NCLEX Delegation Questions and Answers Graded A+
1. Ans: 4 As charge nurse, you must assess the perfor-
1. You are the charge nurse. A client with chronic pain re-
mance and attitude of the statt in relation to this client.
ports to you that the nurses have not been responding to
After data are gathered from the nurses, additional infor-
requests for pain medication. What is your initial action?
mation can be obtained from the records and the client as
1. Check the medication administration records (MARs)
necessary. The educator may be of assistance if a knowl-
for the past several days.
edge deficit or need for performance improvement is the
2. Ask the nurse educator to provide in-service training
problem. Focus: Supervision, prioritization
about pain management.
3. Perform a complete pain assessment on the client and
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
take a pain history.
(2013-11-22). Prioritization, Delegation, and Assignment:
4. Have a conference with the nurses responsible for the
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
care of this client.
Health Sciences. Kindle Edition.
5. As the charge nurse, you are reviewing the charts of
5. Ans: 4 In supervision of the new RN, good performance
clients who were assigned to the care of a newly grad-
should be reinforced first and then areas of improvement
uated RN. The RN has correctly charted dose and time
can be addressed. Asking the nurse about knowledge of
of medication, but there is no documentation regarding
pain management is also an option; however, it would be
nonpharmaceutical measures. What action should you
a more indirect and time-consuming approach. Making a
take first?
note and watching do not help the nurse to correct the im-
1. Make a note in the nurse's file and continue to observe
mediate problem. In-service training might be considered
clinical performance.
if the problem persists. Focus: Supervision, delegation
2. Refer the new nurse to the in-service education depart-
ment.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
3. Quiz the nurse about knowledge of pain management
(2013-11-22). Prioritization, Delegation, and Assignment:
and pharmacology.
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
4. Give praise for correctly charting the dose and time and
Health Sciences. Kindle Edition.
discuss the deficits in charting.
1. Ans: 1 Oral hygiene is within the scope of duties of the
1. You are caring for a patient with esophageal cancer. UAP. It is the responsibility of the nurse to observe re-
Which task could be delegated to a UAP? sponse to treatments and to help the patient deal with loss
1. Assisting the patient with oral hygiene or anxiety. The UAP can be directed to weigh the patient
but should not be expected to know when to initiate that
, NCLEX Delegation Questions and Answers Graded A+
measurement. Focus: Delegation
2. Observing the patient's response to feedings
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
3. Facilitating expression of grief or anxiety
(2013-11-22). Prioritization, Delegation, and Assignment:
4. Initiating daily weighings
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
Health Sciences. Kindle Edition.
5. When care assignments are being made for patients 5. Ans: 2 Administering enemas and antibiotics is within
with alterations related to gastrointestinal (GI) cancer, the scope of practice of LPNs/ LVNs. Although some states
which patient would be the most appropriate to assign to an facilities may allow the LPN/ LVN to administer blood,
an LPN/ LVN under the supervision of a team leader RN? in general, administering blood, providing preoperative
1. A patient with severe anemia secondary to GI bleeding teaching, and assisting with central line insertion are the
2. A patient who needs enemas and antibiotics to control responsibilities of the RN. Focus: Assignment
GI bacteria
3. A patient who needs preoperative teaching for bowel LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
resection surgery (2013-11-22). Prioritization, Delegation, and Assignment:
4. A patient who needs central line insertion for Practice Excercises for the NCLEX Exam (p. 168). Elsevier
chemotherapy Health Sciences. Kindle Edition.
1. Ans: 3 Epinephrine is the initial drug of choice for
treatment of anaphylaxis. Giving epinephrine rapidly at
1. A few minutes after you have given an intradermal in- the onset of an anaphylactic reaction may prevent or re-
jection of an allergen to a patient who is undergoing skin verse cardiovascular collapse as well as airway narrowing
testing for allergies, the patient reports feeling anxious, caused by bronchospasm and inflammation. Oxygen use
short of breath, and dizzy. Which action included in the is also appropriate, but oxygen would be administered
emergency protocol should you take first? using a nonrebreather mask in order to achieve a fraction
1. Start oxygen at 4 L/ min using a nasal cannula. of inspired oxygen closer to 100%. Albuterol may also be
2. Obtain IV access with a large-bore IV catheter. administered to decrease airway narrowing but would not
3. Give epinephrine (Adrenalin) 0.3 mL intramuscularly. be the first therapy used for anaphylaxis. IV access will take
4. Administer 3 mL of nebulized albuterol (Proventil) longer to establish and should not be the first intervention.
0.083%. Focus: Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
, NCLEX Delegation Questions and Answers Graded A+
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 170). Elsevier
Health Sciences. Kindle Edition.
