JD NEXT EXAM QUESTIONS & CORRECT ANSWERS
GRADED A LATEST EXAM - 189 Questions
This exam assesses advanced understanding of management of care principles including delegation, supervision,
prioritization, resource allocation, ethical decision-making, and interdisciplinary collaboration in complex
healthcare settings. Designed for graduate-level nursing students seeking to demonstrate mastery in leadership
and management competencies. It contains 189 multiple-choice questions, each with four distractors and a fully
worked rationale that explains why the keyed answer is correct. Content is organized into 8 focused sections:
Management of Care, Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity,
Basic Care and Comfort, Pharmacological Therapies, Reduction of Risk Potential, Physiological Adaptation.
Targeted learning outcomes include: Analyze legal and ethical frameworks for delegation and supervision;
Evaluate prioritization frameworks for multiple patient care needs; Synthesize resource management strategies in
acute care environments; Apply conflict resolution and team dynamics principles. Every item has been reviewed
for clinical accuracy, current guidelines, and clarity so that students can study with confidence and self-correct as
they work through the bank. Use it as a high-yield review immediately before the exam, or as a structured practice
tool during the unit - the rationales double as concise teaching notes. The recommended writing time is 3 hours,
with a passing score of 90%. Aligned with Meets AACN Essentials for graduate-level nursing education and
aligns with NCLEX-RN test plan for management of care. standards and reflects the question style commonly seen
Section 1: Management of Care (Questions 1-25)
1 A charge nurse on a medical-surgical unit is making assignments for the next
shift. Which patient should be assigned to the most experienced registered
nurse (RN)?
A) A patient with stable angina awaiting discharge
B) A patient with diabetic ketoacidosis requiring insulin drip titration
C) A patient with pneumonia receiving IV antibiotics every 6 hours
D) A patient with cellulitis requiring wound care every shift
Answer: B
Rationale: The patient with diabetic ketoacidosis requires complex assessment
and titration of insulin, which demands the highest level of clinical judgment.
Option A is stable, options C and D are routine tasks that can be delegated to
less experienced staff.
2 Which action by a nurse manager best demonstrates effective resource
management in a budget-constrained unit?
A) Reducing staff-to-patient ratios to save costs
B) Implementing a just-in-time supply system to minimize waste
C) Deferring all equipment maintenance to the next fiscal year
D) Increasing the use of overtime to cover staff shortages
,Answer: B
Rationale: Just-in-time supply systems reduce inventory waste and ensure
availability without compromising patient care. Option A compromises safety,
option C risks equipment failure, and option D increases costs and staff
burnout.
3 During a conflict between a physician and a nurse regarding a patient's
treatment plan, the nurse manager uses a collaborative approach. Which
statement reflects this approach?
A) "I will decide the plan after reviewing both perspectives."
B) "Let's explore each other's concerns and find a mutually acceptable
solution."
C) "The physician's order must be followed as written."
D) "We should compromise by splitting the difference."
Answer: B
Rationale: Collaboration involves open dialogue and joint problem-solving to
reach a consensus that respects all viewpoints. Option A is authoritative, option
C avoids discussion, and option D may not address underlying issues.
4 A nurse is delegating tasks to a licensed practical nurse (LPN) and a nursing
assistant (NA). Which task should the nurse delegate to the NA?
A) Administering a scheduled oral medication
B) Assessing the lung sounds of a patient with asthma
C) Ambulating a patient with a history of falls
D) Reinforcing teaching about a new insulin pen
Answer: C
Rationale: Ambulating a patient with a fall risk is within the NA's scope after
appropriate training and delegation. Option A is for LPN/RN, option B is
assessment (RN), and option D involves teaching (RN/LPN with competency).
5 A nurse is prioritizing care for four patients after receiving shift report.
Which patient should the nurse assess first?
A) A patient with a new order for a blood transfusion
B) A patient requesting pain medication for a headache
C) A patient with a cast complaining of numbness in the limb
D) A patient scheduled for discharge in one hour
,Answer: C
Rationale: Numbness in a casted limb suggests compartment syndrome, a
time-sensitive emergency. Option A is important but can be delayed briefly,
option B is non-urgent, and option D is routine.
6 A nurse manager is implementing a quality improvement initiative to reduce
catheter-associated urinary tract infections (CAUTIs). Which strategy is most
effective?
A) Requiring daily urine cultures for all patients with catheters
B) Using a nurse-driven protocol for early catheter removal
C) Changing catheter tubing every 48 hours
D) Placing all patients on prophylactic antibiotics
Answer: B
Rationale: Nurse-driven protocols empower nurses to remove catheters when no
longer indicated, reducing CAUTI risk. Option A is wasteful, option C is not
recommended, and option D increases antibiotic resistance.
