**THE NURSING LEADERSHIP DECISION MAKER:
2026 PRIORITIZATION & DELEGATION INTENSIVE**
---
**Question 1**
A nurse is caring for four patients. Which patient should the nurse assess first?
A) Patient with diabetes, blood glucose 65 mg/dL, alert and diaphoretic
B) Patient with COPD, SpO2 89% on 2 L oxygen
C) Patient with heart failure, 3+ pitting edema
D) Patient with pneumonia, temperature 38.5°C (101.3°F)
---
💫RATIONALE✔️✔️: Hypoglycemia (BG 65) with diaphoresis requires immediate oral glucose to prevent
neurological deterioration, but the hypoxic patient (SpO2 89%) has an airway/breathing priority. Correct
answer is B.
💫ANSWER✔️✔️: B) Patient with COPD, SpO2 89% on 2 L oxygen
---
**Question 2**
A charge nurse is assigning tasks to an LPN/LVN. Which task is appropriate to delegate?
A) Perform an initial admission assessment
B) Administer a blood transfusion
C) Monitor a stable patient's vital signs
D) Create a nursing care plan
---
💫RATIONALE✔️✔️: LPN/LVNs can monitor stable patients and perform routine vital signs; admission
assessments, blood transfusion administration (in most states), and care plans require RN scope.
💫ANSWER✔️✔️: C) Monitor a stable patient's vital signs
,---
**Question 3**
A nurse on a medical-surgical unit receives report. Which patient should the nurse see first?
A) Patient with a fractured hip in Buck's traction, pain 8/10
B) Patient with a new colostomy, stoma is pale pink
C) Patient post-thyroidectomy, reports difficulty breathing
D) Patient with cellulitis, receiving IV antibiotics
---
💫RATIONALE✔️✔️: Difficulty breathing post-thyroidectomy indicates possible hematoma or laryngeal
edema causing airway compromise; this is a life-threatening emergency.
💫ANSWER✔️✔️: C) Patient post-thyroidectomy, reports difficulty breathing
---
**Question 4**
A nurse is delegating to a UAP. Which task requires the nurse to provide supervision?
A) Emptying a urinary drainage bag
B) Answering a patient's call light
C) Feeding a patient with dysphagia
D) Making an unoccupied bed
---
💫RATIONALE✔️✔️: Feeding a dysphagia patient carries aspiration risk; the UAP must be trained and the
nurse must supervise closely or perform the task themselves.
💫ANSWER✔️✔️: C) Feeding a patient with dysphagia
---
,**Question 5**
A nurse is prioritizing morning care. Which patient should the nurse bathe first?
A) Patient who is incontinent of stool
B) Patient scheduled for physical therapy in 30 minutes
C) Patient requesting a shower after breakfast
D) Patient going for a CT scan in 1 hour
---
💫RATIONALE✔️✔️: The incontinent patient requires immediate hygiene to prevent skin breakdown and
maintain dignity; this is the highest priority for basic care.
💫ANSWER✔️✔️: A) Patient who is incontinent of stool
---
**Question 6**
A charge nurse is making assignments for a shift. Which patient should be assigned to the most
experienced RN?
A) Patient with a newly inserted chest tube
B) Patient with stable angina on nitrates
C) Patient with a urinary tract infection on oral antibiotics
D) Patient with a pressure injury requiring a dressing change
---
💫RATIONALE✔️✔️: A newly inserted chest tube requires frequent assessment for air leaks, output, and
respiratory status; the experienced RN can recognize complications early.
💫ANSWER✔️✔️: A) Patient with a newly inserted chest tube
---
**Question 7**
A nurse is caring for a patient with a head injury. Which finding requires immediate provider
notification?
, A) Blood pressure 130/80 mmHg
B) Heart rate 88 bpm
C) Glasgow Coma Scale drop from 15 to 12
D) Respiratory rate 18 breaths/min
---
💫RATIONALE✔️✔️: A GCS drop of 3 points indicates neurological deterioration and possible increased
intracranial pressure; requires immediate assessment and provider notification.
💫ANSWER✔️✔️: C) Glasgow Coma Scale drop from 15 to 12
---
**Question 8**
A nurse is delegating to a UAP. Which statement by the UAP indicates a need for further teaching?
A) "I will report if the patient's skin is cool and clammy."
B) "I can change the patient's oxygen flow rate if they are short of breath."
C) "I will tell the nurse if the patient is confused."
D) "I can help the patient walk to the bathroom."
---
💫RATIONALE✔️✔️: UAPs cannot adjust oxygen flow rates; this requires nursing assessment and provider
orders. The UAP should report shortness of breath to the nurse.
💫ANSWER✔️✔️: B) "I can change the patient's oxygen flow rate if they are short of breath."
---
**Question 9**
A nurse receives shift report on four patients. Which patient should the nurse assess first?