2. As the nurse manager in a public health department,
you are implementing a plan to reduce the incidence of
infection with human immunodeficiency virus (HIV) in the
community. Which nursing action will you delegate to
health assistants working for the agency? 2. Ans: 1 Supplying sterile injection supplies to patients
1. Supplying injection drug users with sterile injection who are at risk for HIV infection can be done by statt
equipment such as needles and syringes members with health assistant education. Assessing for
2. Interviewing patients about behaviors that indicate a high-risk behaviors, education, and community assess-
need for annual HIV testing ment are RN-level skills. Focus: Delegation
3. Teaching high-risk community members about the use
of condoms in preventing HIV infection LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
4. Assessing the community to determine which popula- (2013-11-22). Prioritization, Delegation, and Assignment:
tion groups to target for education Practice Excercises for the NCLEX Exam (p. 171). Elsevier
Health Sciences. Kindle Edition.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 18). Elsevier
Health Sciences. Kindle Edition.
3. Ans: 2 Nystatin should be in contact with the oral and
3. You are working with a student nurse to care for an
esophageal tissues as long as possible for maximum ef-
HIV-positive patient with severe esophagitis caused by
fect. The other actions are also inappropriate and should
Candida albicans. Which action by the student indicates
be discussed with the student but do not require action
that you need to intervene most quickly?
as quickly. HIV-positive patients do not require droplet/
1. Putting on a mask and gown before entering the pa-
contact precautions or visitor restrictions to prevent op-
tient's room
portunistic infections. Hot or spicy foods are not usually
2. Giving the patient a glass of water after administering
well tolerated by patients with oral or esophageal fungal
the ordered oral nystatin (Mycostatin) suspension
infections. Focus: Prioritization
3. Suggesting that the patient should order chile con
1. Ans: 4 As charge nurse, you must assess the perfor-
1. You are the charge nurse. A client with chronic pain re-
mance and attitude of the statt in relation to this client.
ports to you that the nurses have not been responding to
After data are gathered from the nurses, additional infor-
requests for pain medication. What is your initial action?
mation can be obtained from the records and the client as
1. Check the medication administration records (MARs)
necessary. The educator may be of assistance if a knowl-
for the past several days.
edge deficit or need for performance improvement is the
2. Ask the nurse educator to provide in-service training
problem. Focus: Supervision, prioritization
about pain management.
3. Perform a complete pain assessment on the client and
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
take a pain history.
(2013-11-22). Prioritization, Delegation, and Assignment:
4. Have a conference with the nurses responsible for the
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
care of this client.
Health Sciences. Kindle Edition.
5. As the charge nurse, you are reviewing the charts of
5. Ans: 4 In supervision of the new RN, good performance
clients who were assigned to the care of a newly grad-
should be reinforced first and then areas of improvement
uated RN. The RN has correctly charted dose and time
can be addressed. Asking the nurse about knowledge of
of medication, but there is no documentation regarding
pain management is also an option; however, it would be
nonpharmaceutical measures. What action should you
a more indirect and time-consuming approach. Making a
take first?
note and watching do not help the nurse to correct the im-
1. Make a note in the nurse's file and continue to observe
mediate problem. In-service training might be considered
clinical performance.
if the problem persists. Focus: Supervision, delegation
2. Refer the new nurse to the in-service education depart-
ment.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
3. Quiz the nurse about knowledge of pain management
(2013-11-22). Prioritization, Delegation, and Assignment:
and pharmacology.
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
4. Give praise for correctly charting the dose and time and
Health Sciences. Kindle Edition.
discuss the deficits in charting.
