Holistic Nursing
Practice & Clinical
Judgment Examination
2026/2027
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**Question 1**
The nurse is assessing a client with suspected pericarditis. Which finding is most characteristic of this
condition?
A. Chest pain that worsens with deep inspiration
B. Chest pain that radiates to the left arm
C. Chest pain that is relieved with nitroglycerin
D. Chest pain that is described as crushing and substernal
,💫RATIONALE✔️✔️: Pericarditis is inflammation of the pericardial sac. The hallmark sign is sharp,
pleuritic chest pain that worsens with deep inspiration, coughing, or lying flat. The pain is typically
relieved by sitting up and leaning forward. Radiating pain and relief with nitroglycerin are more
indicative of angina.
💫ANSWER✔️✔️: A. Chest pain that worsens with deep inspiration
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**Question 2**
A client with a history of chronic heart failure is prescribed digoxin (Lanoxin). The nurse should monitor
the client for which early sign of digoxin toxicity?
A. Visual disturbances
B. Anorexia and nausea
C. Bradycardia
D. Confusion
💫RATIONALE✔️✔️: Anorexia, nausea, and vomiting are among the earliest signs of digoxin toxicity.
Visual disturbances (yellow-green halos), bradycardia, and confusion can occur but typically develop
later. Recognizing early signs allows for prompt intervention.
💫ANSWER✔️✔️: B. Anorexia and nausea
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**Question 3**
,The nurse is caring for a client who is 24 hours post-operative following a bowel resection. The client's
nasogastric (NG) tube is draining 200 mL of greenish fluid. Which action is most appropriate?
A. Notify the healthcare provider immediately
B. Clamp the NG tube for 2 hours
C. Document the finding as expected
D. Increase the suction pressure
💫RATIONALE✔️✔️: Greenish drainage from an NG tube post-abdominal surgery is expected and
indicates the return of gastric and biliary secretions. The nurse should document the amount, color, and
consistency as part of routine monitoring. Notifying the provider is unnecessary.
💫ANSWER✔️✔️: C. Document the finding as expected
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**Question 4**
A client with major depressive disorder is started on duloxetine (Cymbalta). Which instruction should
the nurse include in the teaching plan?
A. "Take this medication at bedtime to prevent insomnia."
B. "Do not stop this medication abruptly."
C. "This medication will work within 24 hours."
D. "You can take this medication with grapefruit juice."
, 💫RATIONALE✔️✔️: Duloxetine is an SNRI that should not be stopped abruptly due to the risk of
withdrawal symptoms. It takes several weeks to reach therapeutic effect, and grapefruit juice should be
avoided with many psychiatric medications.
💫ANSWER✔️✔️: B. "Do not stop this medication abruptly."
---
**Question 5**
The nurse is assessing a client in the emergency department who was in a motor vehicle accident. The
client has bruising over the lower abdomen and reports severe abdominal pain. The nurse notes a rigid
abdomen. Which condition should the nurse suspect?
A. Ruptured spleen
B. Bladder rupture
C. Abdominal aortic aneurysm
D. Hepatic laceration
💫RATIONALE✔️✔️: A rigid abdomen and severe abdominal pain following blunt trauma are signs of
internal bleeding and peritoneal irritation. A ruptured spleen is a common injury in motor vehicle
accidents, especially with left upper quadrant pain. A rigid abdomen is a late sign of significant bleeding.
💫ANSWER✔️✔️: A. Ruptured spleen
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**Question 6**
Practice & Clinical
Judgment Examination
2026/2027
---
**Question 1**
The nurse is assessing a client with suspected pericarditis. Which finding is most characteristic of this
condition?
A. Chest pain that worsens with deep inspiration
B. Chest pain that radiates to the left arm
C. Chest pain that is relieved with nitroglycerin
D. Chest pain that is described as crushing and substernal
,💫RATIONALE✔️✔️: Pericarditis is inflammation of the pericardial sac. The hallmark sign is sharp,
pleuritic chest pain that worsens with deep inspiration, coughing, or lying flat. The pain is typically
relieved by sitting up and leaning forward. Radiating pain and relief with nitroglycerin are more
indicative of angina.
💫ANSWER✔️✔️: A. Chest pain that worsens with deep inspiration
---
**Question 2**
A client with a history of chronic heart failure is prescribed digoxin (Lanoxin). The nurse should monitor
the client for which early sign of digoxin toxicity?
A. Visual disturbances
B. Anorexia and nausea
C. Bradycardia
D. Confusion
💫RATIONALE✔️✔️: Anorexia, nausea, and vomiting are among the earliest signs of digoxin toxicity.
Visual disturbances (yellow-green halos), bradycardia, and confusion can occur but typically develop
later. Recognizing early signs allows for prompt intervention.
💫ANSWER✔️✔️: B. Anorexia and nausea
---
**Question 3**
,The nurse is caring for a client who is 24 hours post-operative following a bowel resection. The client's
nasogastric (NG) tube is draining 200 mL of greenish fluid. Which action is most appropriate?
A. Notify the healthcare provider immediately
B. Clamp the NG tube for 2 hours
C. Document the finding as expected
D. Increase the suction pressure
💫RATIONALE✔️✔️: Greenish drainage from an NG tube post-abdominal surgery is expected and
indicates the return of gastric and biliary secretions. The nurse should document the amount, color, and
consistency as part of routine monitoring. Notifying the provider is unnecessary.
💫ANSWER✔️✔️: C. Document the finding as expected
---
**Question 4**
A client with major depressive disorder is started on duloxetine (Cymbalta). Which instruction should
the nurse include in the teaching plan?
A. "Take this medication at bedtime to prevent insomnia."
B. "Do not stop this medication abruptly."
C. "This medication will work within 24 hours."
D. "You can take this medication with grapefruit juice."
, 💫RATIONALE✔️✔️: Duloxetine is an SNRI that should not be stopped abruptly due to the risk of
withdrawal symptoms. It takes several weeks to reach therapeutic effect, and grapefruit juice should be
avoided with many psychiatric medications.
💫ANSWER✔️✔️: B. "Do not stop this medication abruptly."
---
**Question 5**
The nurse is assessing a client in the emergency department who was in a motor vehicle accident. The
client has bruising over the lower abdomen and reports severe abdominal pain. The nurse notes a rigid
abdomen. Which condition should the nurse suspect?
A. Ruptured spleen
B. Bladder rupture
C. Abdominal aortic aneurysm
D. Hepatic laceration
💫RATIONALE✔️✔️: A rigid abdomen and severe abdominal pain following blunt trauma are signs of
internal bleeding and peritoneal irritation. A ruptured spleen is a common injury in motor vehicle
accidents, especially with left upper quadrant pain. A rigid abdomen is a late sign of significant bleeding.
💫ANSWER✔️✔️: A. Ruptured spleen
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**Question 6**
