2026/2027
SECTION 1: MANAGEMENT OF CARE (15 Questions)
**1.** A charge nurse is making patient assignments on a medical-surgical
unit. Which patient should be assigned to the most experienced RN?
A) A patient requiring routine wound care
B) A patient with a new tracheostomy and unstable vital signs
C) A patient needing assistance with activities of daily living
D) A patient being discharged with home care instructions
**Correct Answer:** B) A patient with a new tracheostomy and unstable vital
signs
**Rationale:** The most complex and unstable patient requires the most
experienced nurse. A patient with a new airway and instability needs
advanced assessment skills, clinical judgment, and the ability to respond
rapidly to changes in condition. Routine care, ADL assistance, and discharge
instructions can be delegated to less experienced staff under supervision.
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**2.** A nurse is preparing to delegate tasks to unlicensed assistive
personnel (UAP). Which task is appropriate to delegate?
A) Performing an initial admission assessment
B) Administering oral medications
C) Assisting a patient with ambulation using a gait belt
,D) Evaluating the effectiveness of patient education
**Correct Answer:** C) Assisting a patient with ambulation using a gait belt
**Rationale:** Delegation follows the "Five Rights": right task, right
circumstance, right person, right direction/communication, and right
supervision. UAP can ambulate stable clients, assist with activities of daily
living, and obtain vital signs on stable clients. Assessment, medication
administration, and evaluation require licensed nursing judgment.
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**3.** A nurse is providing a handoff report using the SBAR communication
tool. Which statement is an example of the "Assessment" component?
A) "The patient is a 65-year-old male admitted with pneumonia."
B) "The patient's oxygen saturation is 88% on room air, and crackles are
audible in the lung bases."
C) "I recommend that the provider be notified and the patient be assessed
for possible intubation."
D) "The patient was admitted 2 days ago and has been on IV antibiotics."
**Correct Answer:** B) "The patient's oxygen saturation is 88% on room air,
and crackles are audible in the lung bases."
**Rationale:** In SBAR, the Assessment component describes the nurse's
clinical judgment and findings. Option B provides objective assessment data
and clinical findings. Situation describes the current issue; Background
provides relevant history; Recommendation states what is needed.
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**4.** A nurse is caring for a patient who is refusing a prescribed blood
transfusion. The patient is competent and has been informed of the risks and
benefits. What is the nurse's appropriate action?
A) Administer the transfusion despite the refusal to prevent harm
B) Honor the patient's refusal and document it in the medical record
C) Ask the family to convince the patient to accept the transfusion
D) Notify security to restrain the patient
**Correct Answer:** B) Honor the patient's refusal and document it in the
medical record
**Rationale:** Respect for patient autonomy requires honoring a competent
patient's refusal of treatment. The nurse should ensure informed refusal,
document thoroughly, notify the provider, and continue to monitor the
patient.
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**5.** A nurse is caring for a patient with an advance directive stating "do
not resuscitate" (DNR). The patient's family requests that everything be
done. What should the nurse do?
A) Follow the family's wishes and initiate CPR if needed
B) Follow the patient's advance directive
C) Call an ethics consult before making a decision
D) Ask the provider to override the advance directive