Free Clinical Judgement and Prioritisation MCQs with Answers
50 Clinical Judgement and Prioritisation MCQs from International Nursing Practice, each with the correct answer and a written explanation of why it is correct. Free and unlimited, with no account needed.
Clinical judgement links assessment findings, nursing knowledge and patient responses to a safe decision. Coverage includes ABCDE assessment, recognising actual or potential instability, prioritising airway, breathing and circulation, using urgency and risk rather than routine order, reassessing after intervention, and distinguishing a nursing priority from a medical diagnosis or a task that can wait.
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50 questions · page 1 of 3
- A. Activate emergency assistance and remain with the patient
- B. Offer oral fluids and reassess the breathing later
- C. Document the findings before notifying the provider
- D. Place the patient flat and obtain a routine history
Explanation: Stridor and difficulty speaking suggest an acute upper-airway threat. The nurse should activate emergency assistance, stay with the…
Correct answer: Activate emergency assistance and remain with the patient- A. A patient requesting help to choose a meal
- B. A patient with new confusion and a respiratory rate of 30
- C. A patient waiting for routine discharge instructions
- D. A patient reporting expected pain after physiotherapy
Explanation: New confusion with marked tachypnoea may indicate hypoxia, sepsis, or another acute deterioration.
Correct answer: A patient with new confusion and a respiratory rate of 30- A. Assessing a new report of chest pain
- B. Teaching the patient how to use an inhaler
- C. Measuring and recording urine output from a catheter
- D. Deciding whether a wound is becoming infected
Explanation: Measuring and recording urine output for a stable patient is a routine, predictable task that can be delegated with clear instructions.
Correct answer: Measuring and recording urine output from a catheter- A. Assess airway and breathing while calling for urgent help
- B. Allow the patient to sleep because pain treatment is expected
- C. Offer the next prescribed dose to prevent pain returning
- D. Complete the medication record before reassessing the patient
Explanation: A respiratory rate of 8 and reduced responsiveness indicate possible opioid-induced respiratory depression.
Correct answer: Assess airway and breathing while calling for urgent help- A. Perform an immediate focused assessment and escalate the deterioration
- B. Reassure the patient that these changes are common after surgery
- C. Offer oral fluids and review the condition during the next round
- D. Give the prescribed analgesic before assessing the vital signs
Explanation: Restlessness, pallor, tachycardia, tachypnoea, and reduced urine output form a concerning pattern of possible shock or serious…
Correct answer: Perform an immediate focused assessment and escalate the deterioration- A. Give the patient water to assess swallowing
- B. Activate the urgent stroke response pathway
- C. Ask the patient to rest and reassess later
- D. Administer the prescribed oral analgesic
Explanation: Sudden focal neurological changes suggest an acute stroke and require immediate activation of the stroke response pathway.
Correct answer: Activate the urgent stroke response pathway- A. Slow the transfusion and observe the patient
- B. Stop the transfusion and maintain venous access
- C. Obtain a urine specimen for laboratory testing
- D. Give the prescribed antipyretic medication
Explanation: The symptoms may indicate an acute transfusion reaction, so the transfusion must be stopped immediately.
Correct answer: Stop the transfusion and maintain venous access- A. Offer a fast-acting source of carbohydrate
- B. Administer the patient's scheduled insulin
- C. Ask the patient to walk to improve circulation
- D. Wait for the patient to become more alert
Explanation: An awake patient who can swallow safely should receive a fast-acting carbohydrate to correct hypoglycaemia.
Correct answer: Offer a fast-acting source of carbohydrate- A. Encourage the patient to walk to the bathroom
- B. Place the patient in a suitable position and call for urgent help
- C. Offer oral fluids and reassess the pain
- D. Document the findings before contacting the prescriber
Explanation: The sudden symptoms suggest a potentially life-threatening pulmonary embolism or other acute respiratory problem.
Correct answer: Place the patient in a suitable position and call for urgent help- A. Complete the routine evening hygiene care
- B. Escalate immediately for urgent clinical assessment
- C. Ask the family to remain quietly at the bedside
- D. Recheck the blood pressure after the next meal
Explanation: New confusion, hypotension, mottled skin, and tachypnoea indicate possible shock and severe deterioration.