7 A nurse is caring for a patient who refuses a life-saving blood transfusion
due to religious beliefs. The nurse should:
A) Administer the transfusion to save the patient's life
B) Respect the refusal and document the decision
C) Obtain a court order to override the patient's wishes
D) Convince the patient to accept the transfusion
Answer: B
Rationale: A competent patient has the right to refuse treatment, even
life-saving. Option A violates autonomy, option C is only if legal criteria are
met (e.g., risk to others), and option D is coercive.
8 Which factor most significantly influences a nurse's ability to effectively
delegate tasks?
A) The nurse's personal relationship with the delegatee
B) The complexity of the task and the delegatee's competency
C) The number of staff available on the unit
D) The time of day the task is to be performed
Answer: B
Rationale: Effective delegation requires matching task complexity with the
, delegatee's skill level and legal scope. Option A is irrelevant, option C affects
workload but not delegation appropriateness, and option D is secondary.
9 During a disaster drill, the nurse in charge must allocate limited ventilators to
multiple patients. Using ethical principles, which patient should receive
priority?
A) The patient with the highest chance of survival with ventilation
B) The patient who arrived first to the emergency department
C) The patient who is a healthcare worker
D) The patient who is the youngest
Answer: A
Rationale: In disaster triage, utilitarianism prioritizes those with the best chance
of survival to maximize benefit. Option B is first-come-first-served, option C is
preferential, and option D is age-based but not necessarily survival.
10 A nurse is leading a team of interdisciplinary professionals in a patient care
conference. To ensure effective collaboration, the nurse should:
A) Present the nursing plan without input from others
B) Encourage each member to share their expertise and recommendations
C) Limit discussion to avoid conflicts
D) Assign tasks based on hierarchy
Answer: B
Rationale: Effective collaboration values each discipline's input to create a
comprehensive plan. Option A is autocratic, option C stifles communication,
and option D ignores individual competence.
11 A nurse manager notices that a unit's medication error rate has increased
over the past quarter. Which leadership action is most likely to reduce
errors sustainably?
A) Implement a punitive disciplinary policy for any medication error
B) Conduct a root cause analysis and revise protocols with staff input
C) Increase the frequency of medication audits by the pharmacy
D) Replace all nursing staff with temporary agency nurses
Answer: B
Rationale: Root cause analysis and staff involvement address system flaws
rather than individual blame, promoting a culture of safety. Punitive measures
GRADED A LATEST EXAM - 189 Questions
This exam assesses advanced understanding of management of care principles including delegation, supervision,
prioritization, resource allocation, ethical decision-making, and interdisciplinary collaboration in complex
healthcare settings. Designed for graduate-level nursing students seeking to demonstrate mastery in leadership
and management competencies. It contains 189 multiple-choice questions, each with four distractors and a fully
worked rationale that explains why the keyed answer is correct. Content is organized into 8 focused sections:
Management of Care, Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity,
Basic Care and Comfort, Pharmacological Therapies, Reduction of Risk Potential, Physiological Adaptation.
Targeted learning outcomes include: Analyze legal and ethical frameworks for delegation and supervision;
Evaluate prioritization frameworks for multiple patient care needs; Synthesize resource management strategies in
acute care environments; Apply conflict resolution and team dynamics principles. Every item has been reviewed
for clinical accuracy, current guidelines, and clarity so that students can study with confidence and self-correct as
they work through the bank. Use it as a high-yield review immediately before the exam, or as a structured practice
tool during the unit - the rationales double as concise teaching notes. The recommended writing time is 3 hours,
with a passing score of 90%. Aligned with Meets AACN Essentials for graduate-level nursing education and
aligns with NCLEX-RN test plan for management of care. standards and reflects the question style commonly seen
Section 1: Management of Care (Questions 1-25)
1 A charge nurse on a medical-surgical unit is making assignments for the next
shift. Which patient should be assigned to the most experienced registered
nurse (RN)?
A) A patient with stable angina awaiting discharge
B) A patient with diabetic ketoacidosis requiring insulin drip titration
C) A patient with pneumonia receiving IV antibiotics every 6 hours
D) A patient with cellulitis requiring wound care every shift
Answer: B
Rationale: The patient with diabetic ketoacidosis requires complex assessment
and titration of insulin, which demands the highest level of clinical judgment.
Option A is stable, options C and D are routine tasks that can be delegated to
less experienced staff.
2 Which action by a nurse manager best demonstrates effective resource
management in a budget-constrained unit?
A) Reducing staff-to-patient ratios to save costs
B) Implementing a just-in-time supply system to minimize waste
C) Deferring all equipment maintenance to the next fiscal year
D) Increasing the use of overtime to cover staff shortages
,Answer: B
Rationale: Just-in-time supply systems reduce inventory waste and ensure
availability without compromising patient care. Option A compromises safety,
option C risks equipment failure, and option D increases costs and staff
burnout.
