Prioritization, Delegation, and Assignment Practice Exercises for
the NCLE Examination Test Questions and Answers Graded A+
1. Ans: 4 As charge nurse, you must assess the perfor-
1. You are the charge nurse. A client with chronic pain re-
mance and attitude of the statt in relation to this client.
ports to you that the nurses have not been responding to
After data are gathered from the nurses, additional infor-
requests for pain medication. What is your initial action?
mation can be obtained from the records and the client as
1. Check the medication administration records (MARs)
necessary. The educator may be of assistance if a knowl-
for the past several days.
edge deficit or need for performance improvement is the
2. Ask the nurse educator to provide in-service training
problem. Focus: Supervision, prioritization
about pain management.
3. Perform a complete pain assessment on the client and
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
take a pain history.
(2013-11-22). Prioritization, Delegation, and Assignment:
4. Have a conference with the nurses responsible for the
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
care of this client.
Health Sciences. Kindle Edition.
2. Family members are encouraging your client to "tough
out the pain" rather than risk drug addiction to narcotics.
2. Ans: 3 Beliefs, attitudes, and familial influence are part
The client is stoically abiding. You recognize that the so-
of the sociocultural dimension of pain. Location and radi-
ciocultural dimension of pain is the current priority for the
ation of pain address the sensory dimension. Describing
client. Which question will you ask?
pain and its ettects addresses the attective dimension. Ac-
1. " Where is the pain located, and does it radiate to other
tivity level and function address the behavioral dimension.
parts of your body?"
Asking about knowledge addresses the cognitive dimen-
2. " How would you describe the pain, and how is it
sion. Focus: Prioritization 3.
attecting you?"
3. " What do you believe about pain medication and drug
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
addiction?"
(2013-11-22). Prioritization, Delegation, and Assignment:
4. " How is the pain attecting your activity level and your
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
ability to function?"
Health Sciences. Kindle Edition.
5. " What information do you need about pain, healing,
and addiction?"
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
,Prioritization, Delegation, and Assignment Practice Exercises for
the NCLE Examination Test Questions and Answers Graded A+
stronger opioid, and it is not the first choice for chronic
3. A client with diabetic neuropathy reports a burning,
pain that can be managed with other drugs. Lorazepam is
electrical-type pain in the lower extremities that is worse at
an anxiolytic that may be ordered as an adjuvant nedica-
night and not responding to nonsteroidal anti-inflamma-
tion. Focus: Prioritization
tory drugs. Which medication will you advocate for first?
1. Gabapentin (Neurontin)
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
2. Corticosteroids
(2013-11-22). Prioritization, Delegation, and Assignment:
3. Hydromorphone (Dilaudid)
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
4. Lorazepam (Ativan)
Health Sciences. Kindle Edition.
4. Ans: 3 Cancer pain generally worsens with disease pro-
gression, and the use of opioids is more generous. Fi-
bromyalgia is more likely to be treated with nonopioid and
4. Which client is most likely to receive opioids for extend- adjuvant medications. Trigeminal neuralgia is treated with
ed periods of time? antiseizure medications such as carbamazepine (Tegre-
1. A client with fibromyalgia tol). Phantom limb pain usually subsides after ambulation
2. A client with phantom limb pain in the leg begins. Focus: Prioritization
3. A client with progressive pancreatic cancer
4. A client with trigeminal neuralgia 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 5. Ans: 4 In supervision of the new RN, good performance
clients who were assigned to the care of a newly grad- should be reinforced first and then areas of improvement
uated RN. The RN has correctly charted dose and time can be addressed. Asking the nurse about knowledge of
of medication, but there is no documentation regarding pain management is also an option; however, it would be
nonpharmaceutical measures. What action should you a more indirect and time-consuming approach. Making a
take first? note and watching do not help the nurse to correct the im-
1. Make a note in the nurse's file and continue to observe mediate problem. In-service training might be considered
clinical performance. if the problem persists. Focus: Supervision, delegation
2. Refer the new nurse to the in-service education depart-
,ment.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
3. Quiz the nurse about knowledge of pain management
(2013-11-22). Prioritization, Delegation, and Assignment:
and pharmacology.
