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 2 of 3

Fairly easy
  • A. Assess airway and breathing while calling for urgent help
  • B. Ask the patient to take several deep breaths
  • C. Document the sedation score and reassess in 30 minutes
  • D. Give the next prescribed dose to prevent withdrawal symptoms

Explanation: Reduced consciousness, slow breathing, and falling oxygen saturation indicate possible respiratory depression.

Correct answer: Assess airway and breathing while calling for urgent help
Moderate
  • A. Assess vital signs and notify the nurse in charge promptly
  • B. Ask the patient to walk slowly to improve circulation
  • C. Restrict fluids until the stoma output decreases
  • D. Give an antidiarrhoeal medicine without further assessment

Explanation: High ileostomy output with dizziness and dry mucous membranes suggests fluid and electrolyte loss.

Correct answer: Assess vital signs and notify the nurse in charge promptly
  • A. Sit the patient upright and assess for a triggering stimulus
  • B. Place the patient flat and encourage oral fluids
  • C. Give a prescribed sedative and reassess the blood pressure later
  • D. Apply a warm blanket and ask the patient to rest quietly

Explanation: This pattern suggests autonomic dysreflexia, which is an emergency after spinal cord injury.

Correct answer: Sit the patient upright and assess for a triggering stimulus
Fairly easy
  • A. Stop oral intake and assess the patient's airway
  • B. Encourage smaller sips of water through a straw
  • C. Continue the drink while documenting the coughing
  • D. Place food at the bedside for the patient to try later

Explanation: Coughing and a wet voice during drinking are signs of possible aspiration and impaired swallowing.

Correct answer: Stop oral intake and assess the patient's airway
  • A. Assess the airway and suction the tracheostomy as indicated
  • B. Offer oral fluids and reassess the oxygen saturation later
  • C. Remove the tracheostomy tube to inspect the airway
  • D. Ask the patient to lie flat and breathe slowly

Explanation: Restlessness, noisy breathing, and visible thick secretions suggest airway obstruction.

Correct answer: Assess the airway and suction the tracheostomy as indicated
Very hard
  • A. Cover the exposed organs with sterile saline dressings
  • B. Place the patient in a high-Fowler position
  • C. Attempt to gently replace the organs into the abdomen
  • D. Offer oral fluids to prevent dehydration

Explanation: Sterile saline dressings protect the exposed organs from drying and contamination.

Correct answer: Cover the exposed organs with sterile saline dressings
  • A. Protect the patient from injury and lower them safely
  • B. Insert a padded tongue blade between the teeth
  • C. Restrain the arms and legs to stop the movements
  • D. Give oral water when the movements begin to slow

Explanation: The immediate priority during a seizure is preventing injury while maintaining airway safety.

Correct answer: Protect the patient from injury and lower them safely
Fairly easy
  • A. Check the tubing for kinks or dependent loops
  • B. Increase the irrigation rate to its maximum setting
  • C. Remove the catheter and insert a new one
  • D. Administer an opioid and reassess in one hour

Explanation: Suprapubic pressure with absent drainage suggests obstruction of the irrigation system.

Correct answer: Check the tubing for kinks or dependent loops
Very hard
  • A. Stop the infusion and leave the cannula in place
  • B. Flush the cannula rapidly with normal saline
  • C. Remove the cannula and apply firm pressure
  • D. Apply heat before checking the infusion site

Explanation: Burning and swelling suggest possible extravasation. The nurse stops the infusion immediately but leaves the cannula in place so any…

Correct answer: Stop the infusion and leave the cannula in place
  • A. Activate the emergency response and remain with the patient
  • B. Give the prescribed oral antiemetic and reassess
  • C. Place the patient in a chair to improve lung expansion
  • D. Ask the patient to walk to the bathroom for a stool sample

Explanation: The patient shows signs of haemorrhagic shock with deteriorating consciousness and severe hypotension.

