: Leadership & Delegation NCLEX-Style
Practice Exam Review – Nursing
Leadership, Management, and
Delegation Questions & Rationales
Instructions: This comprehensive practice exam contains 100 questions covering nursing
leadership, management principles, delegation, prioritization, quality improvement, and
legal/ethical issues in nursing. Select the best answer. Answers are in bold and rationales are
in italic.
DELEGATION AND SUPERVISION (Questions 1-25)
1. Which task is appropriate for the nurse to delegate to an unlicensed assistive personnel
(UAP)?
A) Administering oral medications
B) Performing routine vital signs on a stable client
C) Assessing a wound for infection
D) Inserting a urinary catheter
Answer: B
Rationale: Performing routine vital signs on a stable client is within the scope of practice for
UAP. Medication administration, wound assessment, and catheter insertion require licensed
nursing judgment and skills.
2. The nurse is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate
to delegate?
A) Administering IV push medications
B) Performing a comprehensive admission assessment
C) Administering oral medications to stable clients
D) Developing a nursing care plan
Answer: C
Rationale: LPNs can administer oral medications to stable clients. IV push medications,
comprehensive assessments, and care plan development are within the RN's scope of practice.
,3. The nurse is delegating a task to a UAP. Which statement by the UAP indicates
understanding of the delegation?
A) "I will report any changes in the client's condition to the nurse."
B) "I will assess the client's pain level before and after the procedure."
C) "I will teach the client about their medications."
D) "I will evaluate the effectiveness of the intervention."
Answer: A
Rationale: UAPs should report any changes in the client's condition to the nurse. Assessment,
teaching, and evaluation are nursing responsibilities that cannot be delegated.
4. The nurse is supervising a new graduate RN. Which action by the new graduate requires
immediate intervention?
A) Asking the nurse for guidance on a complex procedure
B) Delegating medication administration to a UAP
C) Documenting client care in the medical record
D) Assessing a client's pain level
Answer: B
Rationale: Medication administration cannot be delegated to a UAP. The nurse must intervene
and provide appropriate education to the new graduate.
5. Which of the following is a key principle of delegation in nursing?
A) The RN is accountable for the delegation and supervision of tasks
B) The UAP is accountable for all aspects of client care
C) Delegation transfers accountability to the delegate
D) The RN is not responsible for tasks delegated to others
Answer: A
Rationale: The RN retains accountability for the delegation and supervision of tasks. The
delegate is responsible for performing the task, but the RN is accountable for the overall care.
6. The nurse is delegating a task to a UAP. Which is the most important factor to consider?
A) The UAP's workload
B) The UAP's experience and competency
C) The UAP's preferences
D) The UAP's shift schedule
Answer: B
, Rationale: The UAP's experience and competency are the most important factors in determining
if a task can be safely delegated.
7. Which of the following tasks cannot be delegated to a UAP?
A) Ambulating a client
B) Feeding a client
C) Assessing a client's skin
D) Measuring intake and output
Answer: C
Rationale: Skin assessment is a nursing assessment that requires clinical judgment and cannot
be delegated to a UAP. Ambulation, feeding, and I&O measurement can be delegated.
8. The nurse is caring for a client with a new tracheostomy. Which task can be delegated to
the LPN?
A) Suctioning the tracheostomy
B) Assessing the tracheostomy site
C) Developing the care plan
D) Evaluating the effectiveness of interventions
Answer: A
Rationale: Suctioning a tracheostomy is within the scope of practice for an LPN. Assessment,
care planning, and evaluation are RN responsibilities.
9. The nurse is delegating a task to a UAP. Which instruction is most appropriate?
A) "Please take vital signs on room 204 and report any abnormal findings."
B) "Please assess the client's pain level and report it to me."
C) "Please evaluate the client's response to the medication."
D) "Please teach the client about their new diagnosis."
Answer: A
Rationale: Vital signs are within the UAP's scope. Assessment, evaluation, and teaching are
nursing responsibilities.
10. The nurse is supervising a UAP who is providing care to a client with a urinary catheter.
Which finding should the nurse follow up on?
