NCLEX ® Delegation Questions N N N
1. You are the charge nurse. A client with chronic pain reports to you that the nurses have not
N N N N N N N N N N N N N N N N N N
been responding to requests for pain medication. What is your initial action?
N N N N N N N N N N N N N
1. Check the medication administration records (MARs) for the past several days.
N N N N N N N N N N N N
2. Ask the nurse educator to provide in-service training about pain management.
N N N N N N N N N N N N
3. Perform a complete pain assessment on the client and take a pain history.
N N N N N N N N N N N N N N
4. Have a conference with the nurses responsible for the care of this client. - CORRECT
N N N N N N N N N N N N N N N N
ANSWER-1. Ans: 4 As charge nurse, you must assess the performance and attitude of the staff in
N N N N N N N N N N N N N N N N N
relation to this client. After data are gathered from the nurses, additional information can be
N N N N N N N N N N N N N N N
obtained from the records and the client as necessary. The educator may be of assistance if a
N N N N N N N N N N N N N N N N N
knowledge deficit or need for performance improvement is the problem. Focus: Supervision,
N N N N N N N N N N N N
prioritization
N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
N N N N N N N N N N N N N N
Edition.
N
5. As the charge nurse, you are reviewing the charts of clients who were assigned to the care of
N N N N N N N N N N N N N N N N N N
a newly graduated RN. The RN has correctly charted dose and time of medication, but there is
N N N N N N N N N N N N N N N N N
no documentation regarding nonpharmaceutical measures. What action should you take first?
N N N N N N N N N N N N
1. Make a note in the nurse's file and continue to observe clinical performance.
N N N N N N N N N N N N N N
2. Refer the new nurse to the in-service education department.
N N N N N N N N N N
3. Quiz the nurse about knowledge of pain management and pharmacology.
N N N N N N N N N N N
4. Give praise for correctly charting the dose and time and discuss the deficits in charting. -
N N N N N N N N N N N N N N N N
CORRECT ANSWER-5. Ans: 4 In supervision of the new RN, good performance should be
N NN N N N N N N N N N N N N
reinforced first and then areas of improvement can be addressed. Asking the nurse about
N N N N N N N N N N N N N N
knowledge of pain management is also an option; however, it would be a more indirect and
N N N N N N N N N N N N N N N N
,time-consuming approach. Making a note and watching do not help the nurse to correct the
N N N N N N N N N N N N N N N
immediate problem. In-service training might be considered if the problem persists. Focus:
N N N N N N N N N N N N
Supervision, delegation
N N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
N N N N N N N N N N N N N N
Edition.
N
1. You are caring for a patient with esophageal cancer. Which task could be delegated to a UAP?
N N N N N N N N N N N N N N N N N N
1. Assisting the patient with oral hygiene
N N N N N N N
2. Observing the patient's response to feedings
N N N N N N N
3. Facilitating expression of grief or anxiety
N N N N N N N
4. Initiating daily weighings - CORRECT ANSWER-1. Ans: 1 Oral hygiene is within the scope of
N N N N N NN N N N N N N N N N
duties of the UAP. It is the responsibility of the nurse to observe response to treatments and to
N N N N N N N N N N N N N N N N N N
help the patient deal with loss or anxiety. The UAP can be directed to weigh the patient but
N N N N N N N N N N N N N N N N N N
should not be expected to know when to initiate that measurement. Focus: Delegation
N N N N N N N N N N N N N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
N N N N N N N N N N N N N
Kindle Edition.
N N
5. When care assignments are being made for patients with alterations related to
N N N N N N N N N N N N
gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/
N N N N N N N N N N N N N N N
LVN under the supervision of a team leader RN? 1. A patient with severe anemia secondary to
N N N N N N N N N N N N N N N N N
GI bleeding 2. A patient who needs enemas and antibiotics to control GI bacteria
N N N N N N N N N N N N N N N
3. A patient who needs preoperative teaching for bowel resection surgery
N N N N N N N N N N N
4. A patient who needs central line insertion for chemotherapy - CORRECT ANSWER-5. Ans: 2
N N N N N N N N N N N NN N N
Administering enemas and antibiotics is within the scope of practice of LPNs/ LVNs. Although
N N N N N N N N N N N N N N
some states an facilities may allow the LPN/ LVN to administer blood, in general, administering
N N N N N N N N N N N N N N N
blood, providing preoperative teaching, and assisting with central line insertion are the
N N N N N N N N N N N N
responsibilities of the RN. Focus: Assignment
N N N N N N
, LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
N N N N N N N N N N N N N
Kindle Edition.