Correct answer: Activate the emergency response and remain with the patient
  • A. Stop the potassium infusion immediately
  • B. Encourage the patient to drink additional fluids
  • C. Recheck the potassium level at the next routine time
  • D. Ask the patient to walk to assess muscle strength

Explanation: Widened QRS complexes during potassium administration indicate potentially life-threatening potassium toxicity.

Correct answer: Stop the potassium infusion immediately
Hard
  • A. Massage the uterine fundus
  • B. Place the patient in a sitting position
  • C. Offer a warm drink and observe the bleeding
  • D. Apply an abdominal ice pack without assessing the uterus

Explanation: A boggy uterus with heavy bleeding indicates uterine atony, a common cause of postpartum haemorrhage.

Correct answer: Massage the uterine fundus
  • A. Raise the head of the bed and assess breathing
  • B. Remove the tracheostomy tube to improve airflow
  • C. Give oral fluids to loosen airway secretions
  • D. Ask the patient to walk to improve ventilation

Explanation: Raising the head of the bed can immediately improve lung expansion and reduce the work of breathing.

Correct answer: Raise the head of the bed and assess breathing
Very hard
  • A. Place the patient on continuous cardiac monitoring
  • B. Offer a high-potassium snack to improve energy
  • C. Encourage ambulation to assess functional strength
  • D. Document the result and wait for the next ward round

Explanation: Severe hyperkalaemia can cause sudden, fatal cardiac dysrhythmias, even before other symptoms appear.

Correct answer: Place the patient on continuous cardiac monitoring
Fairly easy
  • A. Apply firm pressure to the bleeding site
  • B. Remove the dressing to inspect the wound fully
  • C. Offer prescribed analgesia before taking action
  • D. Place the patient in a standing position

Explanation: Fresh heavy bleeding with signs of poor perfusion requires immediate control of external haemorrhage.

Correct answer: Apply firm pressure to the bleeding site
Fairly easy
  • A. Raise the head of the bed and apply prescribed oxygen
  • B. Increase the intravenous fluid rate to improve circulation
  • C. Ask the patient to walk to assess exercise tolerance
  • D. Document the findings and reassess at the next round

Explanation: The findings suggest acute fluid overload with impaired oxygenation. Sitting the patient upright and supporting oxygenation addresses…

Correct answer: Raise the head of the bed and apply prescribed oxygen
Hard
  • A. Stop the feeding and assess the patient's breathing
  • B. Flush the feeding tube with additional sterile water
  • C. Lower the head of the bed to reduce abdominal pressure
  • D. Continue the feeding while requesting a chest radiograph

Explanation: Coughing, a wet voice, and falling oxygen saturation suggest aspiration during feeding.

Correct answer: Stop the feeding and assess the patient's breathing
Hard
  • A. Activate the emergency response system for urgent review
  • B. Ask the patient to perform slow breathing exercises
  • C. Offer oral fluids and repeat the blood pressure later
  • D. Record the rhythm and continue the scheduled observations

Explanation: The dysrhythmia is accompanied by hypotension and chest discomfort, indicating haemodynamic instability.

Correct answer: Activate the emergency response system for urgent review
  • A. Call for emergency assistance and provide high-flow oxygen
  • B. Place the patient in a sitting position and offer reassurance
  • C. Ask the patient to cough while checking the catheter dressing
  • D. Leave the patient briefly to obtain a portable chest radiograph

Explanation: Sudden symptoms after catheter removal may indicate an air embolism or another life-threatening complication.

Correct answer: Call for emergency assistance and provide high-flow oxygen
Hard
  • A. Notify the prescriber urgently and activate the febrile neutropenia pathway
  • B. Give an antipyretic and wait to see whether the temperature falls
  • C. Place the patient in a shared room for closer observation
  • D. Encourage fluids and repeat the temperature in four hours

Explanation: Fever with severe neutropenia is a medical emergency because infection can progress rapidly with few localising signs.

Correct answer: Notify the prescriber urgently and activate the febrile neutropenia pathway