REx-PN Questions & Answers |
Clinical Judgment & Nursing
Care 200+ Question And
Answer With Rationales 2026
Latest Exam
1. The practical nurse receives report on four clients. Which client
should be assessed first?
A. Client with chronic arthritis reporting pain of 5/10
B. Client 1 day after surgery with a temperature of 37.8°C (100°F)
C. Client with COPD whose oxygen saturation is 86% despite
prescribed oxygen
D. Client awaiting discharge instructions
Answer: BOLD C. Client with COPD whose oxygen saturation is 86%
despite prescribed oxygen
Rationale: An oxygen saturation of 86% despite oxygen therapy
indicates impaired oxygenation and requires immediate assessment
and intervention.
2. A client suddenly develops facial drooping and difficulty speaking.
What is the nurse's priority action?
A. Give oral fluids
B. Determine the exact time symptoms began
,C. Place the client in Trendelenburg position
D. Encourage the client to walk
Answer: BOLD B. Determine the exact time symptoms began
Rationale: Establishing the last-known-well time is critical when
evaluating a possible acute stroke because time-sensitive treatment
decisions depend on symptom onset.
3. Which finding requires immediate intervention?
A. Heart rate 88/min
B. Respiratory rate 8/min after opioid administration
C. Blood pressure 128/76 mmHg
D. Temperature 37°C
Answer: BOLD B. Respiratory rate 8/min after opioid administration
Rationale: Respiratory depression is a potentially life-threatening
opioid adverse effect and requires immediate assessment and
intervention.
4. Which client should the nurse see first?
A. Client requesting a sleeping medication
B. Client with potassium of 6.4 mmol/L
C. Client with mild nausea
D. Client with chronic back pain
Answer: BOLD B. Client with potassium of 6.4 mmol/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias and requires urgent assessment and treatment.
,5. A client receiving a blood transfusion develops chills, fever, and
back pain. What should the nurse do first?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Recheck the temperature in 30 minutes
Answer: BOLD B. Stop the transfusion
Rationale: Fever, chills, and back pain may indicate an acute
transfusion reaction. The transfusion must be stopped immediately.
6. Which assessment finding is most concerning in a client with
asthma?
A. Expiratory wheezing
B. Productive cough
C. Ability to speak only one or two words at a time
D. Respiratory rate of 20/min
Answer: BOLD C. Ability to speak only one or two words at a time
Rationale: Inability to speak normally indicates severe respiratory
distress and possible impending respiratory failure.
7. A client reports crushing substernal chest pain radiating to the jaw.
What is the priority?
A. Offer a meal
B. Obtain an ECG promptly
C. Encourage ambulation
D. Apply a heating pad
Answer: BOLD B. Obtain an ECG promptly
, Rationale: The symptoms are concerning for acute coronary
syndrome. Rapid ECG assessment is essential.
8. Which client is most appropriate for assignment to a practical
nurse?
A. Client requiring initial assessment for septic shock
B. Stable client needing routine wound care
C. Client requiring complex ventilator management
D. Client with rapidly changing neurological status
Answer: BOLD B. Stable client needing routine wound care
Rationale: Stable clients with predictable outcomes and routine
interventions are generally appropriate for practical-nurse care
within scope and organizational policy.
9. A client becomes confused and restless several hours after
surgery. Which assessment should be performed first?
A. Check oxygen saturation
B. Ask about the client's favorite foods
C. Measure abdominal circumference
D. Offer a sleeping medication
Answer: BOLD A. Check oxygen saturation
Rationale: Acute confusion can result from hypoxemia. Oxygenation
should be assessed promptly.
10. Which finding suggests deterioration in a client with sepsis?
A. Warm skin and normal mentation
B. Urine output of 10 mL/hr
Clinical Judgment & Nursing
Care 200+ Question And
Answer With Rationales 2026
Latest Exam
1. The practical nurse receives report on four clients. Which client
should be assessed first?
A. Client with chronic arthritis reporting pain of 5/10
B. Client 1 day after surgery with a temperature of 37.8°C (100°F)
C. Client with COPD whose oxygen saturation is 86% despite
prescribed oxygen
D. Client awaiting discharge instructions
Answer: BOLD C. Client with COPD whose oxygen saturation is 86%
despite prescribed oxygen
Rationale: An oxygen saturation of 86% despite oxygen therapy
indicates impaired oxygenation and requires immediate assessment
and intervention.
2. A client suddenly develops facial drooping and difficulty speaking.
What is the nurse's priority action?
A. Give oral fluids
B. Determine the exact time symptoms began
,C. Place the client in Trendelenburg position
D. Encourage the client to walk
Answer: BOLD B. Determine the exact time symptoms began
Rationale: Establishing the last-known-well time is critical when
evaluating a possible acute stroke because time-sensitive treatment
decisions depend on symptom onset.
3. Which finding requires immediate intervention?
A. Heart rate 88/min
B. Respiratory rate 8/min after opioid administration
C. Blood pressure 128/76 mmHg
D. Temperature 37°C
Answer: BOLD B. Respiratory rate 8/min after opioid administration
Rationale: Respiratory depression is a potentially life-threatening
opioid adverse effect and requires immediate assessment and
intervention.
4. Which client should the nurse see first?
A. Client requesting a sleeping medication
B. Client with potassium of 6.4 mmol/L
C. Client with mild nausea
D. Client with chronic back pain
Answer: BOLD B. Client with potassium of 6.4 mmol/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac
dysrhythmias and requires urgent assessment and treatment.
,5. A client receiving a blood transfusion develops chills, fever, and
back pain. What should the nurse do first?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Recheck the temperature in 30 minutes
Answer: BOLD B. Stop the transfusion
Rationale: Fever, chills, and back pain may indicate an acute
transfusion reaction. The transfusion must be stopped immediately.
6. Which assessment finding is most concerning in a client with
asthma?
A. Expiratory wheezing
B. Productive cough
C. Ability to speak only one or two words at a time
D. Respiratory rate of 20/min
Answer: BOLD C. Ability to speak only one or two words at a time
Rationale: Inability to speak normally indicates severe respiratory
distress and possible impending respiratory failure.
7. A client reports crushing substernal chest pain radiating to the jaw.
What is the priority?
A. Offer a meal
B. Obtain an ECG promptly
C. Encourage ambulation
D. Apply a heating pad
Answer: BOLD B. Obtain an ECG promptly
, Rationale: The symptoms are concerning for acute coronary
syndrome. Rapid ECG assessment is essential.
8. Which client is most appropriate for assignment to a practical
nurse?
A. Client requiring initial assessment for septic shock
B. Stable client needing routine wound care
C. Client requiring complex ventilator management
D. Client with rapidly changing neurological status
Answer: BOLD B. Stable client needing routine wound care
Rationale: Stable clients with predictable outcomes and routine
interventions are generally appropriate for practical-nurse care
within scope and organizational policy.
9. A client becomes confused and restless several hours after
surgery. Which assessment should be performed first?
A. Check oxygen saturation
B. Ask about the client's favorite foods
C. Measure abdominal circumference
D. Offer a sleeping medication
Answer: BOLD A. Check oxygen saturation
Rationale: Acute confusion can result from hypoxemia. Oxygenation
should be assessed promptly.
10. Which finding suggests deterioration in a client with sepsis?
A. Warm skin and normal mentation
B. Urine output of 10 mL/hr
