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,SECTION 1: MANAGEMENT OF CARE (PRIORITIZATION,DELEGATION, ASSIGNMENT)
Q1. A PN is caring for four clients at the start of the shift. Which client should be assessed FIRST?
A) Client with diabetes requesting pain medication for neuropathy
B) Client with COPD who has a new cough producing green sputum
C) Client post-op day 1 with new-onset confusion and BP 88/50
D) Client with a fractured tibia requesting help to the bathroom
Answer: C
New confusion + hypotension suggests possible sepsis, hemorrhage, or shock — unstable priority.
Airway and circulation precede stable complaints .
Q2. Which client can be assigned to a PN (LPN/LVN) under RN supervision?
A) Client newly diagnosed with unstable angina on a titratable heparin drip
B) Client with stable congestive heart failure receiving daily furosemide
C) Client requiring blood transfusion for symptomatic anemia
D) Client with chest tube and continuous bubbling in water seal chamber
Answer: B
Stable CHF on routine diuretic is within PN scope. Titratable drips, blood transfusions, and chest tube
troubleshooting are typically RN scope .
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,Q3. A charge nurse is assigning staff for the shift. Which client should be assigned to an RN rather than a
PN?
A) A client with stable CHF receiving daily Lasix
B) A client requiring a blood transfusion for symptomatic anemia
C) A client with a new diagnosis of diabetes needing insulin instruction
D) A client with a PEG tube requiring intermittent feedings
Answer: C
Client education (specifically initial instruction) falls under the scope of the RN, as it requires complex
assessment and evaluation of learning. PNs can reinforce teaching but cannot perform initial patient
teaching .
Q4. A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to delegate?
A) Administering an enema
B) Inserting an indwelling urinary catheter
C) Measuring a client's vital signs
D) Teaching a client how to use an incentive spirometer
Answer: C
Measuring vital signs is within the AP's scope of practice. The nurse cannot delegate tasks requiring
nursing judgment, sterile technique (catheter insertion), or client education .
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, Q5. A nurse on a medical-surgical unit has received change-of-shift report and will care for four clients.
Which client need should the nurse assign to an AP?
A) Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client who is learning to walk with a quad cane
C) Reapplying a condom catheter for a client who has urinary incontinence
D) Applying a sterile dressing to a pressure ulcer
Answer: C
Reapplying a condom catheter is a non-invasive task within the AP's scope. Options A, B, and D require
nursing judgment or sterile technique .
Q6. A nurse is preparing a client for transfer to a long-term care facility. Which information should the
nurse include in the transfer report? (Select all that apply)
A) The client's advance directive status
B) The client's recent laboratory values
C) The client's current medications
D) The client's preferred activities
E) The client's code status
Answer: A, B, C, D, E
All of these are essential for continuity of care. Transfer reports must include advance directives, recent
labs, current medications, activity preferences, and code status to ensure safe handoff .
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,SECTION 1: MANAGEMENT OF CARE (PRIORITIZATION,DELEGATION, ASSIGNMENT)
Q1. A PN is caring for four clients at the start of the shift. Which client should be assessed FIRST?
A) Client with diabetes requesting pain medication for neuropathy
B) Client with COPD who has a new cough producing green sputum
C) Client post-op day 1 with new-onset confusion and BP 88/50
D) Client with a fractured tibia requesting help to the bathroom
Answer: C
New confusion + hypotension suggests possible sepsis, hemorrhage, or shock — unstable priority.
Airway and circulation precede stable complaints .
Q2. Which client can be assigned to a PN (LPN/LVN) under RN supervision?
A) Client newly diagnosed with unstable angina on a titratable heparin drip
B) Client with stable congestive heart failure receiving daily furosemide
C) Client requiring blood transfusion for symptomatic anemia
D) Client with chest tube and continuous bubbling in water seal chamber
Answer: B
Stable CHF on routine diuretic is within PN scope. Titratable drips, blood transfusions, and chest tube
troubleshooting are typically RN scope .
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,Q3. A charge nurse is assigning staff for the shift. Which client should be assigned to an RN rather than a
PN?
A) A client with stable CHF receiving daily Lasix
B) A client requiring a blood transfusion for symptomatic anemia
C) A client with a new diagnosis of diabetes needing insulin instruction
D) A client with a PEG tube requiring intermittent feedings
Answer: C
Client education (specifically initial instruction) falls under the scope of the RN, as it requires complex
assessment and evaluation of learning. PNs can reinforce teaching but cannot perform initial patient
teaching .
Q4. A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to delegate?
A) Administering an enema
B) Inserting an indwelling urinary catheter
C) Measuring a client's vital signs
D) Teaching a client how to use an incentive spirometer
Answer: C
Measuring vital signs is within the AP's scope of practice. The nurse cannot delegate tasks requiring
nursing judgment, sterile technique (catheter insertion), or client education .
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, Q5. A nurse on a medical-surgical unit has received change-of-shift report and will care for four clients.
Which client need should the nurse assign to an AP?
A) Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client who is learning to walk with a quad cane
C) Reapplying a condom catheter for a client who has urinary incontinence
D) Applying a sterile dressing to a pressure ulcer
Answer: C
Reapplying a condom catheter is a non-invasive task within the AP's scope. Options A, B, and D require
nursing judgment or sterile technique .
Q6. A nurse is preparing a client for transfer to a long-term care facility. Which information should the
nurse include in the transfer report? (Select all that apply)
A) The client's advance directive status
B) The client's recent laboratory values
C) The client's current medications
D) The client's preferred activities
E) The client's code status
Answer: A, B, C, D, E
All of these are essential for continuity of care. Transfer reports must include advance directives, recent
labs, current medications, activity preferences, and code status to ensure safe handoff .
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