3 During a conflict between a physician and a nurse regarding a patient's
treatment plan, the nurse manager uses a collaborative approach. Which
statement reflects this approach?
A) "I will decide the plan after reviewing both perspectives."
B) "Let's explore each other's concerns and find a mutually acceptable
solution."
C) "The physician's order must be followed as written."
D) "We should compromise by splitting the difference."
Answer: B
Rationale: Collaboration involves open dialogue and joint problem-solving to
reach a consensus that respects all viewpoints. Option A is authoritative, option
C avoids discussion, and option D may not address underlying issues.
4 A nurse is delegating tasks to a licensed practical nurse (LPN) and a nursing
assistant (NA). Which task should the nurse delegate to the NA?
A) Administering a scheduled oral medication
B) Assessing the lung sounds of a patient with asthma
C) Ambulating a patient with a history of falls
D) Reinforcing teaching about a new insulin pen
Answer: C
Rationale: Ambulating a patient with a fall risk is within the NA's scope after
appropriate training and delegation. Option A is for LPN/RN, option B is
assessment (RN), and option D involves teaching (RN/LPN with competency).
5 A nurse is prioritizing care for four patients after receiving shift report.
Which patient should the nurse assess first?
A) A patient with a new order for a blood transfusion
B) A patient requesting pain medication for a headache
C) A patient with a cast complaining of numbness in the limb
D) A patient scheduled for discharge in one hour
,Answer: C
Rationale: Numbness in a casted limb suggests compartment syndrome, a
time-sensitive emergency. Option A is important but can be delayed briefly,
option B is non-urgent, and option D is routine.
6 A nurse manager is implementing a quality improvement initiative to reduce
catheter-associated urinary tract infections (CAUTIs). Which strategy is most
effective?
A) Requiring daily urine cultures for all patients with catheters
B) Using a nurse-driven protocol for early catheter removal
C) Changing catheter tubing every 48 hours
D) Placing all patients on prophylactic antibiotics
Answer: B
Rationale: Nurse-driven protocols empower nurses to remove catheters when no
longer indicated, reducing CAUTI risk. Option A is wasteful, option C is not
recommended, and option D increases antibiotic resistance.
7 A nurse is caring for a patient who refuses a life-saving blood transfusion
due to religious beliefs. The nurse should:
A) Administer the transfusion to save the patient's life
B) Respect the refusal and document the decision
C) Obtain a court order to override the patient's wishes
D) Convince the patient to accept the transfusion
Answer: B
Rationale: A competent patient has the right to refuse treatment, even
life-saving. Option A violates autonomy, option C is only if legal criteria are
met (e.g., risk to others), and option D is coercive.
8 Which factor most significantly influences a nurse's ability to effectively
delegate tasks?
A) The nurse's personal relationship with the delegatee
B) The complexity of the task and the delegatee's competency
C) The number of staff available on the unit
D) The time of day the task is to be performed
Answer: B
Rationale: Effective delegation requires matching task complexity with the
, delegatee's skill level and legal scope. Option A is irrelevant, option C affects
workload but not delegation appropriateness, and option D is secondary.
9 During a disaster drill, the nurse in charge must allocate limited ventilators to
multiple patients. Using ethical principles, which patient should receive
priority?
A) The patient with the highest chance of survival with ventilation
B) The patient who arrived first to the emergency department
C) The patient who is a healthcare worker
D) The patient who is the youngest
Answer: A
Rationale: In disaster triage, utilitarianism prioritizes those with the best chance
of survival to maximize benefit. Option B is first-come-first-served, option C is
preferential, and option D is age-based but not necessarily survival.
10 A nurse is leading a team of interdisciplinary professionals in a patient care
conference. To ensure effective collaboration, the nurse should:
A) Present the nursing plan without input from others
B) Encourage each member to share their expertise and recommendations
C) Limit discussion to avoid conflicts
D) Assign tasks based on hierarchy
Answer: B
Rationale: Effective collaboration values each discipline's input to create a
comprehensive plan. Option A is autocratic, option C stifles communication,
and option D ignores individual competence.
11 A nurse manager notices that a unit's medication error rate has increased
over the past quarter. Which leadership action is most likely to reduce
errors sustainably?
A) Implement a punitive disciplinary policy for any medication error
B) Conduct a root cause analysis and revise protocols with staff input
C) Increase the frequency of medication audits by the pharmacy
D) Replace all nursing staff with temporary agency nurses
Answer: B
Rationale: Root cause analysis and staff involvement address system flaws
rather than individual blame, promoting a culture of safety. Punitive measures
