COMPREHENSIVE NURSING PRACTICE REVIEW
Clinical Judgment & Client Care Across the Lifespan
Original Study Guide & Practice Questions – 2026 Edition
SECTION 1: MANAGEMENT OF CARE – DELEGATION, PRIORITIZATION &
SAFETY
Key Concept: The Five Rights of Delegation
Before delegating any task, verify:
1. Right Task – Is it appropriate for delegation?
2. Right Circumstances – Is the client stable with predictable outcomes?
3. Right Person – Does the delegatee have appropriate training?
4. Right Direction/Communication – Are instructions clear, specific, and
understood?
5. Right Supervision – Will appropriate monitoring and evaluation occur?
Scope of Practice Boundaries:
TableCopy
Rol
Can Perform Cannot Perform
e
Assessment, care planning, teaching, IV
Delegate nursing judgment, accountability
RN push meds (most states), blood
for nursing process
administration, initial client education
, Stable client care, medication
LPN Initial assessment, care planning, teaching
administration (PO, IM, subcut), wound
/LV new concepts, IV push (most states),
care, reinforcement of teaching, data
N unstable clients
collection
UAP
ADLs, vital signs on stable clients, I&O, Medications, sterile procedures,
/CN
ambulation, feeding, hygiene assessments, teaching, unstable clients
A
Practice Questions: Management of Care
Q1. A charge nurse is making assignments for the shift. Which client is MOST
APPROPRIATE for the LPN?
A. A client admitted 2 hours ago with chest pain who needs discharge teaching
B. A client with heart failure who requires a focused cardiovascular assessment
C. A client with diabetes who needs reinforcement of insulin injection technique
D. A client receiving chemotherapy who reports nausea and needs antiemetic
administration
Correct Answer: C
Rationale: LPNs can reinforce teaching that has already been initiated by an RN. This
client has a predictable outcome and requires reinforcement rather than initial
education.
● A is incorrect: Discharge teaching requires RN scope (initial teaching, care
planning).
● B is incorrect: Focused assessments requiring clinical judgment and
interpretation are RN responsibilities.
● D is incorrect: Chemotherapy administration and management of side effects in
immunocompromised clients require RN assessment and intervention.
, Key Strategy: When determining delegation appropriateness, ask: "Does this require
nursing judgment, assessment, or initial teaching?" If yes, RN must perform. If no,
consider LPN/UAP based on stability.
Q2. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A. A client with COPD who has an SpO2 of 92% on 2L nasal cannula
B. A client post-appendectomy who reports pain of 6/10 and is due for pain medication
C. A client with a chest tube who has 150 mL of serosanguineous drainage in the last
hour
D. A client with heart failure who has 2+ pitting edema and is scheduled for diuretic
administration
Correct Answer: C
Rationale: Apply the ABC framework and unstable vs. stable prioritization. Chest tube
drainage of 150 mL/hour suggests hemorrhage and requires immediate assessment for
hemodynamic instability.
● A: SpO2 92% on supplemental oxygen is expected for COPD clients (often
maintained at 88-92%); stable.
● B: Pain is a priority but not life-threatening; can address after ensuring no
emergent issues.
● D: 2+ edema is chronic finding; diuretics can be administered after addressing
acute issues.
Clinical Pearl: Postoperative chest tube drainage >100-150 mL/hour for 2+ consecutive
hours indicates excessive bleeding and requires immediate provider notification and
potential surgical intervention.
Q3. A nurse discovers that a medication error occurred—the wrong dose of metoprolol
was administered. What is the FIRST action the nurse should take?
Clinical Judgment & Client Care Across the Lifespan
Original Study Guide & Practice Questions – 2026 Edition
SECTION 1: MANAGEMENT OF CARE – DELEGATION, PRIORITIZATION &
SAFETY
Key Concept: The Five Rights of Delegation
Before delegating any task, verify:
1. Right Task – Is it appropriate for delegation?
2. Right Circumstances – Is the client stable with predictable outcomes?
3. Right Person – Does the delegatee have appropriate training?
4. Right Direction/Communication – Are instructions clear, specific, and
understood?
5. Right Supervision – Will appropriate monitoring and evaluation occur?
Scope of Practice Boundaries:
TableCopy
Rol
Can Perform Cannot Perform
e
Assessment, care planning, teaching, IV
Delegate nursing judgment, accountability
RN push meds (most states), blood
for nursing process
administration, initial client education
, Stable client care, medication
LPN Initial assessment, care planning, teaching
administration (PO, IM, subcut), wound
/LV new concepts, IV push (most states),
care, reinforcement of teaching, data
N unstable clients
collection
UAP
ADLs, vital signs on stable clients, I&O, Medications, sterile procedures,
/CN
ambulation, feeding, hygiene assessments, teaching, unstable clients
A
Practice Questions: Management of Care
Q1. A charge nurse is making assignments for the shift. Which client is MOST
APPROPRIATE for the LPN?
A. A client admitted 2 hours ago with chest pain who needs discharge teaching
B. A client with heart failure who requires a focused cardiovascular assessment
C. A client with diabetes who needs reinforcement of insulin injection technique
D. A client receiving chemotherapy who reports nausea and needs antiemetic
administration
Correct Answer: C
Rationale: LPNs can reinforce teaching that has already been initiated by an RN. This
client has a predictable outcome and requires reinforcement rather than initial
education.
● A is incorrect: Discharge teaching requires RN scope (initial teaching, care
planning).
● B is incorrect: Focused assessments requiring clinical judgment and
interpretation are RN responsibilities.
● D is incorrect: Chemotherapy administration and management of side effects in
immunocompromised clients require RN assessment and intervention.
, Key Strategy: When determining delegation appropriateness, ask: "Does this require
nursing judgment, assessment, or initial teaching?" If yes, RN must perform. If no,
consider LPN/UAP based on stability.
Q2. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A. A client with COPD who has an SpO2 of 92% on 2L nasal cannula
B. A client post-appendectomy who reports pain of 6/10 and is due for pain medication
C. A client with a chest tube who has 150 mL of serosanguineous drainage in the last
hour
D. A client with heart failure who has 2+ pitting edema and is scheduled for diuretic
administration
Correct Answer: C
Rationale: Apply the ABC framework and unstable vs. stable prioritization. Chest tube
drainage of 150 mL/hour suggests hemorrhage and requires immediate assessment for
hemodynamic instability.
● A: SpO2 92% on supplemental oxygen is expected for COPD clients (often
maintained at 88-92%); stable.
● B: Pain is a priority but not life-threatening; can address after ensuring no
emergent issues.
● D: 2+ edema is chronic finding; diuretics can be administered after addressing
acute issues.
Clinical Pearl: Postoperative chest tube drainage >100-150 mL/hour for 2+ consecutive
hours indicates excessive bleeding and requires immediate provider notification and
potential surgical intervention.
Q3. A nurse discovers that a medication error occurred—the wrong dose of metoprolol
was administered. What is the FIRST action the nurse should take?