N N
1. A few minutes after you have given an intradermal injection of an allergen to a patient who is
N N N N N N N N N N N N N N N N N N
undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and
N N N N N N N N N N N N N N
dizzy. Which action included in the emergency protocol should you take first?
N N N N N N N N N N N N N
1. Start oxygen at 4 L/ min using a nasal cannula.
N N N N N N N N N N N
2. Obtain IV access with a large-bore IV catheter.
N N N N N N N N N
3. Give epinephrine (Adrenalin) 0.3 mL intramuscularly.
N N N N N N N
4. Administer 3 mL of nebulized albuterol (Proventil) 0.083%. - CORRECT ANSWER-1. Ans: 3
N N N N N N N N N N NN N N
Epinephrine is the initial drug of choice for treatment of anaphylaxis. Giving epinephrine rapidly
N N N N N N N N N N N N N N
at the onset of an anaphylactic reaction may prevent or reverse cardiovascular collapse as well
N N N N N N N N N N N N N N N
as airway narrowing caused by bronchospasm and inflammation. Oxygen use is also
N N N N N N N N N N N N
appropriate, but oxygen would be administered using a nonrebreather mask in order to achieve
N N N N N N N N N N N N N N
a fraction of inspired oxygen closer to 100%. Albuterol may also be administered to decrease
N N N N N N N N N N N N N N N
airway narrowing but would not be the first therapy used for anaphylaxis. IV access will take
N N N N N N N N N N N N N N N N
longer to establish and should not be the first intervention. Focus: Prioritization
N N N N N N N N N N N N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 170). Elsevier Health Sciences.
N N N N N N N N N N N N N
Kindle Edition.
N N
2. As the nurse manager in a public health department, you are implementing a plan to reduce
N N N N N N N N N N N N N N N N
the incidence of infection with human immunodeficiency virus (HIV) in the community. Which
N N N N N N N N N N N N N
nursing action will you delegate to health assistants working for the agency?
N N N N N N N N N N N N N
1. Supplying injection drug users with sterile injection equipment such as needles and syringes
N N N N N N N N N N N N N N
2. Interviewing patients about behaviors that indicate a need for annual HIV testing
N N N N N N N N N N N N N
3. Teaching high-risk community members about the use of condoms in preventing HIV infection
N N N N N N N N N N N N N
N
4. Assessing the community to determine which population groups to target for education
N N N N N N N N N N N N
1. You are the charge nurse. A client with chronic pain reports to you that the nurses have not
N N N N N N N N N N N N N N N N N N
been responding to requests for pain medication. What is your initial action?
N N N N N N N N N N N N N
1. Check the medication administration records (MARs) for the past several days.
N N N N N N N N N N N N
2. Ask the nurse educator to provide in-service training about pain management.
N N N N N N N N N N N N
3. Perform a complete pain assessment on the client and take a pain history.
N N N N N N N N N N N N N N
4. Have a conference with the nurses responsible for the care of this client. - CORRECT
N N N N N N N N N N N N N N N N
ANSWER-1. Ans: 4 As charge nurse, you must assess the performance and attitude of the staff in
N N N N N N N N N N N N N N N N N
relation to this client. After data are gathered from the nurses, additional information can be
N N N N N N N N N N N N N N N
obtained from the records and the client as necessary. The educator may be of assistance if a
N N N N N N N N N N N N N N N N N
knowledge deficit or need for performance improvement is the problem. Focus: Supervision,
N N N N N N N N N N N N
prioritization
N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
N N N N N N N N N N N N N N
Edition.
N
5. As the charge nurse, you are reviewing the charts of clients who were assigned to the care of
N N N N N N N N N N N N N N N N N N
a newly graduated RN. The RN has correctly charted dose and time of medication, but there is
N N N N N N N N N N N N N N N N N
no documentation regarding nonpharmaceutical measures. What action should you take first?
N N N N N N N N N N N N
1. Make a note in the nurse's file and continue to observe clinical performance.
N N N N N N N N N N N N N N
2. Refer the new nurse to the in-service education department.
N N N N N N N N N N
3. Quiz the nurse about knowledge of pain management and pharmacology.
N N N N N N N N N N N
4. Give praise for correctly charting the dose and time and discuss the deficits in charting. -
N N N N N N N N N N N N N N N N
CORRECT ANSWER-5. Ans: 4 In supervision of the new RN, good performance should be
N NN N N N N N N N N N N N N
reinforced first and then areas of improvement can be addressed. Asking the nurse about
N N N N N N N N N N N N N N
knowledge of pain management is also an option; however, it would be a more indirect and
N N N N N N N N N N N N N N N N
,time-consuming approach. Making a note and watching do not help the nurse to correct the
N N N N N N N N N N N N N N N
immediate problem. In-service training might be considered if the problem persists. Focus:
N N N N N N N N N N N N
Supervision, delegation
N N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
N N N N N N N N N N N N N N
Edition.
