**Title:** **Next Generation NCLEX-RN Clinical
Judgment Bootcamp: From Fundamentals to
Critical Care**
---
### Question 1 of 84
A nurse in the emergency department is assessing a client who was involved in a motor vehicle collision.
The client has bruising across the lower abdomen and reports severe left upper quadrant pain that
radiates to the left shoulder. The nurse should suspect injury to which organ?
A) Liver
B) Spleen
C) Kidney
D) Stomach
💫RATIONALE✔️✔️: The left upper quadrant pain radiating to the left shoulder (Kehr’s sign) along with
abdominal bruising is classic for splenic rupture or injury. The spleen is located in the LUQ, and
diaphragmatic irritation from blood refers pain to the left shoulder via the phrenic nerve. The liver is in
the RUQ.
💫ANSWER✔️✔️: B) Spleen
---
### Question 2 of 84
,A nurse is caring for a client who has a new tracheostomy. Which of the following actions should the
nurse take when performing tracheostomy suctioning?
A) Insert the suction catheter while applying continuous suction.
B) Hyperoxygenate the client before and after suctioning.
C) Limit suctioning to 30 seconds per pass.
D) Use a sterile catheter for each suctioning pass.
💫RATIONALE✔️✔️: Hyperoxygenation (B) prevents hypoxemia during suctioning. Suction should be
applied only during withdrawal, not insertion. Suction time should be <10-15 seconds, not 30. Sterile
technique is required, but the same catheter can be used for multiple passes if kept sterile; however, a
new sterile catheter is often used for each session.
💫ANSWER✔️✔️: B) Hyperoxygenate the client before and after suctioning.
---
### Question 3 of 84
**Select-All-That-Apply (SATA):** A nurse is assessing a client who has a massive pulmonary embolism
(PE). Which of the following findings should the nurse expect? (Select all that apply.)
A) Hypotension
B) Tachycardia
C) Bradypnea
D) Jugular vein distention
E) Hemoptysis
💫RATIONALE✔️✔️: Massive PE causes right ventricular failure and obstructive shock: hypotension (A),
tachycardia (B), JVD (D), and sometimes hemoptysis (E). Bradypnea (C) is incorrect; tachypnea is
expected.
💫ANSWER✔️✔️: A, B, D, E
, ---
### Question 4 of 84
A nurse is caring for a client with a cervical spine injury at level C5 who is wearing a cervical collar. The
client suddenly develops bradycardia and hypotension. Which of the following actions should the nurse
take first?
A) Administer atropine as prescribed.
B) Notify the provider immediately.
C) Assess the client’s airway and breathing.
D) Raise the head of the bed to 90 degrees.
💫RATIONALE✔️✔️: Bradycardia and hypotension after cervical spine injury indicate neurogenic shock
from loss of sympathetic tone. Airway and breathing (C) are always the priority in any sudden
deterioration, even with known neurogenic shock. After ensuring ABCs, the nurse may administer
atropine or vasopressors.
💫ANSWER✔️✔️: C) Assess the client’s airway and breathing.
---
### Question 5 of 84
A nurse is providing dietary teaching to a client with celiac disease. Which of the following foods should
the nurse instruct the client to avoid?
A) White rice
B) Corn tortillas
C) Rye bread
D) Mashed potatoes
Judgment Bootcamp: From Fundamentals to
Critical Care**
---
### Question 1 of 84
A nurse in the emergency department is assessing a client who was involved in a motor vehicle collision.
The client has bruising across the lower abdomen and reports severe left upper quadrant pain that
radiates to the left shoulder. The nurse should suspect injury to which organ?
A) Liver
B) Spleen
C) Kidney
D) Stomach
💫RATIONALE✔️✔️: The left upper quadrant pain radiating to the left shoulder (Kehr’s sign) along with
abdominal bruising is classic for splenic rupture or injury. The spleen is located in the LUQ, and
diaphragmatic irritation from blood refers pain to the left shoulder via the phrenic nerve. The liver is in
the RUQ.
💫ANSWER✔️✔️: B) Spleen
---
### Question 2 of 84
,A nurse is caring for a client who has a new tracheostomy. Which of the following actions should the
nurse take when performing tracheostomy suctioning?
A) Insert the suction catheter while applying continuous suction.
B) Hyperoxygenate the client before and after suctioning.
C) Limit suctioning to 30 seconds per pass.
D) Use a sterile catheter for each suctioning pass.
💫RATIONALE✔️✔️: Hyperoxygenation (B) prevents hypoxemia during suctioning. Suction should be
applied only during withdrawal, not insertion. Suction time should be <10-15 seconds, not 30. Sterile
technique is required, but the same catheter can be used for multiple passes if kept sterile; however, a
new sterile catheter is often used for each session.
💫ANSWER✔️✔️: B) Hyperoxygenate the client before and after suctioning.
---
### Question 3 of 84
**Select-All-That-Apply (SATA):** A nurse is assessing a client who has a massive pulmonary embolism
(PE). Which of the following findings should the nurse expect? (Select all that apply.)
A) Hypotension
B) Tachycardia
C) Bradypnea
D) Jugular vein distention
E) Hemoptysis
💫RATIONALE✔️✔️: Massive PE causes right ventricular failure and obstructive shock: hypotension (A),
tachycardia (B), JVD (D), and sometimes hemoptysis (E). Bradypnea (C) is incorrect; tachypnea is
expected.
💫ANSWER✔️✔️: A, B, D, E
, ---
### Question 4 of 84
A nurse is caring for a client with a cervical spine injury at level C5 who is wearing a cervical collar. The
client suddenly develops bradycardia and hypotension. Which of the following actions should the nurse
take first?
A) Administer atropine as prescribed.
B) Notify the provider immediately.
C) Assess the client’s airway and breathing.
D) Raise the head of the bed to 90 degrees.
💫RATIONALE✔️✔️: Bradycardia and hypotension after cervical spine injury indicate neurogenic shock
from loss of sympathetic tone. Airway and breathing (C) are always the priority in any sudden
deterioration, even with known neurogenic shock. After ensuring ABCs, the nurse may administer
atropine or vasopressors.
💫ANSWER✔️✔️: C) Assess the client’s airway and breathing.
---
### Question 5 of 84
A nurse is providing dietary teaching to a client with celiac disease. Which of the following foods should
the nurse instruct the client to avoid?
A) White rice
B) Corn tortillas
C) Rye bread
D) Mashed potatoes