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
4. Give praise for correctly charting the dose and time and
Health Sciences. Kindle Edition.
discuss the deficits in charting.
1. Ans: 1 Oral hygiene is within the scope of duties of the
UAP. It is the responsibility of the nurse to observe re-
sponse to treatments and to help the patient deal with loss
1. You are caring for a patient with esophageal cancer.
or anxiety. The UAP can be directed to weigh the patient
Which task could be delegated to a UAP?
but should not be expected to know when to initiate that
1. Assisting the patient with oral hygiene
measurement. Focus: Delegation
2. Observing the patient's response to feedings
3. Facilitating expression of grief or anxiety
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
4. Initiating daily weighings
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
Health Sciences. Kindle Edition.
2. A 56-year-old patient comes to the walk-in clinic report-
ing scant rectal bleeding and intermittent diarrhea and
2. Ans: 4 The patient's physical condition is currently sta-
constipation for the past several months. There is a history
ble, but emotional needs are attecting his or her ability
of polyps and a family history of colorectal cancer. While
to receive the information required to make an informed
you are trying to teach about colonoscopy, the patient
decision. The other diagnoses are relevant, but if the pa-
becomes angry and threatens to leave. What is the priority
tient leaves the clinic the interventions may be delayed or
diagnosis?
ignored. Focus: Prioritization
1. Diarrhea/ Constipation related to altered bowel pat-
terns 2. Deficient Knowledge related to the disease
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
process and diagnostic procedure
(2013-11-22). Prioritization, Delegation, and Assignment:
3. Risk for Deficient Fluid Volume related to rectal bleeding
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
and diarrhea
Health Sciences. Kindle Edition.
4. Anxiety related to unknown outcomes and perceived
threats to body integrity
3. Which patient is at greatest risk for pancreatic cancer?
1. An elderly African-American man who smokes
, 3. Ans: 1 Pancreatic cancer is more common in
African-Americans, males, and smokers. Other associated
factors include alcohol use, diabetes, obesity, history of
pancreatitis, exposure to organic chemicals, consumption
of a high-fat diet, and previous abdominal irradiation.
Focus: Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
Health Sciences. Kindle Edition.
4. Patients receiving chemotherapy are at risk for throm- 4. Ans: 2, 3, 5, 6, 7 Mouthwash should not include al-
bocytopenia related to chemotherapy or disease process- cohol, because it has a drying action that leaves mucous
es. Which actions are needed for patients who must be membranes more vulnerable. Insertion of suppositories,
placed on bleeding precautions? (Select all that apply.) probes, or tampons into the rectal or vaginal cavity is not
1. Provide mouthwash with alcohol for oral rinsing. recommended. All other options are appropriate. Focus:
2. Use paper tape on fragile skin. Prioritization, knowledge
3. Provide a soft toothbrush or oral sponge.
4. Gently insert rectal suppositories. LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
5. Avoid aspirin or aspirin-containing products. (2013-11-22). Prioritization, Delegation, and Assignment:
6. Avoid overinflation of blood pressure cutts. Practice Excercises for the NCLEX Exam (p. 168). Elsevier
7. Pad sharp corners of furniture. Health Sciences. Kindle Edition.
5. When care assignments are being made for patients 5. Ans: 2 Administering enemas and antibiotics is within
with alterations related to gastrointestinal (GI) cancer, the scope of practice of LPNs/ LVNs. Although some states
which patient would be the most appropriate to assign to an facilities may allow the LPN/ LVN to administer blood,
an LPN/ LVN under the supervision of a team leader RN? in general, administering blood, providing preoperative
1. A patient with severe anemia secondary to GI bleeding teaching, and assisting with central line insertion are the
2. A patient who needs enemas and antibiotics to control responsibilities of the RN. Focus: Assignment
GI bacteria
3. A patient who needs preoperative teaching for bowel LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
the NCLE Examination Test Questions and Answers Graded A+
1. Ans: 4 As charge nurse, you must assess the perfor-
1. You are the charge nurse. A client with chronic pain re-
mance and attitude of the statt in relation to this client.
ports to you that the nurses have not been responding to
After data are gathered from the nurses, additional infor-
requests for pain medication. What is your initial action?
mation can be obtained from the records and the client as
1. Check the medication administration records (MARs)
necessary. The educator may be of assistance if a knowl-
for the past several days.
edge deficit or need for performance improvement is the
2. Ask the nurse educator to provide in-service training
problem. Focus: Supervision, prioritization
about pain management.
