NCLEX-PN clinical judgment practice questions, set 74
NCLEX-PN · clinical judgment
NCLEX-PN clinical judgment practice questionsset 74
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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
If a visitor accidentally knocks over a plastic pleural drainage system connected to a client, causing it to crack, what should the nurse do first?
A. Observe the client's response.
B. Notify the physician.
C. Change the drainage system.
D. Observe for leaks.
Show answer and rationale
Correct answer: C — Change the drainage system.
When a pleural drainage system is cracked, the nurse's initial action should be to change the drainage system. This is essential to prevent potential complications like air leaks or infections. While observing the client's response and checking for leaks are important steps, they are secondary to addressing the immediate issue of the cracked system. Notifying the physician, though necessary, can be carried out once the primary concern of the damaged system is resolved.
Question 2
When managing nausea related to Morphine epidural analgesia, the nurse should administer:
A. Indomethacin
B. Codeine
C. Ibuprofen
D. Compazine
Show answer and rationale
Correct answer: D — Compazine
When managing nausea related to Morphine epidural analgesia, Compazine is the appropriate medication to administer. Compazine, also known as prochlorperazine, is commonly used to treat nausea and vomiting. It works by affecting certain chemicals in the brain that trigger nausea and vomiting. Choices A, B, and C are incorrect because Indomethacin, Codeine, and Ibuprofen are not typically used to manage nausea associated with Morphine epidural analgesia.
Question 3
What is the role of an incident report in risk management?
A. To provide liability protection.
B. To provide data for analysis by a risk manager to determine how future problems can be avoided.
C. To discipline staff for errors.
D. All of the above.
Show answer and rationale
Correct answer: B — To provide data for analysis by a risk manager to determine how future problems can be avoided.
The correct answer is B. Incident reports play a crucial role in risk management by providing data for analysis to prevent future problems. They are not primarily for liability protection (A) or disciplining staff (C). Therefore, choice B is the most appropriate answer. Choosing option D is incorrect because incident reports do not solely exist for all the mentioned purposes, but primarily to provide data for analysis and preventive actions.
Question 4
A neighbor telephones the nurse to tell her that her child has erythema infectiosum and asks for information. The nurse knows that another name for the disorder is:
A. Kawasaki disease
B. rheumatic disease
C. lupus erythematosus
D. fifth disease
Show answer and rationale
Correct answer: D — fifth disease
The correct answer is 'fifth disease.' Erythema infectiosum, also known as fifth disease, is a parvovirus flu-like illness that is self-limiting but contagious for two to three weeks. Choice A, Kawasaki disease, is a different condition that involves inflammation of the blood vessels, predominantly affecting children. Choices B and C, rheumatic disease and lupus erythematosus, are also different conditions unrelated to erythema infectiosum.
Question 5
Which of the following lab values is elevated first after a client has a myocardial infarction?
A. LDH
B. troponin
C. CPK
D. SGOT
Show answer and rationale
Correct answer: B — troponin
The correct answer is troponin. Troponin levels are the most specific and sensitive markers for myocardial infarction, and they begin to rise within a few hours after the event. CPK, SGOT, and LDH are also enzymes that can indicate myocardial damage, but troponin is the earliest and most specific indicator. CPK typically rises 4-8 hours after an infarction, followed by SGOT (AST) at 8-12 hours, and LDH at 12-24 hours post-infarction.
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Question 6
What is the most appropriate feeding method for a client who is unable to swallow?
A. Nothing by mouth
B. Nasogastric feedings
C. Clear liquids
D. Total parenteral nutrition
Correct answer:
Nasogastric feedings are the most appropriate feeding method for a client who is unable to swallow. Providing nothing by mouth can lead to nutritional deficiencies, while clear liquids might cause aspiration. Total parenteral nutrition is not necessary if the gastrointestinal tract is functional. Nasogastric feedings are preferred as they can safely provide nutrition without the risks associated with not eating or aspirating.
A gastroenterologist should be consulted for clients suffering from:
A. digestive system diseases
B. urinary system diseases
C. female reproductive system diseases
D. nervous system diseases
Correct answer:
A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.
Which of the following represents a normal serum potassium level?
