1|Page
NCLEX-RN Management of Care
Questions And Well Graded Solutions
With Rationales Updated 2026-2027
A nurse is caring for a client who refuses to take prescribed medication. Which action
should the nurse take first?
A) Administer the medication by another route
B) Notify the healthcare provider
C) Assess the client's reason for refusal
D) Document the refusal and continue with care
Correct Answer: C
Rationale: The nurse should first assess the client's reason for refusal (C) to
understand the underlying concern. Administering by another route (A) is not
appropriate without consent. Notifying the provider (B) occurs after assessment.
Documentation (D) is important but not the first action.
2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A) Administering oral medications
B) Assessing a wound
C) Feeding a client with dysphagia
D) Measuring intake and output
Correct Answer: D
Rationale: Measuring intake and output (D) is within the scope of UAP.
Administering medications (A) and assessing wounds (B) are nursing
responsibilities. Feeding a client with dysphagia (C) requires nursing judgment
and is not appropriate to delegate.
3. A nurse is supervising a newly licensed nurse. Which action by the new nurse requires
intervention?
A) Documenting medication administration after giving it
B) Asking the charge nurse for clarification on an order
, 2|Page
C) Delegating vital signs to a UAP
D) Assessing a client's pain level
Correct Answer: A
Rationale: Medications should be documented immediately after administration
(A), not later. Asking for clarification (B), delegating vital signs (C), and
assessing pain (D) are appropriate actions.
4. A client with terminal cancer tells the nurse, "I want to stop all treatment and go
home." Which action should the nurse take?
A) Encourage the client to continue treatment
B) Notify the healthcare provider of the client's wishes
C) Contact the client's family to discuss the decision
D) Document the client's statement and do nothing
Correct Answer: B
Rationale: The nurse should notify the healthcare provider (B) of the client's
wishes so that the provider can discuss options with the client. Encouraging
treatment (A) is not appropriate. Contacting the family (C) violates client
confidentiality unless the client consents. Doing nothing (D) is not appropriate.
5. A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client goes
into cardiac arrest. Which action should the nurse take?
A) Begin CPR immediately
B) Call a code blue
C) Do not initiate CPR
D) Ask the family for permission to start CPR
Correct Answer: C
Rationale: A DNR order means CPR should not be initiated (C). Starting CPR (A)
and calling a code (B) violate the DNR order. Asking the family (D) is not
appropriate as the order is already in place.
, 3|Page
6. A nurse is preparing to discharge a client. Which action should the nurse take to
ensure continuity of care?
A) Provide written discharge instructions
B) Call the client's family to pick them up
C) Give the client a list of medications to buy
D) Tell the client to follow up with their primary care provider
Correct Answer: A
Rationale: Providing written discharge instructions (A) ensures the client has
clear information about their care. Calling the family (B) is part of discharge
planning but not the primary action. Giving a list of medications (C) without
instructions is not sufficient. Telling the client to follow up (D) is important but
written instructions are more comprehensive.
7. A nurse is caring for a client who is confused and attempting to remove their IV line.
Which action should the nurse take first?
A) Apply wrist restraints
B) Administer a sedative
C) Use a bed alarm and reorient the client
D) Notify the healthcare provider
Correct Answer: C
Rationale: The nurse should first attempt less restrictive measures such as a bed
alarm and reorientation (C). Restraints (A) are a last resort. Sedatives (B) are
not first-line. Notifying the provider (D) occurs after other interventions.
8. A nurse is caring for a client who has a living will. The client's family disagrees with
the client's wishes. Which action should the nurse take?
A) Follow the family's wishes to avoid conflict
B) Follow the client's wishes as documented in the living will
C) Contact the hospital ethics committee
D) Ask the healthcare provider to make the decision
Correct Answer: B
Rationale: The nurse should follow the client's wishes as documented in the
living will (B). The family's wishes (A) do not override the client's documented
, 4|Page
wishes. Contacting the ethics committee (C) may be needed if there is a conflict
but the living will is legally binding. The provider (D) should follow the client's
wishes.
9. A nurse is caring for a client who is scheduled for surgery. The client asks, "What will
happen during the surgery?" Which action should the nurse take?
A) Explain the procedure in detail
B) Ask the surgeon to explain the procedure
C) Tell the client not to worry
D) Give the client a pamphlet about the surgery
Correct Answer: B
Rationale: The surgeon is responsible for obtaining informed consent and
explaining the procedure (B). The nurse should not explain the procedure in
detail (A) as this is outside the nurse's scope. Telling the client not to worry (C)
dismisses their concern. Giving a pamphlet (D) is not sufficient.
10. A nurse is caring for a client who is being discharged to a skilled nursing facility.
Which action should the nurse take to ensure a smooth transition?
A) Call the facility to give a verbal report
B) Send the client's medical records with the client
C) Provide a written transfer summary
D) All of the above
Correct Answer: D
Rationale: A smooth transition requires calling the facility (A), sending medical
records (B), and providing a written transfer summary (C). All are appropriate
actions.
11. A nurse is caring for a client who speaks a different language. Which action should
the nurse take to obtain informed consent?
