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NCLEX-PN clinical judgment practice questions, set 58

NCLEX-PN · clinical judgment

NCLEX-PN clinical judgment practice questions set 58

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

A client with glomerulonephritis is placed on a low-sodium diet. Which of the following snacks is suitable for the client with sodium restriction?

  1. A. Peanut butter cookies
  2. B. Grilled cheese sandwich
  3. C. Cottage cheese and fruit
  4. D. Fresh peach
Show answer and rationale

Correct answer: D — Fresh peach

The correct answer is a fresh peach. It is the most suitable snack for a client with sodium restriction as it is naturally low in sodium. Peanut butter cookies (choice A), grilled cheese sandwich (choice B), and cottage cheese and fruit (choice C) contain higher amounts of sodium, making them unsuitable choices for someone on a low-sodium diet. Fresh fruits like peaches are excellent options for individuals on a low-sodium diet as they are not only low in sodium but also provide essential nutrients and hydration.

Question 2

The nurse receives an assignment of three clients. Which of the following should the nurse consider as the highest priority when determining which client to assess first?

  1. A. the client who most recently rang their call bell
  2. B. the client who has been waiting the longest for their call bell to be answered
  3. C. the client who is in the most pain
  4. D. the client who may have a risk for an airway obstruction
Show answer and rationale

Correct answer: D — the client who may have a risk for an airway obstruction

The nurse should prioritize assessing a client with a potential airway obstruction first based on the ABCs (airway, breathing, circulation) principle. Maintaining a clear airway is crucial for oxygenation and ventilation, making it the highest priority. Choices A and B focus on call bells and waiting times, which are important but not life-threatening in comparison to airway concerns. While pain management is essential, it takes precedence after addressing immediate life-threatening issues like airway compromise.

Question 3

When encountering the significant other of a patient with end-stage AIDS crying during her smoke break, what is the most appropriate action for the nurse to take?

  1. A. Allow her to grieve by herself.
  2. B. Tell her to go ahead and cry, after all, your husband’s pretty bad off.
  3. C. Tell her you realize how upset she is, but you don’t want to talk about it now.
  4. D. Approach her, offering tissues, and encourage her to verbalize her feelings
Show answer and rationale

Correct answer: D — Approach her, offering tissues, and encourage her to verbalize her feelings

Approaching the significant other, offering tissues, and encouraging her to verbalize her feelings is the most appropriate action for the nurse to take. Being left alone during the grief process isolates individuals, and they need an outlet for their feelings. By showing empathy and providing support, the nurse can help the significant other cope with her emotions. Choices A, B, and C are inappropriate because they do not offer support or encourage the expression of feelings, which are crucial in such situations.

Question 4

The nurse is preparing for a dressing change on a full thickness burn to the flank area. The orders include irrigating the wound with each dressing change. To irrigate the wound, what will the nurse use?

  1. A. Sterile saline
  2. B. Distilled water
  3. C. Betadine scrub
  4. D. Tap water
Show answer and rationale

Correct answer: A — Sterile saline

When irrigating a wound, especially in the case of a full-thickness burn, it is crucial to use a solution that is gentle and non-irritating to the tissues. Sterile saline is the preferred choice for wound irrigation as it is isotonic and does not cause additional damage to the already compromised tissue. Distilled water lacks the electrolytes present in saline, Betadine scrub is not used for irrigation due to its potential to be cytotoxic, and tap water may introduce contaminants and microorganisms to the wound.

Question 5

The physician has ordered sodium warfarin (Coumadin) for the client with thrombophlebitis. The order should be entered to administer the medication at:

  1. A. 900
  2. B. 1200
  3. C. 1700
  4. D. 2100
Show answer and rationale

Correct answer: C — 1700

Sodium warfarin is typically administered in the late afternoon, around 1700 hours. This timing allows for accurate bleeding times to be drawn in the morning. Administering it at 0900 (choice A) would not align with this schedule and may affect the monitoring of bleeding times. Choice B (1200) is midday, which is not the recommended time for sodium warfarin administration. Choice D (2100) is in the evening, which is also not ideal. Therefore, the correct time for administering sodium warfarin is 1700 (choice C).

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Question 6

There are many types of torts that can be committed against clients. They include all of the following except:

  1. A. assault.
  2. B. battery.
  3. C. negligence.
  4. D. felony.
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Question 7

After a client has a tubal ligation in the outpatient surgical clinic, what is the priority for the nurse to determine?

  1. A. The client's prior experiences with outpatient surgery
  2. B. The client's medical plan and the extent of coverage for outpatient surgery
  3. C. The client's plan for transportation and care at home
  4. D. The client's plan to spend the night at the surgical center
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Question 8

How often should physical restraints be released?

  1. A. Every 2 hours
  2. B. Between 1 and 3 hours
  3. C. Every 30 minutes
  4. D. At least every 4 hours
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Question 9

Before administering Theodur to a 10-year-old being treated for asthma, the nurse should check the:

  1. A. Urinary output
  2. B. Blood pressure
  3. C. Pulse
  4. D. Temperature
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Question 10

When choosing a needle gauge for an intramuscular injection in a 12-year-old boy, which of the following gauges would you choose?

  1. A. 27 gauge
  2. B. 25 gauge
  3. C. 22 gauge
  4. D. 20 gauge
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Question 11

Distribution of a drug to various tissues depends on the amount of cardiac output to each type of tissue. Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?

  1. A. skin
  2. B. adipose tissue
  3. C. skeletal muscle
  4. D. myocardium
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Question 12

Which physiologic mechanism best describes the function of the sodium-potassium pump?

  1. A. active transport
  2. B. diffusion
  3. C. filtration
  4. D. osmosis
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Question 13

A client is having a seizure; his blood oxygen saturation drops from 92% to 82%. What should the nurse do first?

  1. A. Open the airway.
  2. B. Administer oxygen.
  3. C. Suction the client.
  4. D. Check for breathing.
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Question 14

When placing an IV line in a patient with active TB and HIV, which safety equipment should the nurse wear?

  1. A. Sterile gloves, mask, and goggles
  2. B. Surgical cap, gloves, mask, and proper shoewear
  3. C. Double gloves, gown, and mask
  4. D. Goggles, mask, gloves, and gown
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Question 15

The power a healthcare professional exerts when working to accomplish goals and effect change in an agency or policy is considered what type of power?

  1. A. political
  2. B. personal
  3. C. positional
  4. D. professional
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About these NCLEX-PN clinical judgment questions

NCLEX-PN clinical judgment practice questions, set 58 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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