A. 1.5 mEq/L
B. 3.0 mEq/L
C. 4.0 mEq/L
D. 6.0 mEq/L
Correct answer:
The correct answer is 4.0 mEq/L. Normal serum potassium levels typically range from 3.5-5.5 mEq/L. Choice A (1.5 mEq/L) is below the normal range, Choice B (3.0 mEq/L) is also below the normal range, and Choice D (6.0 mEq/L) is above the normal range. Therefore, the only option within the normal range is Choice C (4.0 mEq/L).
A healthcare professional is reviewing a patient's current Lithium levels. Which of the following values is outside the therapeutic range?
A. 1.0 mEq/L
B. 1.1 mEq/L
C. 1.2 mEq/L
D. 1.3 mEq/L
Correct answer:
The correct answer is 1.3 mEq/L. The therapeutic range for Lithium levels typically falls between 0.6 to 1.2 mEq/L. Values below or above this range can lead to suboptimal treatment outcomes or toxicity. Choices A, B, and C are within the therapeutic range of 1.0-1.2 mEq/L, making them appropriate levels for patient care.
Which of the following medications should be held 24-48 hours prior to an electroencephalogram (EEG)?
A. Lasix (furosemide)
B. Cardizem (diltiazem)
C. Lanoxin (digoxin)
D. Dilantin (phenytoin)
Correct answer:
Anticonvulsants like Dilantin should be held 24-48 hours before an EEG to prevent interference with the test results. Medications such as tranquilizers, barbiturates, and other sedatives should also be avoided. Lasix, Cardizem, and Lanoxin do not belong to these categories and are not known to interfere with EEG results.
During discharge teaching for a client with diverticulitis on a low-roughage diet, which food should be eliminated from the diet?
A. Roasted chicken
B. Noodles
C. Cooked broccoli
D. Custard
Correct answer:
The client with diverticulitis needs to avoid gas-forming foods that can increase abdominal discomfort. Cooked broccoli is a high-fiber food that can worsen symptoms. Roasted chicken, noodles, and custard are suitable choices for a low-roughage diet as they are less likely to cause gas formation or abdominal discomfort.
A healthcare professional is reviewing a patient's serum glucose levels. Which of the following scenarios would indicate abnormal serum glucose values for a 30-year-old male?
A. 70 mg/dL
B. 55 mg/dL
C. 110 mg/dL
D. 100 mg/dL
Correct answer:
The correct answer is 55 mg/dL. The standard range for serum glucose levels is typically 60-115 mg/dL. A serum glucose level of 55 mg/dL falls below this range, indicating hypoglycemia. Options A, C, and D are within the standard range for serum glucose levels and would not be considered abnormal for a 30-year-old male.
The client has jaundice, elevated liver enzymes, and an elevated serum bilirubin. What color urine does the nurse expect to find?
A. Pink-tinged
B. Straw-colored
C. Clear
D. Dark amber
Correct answer:
The correct answer is dark amber. In jaundice, the elevated bilirubin levels are excreted in the urine, giving it a dark amber color. Choices A, B, and C are incorrect because in jaundice, the urine typically appears dark amber due to the presence of elevated bilirubin, not pink-tinged, straw-colored, or clear.
A client goes to the Emergency Department with acute respiratory distress and the following arterial blood gases (ABGs): pH 7.35, PCO2 40 mmHg, PO2 63 mmHg, HCO3 23, and oxygenation saturation (SaO2) 93%. Which of the following represents the best analysis of the etiology of these ABGs?
A. tuberculosis (TB)
B. pneumonia
C. pleural effusion
D. hypoxia
Correct answer:
A combined low PO2 and low SaO2 indicate hypoxia. The pH, PCO2, and HCO3 are normal. ABGs are not necessarily altered in TB or pleural effusion. In pneumonia, the PO2 and PCO2 might be low due to hypoxia stimulating hyperventilation, but the given ABG values specifically point to hypoxia as the primary issue.
The correct answer is 6 years old. At this age, children typically have the potential for 20/20 vision. This is considered the standard age for achieving optimal vision clarity. Choices A, B, and D are incorrect as they are not typically associated with the age at which children achieve 20/20 vision.
NCLEX-PN clinical judgment practice questions, set 74 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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