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NCLEX-PN clinical judgment practice questions, set 54

NCLEX-PN · clinical judgment

NCLEX-PN clinical judgment practice questions set 54

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

When assessing the health-related physical fitness of a client as part of a health assessment, what aspect should be the focus?

  1. A. agility
  2. B. speed
  3. C. body composition
  4. D. risk factors
Show answer and rationale

Correct answer: D — risk factors

When assessing the health-related physical fitness of a client, the primary focus should be on identifying risk factors that could predispose the client to illness or injury. Risk factors are crucial in determining an individual's overall health status and potential health outcomes. While agility, speed, and body composition are important components of physical fitness assessments, they are not the primary focus when assessing health-related physical fitness from a holistic perspective. Therefore, the correct choice is 'risk factors.'

Question 2

The nurse is caring for a client complaining of intense headaches with increasing pain for the past one month. An MRI is ordered. In reviewing the client's information, which piece of information is of concern?

  1. A. Allergy to shellfish
  2. B. Has a cardiac pacemaker
  3. C. A diabetic
  4. D. No IV access
Show answer and rationale

Correct answer: B — Has a cardiac pacemaker

The correct answer is 'Has a cardiac pacemaker.' If a client with a cardiac pacemaker undergoes an MRI, the magnetic field can interfere with the pacemaker's function, leading to serious complications or even death. It is crucial to ensure that the pacemaker is compatible with MRI imaging or to consider alternative imaging modalities. The other choices, such as 'Allergy to shellfish,' 'A diabetic,' and 'No IV access,' are not direct contraindications for an MRI scan and do not pose the same level of risk as having a cardiac pacemaker.

Question 3

When a woman is receiving postpartum epidural morphine, the nurse should plan to observe for which of the following side effects to occur within the first 3 hours?

  1. A. nausea and vomiting
  2. B. itching
  3. C. urinary retention
  4. D. somnolence
Show answer and rationale

Correct answer: B — itching

A side effect of postpartum epidural morphine is the onset of itching within 3 hours of injection and lasting up to 10 hours. Nausea and vomiting might occur 4-7 hours after injection. While urinary retention is a side effect of postpartum epidural morphine, it is not typically assessed within the first 3 hours. Somnolence is a rare side effect and not commonly observed within the first 3 hours. Therefore, itching is the most likely side effect to be observed within the initial 3 hours after administering postpartum epidural morphine.

Question 4

High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by

  1. A. the kidneys' inability to excrete the drug metabolites.
  2. B. rapid cell catabolism.
  3. C. toxic effects of the prophylactic antibiotics given concurrently.
  4. D. the altered blood pH from the acidic nature of the drugs.
Show answer and rationale

Correct answer: B — rapid cell catabolism.

The correct answer is 'rapid cell catabolism.' Chemotherapy leads to the destruction of cells, resulting in increased uric acid levels due to cell breakdown. Choice A is incorrect because the issue is not with the kidneys' ability to excrete the drug metabolites but rather with the cell breakdown. Choice C is incorrect as the question focuses on chemotherapy and its effects, not prophylactic antibiotics. Choice D is incorrect as the question pertains to the development of high uric acid levels, not altered blood pH from acidic drugs.

Question 5

In which of the following conditions might increased cortisol levels be found?

  1. A. Cushing's syndrome
  2. B. Addison's disease
  3. C. Renal failure
  4. D. Congestive heart failure
Show answer and rationale

Correct answer: A — Cushing's syndrome

Cushing's syndrome is characterized by increased cortisol levels due to the overproduction of cortisol by the adrenal glands. This excess cortisol can lead to various symptoms and complications. Addison's disease is associated with decreased cortisol levels as it results from adrenal insufficiency, making it an incorrect choice in this context. Renal failure and congestive heart failure are not typically linked to abnormal cortisol levels, further indicating that they are not the conditions where increased cortisol levels are found.

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Question 6

A patient has experienced a severe third-degree burn to the trunk in the last 36 hours. Which phase of burn management is the patient in?

  1. A. Shock phase
  2. B. Emergent phase
  3. C. Healing phase
  4. D. Wound proliferation phase
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Question 7

The nursing assistant hitting the client in the long-term care facility can be charged with:

  1. A. Negligence
  2. B. Tort
  3. C. Assault
  4. D. Malpractice
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Question 8

Which of the following is not a function of parathyroid hormone?

  1. A. moving calcium from bones to the bloodstream
  2. B. inhibiting renal tubular reabsorption of phosphorus
  3. C. promoting renal tubular reabsorption of calcium
  4. D. enhancing renal production of vitamin D metabolites
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Question 9

Which factor in a client’s health history increases their risk for cancer?

  1. A. Family history and environment
  2. B. Alcohol and smoking
  3. C. Alcohol consumption and smoking
  4. D. Proximity to an electric plant and water source
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Question 10

A 10-year-old boy has been diagnosed with a congenital heart defect. Which of the following clinical signs does not indicate CHF?

  1. A. Increased body weight
  2. B. Elevated heart rate
  3. C. Lower extremity edema
  4. D. Compulsive behavior
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Question 11

For a client with suspected appendicitis, in which quadrant should the nurse expect to find abdominal tenderness?

  1. A. upper right
  2. B. upper left
  3. C. lower right
  4. D. lower left
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Question 12

One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base. The nurse should suspect:

  1. A. cor pulmonale.
  2. B. atelectasis.
  3. C. pulmonary embolism.
  4. D. cardiac tamponade.
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Question 13

The drug of choice to decrease uric acid levels is:

  1. A. prednisone (Colisone)
  2. B. allopurinol (Zyloprim)
  3. C. indomethacin (Indocin)
  4. D. hydrochlorothiazide (HydroDiuril)
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Question 14

The nurse manager of a quality improvement program asks a nurse in the neurological unit to conduct a retrospective audit. Which action should the auditing nurse plan to perform in this type of audit?

  1. A. Checking the crash cart to ensure that all needed supplies are readily available in case of an emergency
  2. B. Checking the documentation written by a new nursing graduate on her assigned clients at the end of the shift
  3. C. Reviewing neurological assessment checklists for all clients on the unit to ensure that these assessments are being conducted as prescribed
  4. D. Obtaining the assigned medical record from the hospital's medical record room to review documentation made during a client's hospital stay
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Question 15

Which of the following lab values is associated with a decreased risk of cardiovascular disease?

  1. A. high HDL cholesterol
  2. B. low HDL cholesterol
  3. C. low total cholesterol
  4. D. low triglycerides
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About these NCLEX-PN clinical judgment questions

NCLEX-PN clinical judgment practice questions, set 54 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.

No. Nursier is independent practice. Register through the official path named on the NCLEX-PN exam guide.

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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