NCLEX-PN clinical judgment practice questions, set 63
NCLEX-PN · clinical judgment
NCLEX-PN clinical judgment practice questionsset 63
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 who is immobilized secondary to traction is complaining of constipation. Which of the following medications should the nurse expect to be ordered?
A. Advil
B. Anasaid
C. Clinocil
D. Colace
Show answer and rationale
Correct answer: D — Colace
The correct answer is Colace. Colace is a stool softener that helps relieve constipation by drawing more water into the bowel, making the stool softer and easier to pass. This is beneficial for an immobilized client as it can help prevent constipation due to decreased mobility. Options A, B, and C (Advil, Anasaid, Clinocil) are not indicated for constipation relief. Advil and Anasaid are nonsteroidal anti-inflammatory drugs used for pain relief, while Clinocil is a fictional medication.
Question 2
How often should the intravenous tubing on total parenteral nutrition solutions be changed?
A. every 24 hours
B. every 36 hours
C. every 48 hours
D. every 72 hours
Show answer and rationale
Correct answer: A — every 24 hours
The correct answer is to change the intravenous tubing on total parenteral nutrition solutions every 24 hours. This frequency is necessary due to the high risk of bacterial growth associated with TPN solutions. Changing the tubing every 24 hours helps prevent contamination and bloodstream infections. Choices B, C, and D are incorrect because waiting longer intervals increases the risk of introducing harmful bacteria into the patient's system, leading to potentially severe complications.
Question 3
When medications have an additive, synergistic, or antagonistic effect on a tissue, a ________ reaction has occurred.
A. pharmaceutical
B. pharmacodynamic
C. pharmacokinetic
D. drug incompatibility
Show answer and rationale
Correct answer: B — pharmacodynamic
The correct answer is 'pharmacodynamic.' Pharmacodynamics pertain to the effect of a drug on receptors, explaining how drugs affect tissues. Pharmaceutical reactions refer to chemical reactions between drugs before administration or absorption, not their effect on tissues. Pharmacokinetic reactions involve how the body affects the drug, not the tissue. Drug incompatibilities are essentially pharmaceutical reactions, not the specific effects on tissues seen in pharmacodynamic reactions.
Question 4
A patient has been diagnosed with Guillain-Barre Syndrome. Which of the following statements is the most applicable when discussing the impairments with Guillain-Barre Syndrome with the patient?
A. Guillain-Barre Syndrome improves in almost all cases within 5 years.
B. Guillain-Barre Syndrome causes limited sensation in the abdominal region.
C. Guillain-Barre Syndrome causes muscle weakness in the legs.
D. Guillain-Barre Syndrome affects breathing in severe cases.
Show answer and rationale
Correct answer: C — Guillain-Barre Syndrome causes muscle weakness in the legs.
The correct statement is that Guillain-Barre Syndrome causes muscle weakness in the legs. This muscle weakness typically starts in the legs and can progress to the upper body. Choice A is incorrect as while most cases do improve, the recovery time can vary. Choice B is incorrect as Guillain-Barre Syndrome primarily affects muscle weakness rather than sensation. Choice D is incorrect as severe cases of Guillain-Barre Syndrome can lead to respiratory muscle weakness, impacting breathing.
Question 5
A client arrives in the emergency room with a possible fractured femur. The nurse should anticipate an order for:
A. Trendelenburg position
B. Ice to the entire extremity
C. Buck's traction
D. An abduction pillow
Show answer and rationale
Correct answer: C — Buck's traction
The correct answer is Buck's traction. This intervention is used to realign the fractured femur, reduce spasms, and alleviate pain. Placing the client in the Trendelenburg position is inappropriate for a femur fracture, making answer A incorrect. While ice may be used post-repair, applying it to the entire extremity is unnecessary, so answer B is wrong. An abduction pillow is typically employed following a total hip replacement, not for a fractured femur, rendering answer D incorrect.
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Question 6
A 20-year-old female has a prescription for tetracycline. While teaching the client how to take her medicine, the nurse learns that the client is also taking Ortho-Novum oral contraceptive pills. Which instructions should be included in the teaching plan?
A. The oral contraceptives will decrease the effectiveness of the tetracycline.
B. Nausea often results from taking oral contraceptives and antibiotics.
C. Toxicity can result when taking these two medications together.
D. Antibiotics can decrease the effectiveness of oral contraceptives, so the client should use an alternate method of birth control.
Correct answer:
When antibiotics and oral contraceptives are taken together, the effectiveness of the oral contraceptives can be reduced, increasing the risk of pregnancy. Therefore, it is important to advise the client to use an alternate method of birth control to prevent unintended pregnancy. Choices A, B, and C are incorrect because there is no evidence to suggest that oral contraceptives decrease the effectiveness of tetracycline, cause nausea, or result in toxicity when taken with antibiotics.
While undergoing fetal heart monitoring, a pregnant Native-American woman requests that a medicine woman be present in the examination room. Which of the following is an appropriate response by the nurse?
A. "I will assist you in arranging to have a medicine woman present."?
B. "We do not allow medicine women in exam rooms."?
C. "That does not make any difference in the outcome."?
D. "It is old-fashioned to believe in that."?
Correct answer:
The correct response is to show cultural awareness and respect the client's request by offering assistance in arranging for the medicine woman to be present. This approach acknowledges the importance of cultural beliefs and practices in the client's care, fostering trust and cooperation. Choices B, C, and D are inappropriate as they dismiss or belittle the client's cultural beliefs, showing insensitivity and lack of respect, which can negatively impact the nurse-client relationship.
