REx-PN Ultimate Practice Test: Clinical Judgment, Prioritization &
Delegation
REx-PN Ultimate Practice Test Clinical
Judgment, Prioritization & Delegation
Practice Exam 2026–2027| Complete
Test Prep Practice Questions With
Answers & Detailed Rationales
|clinical Judgment &Safety |A+ Rated
1. A client is admitted with shortness of breath. Which finding
requires the nurse's immediate attention?
A. Respiratory rate 22/min
B. Oxygen saturation 88% on room air
C. Productive cough with clear sputum
D. Temperature 37.4°C (99.3°F)
Answer: B. Oxygen saturation 88% on room air
An oxygen saturation of 88% indicates hypoxemia. Airway and
breathing take priority over less urgent findings.
2. Which client should the practical nurse assess first?
A. Client requesting a pain medication
B. Client with new-onset confusion
C. Client awaiting discharge instructions
D. Client asking for assistance with bathing
Answer: B. Client with new-onset confusion
,Acute confusion can indicate hypoxia, hypoglycemia, infection, or
another rapidly developing problem and requires prompt assessment.
3. A client suddenly develops facial drooping and difficulty speaking.
What is the priority action?
A. Give oral fluids
B. Assist the client to ambulate
C. Activate the stroke/emergency response according to facility
policy
D. Allow the client to rest
Answer: C. Activate the stroke/emergency response according to
facility policy
Sudden neurologic deficits may indicate an acute stroke. Rapid
evaluation is essential because time-sensitive treatment may be
possible.
4. Which assessment finding is most concerning in a postoperative
client?
A. Incisional pain rated 4/10
B. Temperature 37.6°C
C. Urine output of 15 mL/hr
D. Mild nausea
Answer: C. Urine output of 15 mL/hr
Urine output below approximately 30 mL/hr in an adult may indicate
inadequate renal perfusion and requires prompt assessment.
5. A client reports dizziness when standing. Which action should the
nurse take first?
A. Encourage rapid ambulation
,B. Have the client sit or lie down safely
C. Restrict oral fluids
D. Administer a sedative
Answer: B. Have the client sit or lie down safely
The immediate priority is preventing a fall and injury. Further
assessment can then determine the cause of the dizziness.
6. Which statement best demonstrates appropriate clinical
judgment?
A. "I always follow the same intervention for this symptom."
B. "I will compare the client's current findings with the baseline and
determine what has changed."
C. "The diagnosis tells me everything I need to know."
D. "I will wait until the next shift to report abnormal findings."
Answer: B. "I will compare the client's current findings with the
baseline and determine what has changed."
Clinical judgment involves recognizing changes, interpreting findings,
determining priorities, taking action, and evaluating the response.
7. A client has a blood glucose level of 2.8 mmol/L (50 mg/dL) and is
awake and able to swallow. What should the nurse do?
A. Administer fast-acting carbohydrate
B. Give long-acting insulin
C. Encourage exercise
D. Restrict food
Answer: A. Administer fast-acting carbohydrate
An alert client with symptomatic or significantly low blood glucose
who can swallow should receive a rapid source of glucose.
, 8. Which finding indicates that a nursing intervention was effective
for a client with dyspnea?
A. Respiratory rate increases from 20 to 30/min
B. Oxygen saturation increases from 88% to 95%
C. Client becomes increasingly restless
D. Heart rate increases from 88 to 118/min
Answer: B. Oxygen saturation increases from 88% to 95%
Improved oxygen saturation is objective evidence that oxygenation
has improved.
9. Which client should be seen first?
A. Client with chronic arthritis reporting pain
B. Client with asthma who has difficulty speaking in complete
sentences
C. Client needing assistance with toileting
D. Client requesting a snack
Answer: B. Client with asthma who has difficulty speaking in
complete sentences
Difficulty speaking because of respiratory distress suggests significant
airway or breathing compromise and requires immediate attention.
10. A nurse discovers that a medication was administered to the
wrong client. What is the priority action?
