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NCLEX-RN clinical judgment practice questions, set 57

NCLEX-RN · clinical judgment

NCLEX-RN clinical judgment practice questions set 57

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

The nurse is caring for a patient who has a right-sided chest tube after a right lower lobectomy. Which nursing action can the nurse delegate to the unlicensed assistive personnel (UAP)?

  1. A. Document the amount of drainage every eight hours
  2. B. Obtain samples of drainage for culture from the system
  3. C. Assess patient pain level associated with the chest tube
  4. D. Check the water-seal chamber for the correct fluid level
Show answer and rationale

Correct answer: A — Document the amount of drainage every eight hours

The correct answer is to document the amount of drainage every eight hours. UAP education typically includes tasks related to documentation of intake and output. Obtaining samples of drainage for culture and assessing patient pain level are nursing responsibilities that require licensed nursing personnel's education and scope of practice. Checking the water-seal chamber for the correct fluid level also falls under the nursing role, as it involves monitoring and maintaining the chest tube system, which requires nursing knowledge and training.

Question 2

A nurse is preparing to irrigate a client's indwelling catheter through a closed, intermittent system. Which of the following steps must the nurse take as part of this process?

  1. A. Use sterile solution at room temperature
  2. B. Position the client in a comfortable position
  3. C. Clamp the catheter at the level above the injection port
  4. D. Inject sterile solution through the injection port into the catheter
Show answer and rationale

Correct answer: D — Inject sterile solution through the injection port into the catheter

When performing closed intermittent system catheter irrigation, the nurse should use sterile solution at room temperature with sterile technique. It is important to position the client comfortably for easy access to the catheter site and to assess the abdomen during the procedure. Clamping the catheter should be done below the level of the injection port, not above. The correct step is to inject sterile solution through the injection port into the catheter, allowing the fluid to travel up the catheter to irrigate the tubing and the bladder.

Question 3

A 60-year-old patient has been treated for pneumonia for the past 6 weeks. The patient is seen today in the clinic for an unexplained weight loss of 10 pounds over the last 6 weeks. Which is an appropriate rationale for this patient's weight loss?

  1. A. Chronic diseases such as hypertension do not usually cause weight loss.
  2. B. Weight loss is more likely due to underlying medical conditions than unhealthy eating habits.
  3. C. Unexplained weight loss often accompanies short-term illnesses.
  4. D. Weight loss is not typically caused by mental health dysfunctions.
Show answer and rationale

Correct answer: C — Unexplained weight loss often accompanies short-term illnesses.

Unexplained weight loss in a patient with pneumonia could indicate an underlying short-term illness or a chronic condition like endocrine disease, malignancy, depression, anorexia nervosa, or bulimia. Hypertension is not commonly associated with weight loss; it usually leads to weight gain due to fluid retention. Unhealthy eating habits are less likely to explain significant unexplained weight loss over a short period. Mental health dysfunctions can affect appetite but are not typically primary causes of significant unexplained weight loss.

Question 4

A patient has just been admitted with probable bacterial pneumonia and sepsis. Which order should the nurse implement first?

  1. A. Performing a chest x-ray via stretcher
  2. B. Obtaining blood cultures from two sites
  3. C. Administering Ciprofloxacin (Cipro) 400 mg IV
  4. D. Inserting an Acetaminophen (Tylenol) rectal suppository
Show answer and rationale

Correct answer: B — Obtaining blood cultures from two sites

In a patient with probable bacterial pneumonia and sepsis, the priority intervention is to obtain blood cultures from two sites before initiating antibiotic therapy. This is crucial to identify the causative organism and guide appropriate antibiotic treatment. Administering antibiotics without obtaining cultures first can interfere with accurate results. Performing a chest x-ray and administering acetaminophen can be done after obtaining blood cultures as they are important but not as urgent as identifying the causative organism in sepsis.

Question 5

A 45-year-old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The patient is living at home with her daughter. The nurse is most concerned about which side effect of ropinirole?

