NCLEX-RN clinical judgment practice questions, set 56
NCLEX-RN · clinical judgment
NCLEX-RN clinical judgment practice questionsset 56
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 diagnosed with alopecia would be described as having:
A. body lice
B. lack of ear lobes
C. Indigestion
D. hair loss
Show answer and rationale
Correct answer: D — hair loss
The correct answer is 'hair loss.' Alopecia is a medical term that specifically refers to the condition of hair loss, usually in patches or all over the body. Choice A, 'body lice,' refers to a parasitic infestation and is not related to alopecia. Choice B, 'lack of ear lobes,' is completely unrelated to the term alopecia, which is solely about hair loss. Choice C, 'Indigestion,' has no connection to alopecia as it pertains to digestive issues, not hair loss. Therefore, the correct description for a patient diagnosed with alopecia is 'hair loss.'
Question 2
A 24-year-old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?
A. Diverticulosis
B. Hypercalcemia
C. Hypocalcemia
D. Irritable bowel syndrome
Show answer and rationale
Correct answer: B — Hypercalcemia
The correct answer is Hypercalcemia. In this case, the patient's history of myeloma, constipation, intense abdominal pain, and polyuria suggests hypercalcemia. Elevated calcium levels can lead to polyuria, severe abdominal pain, and confusion. Diverticulosis (Choice A), characterized by small pouches in the colon wall, typically does not present with confusion and polyuria. Hypocalcemia (Choice C) is unlikely given the symptoms described. Irritable bowel syndrome (Choice D) does not typically cause confusion and polyuria as seen in hypercalcemia.
Question 3
The healthcare provider is reviewing theories of illness. The germ theory, which states that microscopic organisms such as bacteria and viruses are responsible for specific disease conditions, is a basic belief of which theory of illness?
A. Holistic
B. Biomedical
C. Naturalistic
D. Magicoreligious
Show answer and rationale
Correct answer: B — Biomedical
The correct answer is B: Biomedical. Among the biomedical explanations for disease is the germ theory, which states that microscopic organisms such as bacteria and viruses are responsible for specific disease conditions. The naturalistic or holistic perspective holds that the forces of nature must be kept in natural balance. The magicoreligious perspective holds that supernatural forces dominate and cause illness or health. Therefore, options A, C, and D are incorrect as they do not align with the germ theory explanation provided in the question.
Question 4
A patient experiences a chest wall contusion as a result of being struck in the chest with a baseball bat. The emergency department nurse would be most concerned if which finding is observed during the initial assessment?
A. Paradoxic chest movement
B. Complaint of chest wall pain
C. Heart rate of 110 beats/minute
D. Large bruised area on the chest
Show answer and rationale
Correct answer: A — Paradoxic chest movement
Paradoxic chest movement is the most concerning finding as it indicates a potential flail chest, which can lead to severe compromise in gas exchange and rapid hypoxemia. This condition requires immediate attention to prevent respiratory distress. Complaint of chest wall pain, a slightly elevated heart rate, and a large bruised area on the chest are important assessment findings but may not immediately threaten gas exchange or respiratory function. Therefore, identifying paradoxic chest movement is critical for prompt intervention and management.
Question 5
A client is undergoing range of motion exercises, and the nurse moves the leg in a pattern of circumduction. Which movement is the nurse performing?
A. Bending the leg at the knee
B. Turning the foot inward and outward
C. Moving the leg in a circle
D. Moving the leg forward and up
Show answer and rationale
Correct answer: C — Moving the leg in a circle
Circumduction involves moving a limb in a circular pattern. In this scenario, the nurse is performing circumduction by moving the leg in a circular motion, engaging the muscles of the gluteus maximus and gluteus medius. Choice A, 'Bending the leg at the knee,' is incorrect as it describes flexion and extension movements. Choice B, 'Turning the foot inward and outward,' refers to inversion and eversion movements of the foot, not circumduction. Choice D, 'Moving the leg forward and up,' describes flexion and abduction movements, not circumduction.
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Question 6
The patient is being taught about pulmonary function testing (PFT). Which statement made by the patient indicates effective teaching?
A. I will use my inhaler right before the test.
B. I won't eat or drink anything 8 hours before the test.
C. I should inhale deeply and blow out as hard as I can during the test.
D. My blood pressure and pulse will be checked every 15 minutes after the test.
Correct answer:
The correct answer is 'I should inhale deeply and blow out as hard as I can during the test.' This statement indicates effective teaching because for PFT, the patient needs to inhale deeply and exhale forcefully. This maneuver helps in assessing lung function accurately. Choices A, B, and D are incorrect. Using an inhaler right before the test may alter the test results, which is not recommended. Fasting for 8 hours is not necessary for a PFT, and checking blood pressure and pulse every 15 minutes after the test is not part of the PFT procedure.
In which of these patients would rectal temperatures be measured?
A. Older adult
B. Critically ill patient
C. School-age child
D. Patient receiving oxygen via nasal cannula
Correct answer:
Rectal temperature measurement is preferred in situations where other routes are impractical or when the most accurate measure is necessary, such as in critically ill patients. The rectal route may be chosen due to its reliability in such cases. For older adults, school-age children, and patients receiving oxygen via nasal cannula, rectal temperature measurement is not typically indicated. Other routes like oral, tympanic, or axillary measurements are more commonly used in these populations due to comfort, convenience, and non-invasive nature.
What is the most useful patient position for proctologic exams?