A. Hide the error
B. Assess the client and notify the appropriate healthcare
professional
C. Wait for symptoms to appear
D. Document that the medication was refused
Delegation
REx-PN Ultimate Practice Test Clinical
Judgment, Prioritization & Delegation
Practice Exam 2026–2027| Complete
Test Prep Practice Questions With
Answers & Detailed Rationales
|clinical Judgment &Safety |A+ Rated
1. A client is admitted with shortness of breath. Which finding
requires the nurse's immediate attention?
A. Respiratory rate 22/min
B. Oxygen saturation 88% on room air
C. Productive cough with clear sputum
D. Temperature 37.4°C (99.3°F)
Answer: B. Oxygen saturation 88% on room air
An oxygen saturation of 88% indicates hypoxemia. Airway and
breathing take priority over less urgent findings.
2. Which client should the practical nurse assess first?
A. Client requesting a pain medication
B. Client with new-onset confusion
C. Client awaiting discharge instructions
D. Client asking for assistance with bathing
Answer: B. Client with new-onset confusion
,Acute confusion can indicate hypoxia, hypoglycemia, infection, or
another rapidly developing problem and requires prompt assessment.
3. A client suddenly develops facial drooping and difficulty speaking.
What is the priority action?
A. Give oral fluids
B. Assist the client to ambulate
C. Activate the stroke/emergency response according to facility
policy
D. Allow the client to rest
Answer: C. Activate the stroke/emergency response according to
facility policy
Sudden neurologic deficits may indicate an acute stroke. Rapid
evaluation is essential because time-sensitive treatment may be
possible.
4. Which assessment finding is most concerning in a postoperative
client?
A. Incisional pain rated 4/10
B. Temperature 37.6°C
C. Urine output of 15 mL/hr
D. Mild nausea
Answer: C. Urine output of 15 mL/hr
Urine output below approximately 30 mL/hr in an adult may indicate
inadequate renal perfusion and requires prompt assessment.
5. A client reports dizziness when standing. Which action should the
nurse take first?
A. Encourage rapid ambulation
,B. Have the client sit or lie down safely
C. Restrict oral fluids
D. Administer a sedative
Answer: B. Have the client sit or lie down safely
The immediate priority is preventing a fall and injury. Further
assessment can then determine the cause of the dizziness.
6. Which statement best demonstrates appropriate clinical
judgment?
A. "I always follow the same intervention for this symptom."
B. "I will compare the client's current findings with the baseline and
determine what has changed."
C. "The diagnosis tells me everything I need to know."
D. "I will wait until the next shift to report abnormal findings."
Answer: B. "I will compare the client's current findings with the
baseline and determine what has changed."
Clinical judgment involves recognizing changes, interpreting findings,
determining priorities, taking action, and evaluating the response.
7. A client has a blood glucose level of 2.8 mmol/L (50 mg/dL) and is
awake and able to swallow. What should the nurse do?
A. Administer fast-acting carbohydrate
B. Give long-acting insulin
C. Encourage exercise
D. Restrict food
Answer: A. Administer fast-acting carbohydrate
An alert client with symptomatic or significantly low blood glucose
who can swallow should receive a rapid source of glucose.
, 8. Which finding indicates that a nursing intervention was effective
for a client with dyspnea?
A. Respiratory rate increases from 20 to 30/min
B. Oxygen saturation increases from 88% to 95%
C. Client becomes increasingly restless
D. Heart rate increases from 88 to 118/min
Answer: B. Oxygen saturation increases from 88% to 95%
Improved oxygen saturation is objective evidence that oxygenation
has improved.
9. Which client should be seen first?
A. Client with chronic arthritis reporting pain
B. Client with asthma who has difficulty speaking in complete
sentences
C. Client needing assistance with toileting
D. Client requesting a snack
Answer: B. Client with asthma who has difficulty speaking in
complete sentences
Difficulty speaking because of respiratory distress suggests significant
airway or breathing compromise and requires immediate attention.
10. A nurse discovers that a medication was administered to the
wrong client. What is the priority action?
A. Hide the error
B. Assess the client and notify the appropriate healthcare
professional
C. Wait for symptoms to appear
D. Document that the medication was refused
