1
Clinical Judgment & NGN Mastery | Saunders 9th Ed
Chapter 1 | 180 NCLEX Next Gen Questions + Detailed
Rationales (HealthStudyPro 2025/2026)
1. Which action is an example of the "Recognize Cues" step in the NCSBN
Clinical Judgment Measurement Model (CJMM)?
A. Administering a prescribed bronchodilator for wheezing
B. Noticing the client has a respiratory rate of 30 and use of accessory muscles
C. Forming a hypothesis that the client may be in respiratory distress
D. Evaluating the effectiveness of a breathing treatment
Answer: B
Rationale: "Recognize Cues" involves identifying relevant data that signals a
, 2
clinical issue. A respiratory rate of 30 and accessory muscle use are abnormal
assessment findings that require interpretation in later steps.
2. A nurse observes that a post-operative patient is groaning and guarding
their abdomen. According to CJMM, which action comes next after
recognizing these cues?
A. Administer pain medication as prescribed
B. Analyze the cues to determine their significance
C. Document findings in the patient’s chart
D. Reassess pain in 30 minutes
Answer: B
Rationale: After cues are recognized, the next step is to analyze their relevance
and potential causes, which leads to prioritizing a hypothesis.
3. Which scenario reflects the "Prioritize Hypotheses" layer of the Clinical
Judgment Model?
A. Monitoring the client's output post-op
B. Deciding whether the client’s abdominal guarding is due to pain, bleeding,
, 3
or infection
C. Administering a PRN antipyretic
D. Calling the physician about abnormal findings
Answer: B
Rationale: Prioritizing hypotheses means evaluating possible explanations for the
cues and determining which is most likely and urgent.
4. What is the correct sequence of the Clinical Judgment Model (CJMM)
layers from recognizing a problem to evaluating interventions?
A. Recognize cues → Generate solutions → Take action → Analyze cues
B. Recognize cues → Analyze cues → Prioritize hypotheses → Generate
solutions → Take action → Evaluate outcomes
C. Recognize cues → Take action → Evaluate outcomes → Analyze cues
D. Generate solutions → Recognize cues → Take action → Evaluate outcomes
Answer: B
Rationale: This is the correct order of the six cognitive processes as outlined in the
NCSBN Clinical Judgment Measurement Model.
, 4
5. A client with pneumonia has low O2 saturation, increased respiratory rate,
and audible crackles. What should the nurse do next based on CJMM?
A. Notify the provider
B. Prioritize the hypothesis that the client is experiencing hypoxia
C. Increase IV fluid rate
D. Request a dietary consult
Answer: B
Rationale: After recognizing and analyzing cues, the nurse prioritizes the
hypothesis that best explains the issue—here, hypoxia due to pneumonia.
6. The nurse implements interventions to address ineffective airway clearance.
According to CJMM, what comes next?
A. Analyze the client's health history
B. Evaluate the outcomes of the intervention
C. Recognize additional cues
D. Call the provider for new orders
Answer: B
Rationale: Evaluation is the final step, where the nurse determines whether the
actions taken improved the patient’s condition.
Clinical Judgment & NGN Mastery | Saunders 9th Ed
Chapter 1 | 180 NCLEX Next Gen Questions + Detailed
Rationales (HealthStudyPro 2025/2026)
1. Which action is an example of the "Recognize Cues" step in the NCSBN
Clinical Judgment Measurement Model (CJMM)?
A. Administering a prescribed bronchodilator for wheezing
B. Noticing the client has a respiratory rate of 30 and use of accessory muscles
C. Forming a hypothesis that the client may be in respiratory distress
D. Evaluating the effectiveness of a breathing treatment
Answer: B
Rationale: "Recognize Cues" involves identifying relevant data that signals a
, 2
clinical issue. A respiratory rate of 30 and accessory muscle use are abnormal
assessment findings that require interpretation in later steps.
2. A nurse observes that a post-operative patient is groaning and guarding
their abdomen. According to CJMM, which action comes next after
recognizing these cues?
A. Administer pain medication as prescribed
B. Analyze the cues to determine their significance
C. Document findings in the patient’s chart
D. Reassess pain in 30 minutes
Answer: B
Rationale: After cues are recognized, the next step is to analyze their relevance
and potential causes, which leads to prioritizing a hypothesis.
3. Which scenario reflects the "Prioritize Hypotheses" layer of the Clinical
Judgment Model?
A. Monitoring the client's output post-op
B. Deciding whether the client’s abdominal guarding is due to pain, bleeding,
, 3
or infection
C. Administering a PRN antipyretic
D. Calling the physician about abnormal findings
Answer: B
Rationale: Prioritizing hypotheses means evaluating possible explanations for the
cues and determining which is most likely and urgent.
4. What is the correct sequence of the Clinical Judgment Model (CJMM)
layers from recognizing a problem to evaluating interventions?
A. Recognize cues → Generate solutions → Take action → Analyze cues
B. Recognize cues → Analyze cues → Prioritize hypotheses → Generate
solutions → Take action → Evaluate outcomes
C. Recognize cues → Take action → Evaluate outcomes → Analyze cues
D. Generate solutions → Recognize cues → Take action → Evaluate outcomes
Answer: B
Rationale: This is the correct order of the six cognitive processes as outlined in the
NCSBN Clinical Judgment Measurement Model.
, 4
5. A client with pneumonia has low O2 saturation, increased respiratory rate,
and audible crackles. What should the nurse do next based on CJMM?
A. Notify the provider
B. Prioritize the hypothesis that the client is experiencing hypoxia
C. Increase IV fluid rate
D. Request a dietary consult
Answer: B
Rationale: After recognizing and analyzing cues, the nurse prioritizes the
hypothesis that best explains the issue—here, hypoxia due to pneumonia.
6. The nurse implements interventions to address ineffective airway clearance.
According to CJMM, what comes next?
A. Analyze the client's health history
B. Evaluate the outcomes of the intervention
C. Recognize additional cues
D. Call the provider for new orders
Answer: B
Rationale: Evaluation is the final step, where the nurse determines whether the
actions taken improved the patient’s condition.