A) Use a family member as an interpreter
B) Use a hospital-approved interpreter
NCLEX-RN Management of Care
Questions And Well Graded Solutions
With Rationales Updated 2026-2027
A nurse is caring for a client who refuses to take prescribed medication. Which action
should the nurse take first?
A) Administer the medication by another route
B) Notify the healthcare provider
C) Assess the client's reason for refusal
D) Document the refusal and continue with care
Correct Answer: C
Rationale: The nurse should first assess the client's reason for refusal (C) to
understand the underlying concern. Administering by another route (A) is not
appropriate without consent. Notifying the provider (B) occurs after assessment.
Documentation (D) is important but not the first action.
2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A) Administering oral medications
B) Assessing a wound
C) Feeding a client with dysphagia
D) Measuring intake and output
Correct Answer: D
Rationale: Measuring intake and output (D) is within the scope of UAP.
Administering medications (A) and assessing wounds (B) are nursing
responsibilities. Feeding a client with dysphagia (C) requires nursing judgment
and is not appropriate to delegate.
3. A nurse is supervising a newly licensed nurse. Which action by the new nurse requires
intervention?
A) Documenting medication administration after giving it
B) Asking the charge nurse for clarification on an order
, 2|Page
C) Delegating vital signs to a UAP
D) Assessing a client's pain level
Correct Answer: A
Rationale: Medications should be documented immediately after administration
(A), not later. Asking for clarification (B), delegating vital signs (C), and
assessing pain (D) are appropriate actions.
4. A client with terminal cancer tells the nurse, "I want to stop all treatment and go
home." Which action should the nurse take?
A) Encourage the client to continue treatment
B) Notify the healthcare provider of the client's wishes
C) Contact the client's family to discuss the decision
D) Document the client's statement and do nothing
Correct Answer: B
Rationale: The nurse should notify the healthcare provider (B) of the client's
wishes so that the provider can discuss options with the client. Encouraging
treatment (A) is not appropriate. Contacting the family (C) violates client
confidentiality unless the client consents. Doing nothing (D) is not appropriate.
5. A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client goes
into cardiac arrest. Which action should the nurse take?
A) Begin CPR immediately
B) Call a code blue
C) Do not initiate CPR
D) Ask the family for permission to start CPR
Correct Answer: C
Rationale: A DNR order means CPR should not be initiated (C). Starting CPR (A)
and calling a code (B) violate the DNR order. Asking the family (D) is not
appropriate as the order is already in place.
, 3|Page
6. A nurse is preparing to discharge a client. Which action should the nurse take to
ensure continuity of care?
A) Provide written discharge instructions
B) Call the client's family to pick them up
C) Give the client a list of medications to buy
D) Tell the client to follow up with their primary care provider
Correct Answer: A
Rationale: Providing written discharge instructions (A) ensures the client has
clear information about their care. Calling the family (B) is part of discharge
planning but not the primary action. Giving a list of medications (C) without
instructions is not sufficient. Telling the client to follow up (D) is important but
written instructions are more comprehensive.
7. A nurse is caring for a client who is confused and attempting to remove their IV line.
Which action should the nurse take first?
A) Apply wrist restraints
B) Administer a sedative
C) Use a bed alarm and reorient the client
D) Notify the healthcare provider
Correct Answer: C
Rationale: The nurse should first attempt less restrictive measures such as a bed
alarm and reorientation (C). Restraints (A) are a last resort. Sedatives (B) are
not first-line. Notifying the provider (D) occurs after other interventions.
8. A nurse is caring for a client who has a living will. The client's family disagrees with
the client's wishes. Which action should the nurse take?
A) Follow the family's wishes to avoid conflict
B) Follow the client's wishes as documented in the living will
C) Contact the hospital ethics committee
D) Ask the healthcare provider to make the decision
Correct Answer: B
Rationale: The nurse should follow the client's wishes as documented in the
living will (B). The family's wishes (A) do not override the client's documented
, 4|Page
wishes. Contacting the ethics committee (C) may be needed if there is a conflict
but the living will is legally binding. The provider (D) should follow the client's
wishes.
9. A nurse is caring for a client who is scheduled for surgery. The client asks, "What will
happen during the surgery?" Which action should the nurse take?
A) Explain the procedure in detail
B) Ask the surgeon to explain the procedure
C) Tell the client not to worry
D) Give the client a pamphlet about the surgery
Correct Answer: B
Rationale: The surgeon is responsible for obtaining informed consent and
explaining the procedure (B). The nurse should not explain the procedure in
detail (A) as this is outside the nurse's scope. Telling the client not to worry (C)
dismisses their concern. Giving a pamphlet (D) is not sufficient.
10. A nurse is caring for a client who is being discharged to a skilled nursing facility.
Which action should the nurse take to ensure a smooth transition?
A) Call the facility to give a verbal report
B) Send the client's medical records with the client
C) Provide a written transfer summary
D) All of the above
Correct Answer: D
Rationale: A smooth transition requires calling the facility (A), sending medical
records (B), and providing a written transfer summary (C). All are appropriate
actions.
11. A nurse is caring for a client who speaks a different language. Which action should
the nurse take to obtain informed consent?
A) Use a family member as an interpreter
B) Use a hospital-approved interpreter
