. Placing extra padding under the mother (Choice A) is not a priority in this emergency situation as the focus should be on the baby's immediate needs for breathing and airway clearance.

Question 2

Which of the following tasks are appropriate for an LPN to perform?

  1. A. Adjusting the cervical traction device of a 68-year-old client as instructed by the charge nurse.
  2. B. performing operation on a woman in labour
  3. C. Assessing a 36-year-old man newly admitted for chest pain.
  4. D. Obtaining an occult blood sample from a 16-year-old client with ulcerative colitis.
Show answer and rationale

Correct answer: D — Obtaining an occult blood sample from a 16-year-old client with ulcerative colitis.

Tasks appropriate for an LPN to perform include teaching, obtaining samples, and documenting. LPNs can educate clients on care practices, such as teaching a new mother how to care for her baby. Obtaining samples, like an occult blood sample, falls within the scope of an LPN's responsibilities. Assessments, especially initial assessments, should be conducted by a registered nurse or physician, making option C incorrect. Adjusting devices like a cervical traction device should be done based on direct orders from prescribing providers, not charge nurses, making option A inappropriate for an LPN's role.

Question 3

A nurse is taking the health history of an 85-year-old client. Which of the following physical findings is consistent with normal aging?

  1. A. Increase in subcutaneous fat.
  2. B. Diminished cough reflex.
  3. C. Long-term memory loss.
  4. D. Myopia.
Show answer and rationale

Correct answer: B — Diminished cough reflex.

The correct answer is 'Diminished cough reflex.' Diminished cough reflex is a physical finding consistent with normal aging in older adults, which can increase the risk of aspiration and atelectasis. An increase in subcutaneous fat actually raises the risk of pressure ulcers. While long-term memory is typically preserved in aging unless affected by dementia, short-term memory often declines. Myopia (near-sightedness) is common in younger individuals, but presbyopia (far-sightedness) is more common with aging. Additionally, individuals with myopia may experience an improvement in vision as they age.

Question 4

Why is it often necessary to draw a complete blood count and differential (CBC/differential) when a client is being treated with an antiepileptic drug (AED)?

  1. A. The hematocrit is adversely affected due to increased vascular volume.
  2. B. AEDs can lead to blood dyscrasia as a side effect.
  3. C. AEDs may cause aplastic anemia and megaloblastic anemia.
  4. D. Some AEDs induce white blood cell reduction.
Show answer and rationale

Correct answer: B — AEDs can lead to blood dyscrasia as a side effect.

When a client is being treated with antiepileptic drugs (AEDs), it is essential to monitor for potential side effects on blood parameters. Some AEDs can lead to blood dyscrasia, which includes conditions like aplastic anemia and megaloblastic anemia. Therefore, drawing a complete blood count and differential helps in identifying these adverse effects early. Choices A, C, and D are incorrect because the primary concern when monitoring blood parameters in clients on AEDs is the risk of blood dyscrasia, not changes in hematocrit due to vascular volume, white blood cell reduction, or immune modulation.

Question 5

When evaluating the lab work of a client in hepatic coma, which of the following lab tests is most important?

  1. A. blood urea nitrogen
  2. B. serum calcium
  3. C. serum ammonia
  4. D. serum creatinine
Show answer and rationale

Correct answer: C — serum ammonia

When a client is in hepatic coma due to liver failure, the liver cannot metabolize amino acids completely, leading to elevated ammonia levels. Increased ammonia can cause brain-tissue irritation, worsening the coma. Therefore, monitoring serum ammonia levels is crucial in assessing the severity of hepatic coma. Choices A, B, and D are less relevant in the context of hepatic coma. Blood urea nitrogen primarily assesses kidney function, serum calcium levels are not directly related to hepatic coma, and serum creatinine is more indicative of kidney function rather than liver function in this scenario.

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Question 6

Priorities designated as intermediate by the nurse are:

  1. A. the nonemergency, non-life-threatening needs of the client.
  2. B. those tasks that can be delegated to assistive personnel.
  3. C. those tasks that can be performed at the end of the shift.
  4. D. those tasks that can be performed at any time
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Question 7

When teaching a patient with COPD pulmonary exercises, what should be done?

  1. A. Teach pursed-lip breathing techniques.
  2. B. Encourage repetitive heavy lifting exercises to increase strength.
  3. C. Limit exercises due to respiratory acidosis.
  4. D. Take breaks every 10-20 minutes during exercises.
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Question 8

Which of the following is an indication for electroencephalography?

  1. A. paralysis
  2. B. neuropathy
  3. C. seizure disorder
  4. D. myocardial infarction
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Question 9

Nonpharmacological pain management involves all of the following except:

  1. A. hypnosis alone.
  2. B. psychological care, including support groups.
  3. C. physical and psychological modalities.
  4. D. pain-reducing drugs only.
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Question 10

Which of the following is not considered one of the five rights of medication administration?

  1. A. client
  2. B. drug
  3. C. dose
  4. D. routine
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Question 11

Paula is a 32-year-old woman seeking evaluation and treatment for major depressive symptoms. A major nursing priority during the assessment process includes which of the following?

  1. A. meaning of current stressors
  2. B. possibility of self-harm
  3. C. motivation to participate in treatment
  4. D. presence of alcohol or other drug use
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Question 12

During a well-baby check of a 6-month-old infant, the nurse notes abrasions and petechiae of the palate. The nurse should:

  1. A. inquire about the possibility of sexual abuse.
  2. B. ask about the types of foods the child is eating.
  3. C. request to see the type of bottle used for feedings.
  4. D. question the parent about objects the child plays with.
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Question 13

A healthcare provider is preparing to assess the acoustic nerve during a neurological examination. To assess this nerve, the provider uses which technique?

  1. A. Uses a tuning fork
  2. B. Asks the client to puff out the cheeks
  3. C. Tests taste perception on the client's tongue
  4. D. Checks the client's ability to clench the teeth
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Question 14

An infection in a central venous access device is not eliminated by giving antibiotics through the catheter. How might bacterial glycocalyx contribute to this?

  1. A. It protects the bacteria from antibiotic and immunologic destruction.
  2. B. Glycocalyx neutralizes the antibiotic, rendering it ineffective.
  3. C. It competes with the antibiotic for binding sites on the microbe.
  4. D. Glycocalyx provides nutrients for microbial growth.
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Question 15

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.
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About these NCLEX-PN clinical judgment questions

NCLEX-PN clinical judgment practice questions, set 42 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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