Real NCLEX Nursing Exam Prep
Prioritization, Delegation, and
Assignment Practice Exercises for the
NCLEX ® Examination 2026
1. You are the charge nurse. A client with chronic pain reports to you
that the nurses have not been responding to requests for pain medication.
What is your initial action?
1. Check the medication administration records (MARs) for the past
several days.
2. Ask the nurse educator to provide in-service training about pain
management.
3. Perform a complete pain assessment on the client and take a pain
history.
4. Have a conference with the nurses responsible for the care of this
client. -- Verified--Solution----1. Ans: 4 As charge nurse, you must
assess the performance and attitude of the staff in relation to this client.
After data are gathered from the nurses, additional information can be
obtained from the records and the client as necessary. The educator may
be of assistance if a knowledge deficit or need for performance
improvement is the problem. Focus: Supervision, prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-
22). Prioritization, Delegation, and Assignment: Practice Excercises for
the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle Edition.
,2 | Page
2. Family members are encouraging your client to "tough out the pain"
rather than risk drug addiction to narcotics. The client is stoically
abiding. You recognize that the sociocultural dimension of pain is the
current priority for the client. Which question will you ask?
1. " Where is the pain located, and does it radiate to other parts of your
body?"
2. " How would you describe the pain, and how is it affecting you?"
3. " What do you believe about pain medication and drug addiction?"
4. " How is the pain affecting your activity level and your ability to
function?"
5. " What information do you need about pain, healing, and addiction?" -
- Verified--Solution----2. Ans: 3 Beliefs, attitudes, and familial influence
are part of the sociocultural dimension of pain. Location and radiation of
pain address the sensory dimension. Describing pain and its effects
addresses the affective dimension. Activity level and function address
the behavioral dimension. Asking about knowledge addresses the
cognitive dimension. Focus: Prioritization 3.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-
22). Prioritization, Delegation, and Assignment: Practice Excercises for
the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle Edition.
3. A client with diabetic neuropathy reports a burning, electrical-type
pain in the lower extremities that is worse at night and not responding to
nonsteroidal anti-inflammatory drugs. Which medication will you
advocate for first?
1. Gabapentin (Neurontin)
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2. Corticosteroids
3. Hydromorphone (Dilaudid)
4. Lorazepam (Ativan) -- Verified--Solution----3. Ans: 1 Gabapentin is
an antiepileptic drug, but it is also used to treat diabetic neuropathy.
Corticosteroids are for pain associated with inflammation.
Hydromorphone is a stronger opioid, and it is not the first choice for
chronic pain that can be managed with other drugs. Lorazepam is an
anxiolytic that may be ordered as an adjuvant nedication. Focus:
Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-
22). Prioritization, Delegation, and Assignment: Practice Excercises for
the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle Edition.
4. Which client is most likely to receive opioids for extended periods of
time?
1. A client with fibromyalgia
2. A client with phantom limb pain in the leg
3. A client with progressive pancreatic cancer
4. A client with trigeminal neuralgia -- Verified--Solution----4. Ans: 3
Cancer pain generally worsens with disease progression, and the use of
opioids is more generous. Fibromyalgia is more likely to be treated with
nonopioid and adjuvant medications. Trigeminal neuralgia is treated
with antiseizure medications such as carbamazepine (Tegretol). Phantom
limb pain usually subsides after ambulation begins. Focus: Prioritization
, 4 | Page
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-
22). Prioritization, Delegation, and Assignment: Practice Excercises for
the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle Edition.
5. As the charge nurse, you are reviewing the charts of clients who were
assigned to the care of a newly graduated RN. The RN has correctly
charted dose and time of medication, but there is no documentation
regarding nonpharmaceutical measures. What action should you take
first?
1. Make a note in the nurse's file and continue to observe clinical
performance.
2. Refer the new nurse to the in-service education department.
3. Quiz the nurse about knowledge of pain management and
pharmacology.
4. Give praise for correctly charting the dose and time and discuss the
deficits in charting. -- Verified--Solution----5. Ans: 4 In supervision of
the new RN, good performance should be reinforced first and then areas
of improvement can be addressed. Asking the nurse about knowledge of
pain management is also an option; however, it would be a more indirect
and time-consuming approach. Making a note and watching do not help
the nurse to correct the immediate problem. In-service training might be
considered if the problem persists. Focus: Supervision, delegation
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-
22). Prioritization, Delegation, and Assignment: Practice Excercises for
the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle Edition.