When performing an abdominal assessment, what is the correct order of the tasks?
A. inspect, percuss, palpate, auscultate
B. inspect, palpate, percuss, auscultate
C. inspect, auscultate, percuss, palpate
D. inspect, palpate, auscultate, percuss
Correct answer:
The correct order of tasks when performing an abdominal assessment is to first inspect the abdomen visually, then auscultate to assess bowel sounds without altering them, followed by percussing to assess the presence of tympany or dullness, and finally palpating to feel for any tenderness, masses, or organ enlargement. Placing palpation or percussion before auscultation, as in choices A, B, and D, can affect the bowel sounds and examination findings, making them incorrect sequences.
A nurse is caring for a client with an elevated cortisol level. The nurse can expect the client to exhibit symptoms of:
A. urinary excess
B. hyperpituitarism
C. urinary deficit
D. hyperthyroidism
Correct answer:
Elevated cortisol levels can lead to sodium and fluid retention and potassium deficit, resulting in urinary deficit. This imbalance in electrolytes and fluid can cause a decrease in urinary output. Choices B, hyperpituitarism, and D, hyperthyroidism, are incorrect as they do not directly relate to the symptoms expected with elevated cortisol levels. Option A, urinary excess, is also incorrect as high cortisol levels typically lead to fluid retention and urinary deficit, not excess.
An assessment of the skull of a normal 10-month-old baby should identify which of the following?
A. closure of the posterior fontanel.
B. closure of the anterior fontanel.
C. overlap of cranial bones.
D. ossification of the sutures.
Correct answer:
The correct answer is the closure of the anterior fontanel. By 10 months of age, the anterior fontanel should be closed. The posterior fontanel should actually close by the age of 2 months, making choice A incorrect. Overlap of cranial bones is not a typical finding in a normal 10-month-old baby's skull, so choice C is incorrect. Ossification of the sutures is an ongoing process in skull development and should not be a definitive indicator at this age, making choice D incorrect.
A client admitted with an episode of bleeding esophageal varices is receiving propranolol (Inderal LA). The nurse knows to monitor for?
A. Hypertension
B. Hyperkalemia
C. Bradycardia
D. Arthralgia
Correct answer:
The correct answer is 'Bradycardia.' Propranolol is a beta-blocking agent used to decrease the heart rate. In the case of bleeding esophageal varices, propranolol is given to reduce the risk of bleeding by keeping the heart rate around 55 beats per minute. Monitoring for bradycardia is essential as the medication's intended effect is to lower the heart rate. Choices A, B, and D are incorrect because propranolol would not typically cause hypertension, hyperkalemia, or arthralgia.
A healthcare professional is reviewing the health care record of a client who has just undergone an examination of the internal genitalia. Which documented finding indicates an abnormality?
A. The cervix is pink.
B. The cervix is midline.
C. The cervix is about 1 inch in diameter.
D. Clear secretions with a foul odor are noted on the cervix.
Correct answer:
The correct answer is 'Clear secretions with a foul odor are noted on the cervix.' Normally, the cervix is pink, midline, and about 1 inch in diameter. Depending on the day of the menstrual cycle, secretions may vary. However, they should always be odorless and nonirritating. Secretions with a foul odor are indicative of an infection, making this finding abnormal. Choices A, B, and C describe normal cervix characteristics, so they do not indicate an abnormality in this scenario.
A patient had a pneumonectomy to the right lung performed 48 hours ago. Which of the following conditions most likely exists?
A. Decreased breath sound volume
B. Elevated tidal volume
C. Elevated respiratory capacity
D. Wheezing
Correct answer:
After a pneumonectomy, where a lung is surgically removed, there will be a decrease in breath sound volume on the affected side due to reduced airflow. This reduction in breath sound volume is expected as there is less lung tissue to produce sound. Choices B, C, and D are incorrect. Elevated tidal volume and respiratory capacity are not expected after a pneumonectomy, and wheezing is more commonly associated with conditions like asthma or bronchitis, not a recent pneumonectomy.
When meeting nurses for the first time, a new nurse manager makes eye contact, smiles, initiates conversation about their previous work experience, and encourages active participation. This behavior is an example of
A. aggressiveness
B. passive aggressiveness
C. passiveness
D. assertiveness
Correct answer:
The nurse manager is demonstrating assertive behavior by confidently engaging with the nurses through eye contact, smiling, and encouraging participation. This behavior shows a balance between expressing her own opinions and respecting others. Aggressive behavior would involve dominating or embarrassing others, while passive behavior is characterized by being timid or nervous. Passive-aggressive behavior is indirect and manipulative, which is not demonstrated in this scenario.
A patient who has delivered an 8.2 lb. baby boy 3 days ago via c-section, reports white patches on her breast that aren't going away. Which of the following medications may be necessary?
A. Nystatin
B. Atropine
C. Amoxil
D. Lortab
Correct answer:
The patient is likely experiencing thrush, a fungal infection, which can present as white patches on the breast that persist. Nystatin is an antifungal medication commonly used to treat thrush. Therefore, the correct answer is Nystatin. Atropine is not indicated for this condition and is used for different purposes. Amoxil is an antibiotic and would not be effective against a fungal infection like thrush. Lortab is a pain medication and is not appropriate for treating thrush.
NCLEX-PN clinical judgment practice questions, set 63 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.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
