NCLEX RN Management of Care Practice
Exam 4 Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. The nurse is caring for four clients. Which client should the nurse
assess first?
A. A client with chronic arthritis reporting pain of 6/10
B. A client with pneumonia who has an oxygen saturation of 88%
C. A client awaiting discharge instructions
D. A client requesting assistance with bathing
Answer: B. A client with pneumonia who has an oxygen saturation of
88%
An oxygen saturation of 88% indicates impaired oxygenation and
requires immediate assessment and intervention. Airway and breathing
take priority.
2. Which task is appropriate for the RN to delegate to an experienced
unlicensed assistive personnel (UAP)?
A. Assessing a newly admitted client
B. Teaching a client how to use a walker
C. Obtaining vital signs for a stable client
D. Evaluating a client's response to medication
Answer: C. Obtaining vital signs for a stable client
,Routine vital-sign measurement for a stable client can be delegated to a
competent UAP. Assessment, teaching, and evaluation remain the RN's
responsibilities.
3. A nurse is assigning clients to an LPN/LVN. Which client is most
appropriate?
A. A client requiring initial discharge teaching
B. A client with unstable chest pain
C. A stable client requiring a routine dressing change
D. A client with newly developed neurological deficits
Answer: C. A stable client requiring a routine dressing change
LPN/LVNs can provide care to stable clients with predictable outcomes.
Initial assessment, unstable conditions, and complex teaching require
an RN.
4. Which client should the nurse see first after receiving shift report?
A. Client with a temperature of 38.1°C (100.6°F)
B. Client with new-onset confusion and unequal pupils
C. Client requesting pain medication
D. Client awaiting a routine laboratory test
Answer: B. Client with new-onset confusion and unequal pupils
New neurological changes may indicate increased intracranial pressure
or another life-threatening neurological emergency.
5. Which action demonstrates effective prioritization?
,A. Completing paperwork before assessing clients
B. Addressing life-threatening problems before routine needs
C. Seeing clients in order of admission
D. Treating all client needs as equally urgent
Answer: B. Addressing life-threatening problems before routine needs
The nurse prioritizes according to airway, breathing, circulation, safety,
and severity of illness.
6. A nurse receives a prescription that appears unsafe. What should the
nurse do first?
A. Administer the medication
B. Ask another nurse to administer it
C. Clarify the prescription with the prescribing provider
D. Document refusal to administer it
Answer: C. Clarify the prescription with the prescribing provider
The nurse has a responsibility to question unclear or potentially unsafe
prescriptions before administration.
7. Which statement by a nurse indicates appropriate delegation?
A. “The UAP can decide whether the client needs more oxygen.”
B. “The UAP can report abnormal findings to me.”
C. “The UAP is responsible for evaluating the client's progress.”
D. “The UAP can modify the client's plan of care.”
Answer: B. “The UAP can report abnormal findings to me.”
UAPs can collect and report data but cannot independently assess,
evaluate, or modify the plan of care.
, 8. A client refuses a prescribed blood transfusion because of personal
beliefs. What should the nurse do?
A. Tell the client the transfusion is necessary
B. Ask the family to convince the client
C. Respect the client's decision and notify the provider
D. Administer the transfusion because it was prescribed
Answer: C. Respect the client's decision and notify the provider
Competent adults have the right to refuse treatment. The nurse should
respect autonomy and communicate the refusal to the healthcare team.
9. Which action is part of the RN's responsibility when delegating care?
A. Delegating all responsibility for the outcome
B. Selecting a qualified person and providing appropriate supervision
C. Allowing the delegatee to determine the plan of care
D. Avoiding follow-up after delegation
Answer: B. Selecting a qualified person and providing appropriate
supervision
The RN remains accountable for appropriate delegation, supervision,
and evaluation.
10. A nurse identifies a medication error immediately after
administration. What is the priority action?
A. Complete the incident report
B. Notify the client's family
Exam 4 Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. The nurse is caring for four clients. Which client should the nurse
assess first?
A. A client with chronic arthritis reporting pain of 6/10
B. A client with pneumonia who has an oxygen saturation of 88%
C. A client awaiting discharge instructions
D. A client requesting assistance with bathing
Answer: B. A client with pneumonia who has an oxygen saturation of
88%
An oxygen saturation of 88% indicates impaired oxygenation and
requires immediate assessment and intervention. Airway and breathing
take priority.
2. Which task is appropriate for the RN to delegate to an experienced
unlicensed assistive personnel (UAP)?
A. Assessing a newly admitted client
B. Teaching a client how to use a walker
C. Obtaining vital signs for a stable client
D. Evaluating a client's response to medication
Answer: C. Obtaining vital signs for a stable client
,Routine vital-sign measurement for a stable client can be delegated to a
competent UAP. Assessment, teaching, and evaluation remain the RN's
responsibilities.
3. A nurse is assigning clients to an LPN/LVN. Which client is most
appropriate?
A. A client requiring initial discharge teaching
B. A client with unstable chest pain
C. A stable client requiring a routine dressing change
D. A client with newly developed neurological deficits
Answer: C. A stable client requiring a routine dressing change
LPN/LVNs can provide care to stable clients with predictable outcomes.
Initial assessment, unstable conditions, and complex teaching require
an RN.
4. Which client should the nurse see first after receiving shift report?
A. Client with a temperature of 38.1°C (100.6°F)
B. Client with new-onset confusion and unequal pupils
C. Client requesting pain medication
D. Client awaiting a routine laboratory test
Answer: B. Client with new-onset confusion and unequal pupils
New neurological changes may indicate increased intracranial pressure
or another life-threatening neurological emergency.
5. Which action demonstrates effective prioritization?
,A. Completing paperwork before assessing clients
B. Addressing life-threatening problems before routine needs
C. Seeing clients in order of admission
D. Treating all client needs as equally urgent
Answer: B. Addressing life-threatening problems before routine needs
The nurse prioritizes according to airway, breathing, circulation, safety,
and severity of illness.
6. A nurse receives a prescription that appears unsafe. What should the
nurse do first?
A. Administer the medication
B. Ask another nurse to administer it
C. Clarify the prescription with the prescribing provider
D. Document refusal to administer it
Answer: C. Clarify the prescription with the prescribing provider
The nurse has a responsibility to question unclear or potentially unsafe
prescriptions before administration.
7. Which statement by a nurse indicates appropriate delegation?
A. “The UAP can decide whether the client needs more oxygen.”
B. “The UAP can report abnormal findings to me.”
C. “The UAP is responsible for evaluating the client's progress.”
D. “The UAP can modify the client's plan of care.”
Answer: B. “The UAP can report abnormal findings to me.”
UAPs can collect and report data but cannot independently assess,
evaluate, or modify the plan of care.
, 8. A client refuses a prescribed blood transfusion because of personal
beliefs. What should the nurse do?
A. Tell the client the transfusion is necessary
B. Ask the family to convince the client
C. Respect the client's decision and notify the provider
D. Administer the transfusion because it was prescribed
Answer: C. Respect the client's decision and notify the provider
Competent adults have the right to refuse treatment. The nurse should
respect autonomy and communicate the refusal to the healthcare team.
9. Which action is part of the RN's responsibility when delegating care?
A. Delegating all responsibility for the outcome
B. Selecting a qualified person and providing appropriate supervision
C. Allowing the delegatee to determine the plan of care
D. Avoiding follow-up after delegation
Answer: B. Selecting a qualified person and providing appropriate
supervision
The RN remains accountable for appropriate delegation, supervision,
and evaluation.
10. A nurse identifies a medication error immediately after
administration. What is the priority action?
A. Complete the incident report
B. Notify the client's family
