COPD: Home Oxygen and Advance Directives

Clinical Scenario

What You'll Practice

This NGN unfolding case study walks you through 6 linked clinical-judgment questions covering the full NCSBN Clinical Judgment Measurement Model. Each question is mapped to a specific cognitive layer; together they take you from recognizing the first cue at the bedside through evaluating whether your interventions worked.

CJMM cognitive layers in this case

The 6 questions in this Respiratory case test 4 of the 6 CJMM cognitive layers. Knowing which layer a question targets is half the battle — it tells you what mental move the question is rewarding (recognition vs. prioritization vs. action vs. evaluation).

• Recognize CuesIdentify the relevant findings (vitals, labs, behaviors) that matter for this patient
• Generate SolutionsBrainstorm appropriate nursing interventions
• Take ActionExecute the highest-priority intervention first
• Evaluate OutcomesReassess whether the intervention worked

NGN question formats in this case

The April 2026 NCSBN test plan rewards practice across multiple NGN item types. This case includes:

Each format scores differently — bow-tie centers are all-or-nothing, matrix and cloze use partial-credit per row/blank, extended response is polytomous. Practicing the formats together builds the format fluency the exam rewards. See our NGN guide for the scoring breakdown of each.

Sample question from this case

Here's the prompt for the first question in this case — read it once, then think about what you would assess first. (Answer choices and rationale unlock with $29 access.)

Clinical topics covered

This case study touches on the following clinical concept areas:

Why this Respiratory case matters for the NCLEX

Respiratory content represents a meaningful share of the NCSBN April 2026 test plan, and unfolding case studies in this category test exactly the kind of bedside reasoning the exam was redesigned to measure. Working through this case builds the recognize-analyze-prioritize-act sequence you'll use on test day — and on every floor you ever work.

The single biggest predictor of NGN performance isn't memorization — it's pattern recognition built from doing many full case studies under realistic time pressure. Reading this scenario, predicting the first nursing action before answering, and reviewing the rationale afterward is the loop that wires the reasoning skill into your head.

More Respiratory Case Studies

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• Case 010
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• Alcohol Withdrawal Syndrome: Delirium Tremens Management
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