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NCLEX-RN Client advocacy practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Client advocacy sits inside the Management of Care category of the NCLEX-RN. Our bank holds 44 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Client advocacy sample questions

Question 1

A 42-year-old client is admitted with a suspected deep vein thrombosis. The provider orders a heparin infusion at 1000 units/hr. The nurse notes that the client's weight is 85 kg and the recommended starting dose is 18 units/kg/hr. The prescribed dose is below the protocol. Which action should the nurse take?

  1. A Increase the infusion rate to 1530 units/hr per the protocol
  2. B Administer the prescribed dose and document the protocol deviation
  3. C Hold the infusion and notify the provider of the discrepancy
  4. D Administer the prescribed dose and monitor for bleeding
Show the answer and explanation

Correct answer: C

The correct answer is to hold the infusion and notify the provider of the discrepancy. The nurse acts as an advocate by ensuring safe medication administration; a subtherapeutic dose may not prevent clot extension. Administering the prescribed dose (the option "Administer the prescribed dose and monitor for bleeding" ignores the protocol and places the client at risk for ineffective treatment. Increasing the rate without a new order (the option "Increase the infusion rate to 1530 units/hr per the protocol" is outside the nurse's scope and could be considered practicing medicine. Administering and documenting the deviation (the option "Administer the prescribed dose and document the protocol deviation" does not resolve the potential harm; the nurse must clarify the order before proceeding.

Question 2

A 55-year-old client with advanced pancreatic cancer is admitted for pain management. The client tells the nurse, 'I want to try a complementary therapy like medical marijuana, but my doctor said it is not allowed in this hospital.' The client's pain is currently 7/10 despite around-the-clock opioids. Which action by the nurse best demonstrates client advocacy?

  1. A Inform the client that medical marijuana is not evidence-based and recommend sticking with prescribed opioids.
  2. B Contact the healthcare provider to discuss the client's request and explore alternative pain management options.
  3. C Document the client's request in the medical record and offer to arrange a consultation with a pain specialist.
  4. D Explain that hospital policy prohibits medical marijuana and suggest the client discuss it with the provider after discharge.
Show the answer and explanation

Correct answer: B

The best advocacy action is to contact the healthcare provider to discuss the client's request and explore alternative pain management options. Advocacy involves supporting the client's wishes while working within the healthcare system to find solutions. Simply stating hospital policy (the option "Explain that hospital policy prohibits medical marijuana and suggest the client discuss it..." dismisses the client's concerns without further action. Dismissing medical marijuana as not evidence-based (the option "Inform the client that medical marijuana is not evidence-based and recommend sticking with..." is inaccurate and disregards the client's autonomy and suffering. Documenting the request and offering a pain specialist consult (the option "Document the client's request in the medical record and offer to arrange a consultation wi..." is a good step, but directly contacting the provider to discuss the request is a more immediate advocacy action.

Question 3

A 72-year-old client in a long-term care facility has a do-not-resuscitate (DNR) order on file. The nurse observes a new graduate nurse beginning chest compressions after the client becomes pulseless and apneic. Which action by the nurse best demonstrates client advocacy?

  1. A Allow the graduate nurse to continue while the nurse locates the DNR documentation.
  2. B Remind the graduate nurse to verify the DNR status before initiating compressions.
  3. C Document the event and report the graduate nurse to the nursing supervisor later.
  4. D Stop the compressions immediately and confirm the DNR order with the charge nurse.
Show the answer and explanation

Correct answer: D

The client has a DNR order on file, so continuing compressions violates the client's documented wishes. Advocacy means acting at once to protect those wishes: stop the compressions, then confirm the order with the charge nurse.

Why the other options are wrong:
A: Letting compressions continue while searching for paperwork subjects the client to an intervention the client has already refused.
B: Compressions have already started, so a reminder about checking status does not stop the ongoing violation of the client's wishes.
C: Documenting and reporting later allows the unwanted resuscitation to continue and does nothing to protect the client now.

Question 4

A 34-year-old client with sickle cell disease is admitted with vaso-occlusive crisis and reports severe pain at 9 on a 0-10 scale. The provider orders morphine 2 mg IV every 2 hours as needed. The client requests a higher dose, stating that 2 mg 'does nothing.' The nurse notes that the client has received two doses with minimal relief. What is the nurse's best action?

  1. A Offer nonpharmacologic interventions such as distraction and heat packs to supplement.
  2. B Explain to the client that the ordered dose is standard and cannot be changed without an order.
  3. C Administer the next dose of morphine 2 mg as ordered and document the pain level.
  4. D Contact the provider to request a higher dose or a change in analgesic regimen.
Show the answer and explanation

Correct answer: D

Two doses have given little relief from severe vaso-occlusive pain, so the current order is inadequate. The nurse advocates for the client by asking the provider for a higher dose or a different analgesic regimen.

Why the other options are wrong:
A: Nonpharmacologic measures can supplement but not replace effective analgesia for severe crisis pain.
B: Telling the client the dose cannot change, without seeking a new order, fails to advocate for pain relief.
C: Repeating an ineffective dose leaves the client in severe pain.

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All NCLEX-RN sample questions 8 categorys All Management of Care questions 10 topics Informed consent with explanations Legal responsibilities with explanations Delegation with explanations TEAS 7 sample questions with explanations HESI A2 sample questions with explanations

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