A) The UAP empties the drainage bag and measures output
B) The UAP secures the catheter to the client's thigh
C) The UAP reports that the client's urine is cloudy and foul-smelling
D) The UAP maintains the drainage bag below the level of the bladder
Practice Exam Review – Nursing
Leadership, Management, and
Delegation Questions & Rationales
Instructions: This comprehensive practice exam contains 100 questions covering nursing
leadership, management principles, delegation, prioritization, quality improvement, and
legal/ethical issues in nursing. Select the best answer. Answers are in bold and rationales are
in italic.
DELEGATION AND SUPERVISION (Questions 1-25)
1. Which task is appropriate for the nurse to delegate to an unlicensed assistive personnel
(UAP)?
A) Administering oral medications
B) Performing routine vital signs on a stable client
C) Assessing a wound for infection
D) Inserting a urinary catheter
Answer: B
Rationale: Performing routine vital signs on a stable client is within the scope of practice for
UAP. Medication administration, wound assessment, and catheter insertion require licensed
nursing judgment and skills.
2. The nurse is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate
to delegate?
A) Administering IV push medications
B) Performing a comprehensive admission assessment
C) Administering oral medications to stable clients
D) Developing a nursing care plan
Answer: C
Rationale: LPNs can administer oral medications to stable clients. IV push medications,
comprehensive assessments, and care plan development are within the RN's scope of practice.
,3. The nurse is delegating a task to a UAP. Which statement by the UAP indicates
understanding of the delegation?
A) "I will report any changes in the client's condition to the nurse."
B) "I will assess the client's pain level before and after the procedure."
C) "I will teach the client about their medications."
D) "I will evaluate the effectiveness of the intervention."
Answer: A
Rationale: UAPs should report any changes in the client's condition to the nurse. Assessment,
teaching, and evaluation are nursing responsibilities that cannot be delegated.
4. The nurse is supervising a new graduate RN. Which action by the new graduate requires
immediate intervention?
A) Asking the nurse for guidance on a complex procedure
B) Delegating medication administration to a UAP
C) Documenting client care in the medical record
D) Assessing a client's pain level
Answer: B
Rationale: Medication administration cannot be delegated to a UAP. The nurse must intervene
and provide appropriate education to the new graduate.
5. Which of the following is a key principle of delegation in nursing?
A) The RN is accountable for the delegation and supervision of tasks
B) The UAP is accountable for all aspects of client care
C) Delegation transfers accountability to the delegate
D) The RN is not responsible for tasks delegated to others
Answer: A
Rationale: The RN retains accountability for the delegation and supervision of tasks. The
delegate is responsible for performing the task, but the RN is accountable for the overall care.
6. The nurse is delegating a task to a UAP. Which is the most important factor to consider?
A) The UAP's workload
B) The UAP's experience and competency
C) The UAP's preferences
D) The UAP's shift schedule
Answer: B
, Rationale: The UAP's experience and competency are the most important factors in determining
if a task can be safely delegated.
7. Which of the following tasks cannot be delegated to a UAP?
A) Ambulating a client
B) Feeding a client
C) Assessing a client's skin
D) Measuring intake and output
Answer: C
Rationale: Skin assessment is a nursing assessment that requires clinical judgment and cannot
be delegated to a UAP. Ambulation, feeding, and I&O measurement can be delegated.
8. The nurse is caring for a client with a new tracheostomy. Which task can be delegated to
the LPN?
A) Suctioning the tracheostomy
B) Assessing the tracheostomy site
C) Developing the care plan
D) Evaluating the effectiveness of interventions
Answer: A
Rationale: Suctioning a tracheostomy is within the scope of practice for an LPN. Assessment,
care planning, and evaluation are RN responsibilities.
9. The nurse is delegating a task to a UAP. Which instruction is most appropriate?
A) "Please take vital signs on room 204 and report any abnormal findings."
B) "Please assess the client's pain level and report it to me."
C) "Please evaluate the client's response to the medication."
D) "Please teach the client about their new diagnosis."
Answer: A
Rationale: Vital signs are within the UAP's scope. Assessment, evaluation, and teaching are
nursing responsibilities.
10. The nurse is supervising a UAP who is providing care to a client with a urinary catheter.
Which finding should the nurse follow up on?
A) The UAP empties the drainage bag and measures output
B) The UAP secures the catheter to the client's thigh
C) The UAP reports that the client's urine is cloudy and foul-smelling
D) The UAP maintains the drainage bag below the level of the bladder
