**THE LEADERSHIP & MANAGEMENT DECISIONS
EXAM: 2026 NCLEX PRIORITY DRILL**
Question 1
A nurse is caring for a patient with a new colostomy. The UAP reports that the stoma is dark purple and
dry. What should the nurse do first?
A) Ask the UAP to apply a moist compress
B) Document the finding as normal
C) Go to the room and assess the stoma
D) Notify the surgeon immediately
---
💫ANSWER✔️✔️: C) Go to the room and assess the stoma
💫RATIONALE✔️✔️: The nurse must personally assess any abnormal finding before taking action; a dark
stoma may indicate ischemia.
Question 2
A charge nurse is making assignments. Which patient is most appropriate for an LPN?
A) Patient with a new stroke requiring neurological checks q1h
B) Patient with stable hypertension on oral medications
C) Patient with a chest tube after a thoracotomy
D) Patient with DKA on an insulin drip
---
💫ANSWER✔️✔️: B) Patient with stable hypertension on oral medications
💫RATIONALE✔️✔️: Stable, predictable patients on oral meds are appropriate for LPNs; unstable or
complex patients require RNs.
Question 3
A nurse receives shift report. Which patient should the nurse assess first?
A) Patient with a blood glucose of 250 mg/dL
,B) Patient with a fever of 38.5°C (101.3°F)
C) Patient with a respiratory rate of 8 breaths/min
D) Patient with a blood pressure of 160/90 mmHg
---
💫ANSWER✔️✔️: C) Patient with a respiratory rate of 8 breaths/min
💫RATIONALE✔️✔️: Bradypnea (RR <10) indicates respiratory depression and potential failure, requiring
immediate intervention (ABC priority).
Question 4
A nurse manager is observing a staff nurse delegate a task. Which statement by the staff nurse requires
correction?
A) "Please ambulate the patient in room 204 with a gait belt."
B) "Please tell me if the patient's pain level changes."
C) "Please decide if the patient needs more oxygen."
D) "Please record the patient's intake and output."
---
💫ANSWER✔️✔️: C) "Please decide if the patient needs more oxygen."
💫RATIONALE✔️✔️: Clinical decisions (oxygen adjustment) require nursing judgment and cannot be
delegated to UAPs.
Question 5
A nurse is prioritizing care after receiving report. Which patient should the nurse see first?
A) Patient with a fractured femur who is crying in pain
B) Patient with a new onset of slurred speech and arm weakness
C) Patient with a urinary tract infection who has foul-smelling urine
D) Patient with constipation requesting a laxative
---
💫ANSWER✔️✔️: B) Patient with a new onset of slurred speech and arm weakness
💫RATIONALE✔️✔️: New neurological deficits suggest a possible stroke, requiring immediate time-
sensitive intervention.
, Question 6
A charge nurse is delegating to an LPN. Which task is appropriate?
A) Performing the initial assessment on a new admission
B) Developing a discharge plan for a complex patient
C) Administering IV push morphine
D) Administering a routine subcutaneous heparin injection
---
💫ANSWER✔️✔️: D) Administering a routine subcutaneous heparin injection
💫RATIONALE✔️✔️: LPNs can administer routine subcutaneous medications; initial assessment, care
planning, and IV push meds require RNs.
Question 7
A nurse is caring for four patients. Which patient should the nurse assess first?
A) Patient with a history of falls who has a bed alarm
B) Patient with a PCA pump reporting pain 3/10
C) Patient with a chest tube and 150 mL drainage in 4 hours
D) Patient with a Foley catheter and clear yellow urine
---
💫ANSWER✔️✔️: C) Patient with a chest tube and 150 mL drainage in 4 hours
💫RATIONALE✔️✔️: >100 mL/hour chest tube drainage indicates possible hemorrhage and requires
immediate assessment.
Question 8
A nurse manager is teaching a new RN about the "five rights" of delegation. Which of the following is
one of the five rights?