A) Patient with a potassium level of 6.5 mEq/L
B) Patient with a sodium level of 132 mEq/L
C) Patient with a blood glucose of 180 mg/dL
2026 PRIORITIZATION & DELEGATION INTENSIVE**
---
**Question 1**
A nurse is caring for four patients. Which patient should the nurse assess first?
A) Patient with diabetes, blood glucose 65 mg/dL, alert and diaphoretic
B) Patient with COPD, SpO2 89% on 2 L oxygen
C) Patient with heart failure, 3+ pitting edema
D) Patient with pneumonia, temperature 38.5°C (101.3°F)
---
💫RATIONALE✔️✔️: Hypoglycemia (BG 65) with diaphoresis requires immediate oral glucose to prevent
neurological deterioration, but the hypoxic patient (SpO2 89%) has an airway/breathing priority. Correct
answer is B.
💫ANSWER✔️✔️: B) Patient with COPD, SpO2 89% on 2 L oxygen
---
**Question 2**
A charge nurse is assigning tasks to an LPN/LVN. Which task is appropriate to delegate?
A) Perform an initial admission assessment
B) Administer a blood transfusion
C) Monitor a stable patient's vital signs
D) Create a nursing care plan
---
💫RATIONALE✔️✔️: LPN/LVNs can monitor stable patients and perform routine vital signs; admission
assessments, blood transfusion administration (in most states), and care plans require RN scope.
💫ANSWER✔️✔️: C) Monitor a stable patient's vital signs
,---
**Question 3**
A nurse on a medical-surgical unit receives report. Which patient should the nurse see first?
A) Patient with a fractured hip in Buck's traction, pain 8/10
B) Patient with a new colostomy, stoma is pale pink
C) Patient post-thyroidectomy, reports difficulty breathing
D) Patient with cellulitis, receiving IV antibiotics
---
💫RATIONALE✔️✔️: Difficulty breathing post-thyroidectomy indicates possible hematoma or laryngeal
edema causing airway compromise; this is a life-threatening emergency.
💫ANSWER✔️✔️: C) Patient post-thyroidectomy, reports difficulty breathing
---
**Question 4**
A nurse is delegating to a UAP. Which task requires the nurse to provide supervision?
A) Emptying a urinary drainage bag
B) Answering a patient's call light
C) Feeding a patient with dysphagia
D) Making an unoccupied bed
---
💫RATIONALE✔️✔️: Feeding a dysphagia patient carries aspiration risk; the UAP must be trained and the
nurse must supervise closely or perform the task themselves.
💫ANSWER✔️✔️: C) Feeding a patient with dysphagia
---
,**Question 5**
A nurse is prioritizing morning care. Which patient should the nurse bathe first?
A) Patient who is incontinent of stool
B) Patient scheduled for physical therapy in 30 minutes
C) Patient requesting a shower after breakfast
D) Patient going for a CT scan in 1 hour
---
💫RATIONALE✔️✔️: The incontinent patient requires immediate hygiene to prevent skin breakdown and
maintain dignity; this is the highest priority for basic care.
💫ANSWER✔️✔️: A) Patient who is incontinent of stool
---
**Question 6**
A charge nurse is making assignments for a shift. Which patient should be assigned to the most
experienced RN?
A) Patient with a newly inserted chest tube
B) Patient with stable angina on nitrates
C) Patient with a urinary tract infection on oral antibiotics
D) Patient with a pressure injury requiring a dressing change
---
💫RATIONALE✔️✔️: A newly inserted chest tube requires frequent assessment for air leaks, output, and
respiratory status; the experienced RN can recognize complications early.
💫ANSWER✔️✔️: A) Patient with a newly inserted chest tube
---
**Question 7**
A nurse is caring for a patient with a head injury. Which finding requires immediate provider
notification?
, A) Blood pressure 130/80 mmHg
B) Heart rate 88 bpm
C) Glasgow Coma Scale drop from 15 to 12
D) Respiratory rate 18 breaths/min
---
💫RATIONALE✔️✔️: A GCS drop of 3 points indicates neurological deterioration and possible increased
intracranial pressure; requires immediate assessment and provider notification.
💫ANSWER✔️✔️: C) Glasgow Coma Scale drop from 15 to 12
---
**Question 8**
A nurse is delegating to a UAP. Which statement by the UAP indicates a need for further teaching?
A) "I will report if the patient's skin is cool and clammy."
B) "I can change the patient's oxygen flow rate if they are short of breath."
C) "I will tell the nurse if the patient is confused."
D) "I can help the patient walk to the bathroom."
---
💫RATIONALE✔️✔️: UAPs cannot adjust oxygen flow rates; this requires nursing assessment and provider
orders. The UAP should report shortness of breath to the nurse.
💫ANSWER✔️✔️: B) "I can change the patient's oxygen flow rate if they are short of breath."
---
**Question 9**
A nurse receives shift report on four patients. Which patient should the nurse assess first?
A) Patient with a potassium level of 6.5 mEq/L
B) Patient with a sodium level of 132 mEq/L
C) Patient with a blood glucose of 180 mg/dL