3. Perform a complete pain assessment on the client and
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
take a pain history.
(2013-11-22). Prioritization, Delegation, and Assignment:
4. Have a conference with the nurses responsible for the
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
care of this client.
Health Sciences. Kindle Edition.
2. Family members are encouraging your client to "tough
out the pain" rather than risk drug addiction to narcotics.
2. Ans: 3 Beliefs, attitudes, and familial influence are part
The client is stoically abiding. You recognize that the so-
of the sociocultural dimension of pain. Location and radi-
ciocultural dimension of pain is the current priority for the
ation of pain address the sensory dimension. Describing
client. Which question will you ask?
pain and its ettects addresses the attective dimension. Ac-
1. " Where is the pain located, and does it radiate to other
tivity level and function address the behavioral dimension.
parts of your body?"
Asking about knowledge addresses the cognitive dimen-
2. " How would you describe the pain, and how is it
sion. Focus: Prioritization 3.
attecting you?"
3. " What do you believe about pain medication and drug
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
addiction?"
(2013-11-22). Prioritization, Delegation, and Assignment:
4. " How is the pain attecting your activity level and your
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
ability to function?"
Health Sciences. Kindle Edition.
5. " What information do you need about pain, healing,
and addiction?"
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
,Prioritization, Delegation, and Assignment Practice Exercises for
the NCLE Examination Test Questions and Answers Graded A+
stronger opioid, and it is not the first choice for chronic
3. A client with diabetic neuropathy reports a burning,
pain that can be managed with other drugs. Lorazepam is
electrical-type pain in the lower extremities that is worse at
an anxiolytic that may be ordered as an adjuvant nedica-
night and not responding to nonsteroidal anti-inflamma-
tion. Focus: Prioritization
tory drugs. Which medication will you advocate for first?
1. Gabapentin (Neurontin)
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
2. Corticosteroids
(2013-11-22). Prioritization, Delegation, and Assignment:
3. Hydromorphone (Dilaudid)
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
4. Lorazepam (Ativan)
Health Sciences. Kindle Edition.
4. Ans: 3 Cancer pain generally worsens with disease pro-
gression, and the use of opioids is more generous. Fi-
bromyalgia is more likely to be treated with nonopioid and
4. Which client is most likely to receive opioids for extend- adjuvant medications. Trigeminal neuralgia is treated with
ed periods of time? antiseizure medications such as carbamazepine (Tegre-
1. A client with fibromyalgia tol). Phantom limb pain usually subsides after ambulation
2. A client with phantom limb pain in the leg begins. Focus: Prioritization
3. A client with progressive pancreatic cancer
4. A client with trigeminal neuralgia 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 5. Ans: 4 In supervision of the new RN, good performance
clients who were assigned to the care of a newly grad- should be reinforced first and then areas of improvement
uated RN. The RN has correctly charted dose and time can be addressed. Asking the nurse about knowledge of
of medication, but there is no documentation regarding pain management is also an option; however, it would be
nonpharmaceutical measures. What action should you a more indirect and time-consuming approach. Making a
take first? note and watching do not help the nurse to correct the im-
1. Make a note in the nurse's file and continue to observe mediate problem. In-service training might be considered
clinical performance. if the problem persists. Focus: Supervision, delegation
2. Refer the new nurse to the in-service education depart-
,ment.
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
3. Quiz the nurse about knowledge of pain management
(2013-11-22). Prioritization, Delegation, and Assignment:
and pharmacology.