A. Trendelenburg
B. Semi-Fowler's
C. Full Fowler's
D. Jack Knife
Correct answer:
The Jack Knife position is the most useful for proctologic exams as it allows the patient to lie face down while keeping the buttocks elevated, providing optimal access for the examination. The Trendelenburg position, characterized by the body being laid flat with the feet higher than the head, is not suitable for proctologic exams. Semi-Fowler's and Full Fowler's positions are typically utilized for respiratory or cardiovascular conditions and are not ideal for proctologic examinations due to their lack of optimal access to the perianal area.
Which theory reflects the view that illness is caused by an imbalance or disharmony in the forces of nature?
A. Germ theory
B. Naturalistic theory
C. Magicoreligious theory
D. Biomedical or scientific theory
Correct answer:
The naturalistic theory posits that illness results from an imbalance or disharmony in the forces of nature. According to this theory, maintaining a natural balance or harmony is essential to prevent illness. Conversely, germ theory and biomedical or scientific theory attribute illness to microorganisms, while magicoreligious theory attributes illness to supernatural forces such as deities or spirits. Therefore, the most appropriate theory reflecting the belief that illness arises from a disruption in natural forces is the naturalistic theory.
A patient in the cardiac care unit is taking bumetanide (Bumex) for heart issues and is also diagnosed with Parkinson's Disease. An unlicensed assistive personnel is assisting with feeding the patient. Which of these foods should the nurse stress for the patient to eat most?
A. Foods containing the least amount of salt
B. Foods containing the most amount of potassium
C. Foods containing the most amount of calories
D. Foods containing the most amount of fiber
Correct answer:
Bumex is a loop diuretic that can lead to hypokalemia (low potassium levels). Hypokalemia can be dangerous and lead to various complications. To prevent a hypokalemic crisis, it is crucial to ensure an adequate intake of potassium. Therefore, the nurse should stress the patient to eat foods rich in potassium. Choices A, C, and D are not the priority in this situation. While monitoring salt intake is important in cardiac patients, the immediate concern with bumetanide use is the risk of hypokalemia, making choice B the most appropriate option.
During an examination, a nurse notices a draining ulceration on a patient's lower leg. What is the most appropriate action in this situation?
A. Wash hands and then contact the physician.
B. Continue to examine the ulceration and then wash hands.
C. Wash hands, put on gloves, and continue with the examination of the ulceration.
D. Wash hands, proceed with the rest of the physical examination, and perform the examination of the leg ulceration last.
Correct answer:
In this scenario, the most appropriate action is to wash hands, put on gloves, and then continue examining the ulceration. Wearing gloves is crucial when there is a possibility of contact with body fluids, as in the case of a draining ulceration. Contacting the physician is not necessary at this point; the immediate focus should be on proper infection control by washing hands and wearing gloves. Changing the order of the examination is not recommended as it is important to follow a systematic approach to avoid missing any crucial assessments.
An occupational health nurse works at a manufacturing plant where there is potential exposure to inhaled dust. Which action, if recommended by the nurse, will be most helpful in reducing the incidence of lung disease?
A. Treat workers with pulmonary fibrosis.
B. Teach about symptoms of lung disease.
C. Require the use of protective equipment.
D. Monitor workers for coughing and wheezing.
Correct answer:
Prevention of lung disease requires the use of appropriate protective equipment such as masks to reduce exposure to inhaled dust, which is a significant risk factor for lung disease. Teaching about symptoms of lung disease, treating workers with pulmonary fibrosis, and monitoring for coughing and wheezing are important actions for early recognition and treatment of lung disease. However, the most effective strategy to prevent lung damage in this scenario is to require the use of protective equipment to minimize exposure to harmful substances.
During auscultation of a patient's heart sounds, the nurse hears an unfamiliar sound. Which action would the nurse take?
A. Ask the patient how he or she is feeling.
B. Document the findings in the patient's record.
C. Wait 10 minutes and auscultate the sound again.
D. Ask another nurse to double-check the finding.
Correct answer:
When encountering an unfamiliar sound during auscultation, it is crucial for the nurse to seek confirmation from another healthcare professional. Asking the patient about their feelings may not provide insight into the unfamiliar sound. Simply documenting the findings without verification may lead to errors in interpretation. Waiting and auscultating again after 10 minutes might delay necessary intervention. Consulting another nurse for a second opinion ensures accurate identification of the unfamiliar sound and appropriate follow-up actions.
A patient presents with vesicles covering the upper torso. Which of the following situations could cause this condition?
A. Knife fight
B. Auto accident
C. Sunburn
D. Fungal infection
Correct answer:
Vesicles are fluid-filled blisters. In the context of the upper torso, the presentation of vesicles suggests a second-degree sunburn. Sunburn can cause blistering, leading to the formation of vesicles. Choice A, 'Knife fight,' does not align with the presentation of vesicles on the upper torso due to trauma. Choice B, 'Auto accident,' is more likely to cause abrasions or bruises rather than vesicles. Choice D, 'Fungal infection,' typically presents with other symptoms such as redness, itching, or scaling, but not vesicles on the upper torso.
As a valued member of the team on your nursing care unit, you are trying to determine whether the team is doing well. Which of the following is a sign that your team is successful?
A. Conflict occurs but is seen as an opportunity for team growth and development.
B. No negative feelings are expressed, leading to everyone being happy and satisfied.
C. Mistakes are not tolerated and result in disciplinary action.
D. People avoid taking risks and stick to the status quo.
Correct answer:
One of the key indicators of a successful team is the ability to handle conflict positively. Conflict, when managed well, can lead to team growth and development. Choice B is incorrect because suppressing negative feelings does not indicate team success; open communication is crucial. Choice C is incorrect as successful teams view mistakes as learning opportunities rather than resorting to disciplinary action. Choice D is incorrect because successful teams are often innovative and willing to take risks rather than maintaining the status quo.
NCLEX-RN clinical judgment practice questions, set 56 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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