MEDICAL-SURGICAL NURSING: FOCUS ON CLINICAL
JUDGMENT
3rd Edition — Premium Original Clinical-Judgment Practice Bank
Chapters 1–55 • NCLEX-style prioritization • Answers • Rationales • Safety traps
This is an original educational resource. It does not reproduce the publisher's proprietary test bank, locked questions, or answer key. The chapter
coverage follows the publicly listed 55-chapter structure of the 3rd edition.
Honan 3e • Original Clinical-Judgment Practice Bank • Page 1
,1. The Nurse's Role in Adult Health Nursing
QUESTION 1. A nurse is caring for a patient in a situation related to priority assessment. Which action should the nurse take
FIRST?
A. Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate according to
findings.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate
according to findings.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
QUESTION 2. Which finding in a patient with priority assessment should the nurse recognize as the priority?
A. A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority attention.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority
attention.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
QUESTION 3. Which statement by a student nurse demonstrates correct understanding of priority assessment?
A. Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
QUESTION 4. The nurse is evaluating whether an intervention for priority assessment was effective. Which approach is BEST?
A. Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and document/escalate
according to the response.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and
document/escalate according to the response.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
2. Health Education and Health Promotion
Honan 3e • Original Clinical-Judgment Practice Bank • Page 2
,QUESTION 5. A nurse is caring for a patient in a situation related to patient education. Which action should the nurse take
FIRST?
A. Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate according to
findings.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate
according to findings.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
QUESTION 6. Which finding in a patient with patient education should the nurse recognize as the priority?
A. A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority attention.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority
attention.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
QUESTION 7. Which statement by a student nurse demonstrates correct understanding of patient education?
A. Use plain language, assess understanding, and confirm learning with teach-back.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Use plain language, assess understanding, and confirm learning with teach-back.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
QUESTION 8. The nurse is evaluating whether an intervention for patient education was effective. Which approach is BEST?
A. Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and document/escalate
according to the response.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and
document/escalate according to the response.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
3. Chronic Illness and End-of-Life Care
Honan 3e • Original Clinical-Judgment Practice Bank • Page 3
, QUESTION 9. A nurse is caring for a patient in a situation related to goals of care. Which action should the nurse take FIRST?
A. Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate according to
findings.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate
according to findings.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
QUESTION 10. Which finding in a patient with goals of care should the nurse recognize as the priority?
A. A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority attention.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority
attention.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
QUESTION 11. Which statement by a student nurse demonstrates correct understanding of goals of care?
A. Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
QUESTION 12. The nurse is evaluating whether an intervention for goals of care was effective. Which approach is BEST?
A. Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and document/escalate
according to the response.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and
document/escalate according to the response.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
4. Fluid and Electrolyte and Acid–Base Imbalances
Honan 3e • Original Clinical-Judgment Practice Bank • Page 4
JUDGMENT
3rd Edition — Premium Original Clinical-Judgment Practice Bank
Chapters 1–55 • NCLEX-style prioritization • Answers • Rationales • Safety traps
This is an original educational resource. It does not reproduce the publisher's proprietary test bank, locked questions, or answer key. The chapter
coverage follows the publicly listed 55-chapter structure of the 3rd edition.
Honan 3e • Original Clinical-Judgment Practice Bank • Page 1
,1. The Nurse's Role in Adult Health Nursing
QUESTION 1. A nurse is caring for a patient in a situation related to priority assessment. Which action should the nurse take
FIRST?
A. Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate according to
findings.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate
according to findings.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
QUESTION 2. Which finding in a patient with priority assessment should the nurse recognize as the priority?
A. A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority attention.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority
attention.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
QUESTION 3. Which statement by a student nurse demonstrates correct understanding of priority assessment?
A. Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
QUESTION 4. The nurse is evaluating whether an intervention for priority assessment was effective. Which approach is BEST?
A. Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and document/escalate
according to the response.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and
document/escalate according to the response.
CLINICAL-JUDGMENT NOTE: Assess airway, breathing, circulation, immediate safety, and acute change before lower-priority needs.
EXAM TRAP: ABCs and acute deterioration generally outrank routine care.
2. Health Education and Health Promotion
Honan 3e • Original Clinical-Judgment Practice Bank • Page 2
,QUESTION 5. A nurse is caring for a patient in a situation related to patient education. Which action should the nurse take
FIRST?
A. Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate according to
findings.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate
according to findings.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
QUESTION 6. Which finding in a patient with patient education should the nurse recognize as the priority?
A. A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority attention.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority
attention.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
QUESTION 7. Which statement by a student nurse demonstrates correct understanding of patient education?
A. Use plain language, assess understanding, and confirm learning with teach-back.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Use plain language, assess understanding, and confirm learning with teach-back.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
QUESTION 8. The nurse is evaluating whether an intervention for patient education was effective. Which approach is BEST?
A. Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and document/escalate
according to the response.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and
document/escalate according to the response.
CLINICAL-JUDGMENT NOTE: Use plain language, assess understanding, and confirm learning with teach-back.
EXAM TRAP: Teaching is incomplete if the nurse only provides information.
3. Chronic Illness and End-of-Life Care
Honan 3e • Original Clinical-Judgment Practice Bank • Page 3
, QUESTION 9. A nurse is caring for a patient in a situation related to goals of care. Which action should the nurse take FIRST?
A. Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate according to
findings.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Perform the focused assessment needed to identify immediate threats to safety and physiologic stability, then intervene or escalate
according to findings.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
QUESTION 10. Which finding in a patient with goals of care should the nurse recognize as the priority?
A. A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority attention.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: A new or worsening finding that threatens airway, breathing, circulation, neurologic status, or immediate safety requires priority
attention.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
QUESTION 11. Which statement by a student nurse demonstrates correct understanding of goals of care?
A. Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
QUESTION 12. The nurse is evaluating whether an intervention for goals of care was effective. Which approach is BEST?
A. Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and document/escalate
according to the response.
B. Complete routine care first and reassess the change at the next scheduled assessment.
C. Assume the finding is expected because the patient has a medical diagnosis.
D. Delay action until all laboratory results and diagnostic reports are available.
ANSWER: A
RATIONALE: Compare the patient's current clinical status with the baseline/problem, assess the intended outcome and adverse effects, and
document/escalate according to the response.
CLINICAL-JUDGMENT NOTE: Clarify patient preferences, prognosis, symptom burden, and advance-care planning while supporting informed decisions.
EXAM TRAP: Do not equate palliative care with giving up.
4. Fluid and Electrolyte and Acid–Base Imbalances
Honan 3e • Original Clinical-Judgment Practice Bank • Page 4
