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NCLEX-RN clinical judgment practice questions, set 33

NCLEX-RN · clinical judgment

NCLEX-RN clinical judgment practice questions set 33

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-RN exam guide or more NCLEX-RN 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 patient has been told to monitor her LH levels. Which of the following potential conditions might the patient be suffering from?

  1. A. Menorrhagia
  2. B. Grave's Disease
  3. C. Menopause
  4. D. Infertility
Show answer and rationale

Correct answer: D — Infertility

Luteinizing hormone (LH) is released by the pituitary gland to stimulate ovulation. One of the common reasons for monitoring LH levels is infertility. In women with infertility, LH levels are monitored to time intercourse accurately to maximize the chances of conception. Menorrhagia (choice A) is characterized by heavy menstrual bleeding and is not directly related to LH levels. Grave's Disease (choice B) is an autoimmune disorder affecting the thyroid gland and is not typically monitored by LH levels. Menopause (choice C) is a natural process marking the end of a woman's reproductive years and is not a condition where LH monitoring for infertility is common.

Question 2

When assessing a patient's pulse, which of the following characteristics would the nurse also notice?

  1. A. Force
  2. B. Pallor
  3. C. Capillary refill time
  4. D. Timing in the cardiac cycle
Show answer and rationale

Correct answer: A — Force

When assessing a patient's pulse, the nurse should observe characteristics such as rate, rhythm, and force. Force refers to the strength or amplitude of the pulse, which provides important information about cardiac output. Pallor is the paleness of the skin and is not directly related to pulse assessment. Capillary refill time is used to assess peripheral perfusion and is not specifically part of pulse assessment. Timing in the cardiac cycle is a broader concept and not a characteristic directly assessed during a pulse examination. Therefore, choice A, 'Force,' is the correct answer as it aligns with the standard parameters evaluated during pulse assessment.

Question 3

When reading a lab report, you notice that a patient's sample is described as having anisocytosis. Which of the following most accurately describes the patient's condition?

  1. A. The patient has an abnormal condition of skin cells.
  2. B. The patient's red blood cells vary in size.
  3. C. The patient has a high level of fat cells and is obese.
  4. D. The patient's cells are indicative of necrosis.
Show answer and rationale

Correct answer: B — The patient's red blood cells vary in size.

Anisocytosis is a term that indicates variation in the size of red blood cells. When a patient is described as having anisocytosis, it means their red blood cells exhibit differences in size. This condition can be detected in blood samples and may indicate underlying blood disorders. The other choices are incorrect: Choice A refers to a skin cell condition, Choice C relates to obesity and fat cells, and Choice D suggests necrosis, none of which are associated with anisocytosis or red blood cell abnormalities. It is important to recognize specific terms like anisocytosis in laboratory reports to understand the potential implications for the patient's health.

Question 4

A client on lithium has diarrhea and vomiting. What should the nurse do first?

  1. A. Recognize this as a drug interaction
  2. B. Give the client Cogentin
  3. C. Reassure the client that these are common side effects of lithium therapy
  4. D. Hold the next dose and obtain an order for a stat serum lithium level
Show answer and rationale

Correct answer: D — Hold the next dose and obtain an order for a stat serum lithium level

Diarrhea and vomiting are manifestations of lithium toxicity. The priority action for the nurse is to hold the next dose of lithium and obtain an order for a stat serum lithium level to confirm toxicity. This ensures patient safety and prevents further harm. Recognizing it as a drug interaction is not the first step in this scenario. Cogentin is used to manage extrapyramidal symptoms (EPS) associated with antipsychotics, not lithium toxicity. Reassuring the client about these symptoms as common side effects of lithium therapy is inappropriate as they indicate a more serious issue than typical side effects like hand tremors, nausea, polyuria, and polydipsia.

Question 5

A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first?

  1. A. Gastric lavage
  2. B. Administer acetylcysteine (Mucomyst) orally
  3. C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open
  4. D. Have the patient drink activated charcoal mixed with water
Show answer and rationale

Correct answer: A — Gastric lavage

Acetaminophen overdose is extremely toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the fluid back out. This procedure is done in life-threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion.

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Question 6

When orally administering alendronate (Fosamax), a bisphosphonate drug, to a largely bed-bound patient being treated for osteoporosis, what is the most important nursing consideration?

  1. A. Sit the head of the bed up for 30 minutes after administration
  2. B. Give the patient a small amount of water to drink
  3. C. Feed the patient soon, at most 10 minutes after administration
  4. D. Assess the patient for back pain or abdominal pain
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Question 7

Which of the following is NOT a warning sign that compensatory mechanisms in a patient in shock are failing?

  1. A. Increasing heart rate above normal for the patient's age.
  2. B. Absent peripheral pulses
  3. C. Decreasing level of consciousness
  4. D. Increasing blood pressure
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Question 8

Diabetic patients are more prone to ____________ than other people without this chronic disorder.

  1. A. infection
  2. B. increased oxygen saturation
  3. C. low fibrinogen
  4. D. constipation
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Question 9

At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client states, "My blood pressure is usually much lower."? The nurse should tell the client to:

  1. A. Go get a blood pressure check within the next 15 minutes
  2. B. Check blood pressure again in two (2) months
  3. C. See the healthcare provider immediately
  4. D. Visit the healthcare provider within one (1) week for a BP check
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Question 10

The rehabilitation nurse wishes to make the following entry into a client's plan of care: 'Client will reestablish a pattern of daily bowel movements without straining within two months.' The nurse would write this statement under which section of the plan of care?

  1. A. Nursing diagnosis/problem list
  2. B. Nursing orders
  3. C. Short-term goals
  4. D. Long-term goals
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Question 11

Which technique of assessment will the healthcare provider use to determine the presence of crepitus, swelling, and pulsations?

  1. A. Palpation
  2. B. Inspection
  3. C. Percussion
  4. D. Auscultation
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Question 12

When caring for a patient with Parkinson's Disease, which of the following practices would not be included in the care plan?

  1. A. Decrease the calorie content of daily meals to avoid weight gain
  2. B. Allow the patient extra time to respond to questions and perform ADLs
  3. C. Use thickened liquids and a soft diet
  4. D. Encourage the patient to hold the spoon when eating
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Question 13

The nurse is examining a 2-year-old child and asks, "May I listen to your heart now?"? Which critique of the nurse's technique is most accurate?

  1. A. Asking questions may enhance the child's autonomy.
  2. B. Asking the child for permission helps develop a sense of trust.
  3. C. This question is an inappropriate statement because children at this age like to have choices.
  4. D. Children at this age like to say, "No."? The examiner should not offer a choice when no choice is available.
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Question 14

A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is:

  1. A. Surgical repair of a diseased coronary artery
  2. B. Placement of an automatic internal cardiac defibrillator
  3. C. Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow
  4. D. Non-invasive radiographic examination of the heart
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Question 15

The nurse is planning care for a client during the acute phase of a sickle cell vasoocclusive crisis. Which of the following actions would be most appropriate?

  1. A. Fluid restriction to 1000cc per day
  2. B. Ambulate in the hallway 4 times a day
  3. C. Administer analgesic therapy as ordered
  4. D. Encourage increased caloric intake
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About these NCLEX-RN clinical judgment questions

NCLEX-RN clinical judgment practice questions, set 33 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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