Practice

Clinical judgment case studies

Every NCLEX-PN has three case studies of six items, one for each step of clinical judgment. The client's record unfolds as you go. Here you check each item before the next; on the exam you cannot go back.

• Case study 1 · Long-term care facilityA resident who sleeps sitting upThe LPN on the day shift of a long-term care unit takes report on an 86-year-old resident whom the night AP describes as 'not herself.'Start, six items
• Case study 2 · Inpatient rehabilitation unitCalf pain on the rehabilitation unitThe LPN starts the day shift with a 74-year-old client a week after hip replacement surgery who mentions a new ache in the leg.Start, six items
• Case study 3 · Skilled nursing facilityA tube-fed client who starts coughingDuring the night shift on a skilled nursing unit, the AP asks the LPN to come see a client who is receiving continuous tube feeding.Start, six items
• Case study 4 · Home health careA home visit before lunchThe home health LPN arrives for a scheduled visit and finds the client's wife worried about how he is acting.Start, six items
• Case study 5 · Outpatient rheumatology clinicA same-day visit for a sore mouthThe LPN in an outpatient rheumatology clinic rooms a 61-year-old client who called this morning about mouth sores and was given a same-day visit.Start, six items
• Case study 6 · Medical-surgical unitTwenty minutes into a transfusionThe LPN on a medical-surgical unit is monitoring a client who began receiving a unit of packed red blood cells at 1300.Start, six items
• Case study 7 · Mother-baby unitA shaky baby at the second feedThe LPN on a mother-baby unit cares for a mother and her son, born by vaginal birth at 2310. At 0210 the mother calls for help with breastfeeding.Start, six items
• Case study 8 · Pediatric clinicA wheezing preschooler at the clinicThe LPN at a pediatric clinic rooms a 4-year-old whose father says the child's breathing has been noisy since last night.Start, six items
• Case study 9 · Inpatient mental health unitThe fifth morning on the unitThe LPN on an inpatient mental health unit is doing morning checks and finds a client who has been calmer for two days but now seems unwell.Start, six items
• Case study 10 · Outpatient hemodialysis unitA missed treatment dayThe LPN in an outpatient hemodialysis unit collects pre-treatment data on a client who missed his last session.Start, six items
• Case study 11 · Assisted living communityDizzy on the way from breakfastThe LPN in an assisted living community is called to the dining room after an AP sees a resident nearly fall.Start, six items
• Case study 12 · Surgical unitTwo days after abdominal surgeryThe LPN on a surgical unit begins morning care for a client two days after an open bowel operation.Start, six items