1. Ans: 1 Oral hygiene is within the scope of duties of the
1. You are caring for a patient with esophageal cancer. UAP. It is the responsibility of the nurse to observe re-
Which task could be delegated to a UAP? sponse to treatments and to help the patient deal with loss
1. Assisting the patient with oral hygiene or anxiety. The UAP can be directed to weigh the patient
but should not be expected to know when to initiate that
, NCLEX Delegation Questions and Answers Graded A+
measurement. Focus: Delegation
2. Observing the patient's response to feedings
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
3. Facilitating expression of grief or anxiety
(2013-11-22). Prioritization, Delegation, and Assignment:
4. Initiating daily weighings
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
Health Sciences. Kindle Edition.
5. When care assignments are being made for patients 5. Ans: 2 Administering enemas and antibiotics is within
with alterations related to gastrointestinal (GI) cancer, the scope of practice of LPNs/ LVNs. Although some states
which patient would be the most appropriate to assign to an facilities may allow the LPN/ LVN to administer blood,
an LPN/ LVN under the supervision of a team leader RN? in general, administering blood, providing preoperative
1. A patient with severe anemia secondary to GI bleeding teaching, and assisting with central line insertion are the
2. A patient who needs enemas and antibiotics to control responsibilities of the RN. Focus: Assignment
GI bacteria
3. A patient who needs preoperative teaching for bowel LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
resection surgery (2013-11-22). Prioritization, Delegation, and Assignment:
4. A patient who needs central line insertion for Practice Excercises for the NCLEX Exam (p. 168). Elsevier
chemotherapy Health Sciences. Kindle Edition.
1. Ans: 3 Epinephrine is the initial drug of choice for
treatment of anaphylaxis. Giving epinephrine rapidly at
1. A few minutes after you have given an intradermal in- the onset of an anaphylactic reaction may prevent or re-
jection of an allergen to a patient who is undergoing skin verse cardiovascular collapse as well as airway narrowing
testing for allergies, the patient reports feeling anxious, caused by bronchospasm and inflammation. Oxygen use
short of breath, and dizzy. Which action included in the is also appropriate, but oxygen would be administered
emergency protocol should you take first? using a nonrebreather mask in order to achieve a fraction
1. Start oxygen at 4 L/ min using a nasal cannula. of inspired oxygen closer to 100%. Albuterol may also be
2. Obtain IV access with a large-bore IV catheter. administered to decrease airway narrowing but would not
3. Give epinephrine (Adrenalin) 0.3 mL intramuscularly. be the first therapy used for anaphylaxis. IV access will take
4. Administer 3 mL of nebulized albuterol (Proventil) longer to establish and should not be the first intervention.
0.083%. Focus: Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
, NCLEX Delegation Questions and Answers Graded A+
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 170). Elsevier
Health Sciences. Kindle Edition.
2. As the nurse manager in a public health department,
you are implementing a plan to reduce the incidence of
infection with human immunodeficiency virus (HIV) in the
community. Which nursing action will you delegate to
health assistants working for the agency? 2. Ans: 1 Supplying sterile injection supplies to patients
1. Supplying injection drug users with sterile injection who are at risk for HIV infection can be done by statt
equipment such as needles and syringes members with health assistant education. Assessing for
2. Interviewing patients about behaviors that indicate a high-risk behaviors, education, and community assess-
need for annual HIV testing ment are RN-level skills. Focus: Delegation
3. Teaching high-risk community members about the use
of condoms in preventing HIV infection LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
4. Assessing the community to determine which popula- (2013-11-22). Prioritization, Delegation, and Assignment:
tion groups to target for education Practice Excercises for the NCLEX Exam (p. 171). Elsevier
Health Sciences. Kindle Edition.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 18). Elsevier
Health Sciences. Kindle Edition.
3. Ans: 2 Nystatin should be in contact with the oral and
3. You are working with a student nurse to care for an
esophageal tissues as long as possible for maximum ef-
HIV-positive patient with severe esophagitis caused by
fect. The other actions are also inappropriate and should
Candida albicans. Which action by the student indicates
be discussed with the student but do not require action
that you need to intervene most quickly?
as quickly. HIV-positive patients do not require droplet/
1. Putting on a mask and gown before entering the pa-
contact precautions or visitor restrictions to prevent op-
tient's room
portunistic infections. Hot or spicy foods are not usually
2. Giving the patient a glass of water after administering
well tolerated by patients with oral or esophageal fungal
the ordered oral nystatin (Mycostatin) suspension
infections. Focus: Prioritization
3. Suggesting that the patient should order chile con
