Matrix
NCLEX® Practice Questions
4–6 rows · Radio per row · Polytomous 0/1 scoring
A grid of clinical items with one decision per row. You read the scenario, then classify each finding, medication, or intervention into the right category. Each row is scored independently, so partial credit is built in.
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Clinical judgment steps
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A 68-year-old client is 3 days post-stroke and admitted to acute rehabilitation. The health care provider's referral order lists: "Evaluate and manage per interdisciplinary team." Nursing assessment reveals the following findings and needs: the client has moderate difficulty swallowing during meals (currently taking thickened liquids), significant weakness and loss of balance affecting mobility (unable to ambulate safely without assistance), inadequate nutritional intake related to dysphagia, unresolved grief about loss of independence, and concern about returning home given limited family support and a first-floor bedroom accessed by stairs. The nurse has identified the available multidisciplinary team: physical therapy, occupational therapy, speech-language pathology, registered dietitian, social work, and case management. The nurse is prioritizing which needs require collaboration and what information to communicate to each discipline.
Difficulty swallowing; refer to speech-language pathology with current swallow tolerance, diet consistency tried, and recommendations for next feeding trial.
Weakness and gait imbalance; refer to physical therapy with current mobility status, assist level, fall risk factors, and prior ambulation attempts.
Inadequate oral intake from dysphagia; refer to registered dietitian with current intake patterns, caloric goals, texture tolerances, and whether tube feeding should be considered.
Concern about returning home with limited family support and architectural barriers; refer to social work and case management with discharge timeline, living situation, financial and support resources, and safety concerns.
Client expresses unresolved grief about loss of independence; provide supportive listening, validation of feelings, and document emotional adjustment response as part of holistic nursing care.
Swallowing difficulty is suspected aspiration risk; initiate NPO status and do not allow any oral intake until you personally perform a comprehensive swallow assessment to determine safety.
Client reports pain with range-of-motion exercises; reduce therapy intensity unilaterally and communicate the change to physical therapy only after the revised plan is already in effect.
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Common questions
What is a Matrix question on the NCLEX®?
A Matrix/Grid question presents a clinical scenario and a table of 4 to 6 rows. Each row is a finding, medication, or intervention that you classify into one column, like Indicated, Contraindicated, or Non-Essential. You pick one column per row. Every row is a separate decision.
How is a Matrix question scored on the NCLEX®?
Matrix uses NCSBN polytomous 0/1 scoring. Each row is graded independently and earns 1 point for correct or 0 for incorrect. Your total is the sum across all rows, so partial credit is built into the format. You do not lose a whole question for one wrong row.
How is Matrix different from SATA?
SATA gives you one list and asks which options apply. Matrix gives you several items and asks you to sort each one into a category. SATA is one all-or-nothing judgment, Matrix is a series of small decisions you make row by row. Matrix mirrors the kind of chart review you do every shift.
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