  1. A. Slurred speech
  2. B. Sudden dizziness
  3. C. Mask-like facial expression
  4. D. Stooped posture
Show answer and rationale

Correct answer: B — Sudden dizziness

The correct answer is 'Sudden dizziness.' Dizziness and orthostatic hypotension are serious adverse effects of ropinirole that can lead to an increased risk of falls. Ropinirole belongs to the drug class of dopamine agonists, which mimic dopamine in the brain (Parkinson's Disease is characterized by a lack of dopamine). 'Slurred speech' is not a common side effect of ropinirole. 'Mask-like facial expression' and 'Stooped posture' are more associated with the progression of Parkinson's Disease itself rather than a side effect of ropinirole.

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Ten more NCLEX-RN clinical judgment questions

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Question 6

A patient is suspected to have sustained a spinal cord injury. What best describes the overarching principles used to guide the care for this type of condition?

  1. A. Immobilize the cervical area to prevent further injury
  2. B. Monitor the patient's level of consciousness to prevent neurologic deterioration
  3. C. Help the patient with activities of daily living and provide emotional and physical support to help them adjust to their injury
  4. D. Facilitate tissue perfusion to the spinal cord while maintaining airway and breathing
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Question 7

A client with expressive aphasia is pointing wildly at the bath water but unable to speak. Which response from the nurse is most appropriate?

  1. A. Is something wrong with the bath water?
  2. B. Just calm down, we'll finish your bath soon.
  3. C. Are you trying to tell me something?
  4. D. Shall I turn on the television?
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Question 8

After assessing Mr. B, what is the initial action of the nurse?

  1. A. Immediately place the client in a negative-pressure room
  2. B. Set the client up to receive a bronchoscopy
  3. C. Contact the physician for antifungal medications
  4. D. Administer oxygen and assist the client to sit in the semi-Fowler's position
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Question 9

A child is diagnosed with Hirschsprung's disease. The nurse is teaching the parents about the cause of the disease. Which statement, if made by the parent, supports that teaching was successful?

  1. A. The absence of special cells in the rectum caused the disease.
  2. B. Incomplete digestion of the protein part of wheat, barley, rye, and oats is not the cause of the disease.
  3. C. The disease does not occur due to increased bowel motility leading to spasm and pain.
  4. D. The disease is not caused by the inability to tolerate sugar found in dairy products.
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Question 10

When taking the blood pressure (BP) on the right arm of a patient with severe acute pancreatitis, the nurse notices carpal spasms of the patient's right hand. Which action should the nurse take next?

  1. A. Ask the patient about any arm pain.
  2. B. Retake the patient's blood pressure.
  3. C. Check the calcium level in the chart.
  4. D. Notify the healthcare provider immediately.
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Question 11

A man is receiving heparin subcutaneously. The patient has dementia and lives at home with a part-time caretaker. The nurse is most concerned about which side effect of heparin?

  1. A. Back Pain
  2. B. Fever and Chills
  3. C. Risk for Bleeding
  4. D. Dizziness
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Question 12

What term is used to describe the sexual response changes among middle-aged men?

  1. A. Menopause
  2. B. Climacteric
  3. C. Generativity
  4. D. Maturity
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Question 13

Parents of a 6-month-old breastfed baby ask the nurse about increasing the baby's diet. Which of the following should be added first?

  1. A. Cereal
  2. B. Eggs
  3. C. Meat
  4. D. Juice
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Question 14

What does the medical term 'basophilia' refer to?

  1. A. An attachment of the epithelial cells of the skin to a basement membrane
  2. B. An overabundance of a particular white blood cell in the peripheral blood
  3. C. An underrepresentation of basophils on a blood smear
  4. D. None of the above
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Question 15

What is the purpose of performing quality control?

  1. A. Create a paper trail to show that the laboratory is compliant with OSHA standards for quality control.
  2. B. Improve the odds that the results reported for any given test are as accurate and reliable as possible.
  3. C. Be required by law to be part of a quality assurance program.
  4. D. All of the above
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About these NCLEX-RN clinical judgment questions

NCLEX-RN clinical judgment practice questions, set 57 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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