2026–2027 NGN NCLEX-RN 350 Original Clinical Judgment Practice Question

2026–2027 NGN NCLEX-RN 350 Original Clinical Judgment Practice Questions Marked Answers • Rationales • Comprehensive Nursing Review Prepared as an original study resource aligned with the 2026 NCLEX-RN Test Plan structure and its emphasis on clinical judgment. TABLE OF CONTENTS Management of Care — 55 questions Safety & Infection Prevention and Control — 45 questions Health Promotion and Maintenance — 40 questions Psychosocial Integrity — 35 questions Basic Care and Comfort — 40 questions Pharmacological & Parenteral Therapies — 55 questions Reduction of Risk Potential — 40 questions Physiological Adaptation — 40 questions Question format includes multiple-choice and clinical-priority decision making. Answers are marked clearly after each question. 1. [Management of Care] A client with sepsis has a blood pressure of 84/48 mm Hg, new confusion, and cool extremities. Which action should the nurse take first? A. Notify the rapid response team B. Offer oral fluids C. Place the client in Trendelenburg position D. Document the findings and reassess in 30 minutes Correct Answer: A. Notify the rapid response team Rationale: The findings indicate possible septic shock with impaired perfusion. Rapid escalation and stabilization are priorities. 2. [Management of Care] The RN is caring for four clients. Which client should be assessed first? A. A client with new stridor after thyroid surgery B. A client requesting a PRN sleep medication C. A client with chronic arthritis reporting pain 6/10 D. A client awaiting discharge instructions Correct Answer: A. A client with new stridor after thyroid surgery Rationale: Stridor suggests upper-airway obstruction and can rapidly become life-threatening. 3. [Management of Care] A nurse is delegating tasks to assistive personnel. Which task is appropriate? A. Obtain routine vital signs for a stable client B. Assess a new pressure injury C. Teach insulin self-administration D. Evaluate response to an IV medication Correct Answer: A. Obtain routine vital signs for a stable client Rationale: Routine data collection on a stable client is appropriate for assistive personnel; assessment, teaching, and evaluation remain nursing responsibilities. 4. [Management of Care] A client refuses a prescribed blood product after the nurse explains the purpose. What is the best response? A. Explore the client's concerns and verify informed refusal B. Tell the client the transfusion is mandatory C. Ask a family member to convince the client D. Administer the blood product without discussion Correct Answer: A. Explore the client's concerns and verify informed refusal Rationale: The client has the right to make informed decisions. The nurse should explore concerns and respect autonomy. 5. [Management of Care] A client with sepsis has a blood pressure of 84/48 mm Hg, new confusion, and cool extremities. Which action should the nurse take first? Which client statement indicates correct understanding? A. Notify the rapid response team B. Offer oral fluids C. Place the client in Trendelenburg position D. Document the findings and reassess in 30 minutes Correct Answer: A. Notify the rapid response team Rationale: The findings indicate possible septic shock with impaired perfusion. Rapid escalation and stabilization are priorities. 6. [Management of Care] The RN is caring for four clients. Which client should be assessed first? Which nursing action is the priority? A. A client with new stridor after thyroid surgery B. A client requesting a PRN sleep medication C. A client with chronic arthritis reporting pain 6/10 D. A client awaiting discharge instructions Correct Answer: A. A client with new stridor after thyroid surgery Rationale: Stridor suggests upper-airway obstruction and can rapidly become life-threatening. 7. [Management of Care] A nurse is delegating tasks to assistive personnel. Which task is appropriate? Which finding requires the most immediate follow-up? A. Obtain routine vital signs for a stable client B. Assess a new pressure injury C. Teach insulin self-administration D. Evaluate response to an IV medication Correct Answer: A. Obtain routine vital signs for a stable client Rationale: Routine data collection on a stable client is appropriate for assistive personnel; assessment, teaching, and evaluation remain nursing responsibilities. 8. [Management of Care] A client refuses a prescribed blood product after the nurse explains the purpose. What is the best response? Which response by the nurse is best? A. Explore the client's concerns and verify informed refusal B. Tell the client the transfusion is mandatory C. Ask a family member to convince the client D. Administer the blood product without discussion Correct Answer: A. Explore the client's concerns and verify informed refusal Rationale: The client has the right to make informed decisions. The nurse should explore concerns and respect autonomy. 9. [Management of Care] A client with sepsis has a blood pressure of 84/48 mm Hg, new confusion, and cool extremities. Which action should the nurse take first? Which intervention should the nurse implement first? The finding occurs during routine monitoring. A. Notify the rapid response team B. Offer oral fluids C. Place the client in Trendelenburg position D. Document the findings and reassess in 30 minutes Correct Answer: A. Notify the rapid response team Rationale: The findings indicate possible septic shock with impaired perfusion. Rapid escalation and stabilization are priorities. 10. [Management of Care] The RN is caring for four clients. Which client should be assessed first? Which client statement indicates correct understanding? The nurse is preparing the plan of care. A. A client with new stridor after thyroid surgery B. A client requesting a PRN sleep medication C. A client with chronic arthritis reporting pain 6/10 D. A client awaiting discharge instructions Correct Answer: A. A client with new stridor after thyroid surgery Rationale: Stridor suggests upper-airway obstruction and can rapidly become life-threatening. 