A) Right shift
B) Right unit
C) Right supervision
D) Right diagnosis
EXAM: 2026 NCLEX PRIORITY DRILL**
Question 1
A nurse is caring for a patient with a new colostomy. The UAP reports that the stoma is dark purple and
dry. What should the nurse do first?
A) Ask the UAP to apply a moist compress
B) Document the finding as normal
C) Go to the room and assess the stoma
D) Notify the surgeon immediately
---
💫ANSWER✔️✔️: C) Go to the room and assess the stoma
💫RATIONALE✔️✔️: The nurse must personally assess any abnormal finding before taking action; a dark
stoma may indicate ischemia.
Question 2
A charge nurse is making assignments. Which patient is most appropriate for an LPN?
A) Patient with a new stroke requiring neurological checks q1h
B) Patient with stable hypertension on oral medications
C) Patient with a chest tube after a thoracotomy
D) Patient with DKA on an insulin drip
---
💫ANSWER✔️✔️: B) Patient with stable hypertension on oral medications
💫RATIONALE✔️✔️: Stable, predictable patients on oral meds are appropriate for LPNs; unstable or
complex patients require RNs.
Question 3
A nurse receives shift report. Which patient should the nurse assess first?
A) Patient with a blood glucose of 250 mg/dL
,B) Patient with a fever of 38.5°C (101.3°F)
C) Patient with a respiratory rate of 8 breaths/min
D) Patient with a blood pressure of 160/90 mmHg
---
💫ANSWER✔️✔️: C) Patient with a respiratory rate of 8 breaths/min
💫RATIONALE✔️✔️: Bradypnea (RR <10) indicates respiratory depression and potential failure, requiring
immediate intervention (ABC priority).
Question 4
A nurse manager is observing a staff nurse delegate a task. Which statement by the staff nurse requires
correction?
A) "Please ambulate the patient in room 204 with a gait belt."
B) "Please tell me if the patient's pain level changes."
C) "Please decide if the patient needs more oxygen."
D) "Please record the patient's intake and output."
---
💫ANSWER✔️✔️: C) "Please decide if the patient needs more oxygen."
💫RATIONALE✔️✔️: Clinical decisions (oxygen adjustment) require nursing judgment and cannot be
delegated to UAPs.
Question 5
A nurse is prioritizing care after receiving report. Which patient should the nurse see first?
A) Patient with a fractured femur who is crying in pain
B) Patient with a new onset of slurred speech and arm weakness
C) Patient with a urinary tract infection who has foul-smelling urine
D) Patient with constipation requesting a laxative
---
💫ANSWER✔️✔️: B) Patient with a new onset of slurred speech and arm weakness
💫RATIONALE✔️✔️: New neurological deficits suggest a possible stroke, requiring immediate time-
sensitive intervention.
, Question 6
A charge nurse is delegating to an LPN. Which task is appropriate?
A) Performing the initial assessment on a new admission
B) Developing a discharge plan for a complex patient
C) Administering IV push morphine
D) Administering a routine subcutaneous heparin injection
---
💫ANSWER✔️✔️: D) Administering a routine subcutaneous heparin injection
💫RATIONALE✔️✔️: LPNs can administer routine subcutaneous medications; initial assessment, care
planning, and IV push meds require RNs.
Question 7
A nurse is caring for four patients. Which patient should the nurse assess first?
A) Patient with a history of falls who has a bed alarm
B) Patient with a PCA pump reporting pain 3/10
C) Patient with a chest tube and 150 mL drainage in 4 hours
D) Patient with a Foley catheter and clear yellow urine
---
💫ANSWER✔️✔️: C) Patient with a chest tube and 150 mL drainage in 4 hours
💫RATIONALE✔️✔️: >100 mL/hour chest tube drainage indicates possible hemorrhage and requires
immediate assessment.
Question 8
A nurse manager is teaching a new RN about the "five rights" of delegation. Which of the following is
one of the five rights?
A) Right shift
B) Right unit
C) Right supervision
D) Right diagnosis