Correct answer: Escalate immediately for urgent clinical assessment- A. Assist the patient to stand without support
- B. Assess the blood pressure and pulse lying and standing
- C. Tell the patient to stop the medication immediately
- D. Encourage the patient to walk until the dizziness settles
Explanation: The symptoms may reflect postural hypotension, so the nurse should assess lying and standing vital signs while preventing a fall.
Correct answer: Assess the blood pressure and pulse lying and standing- A. Elevate the limb and review it during the next round
- B. Assess circulation, sensation, and movement and escalate urgently
- C. Apply a warm pack over the cast for comfort
- D. Encourage active toe exercises against resistance
Explanation: Pain that is worsening with pallor, coolness, and impaired movement may indicate neurovascular compromise.
Correct answer: Assess circulation, sensation, and movement and escalate urgently- A. Ask the patient to rest and repeat the test tomorrow
- B. Assess the patient promptly and activate urgent clinical review
- C. Offer a potassium-rich meal when tolerated
- D. Remove the cardiac monitor to reduce anxiety
Explanation: Severe potassium loss can cause life-threatening dysrhythmias, especially when palpitations and an irregular rhythm are present.
Correct answer: Assess the patient promptly and activate urgent clinical review- A. Place the patient flat and leave the room briefly
- B. Assess airway and breathing while calling for urgent help
- C. Give an oral antiemetic with a sip of water
- D. Allow the patient to sleep without further observations
Explanation: Increasing drowsiness and repeated vomiting may indicate worsening intracranial pressure and loss of airway protection.
Correct answer: Assess airway and breathing while calling for urgent help- A. Help the patient back into bed immediately
- B. Assess responsiveness and possible injury before moving the patient
- C. Ask the patient to walk to check for weakness
- D. Complete the incident form before examining the patient
Explanation: After an unwitnessed fall, the nurse first assesses responsiveness, airway, breathing, and possible injury before moving the patient.
Correct answer: Assess responsiveness and possible injury before moving the patient- A. Stop the antibiotic infusion and call for emergency help
- B. Slow the infusion and reassess the skin in 10 minutes
- C. Document the reaction and ask the prescriber to review it
- D. Offer oral fluids and place the patient in a sitting position
Explanation: Stopping the suspected antibiotic removes the trigger while emergency help is summoned.
Correct answer: Stop the antibiotic infusion and call for emergency help- A. Check the airway and call for emergency assistance
- B. Give glucose gel inside the patient’s cheek
- C. Offer fruit juice through a drinking straw
- D. Leave the patient briefly to obtain a glucose meter
Explanation: An unresponsive patient requires an immediate airway and breathing assessment, with emergency assistance activated.
Correct answer: Check the airway and call for emergency assistance- A. Place the end of the tube in sterile water
- B. Clamp the chest tube close to the patient
- C. Remove the chest tube and apply a dry dressing
- D. Reconnect the tubing after washing it with tap water
Explanation: Placing the disconnected tube end in sterile water creates a temporary water seal and helps prevent air from entering the pleural space.
Correct answer: Place the end of the tube in sterile water- A. Assess the patient immediately for an acute change
- B. Ask the worker to help the patient walk to the bathroom
- C. Tell the worker to record the finding after the next round
- D. Ask the worker to offer water and reassess the patient later
Explanation: Sudden unsteadiness and slurred speech may indicate an acute neurological event.
Correct answer: Assess the patient immediately for an acute change- A. Assess the bladder and perform a bladder scan
- B. Encourage the patient to drink several glasses of water
- C. Insert another catheter without assessing the cause
- D. Notify the prescriber before performing any assessment
Explanation: Painful inability to void after catheter removal suggests urinary retention.
Correct answer: Assess the bladder and perform a bladder scanClinical Judgement and Prioritisation MCQs: common questions
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There are 50 Clinical Judgement and Prioritisation MCQs in the International Nursing Practice bank, shown ten to a page with the correct answer and an explanation on each.
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