11. [Management of Care] A nurse is delegating tasks to assistive personnel. Which task is appropriate? Which nursing action is the priority? The nurse is reviewing the client's status during a focused assessment. A. Obtain routine vital signs for a stable client B. Assess a new pressure injury C. Teach insulin self-administration D. Evaluate response to an IV medication Correct Answer: A. Obtain routine vital signs for a stable client Rationale: Routine data collection on a stable client is appropriate for assistive personnel; assessment, teaching, and evaluation remain nursing responsibilities. 12. [Management of Care] A client refuses a prescribed blood product after the nurse explains the purpose. What is the best response? Which finding requires the most immediate follow-up? The client has just arrived on the unit. A. Explore the client's concerns and verify informed refusal B. Tell the client the transfusion is mandatory C. Ask a family member to convince the client D. Administer the blood product without discussion Correct Answer: A. Explore the client's concerns and verify informed refusal Rationale: The client has the right to make informed decisions. The nurse should explore concerns and respect autonomy. 13. [Management of Care] A client with sepsis has a blood pressure of 84/48 mm Hg, new confusion, and cool extremities. Which action should the nurse take first? Which response by the nurse is best? The nurse is completing an initial safety check. A. Notify the rapid response team B. Offer oral fluids C. Place the client in Trendelenburg position D. Document the findings and reassess in 30 minutes Correct Answer: A. Notify the rapid response team Rationale: The findings indicate possible septic shock with impaired perfusion. Rapid escalation and stabilization are priorities. 14. [Management of Care] The RN is caring for four clients. Which client should be assessed first? Which intervention should the nurse implement first? The finding occurs during routine monitoring. A. A client with new stridor after thyroid surgery B. A client requesting a PRN sleep medication C. A client with chronic arthritis reporting pain 6/10 D. A client awaiting discharge instructions Correct Answer: A. A client with new stridor after thyroid surgery Rationale: Stridor suggests upper-airway obstruction and can rapidly become life-threatening. 15. [Management of Care] A nurse is delegating tasks to assistive personnel. Which task is appropriate? Which client statement indicates correct understanding? The nurse is preparing the plan of care. A. Obtain routine vital signs for a stable client B. Assess a new pressure injury C. Teach insulin self-administration D. Evaluate response to an IV medication Correct Answer: A. Obtain routine vital signs for a stable client Rationale: Routine data collection on a stable client is appropriate for assistive personnel; assessment, teaching, and evaluation remain nursing responsibilities. 16. [Management of Care] A client refuses a prescribed blood product after the nurse explains the purpose. What is the best response? Which nursing action is the priority? The nurse is reviewing the client's status during a focused assessment. A. Explore the client's concerns and verify informed refusal B. Tell the client the transfusion is mandatory C. Ask a family member to convince the client D. Administer the blood product without discussion Correct Answer: A. Explore the client's concerns and verify informed refusal Rationale: The client has the right to make informed decisions. The nurse should explore concerns and respect autonomy. 17. [Management of Care] A client with sepsis has a blood pressure of 84/48 mm Hg, new confusion, and cool extremities. Which action should the nurse take first? Which finding requires the most immediate follow-up? The client has just arrived on the unit. A. Notify the rapid response team B. Offer oral fluids C. Place the client in Trendelenburg position D. Document the findings and reassess in 30 minutes Correct Answer: A. Notify the rapid response team Rationale: The findings indicate possible septic shock with impaired perfusion. Rapid escalation and stabilization are priorities. 18. [Management of Care] The RN is caring for four clients. Which client should be assessed first? Which response by the nurse is best? The nurse is completing an initial safety check. A. A client with new stridor after thyroid surgery B. A client requesting a PRN sleep medication C. A client with chronic arthritis reporting pain 6/10 D. A client awaiting discharge instructions Correct Answer: A. A client with new stridor after thyroid surgery Rationale: Stridor suggests upper-airway obstruction and can rapidly become life-threatening. 19. [Management of Care] A nurse is delegating tasks to assistive personnel. Which task is appropriate? Which intervention should the nurse implement first? The finding occurs during routine monitoring. A. Obtain routine vital signs for a stable client B. Assess a new pressure injury C. Teach insulin self-administration D. Evaluate response to an IV medication Correct Answer: A. Obtain routine vital signs for a stable client Rationale: Routine data collection on a stable client is appropriate for assistive personnel; assessment, teaching, and evaluation remain nursing responsibilities. 20. [Management of Care] A client refuses a prescribed blood product after the nurse explains the purpose. What is the best response? Which client statement indicates correct understanding? The nurse is preparing the plan of care. A. Explore the client's concerns and verify informed refusal B. Tell the client the transfusion is mandatory C. Ask a family member to convince the client D. Administer the blood product without discussion Correct Answer: A. Explore the client's concerns and verify informed refusal Rationale: The client has the right to make informed decisions. The nurse should explore concerns and respect autonomy.