N
1. You are caring for a patient with esophageal cancer. Which task could be delegated to a UAP?
N N N N N N N N N N N N N N N N N N
1. Assisting the patient with oral hygiene
N N N N N N N
2. Observing the patient's response to feedings
N N N N N N N
3. Facilitating expression of grief or anxiety
N N N N N N N
4. Initiating daily weighings - CORRECT ANSWER-1. Ans: 1 Oral hygiene is within the scope of
N N N N N NN N N N N N N N N N
duties of the UAP. It is the responsibility of the nurse to observe response to treatments and to
N N N N N N N N N N N N N N N N N N
help the patient deal with loss or anxiety. The UAP can be directed to weigh the patient but
N N N N N N N N N N N N N N N N N N
should not be expected to know when to initiate that measurement. Focus: Delegation
N N N N N N N N N N N N N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
N N N N N N N N N N N N N
Kindle Edition.
N N
5. When care assignments are being made for patients with alterations related to
N N N N N N N N N N N N
gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/
N N N N N N N N N N N N N N N
LVN under the supervision of a team leader RN? 1. A patient with severe anemia secondary to
N N N N N N N N N N N N N N N N N
GI bleeding 2. A patient who needs enemas and antibiotics to control GI bacteria
N N N N N N N N N N N N N N N
3. A patient who needs preoperative teaching for bowel resection surgery
N N N N N N N N N N N
4. A patient who needs central line insertion for chemotherapy - CORRECT ANSWER-5. Ans: 2
N N N N N N N N N N N NN N N
Administering enemas and antibiotics is within the scope of practice of LPNs/ LVNs. Although
N N N N N N N N N N N N N N
some states an facilities may allow the LPN/ LVN to administer blood, in general, administering
N N N N N N N N N N N N N N N
blood, providing preoperative teaching, and assisting with central line insertion are the
N N N N N N N N N N N N
responsibilities of the RN. Focus: Assignment
N N N N N N
, LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
N N N N N N N N N N N N N
Kindle Edition.
N N
1. A few minutes after you have given an intradermal injection of an allergen to a patient who is
N N N N N N N N N N N N N N N N N N
undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and
N N N N N N N N N N N N N N
dizzy. Which action included in the emergency protocol should you take first?
N N N N N N N N N N N N N
1. Start oxygen at 4 L/ min using a nasal cannula.
N N N N N N N N N N N
2. Obtain IV access with a large-bore IV catheter.
N N N N N N N N N
3. Give epinephrine (Adrenalin) 0.3 mL intramuscularly.
N N N N N N N
4. Administer 3 mL of nebulized albuterol (Proventil) 0.083%. - CORRECT ANSWER-1. Ans: 3
N N N N N N N N N N NN N N
Epinephrine is the initial drug of choice for treatment of anaphylaxis. Giving epinephrine rapidly
N N N N N N N N N N N N N N
at the onset of an anaphylactic reaction may prevent or reverse cardiovascular collapse as well
N N N N N N N N N N N N N N N
as airway narrowing caused by bronchospasm and inflammation. Oxygen use is also
N N N N N N N N N N N N
appropriate, but oxygen would be administered using a nonrebreather mask in order to achieve
N N N N N N N N N N N N N N
a fraction of inspired oxygen closer to 100%. Albuterol may also be administered to decrease
N N N N N N N N N N N N N N N
airway narrowing but would not be the first therapy used for anaphylaxis. IV access will take
N N N N N N N N N N N N N N N N
longer to establish and should not be the first intervention. Focus: Prioritization
N N N N N N N N N N N N
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
N N N N N N N N N N
and Assignment: Practice Excercises for the NCLEX Exam (p. 170). Elsevier Health Sciences.
N N N N N N N N N N N N N
Kindle Edition.
N N
2. As the nurse manager in a public health department, you are implementing a plan to reduce
N N N N N N N N N N N N N N N N
the incidence of infection with human immunodeficiency virus (HIV) in the community. Which
N N N N N N N N N N N N N
nursing action will you delegate to health assistants working for the agency?
N N N N N N N N N N N N N
1. Supplying injection drug users with sterile injection equipment such as needles and syringes
N N N N N N N N N N N N N N
2. Interviewing patients about behaviors that indicate a need for annual HIV testing
N N N N N N N N N N N N N
3. Teaching high-risk community members about the use of condoms in preventing HIV infection
N N N N N N N N N N N N N
N
4. Assessing the community to determine which population groups to target for education
N N N N N N N N N N N N
