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NCLEX-PN clinical judgment practice questions, set 69

NCLEX-PN · clinical judgment

NCLEX-PN clinical judgment practice questions set 69

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

The nurse is caring for a client with hyperemesis gravidarum. What is the most likely electrolyte imbalance?

  1. A. Hypocalcemia
  2. B. Hypomagnesemia
  3. C. Hyponatremia
  4. D. Hypokalemia
Show answer and rationale

Correct answer: D — Hypokalemia

In hyperemesis gravidarum, where the client experiences severe nausea and vomiting, the most likely electrolyte imbalance is hypokalemia. Potassium is abundant in the stomach, and excessive vomiting leads to potassium loss. Hypocalcemia (Choice A) is not typically associated with hyperemesis gravidarum. Hypomagnesemia (Choice B) and Hyponatremia (Choice C) are less likely to occur compared to hypokalemia in this condition.

Question 2

What is the therapeutic range for carbamazepine (Tegretol)?

  1. A. 7-12 mcg/mL
  2. B. 4-10 mcg/mL
  3. C. 10-14 mcg/mL
  4. D. 1-5 mcg/mL
Show answer and rationale

Correct answer: B — 4-10 mcg/mL

The therapeutic range for carbamazepine (Tegretol) is 4-10 mcg/mL. This range is established based on the optimal balance between effectiveness and safety. Choices A, C, and D are outside the therapeutic range for carbamazepine, which could lead to suboptimal treatment outcomes or increased risk of toxicity. Choice B (4-10 mcg/mL) is the correct range recommended for therapeutic efficacy while minimizing adverse effects.

Question 3

Which of the following foods should be avoided by clients who are prone to developing heartburn as a result of gastroesophageal reflux disease (GERD)?

  1. A. lettuce
  2. B. eggs
  3. C. chocolate
  4. D. butterscotch
Show answer and rationale

Correct answer: C — chocolate

The correct answer is chocolate. Ingestion of chocolate can reduce lower esophageal sphincter (LES) pressure, leading to reflux and clinical symptoms of GERD. Lettuce, eggs, and butterscotch do not affect LES pressure and are less likely to trigger heartburn in individuals with GERD. Therefore, clients who are prone to developing heartburn due to GERD should avoid consuming chocolate to manage their symptoms effectively.

Question 4

The nurse has just received a change-of-shift report. Which client should the nurse assess first?

  1. A. A client 2 hours post-lobectomy with 150cc drainage
  2. B. A client 2 days post-gastrectomy with scant drainage
  3. C. A client with pneumonia with an oral temperature of 102°F
  4. D. A client with a fractured hip in Buck's traction
Show answer and rationale

Correct answer: A — A client 2 hours post-lobectomy with 150cc drainage

The nurse should assess the client 2 hours post-lobectomy with 150cc drainage first because postoperative assessments are crucial during the immediate postoperative period. This client may be at higher risk for complications, such as bleeding or infection, requiring immediate attention. Clients in choices B, C, and D are relatively stable and can be assessed after the immediate postoperative client has been evaluated.

Question 5

A teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?

  1. A. lungs
  2. B. liver
  3. C. kidneys
  4. D. adrenal glands
Show answer and rationale

Correct answer: B — liver

Acetaminophen is extensively metabolized in the liver. An overdose of acetaminophen can lead to severe liver damage and even liver failure, which can be life-threatening. Choices A, C, and D are incorrect because although prolonged use of acetaminophen may lead to an increased risk of renal dysfunction, a single overdose does not typically cause life-threatening abnormalities in the lungs, kidneys, or adrenal glands.

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Question 6

Which of the following vaccines contains a live virus?

  1. A. varicella
  2. B. IPV
  3. C. DTaP
  4. D. hepatitis B
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Question 7

Following the change of shift report, when can or should the nurse alter or modify the plan?

  1. A. halfway through the shift
  2. B. at the end of the shift before handing over
  3. C. when needs change
  4. D. after the top-priority tasks have been completed
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Question 8

The nurse is assessing the client recently returned from surgery. The nurse is aware that the best way to assess pain is to:

  1. A. Take the blood pressure, pulse, and temperature
  2. B. Ask the client to rate his pain on a scale of 0-5
  3. C. Watch the client's facial expression
  4. D. Ask the client if he is in pain
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Question 9

After undergoing gastric resection, the client is informed by the nurse that which of the following meals is most likely to cause rapid emptying of the stomach?

  1. A. a high-protein meal
  2. B. a high-fat meal
  3. C. a large meal regardless of nutrient content
  4. D. a high-carbohydrate meal
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Question 10

Which cultural group has the highest incidence of inflammatory bowel disease (IBD)?

  1. A. Asians
  2. B. Caucasians
  3. C. Hispanics
  4. D. African Americans
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Question 11

A client asks the nurse if all donor blood products are cross-matched with the recipient to prevent a transfusion reaction. Which of the following always requires cross-matching?

  1. A. packed red blood cells
  2. B. platelets
  3. C. plasma
  4. D. granulocytes
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Question 12

The nurse is assessing the newborn's respirations. Which of these findings would indicate a need for follow-up and further intervention?

  1. A. irregular respirations
  2. B. abdominal respirations
  3. C. shallow respirations
  4. D. 70 breaths per minute
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Question 13

Which of the following solutions is routinely used to flush an IV device before and after the administration of blood to a client?

  1. A. 0.9% sodium chloride
  2. B. 5% dextrose in water solution
  3. C. Sterile water
  4. D. Heparin sodium
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Question 14

When assessing a client's mobility status, the physical examination should start with:

  1. A. examining their gait.
  2. B. orienting to time, place, and person.
  3. C. performing the Romberg test.
  4. D. conducting the Tandem Walk test.
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Question 15

The nurse is preparing a client for surgery. Which item is most important to remove before sending the client to surgery?

  1. A. Hearing aid
  2. B. Contact lenses
  3. C. Wedding ring
  4. D. Artificial eye
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About these NCLEX-PN clinical judgment questions

NCLEX-PN clinical judgment practice questions, set 69 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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