REx-PN NCLEX-RN/PN-Style
Clinical Judgment Practice
Exam 2026–2027| Complete
Test Prep Practice Questions
With Answers & Detailed
Rationales |clinical Judgment
&Safety |A+ Rated
1. A client with pneumonia has an oxygen saturation of 88% on
room air. Which action should the practical nurse take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position
C. Obtain a sputum specimen
D. Administer an antipyretic
Answer: B. Place the client in high-Fowler's position
High-Fowler's positioning promotes lung expansion and can
immediately improve ventilation and oxygenation. Airway and
breathing take priority.
2. A client receiving IV potassium chloride reports burning at the IV
site. What is the nurse's priority action?
,A. Slow the infusion
B. Apply a warm compress
C. Stop the infusion and assess the IV site
D. Document the finding
Answer: C. Stop the infusion and assess the IV site
Potassium chloride is irritating to tissues and can cause significant
injury if infiltration or extravasation occurs. The infusion should be
stopped while the site is assessed.
3. A client with diabetes becomes shaky, diaphoretic, and confused.
Which action is most appropriate?
A. Administer rapid-acting insulin
B. Check the client's blood glucose
C. Encourage exercise
D. Restrict oral fluids
Answer: B. Check the client's blood glucose
Shakiness, diaphoresis, and confusion are classic manifestations of
hypoglycemia. Blood glucose should be assessed promptly so
appropriate treatment can be provided.
4. A postoperative client suddenly develops dyspnea, chest pain,
and tachycardia. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Wound infection
D. Hypoglycemia
Answer: B. Pulmonary embolism
,Sudden dyspnea, pleuritic chest pain, and tachycardia are concerning
for pulmonary embolism, which requires immediate evaluation and
intervention.
5. Which finding in a client taking warfarin should the nurse report
immediately?
A. Mild headache
B. Occasional fatigue
C. Black, tarry stools
D. Increased appetite
Answer: C. Black, tarry stools
Melena may indicate gastrointestinal bleeding. Warfarin increases
bleeding risk, so evidence of significant bleeding requires prompt
assessment.
6. A client with heart failure has increasing dyspnea and bilateral
crackles. What should the nurse do first?
A. Encourage ambulation
B. Place the client upright
C. Increase oral fluids
D. Place the client flat
Answer: B. Place the client upright
Upright positioning decreases venous return and promotes lung
expansion, helping reduce pulmonary congestion and improve
breathing.
, 7. A client receiving morphine becomes difficult to arouse and has
respirations of 7/min. Which medication should the nurse
anticipate?
A. Naloxone
B. Furosemide
C. Protamine
D. Vitamin K
Answer: A. Naloxone
Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory depression.
8. A client with chronic kidney disease has a potassium level of 6.4
mEq/L. Which finding is the priority?
A. Constipation
B. Muscle weakness
C. Cardiac dysrhythmia
D. Dry skin
Answer: C. Cardiac dysrhythmia
Severe hyperkalemia can cause life-threatening cardiac conduction
abnormalities. Cardiac monitoring and urgent treatment are
priorities.
9. A client with suspected stroke has difficulty speaking and right-
sided weakness. Which information is most important to
determine?
A. Last bowel movement
B. Time symptoms began
C. Dietary preferences
D. Sleep pattern
Clinical Judgment Practice
Exam 2026–2027| Complete
Test Prep Practice Questions
With Answers & Detailed
Rationales |clinical Judgment
&Safety |A+ Rated
1. A client with pneumonia has an oxygen saturation of 88% on
room air. Which action should the practical nurse take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position
C. Obtain a sputum specimen
D. Administer an antipyretic
Answer: B. Place the client in high-Fowler's position
High-Fowler's positioning promotes lung expansion and can
immediately improve ventilation and oxygenation. Airway and
breathing take priority.
2. A client receiving IV potassium chloride reports burning at the IV
site. What is the nurse's priority action?
,A. Slow the infusion
B. Apply a warm compress
C. Stop the infusion and assess the IV site
D. Document the finding
Answer: C. Stop the infusion and assess the IV site
Potassium chloride is irritating to tissues and can cause significant
injury if infiltration or extravasation occurs. The infusion should be
stopped while the site is assessed.
3. A client with diabetes becomes shaky, diaphoretic, and confused.
Which action is most appropriate?
A. Administer rapid-acting insulin
B. Check the client's blood glucose
C. Encourage exercise
D. Restrict oral fluids
Answer: B. Check the client's blood glucose
Shakiness, diaphoresis, and confusion are classic manifestations of
hypoglycemia. Blood glucose should be assessed promptly so
appropriate treatment can be provided.
4. A postoperative client suddenly develops dyspnea, chest pain,
and tachycardia. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Wound infection
D. Hypoglycemia
Answer: B. Pulmonary embolism
,Sudden dyspnea, pleuritic chest pain, and tachycardia are concerning
for pulmonary embolism, which requires immediate evaluation and
intervention.
5. Which finding in a client taking warfarin should the nurse report
immediately?
A. Mild headache
B. Occasional fatigue
C. Black, tarry stools
D. Increased appetite
Answer: C. Black, tarry stools
Melena may indicate gastrointestinal bleeding. Warfarin increases
bleeding risk, so evidence of significant bleeding requires prompt
assessment.
6. A client with heart failure has increasing dyspnea and bilateral
crackles. What should the nurse do first?
A. Encourage ambulation
B. Place the client upright
C. Increase oral fluids
D. Place the client flat
Answer: B. Place the client upright
Upright positioning decreases venous return and promotes lung
expansion, helping reduce pulmonary congestion and improve
breathing.
, 7. A client receiving morphine becomes difficult to arouse and has
respirations of 7/min. Which medication should the nurse
anticipate?
A. Naloxone
B. Furosemide
C. Protamine
D. Vitamin K
Answer: A. Naloxone
Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory depression.
8. A client with chronic kidney disease has a potassium level of 6.4
mEq/L. Which finding is the priority?
A. Constipation
B. Muscle weakness
C. Cardiac dysrhythmia
D. Dry skin
Answer: C. Cardiac dysrhythmia
Severe hyperkalemia can cause life-threatening cardiac conduction
abnormalities. Cardiac monitoring and urgent treatment are
priorities.
9. A client with suspected stroke has difficulty speaking and right-
sided weakness. Which information is most important to
determine?
A. Last bowel movement
B. Time symptoms began
C. Dietary preferences
D. Sleep pattern
