SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1.
Reference
Ch. 1 — Clinical Judgment and the NGN-PN® Examination —
The Pyramid to Success
Stem
A practical nursing student is creating a study plan using the
"Pyramid to Success" framework from class. Which activity
should the student place at the base of the pyramid to best
support higher clinical judgment skills on NGN-PN items?
A. Memorizing drug generic and trade names in alphabetical
order.
,B. Mastering fundamental assessment skills and accurate data
collection.
C. Practicing timed multiple-choice tests only.
D. Reviewing advanced pathophysiology journal articles.
Correct answer: B
Rationale — Correct
Mastering fundamental assessment and accurate cue
recognition forms the foundation for clinical judgment; reliable
data collection enables application and analysis on NGN items.
Rationale — Incorrect
A: Memorization of names is low-level recall and does not build
clinical judgment.
C: Timed practice helps test endurance but without strong
assessment skills it's insufficient.
D: Advanced pathophysiology is beyond entry-level PN focus
and not the pyramid base.
Teaching point
Accurate assessment and cue recognition are the foundation of
clinical judgment.
Citation
Silvestri, L. A., & Silvestri, A. (2025). Saunders Comprehensive
Review for the NCLEX-PN® Examination (9th ed.). Ch. 1.
2.
,Reference
Ch. 1 — Clinical Judgment and the NGN-PN® Examination —
Clinical Judgment and Next Generation NCLEX® Items
Stem
During NGN-style case work, a PN candidate identifies an
unexpected low oxygen saturation (SpO₂ 88% on room air) in a
postoperative client. According to the CJMM approach, what is
the PN's next best clinical judgment action?
A. Immediately document the finding and continue with the
rest of the assessment.
B. Apply nasal cannula at 2 L/min and reassess SpO₂ and
respiratory status.
C. Tell the charge nurse after the end of the shift.
D. Administer an extra bolus of IV opioid analgesic to reduce
anxiety.
Correct answer: B
Rationale — Correct
Applying oxygen at a low-flow (nurse-initiated, basic
intervention within PN scope) addresses the immediate cue
(hypoxemia) and allows reassessment—consistent with CJMM:
take action and evaluate.
Rationale — Incorrect
A: Delaying intervention risks deterioration; documentation
alone is insufficient.
C: Waiting until end of shift dangerously delays care.
, D: Administering opioid is inappropriate for hypoxemia and may
worsen respiratory depression; beyond PN independent action.
Teaching point
Immediate basic interventions (oxygen, reassess) follow cue
recognition in CJMM.
Citation
Silvestri, L. A., & Silvestri, A. (2025). Saunders Comprehensive
Review for the NCLEX-PN® Examination (9th ed.). Ch. 1.
3.
Reference
Ch. 1 — Clinical Judgment and the NGN-PN® Examination —
CJMM
Stem
A PN assesses a client with sudden confusion and a blood
glucose reading of 58 mg/dL. Using the CJMM, which action
demonstrates appropriate prioritization by the PN?
A. Offer 4 ounces of orange juice and recheck blood glucose in
15 minutes.
B. Notify the provider and wait for orders before acting.
C. Place the client on NPO status until the cause is determined.
D. Chart the glucose value and continue routine vital sign
schedule.
Correct answer: A
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1.
Reference
Ch. 1 — Clinical Judgment and the NGN-PN® Examination —
The Pyramid to Success
Stem
A practical nursing student is creating a study plan using the
"Pyramid to Success" framework from class. Which activity
should the student place at the base of the pyramid to best
support higher clinical judgment skills on NGN-PN items?
A. Memorizing drug generic and trade names in alphabetical
order.
,B. Mastering fundamental assessment skills and accurate data
collection.
C. Practicing timed multiple-choice tests only.
D. Reviewing advanced pathophysiology journal articles.
Correct answer: B
Rationale — Correct
Mastering fundamental assessment and accurate cue
recognition forms the foundation for clinical judgment; reliable
data collection enables application and analysis on NGN items.
Rationale — Incorrect
A: Memorization of names is low-level recall and does not build
clinical judgment.
C: Timed practice helps test endurance but without strong
assessment skills it's insufficient.
D: Advanced pathophysiology is beyond entry-level PN focus
and not the pyramid base.
Teaching point
Accurate assessment and cue recognition are the foundation of
clinical judgment.
Citation
Silvestri, L. A., & Silvestri, A. (2025). Saunders Comprehensive
Review for the NCLEX-PN® Examination (9th ed.). Ch. 1.
2.
,Reference
Ch. 1 — Clinical Judgment and the NGN-PN® Examination —
Clinical Judgment and Next Generation NCLEX® Items
Stem
During NGN-style case work, a PN candidate identifies an
unexpected low oxygen saturation (SpO₂ 88% on room air) in a
postoperative client. According to the CJMM approach, what is
the PN's next best clinical judgment action?
A. Immediately document the finding and continue with the
rest of the assessment.
B. Apply nasal cannula at 2 L/min and reassess SpO₂ and
respiratory status.
C. Tell the charge nurse after the end of the shift.
D. Administer an extra bolus of IV opioid analgesic to reduce
anxiety.
Correct answer: B
Rationale — Correct
Applying oxygen at a low-flow (nurse-initiated, basic
intervention within PN scope) addresses the immediate cue
(hypoxemia) and allows reassessment—consistent with CJMM:
take action and evaluate.
Rationale — Incorrect
A: Delaying intervention risks deterioration; documentation
alone is insufficient.
C: Waiting until end of shift dangerously delays care.
, D: Administering opioid is inappropriate for hypoxemia and may
worsen respiratory depression; beyond PN independent action.
Teaching point
Immediate basic interventions (oxygen, reassess) follow cue
recognition in CJMM.
Citation
Silvestri, L. A., & Silvestri, A. (2025). Saunders Comprehensive
Review for the NCLEX-PN® Examination (9th ed.). Ch. 1.
3.
Reference
Ch. 1 — Clinical Judgment and the NGN-PN® Examination —
CJMM
Stem
A PN assesses a client with sudden confusion and a blood
glucose reading of 58 mg/dL. Using the CJMM, which action
demonstrates appropriate prioritization by the PN?
A. Offer 4 ounces of orange juice and recheck blood glucose in
15 minutes.
B. Notify the provider and wait for orders before acting.
C. Place the client on NPO status until the cause is determined.
D. Chart the glucose value and continue routine vital sign
schedule.
Correct answer: A