Practice Excercises for the NCLEX Exam (p. 3). Elsevier
4. Give praise for correctly charting the dose and time and
Health Sciences. Kindle Edition.
discuss the deficits in charting.
1. Ans: 1 Oral hygiene is within the scope of duties of the
UAP. It is the responsibility of the nurse to observe re-
sponse to treatments and to help the patient deal with loss
1. You are caring for a patient with esophageal cancer.
or anxiety. The UAP can be directed to weigh the patient
Which task could be delegated to a UAP?
but should not be expected to know when to initiate that
1. Assisting the patient with oral hygiene
measurement. Focus: Delegation
2. Observing the patient's response to feedings
3. Facilitating expression of grief or anxiety
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
4. Initiating daily weighings
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
Health Sciences. Kindle Edition.
2. A 56-year-old patient comes to the walk-in clinic report-
ing scant rectal bleeding and intermittent diarrhea and
2. Ans: 4 The patient's physical condition is currently sta-
constipation for the past several months. There is a history
ble, but emotional needs are attecting his or her ability
of polyps and a family history of colorectal cancer. While
to receive the information required to make an informed
you are trying to teach about colonoscopy, the patient
decision. The other diagnoses are relevant, but if the pa-
becomes angry and threatens to leave. What is the priority
tient leaves the clinic the interventions may be delayed or
diagnosis?
ignored. Focus: Prioritization
1. Diarrhea/ Constipation related to altered bowel pat-
terns 2. Deficient Knowledge related to the disease
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
process and diagnostic procedure
(2013-11-22). Prioritization, Delegation, and Assignment:
3. Risk for Deficient Fluid Volume related to rectal bleeding
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
and diarrhea
Health Sciences. Kindle Edition.
4. Anxiety related to unknown outcomes and perceived
threats to body integrity
3. Which patient is at greatest risk for pancreatic cancer?
1. An elderly African-American man who smokes
, 3. Ans: 1 Pancreatic cancer is more common in
African-Americans, males, and smokers. Other associated
factors include alcohol use, diabetes, obesity, history of
pancreatitis, exposure to organic chemicals, consumption
of a high-fat diet, and previous abdominal irradiation.
Focus: Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
(2013-11-22). Prioritization, Delegation, and Assignment:
Practice Excercises for the NCLEX Exam (p. 168). Elsevier
Health Sciences. Kindle Edition.
4. Patients receiving chemotherapy are at risk for throm- 4. Ans: 2, 3, 5, 6, 7 Mouthwash should not include al-
bocytopenia related to chemotherapy or disease process- cohol, because it has a drying action that leaves mucous
es. Which actions are needed for patients who must be membranes more vulnerable. Insertion of suppositories,
placed on bleeding precautions? (Select all that apply.) probes, or tampons into the rectal or vaginal cavity is not
1. Provide mouthwash with alcohol for oral rinsing. recommended. All other options are appropriate. Focus:
2. Use paper tape on fragile skin. Prioritization, knowledge
3. Provide a soft toothbrush or oral sponge.
4. Gently insert rectal suppositories. LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
5. Avoid aspirin or aspirin-containing products. (2013-11-22). Prioritization, Delegation, and Assignment:
6. Avoid overinflation of blood pressure cutts. Practice Excercises for the NCLEX Exam (p. 168). Elsevier
7. Pad sharp corners of furniture. Health Sciences. Kindle Edition.
5. When care assignments are being made for patients 5. Ans: 2 Administering enemas and antibiotics is within
with alterations related to gastrointestinal (GI) cancer, the scope of practice of LPNs/ LVNs. Although some states
which patient would be the most appropriate to assign to an facilities may allow the LPN/ LVN to administer blood,
an LPN/ LVN under the supervision of a team leader RN? in general, administering blood, providing preoperative
1. A patient with severe anemia secondary to GI bleeding teaching, and assisting with central line insertion are the
2. A patient who needs enemas and antibiotics to control responsibilities of the RN. Focus: Assignment
GI bacteria
3. A patient who needs preoperative teaching for bowel LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara
