NSG 6400 CLINICAL DECISION MAKING ACTUAL EXAM
WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |ALREADY
GRADED A+| ||PROFESSOR VERIFIED||
||BRANDNEW!!!||2026/2027!!!!!!
A nurse is planning care for a client who has residual effects from an ischemic stroke.
Which of the following inter-professional consults should the nurse request first?
A. Speech-language pathologist
B. Occupational Therapist
C. Physical Therapist
D. Social worker
Correct Answer: A. Speech-language pathologist
Expert Rationale:
Clients who have experienced an ischemic stroke are at high risk for dysphagia due to impaired
neuromuscular coordination of swallowing. Dysphagia significantly increases the risk of
aspiration, which can lead to aspiration pneumonia, airway obstruction, and respiratory
compromise. Because airway protection is a priority, the nurse should first consult a speech-
language pathologist to assess swallowing ability and implement safe feeding strategies.
Occupational therapy (Option B) focuses on activities of daily living such as dressing and
grooming, but does not address immediate airway safety. Physical therapy (Option C) assists
with mobility and rehabilitation but is not the priority in preventing aspiration. A social worker
(Option D) addresses discharge planning and psychosocial needs, which are important but not
urgent.
NCLEX prioritization principle: airway and breathing take precedence over mobility and
psychosocial support.
DIF: Application
REF: Stroke Management / Dysphagia and Aspiration Risk
OBJ: Prioritize interprofessional collaboration in stroke care
TOP: Management of Care / Prioritization
A nurse is planning care for 4 clients. Which of the following tasks should the nurse
delegate to a licensed practical nurse (LPN)?
,A. Assess a client's post-operative abdominal incision.
B. Provide discharge teaching for a client who has had a laparoscopic cholecystectomy.
C. Perform a wet-to-dry dressing change for a client who has a pressure ulcer.
D. Initiate a blood transfusion for a client who has low hemoglobin.
Correct Answer: C. Perform a wet-to-dry dressing change for a client who has a pressure
ulcer
Expert Rationale:
Delegation decisions are based on scope of practice and client stability. Licensed practical nurses
(LPNs) are trained to perform routine, stable, and predictable care tasks such as sterile or clean
dressing changes, medication administration (excluding IV push in many jurisdictions), and
basic wound care.
Option C is appropriate for delegation because wet-to-dry dressing changes are routine wound
care interventions for stable patients and do not require clinical assessment or critical decision-
making.
Option A is incorrect because assessment requires nursing judgment and critical thinking, which
is the responsibility of the registered nurse (RN).
Option B is incorrect because discharge teaching requires evaluation of understanding and
patient education, which is an RN responsibility.
Option D is incorrect because initiating a blood transfusion requires advanced assessment,
monitoring for transfusion reactions, and verification processes that must be performed by an
RN.
NCLEX delegation principle: LPNs perform care for stable clients with predictable outcomes;
RNs perform assessment, teaching, and high-risk interventions.
DIF: Application
REF: Delegation and Scope of Practice
OBJ: Identify appropriate tasks for LPN delegation
TOP: Management of Care / Delegation
A nurse is managing the care for a client who has recent unexplained weight loss and a low
serum albumin level. Which of the following members of the interprofessional team should
the nurse consult?
A. Occupational therapist
B. Case manager
C. Registered dietician
D. Social worker
Correct Answer: C. Registered dietician
,Expert Rationale:
Unexplained weight loss and low serum albumin levels indicate protein-energy malnutrition and
impaired nutritional status. Serum albumin is a marker of protein stores and can reflect poor
intake, malabsorption, or increased metabolic demand.
A registered dietician is the most appropriate professional to assess dietary intake, identify
nutritional deficiencies, and develop a therapeutic nutrition plan to restore adequate protein and
calorie intake. This intervention directly addresses the underlying physiological problem.
Option A (occupational therapist) focuses on functional ability and activities of daily living, not
nutritional optimization.
Option B (case manager) coordinates discharge planning and resource utilization but does not
provide nutritional therapy.
Option D (social worker) addresses psychosocial and financial barriers but does not manage
clinical nutrition therapy.
NCLEX focus: match client physiological needs with the correct interprofessional provider.
DIF: Application
REF: Nutrition Support / Malnutrition Management
OBJ: Identify appropriate interprofessional referrals
TOP: Basic Care and Comfort / Nutrition
A nurse is receiving change-of-shift report for a group of clients. Which of the following
clients should the nurse attend to first?
A. A client who is scheduled for discharge and requires teaching for wound care.
B. A client who is post-operative and requests medication before ambulation.
C. A client who is to receive an antibiotic in 1 hr and has a prescription for a peak and trough
level.
D. A client who has received nitroglycerin sublingual for chest pain and requires a 12-lead EKG.
Correct Answer: D. A client who has received nitroglycerin sublingual for chest pain and
requires a 12-lead EKG
Expert Rationale:
Prioritization follows the ABC framework (Airway, Breathing, Circulation) and immediate threat
to life. A client with chest pain requiring nitroglycerin and a 12-lead EKG is at risk for acute
coronary syndrome or myocardial infarction, which is a life-threatening cardiac condition
requiring urgent assessment and monitoring.
A 12-lead EKG is needed immediately to evaluate cardiac ischemia and guide further
intervention. Delays could result in worsening myocardial damage.
, Option A involves discharge teaching, which is important but not urgent.
Option B involves pain management and mobility support, but is not life-threatening.
Option C involves scheduled medication administration and lab monitoring, which is time-
sensitive but not emergent.
NCLEX prioritization principle: circulation and potential myocardial ischemia take priority over
routine or scheduled care.
DIF: Analysis
REF: Cardiovascular Emergencies / Acute Coronary Syndrome
OBJ: Prioritize client care based on ABC principles
TOP: Management of Care / Prioritization
A nurse in a rehabilitation facility is performing the role of a case manager for a group of
clients. Which of the following actions should the nurse take?
A. Offer the clients alternative therapies that differ from traditional western medicine.
B. Manage the day-to-day operation of a specific health care unit.
C. Ensure clients receive optimal care in a cost-effective manner.
D. Provide continuing education of nursing staff.
Correct Answer: C. Ensure clients receive optimal care in a cost-effective manner.
Expert Rationale:
The role of a case manager focuses on coordinating care across the continuum to achieve high-
quality outcomes while controlling costs. Case management involves collaboration with the
interprofessional team, appropriate resource utilization, discharge planning, and ensuring that
clients receive timely and efficient care without unnecessary duplication of services.
Option C correctly reflects this role because case managers are responsible for balancing quality
care with cost-effectiveness while ensuring appropriate resource allocation for each client’s
needs.
Option A is incorrect because offering alternative therapies is not a defining responsibility of
case management.
Option B describes the role of a nurse manager or unit manager, who oversees daily operations
of a nursing unit.
Option D relates to nursing education and staff development rather than case coordination.
NCLEX focus: differentiate between nursing leadership roles (case manager vs nurse manager vs
educator).
DIF: Knowledge
REF: Nursing Roles / Case Management
WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |ALREADY
GRADED A+| ||PROFESSOR VERIFIED||
||BRANDNEW!!!||2026/2027!!!!!!
A nurse is planning care for a client who has residual effects from an ischemic stroke.
Which of the following inter-professional consults should the nurse request first?
A. Speech-language pathologist
B. Occupational Therapist
C. Physical Therapist
D. Social worker
Correct Answer: A. Speech-language pathologist
Expert Rationale:
Clients who have experienced an ischemic stroke are at high risk for dysphagia due to impaired
neuromuscular coordination of swallowing. Dysphagia significantly increases the risk of
aspiration, which can lead to aspiration pneumonia, airway obstruction, and respiratory
compromise. Because airway protection is a priority, the nurse should first consult a speech-
language pathologist to assess swallowing ability and implement safe feeding strategies.
Occupational therapy (Option B) focuses on activities of daily living such as dressing and
grooming, but does not address immediate airway safety. Physical therapy (Option C) assists
with mobility and rehabilitation but is not the priority in preventing aspiration. A social worker
(Option D) addresses discharge planning and psychosocial needs, which are important but not
urgent.
NCLEX prioritization principle: airway and breathing take precedence over mobility and
psychosocial support.
DIF: Application
REF: Stroke Management / Dysphagia and Aspiration Risk
OBJ: Prioritize interprofessional collaboration in stroke care
TOP: Management of Care / Prioritization
A nurse is planning care for 4 clients. Which of the following tasks should the nurse
delegate to a licensed practical nurse (LPN)?
,A. Assess a client's post-operative abdominal incision.
B. Provide discharge teaching for a client who has had a laparoscopic cholecystectomy.
C. Perform a wet-to-dry dressing change for a client who has a pressure ulcer.
D. Initiate a blood transfusion for a client who has low hemoglobin.
Correct Answer: C. Perform a wet-to-dry dressing change for a client who has a pressure
ulcer
Expert Rationale:
Delegation decisions are based on scope of practice and client stability. Licensed practical nurses
(LPNs) are trained to perform routine, stable, and predictable care tasks such as sterile or clean
dressing changes, medication administration (excluding IV push in many jurisdictions), and
basic wound care.
Option C is appropriate for delegation because wet-to-dry dressing changes are routine wound
care interventions for stable patients and do not require clinical assessment or critical decision-
making.
Option A is incorrect because assessment requires nursing judgment and critical thinking, which
is the responsibility of the registered nurse (RN).
Option B is incorrect because discharge teaching requires evaluation of understanding and
patient education, which is an RN responsibility.
Option D is incorrect because initiating a blood transfusion requires advanced assessment,
monitoring for transfusion reactions, and verification processes that must be performed by an
RN.
NCLEX delegation principle: LPNs perform care for stable clients with predictable outcomes;
RNs perform assessment, teaching, and high-risk interventions.
DIF: Application
REF: Delegation and Scope of Practice
OBJ: Identify appropriate tasks for LPN delegation
TOP: Management of Care / Delegation
A nurse is managing the care for a client who has recent unexplained weight loss and a low
serum albumin level. Which of the following members of the interprofessional team should
the nurse consult?
A. Occupational therapist
B. Case manager
C. Registered dietician
D. Social worker
Correct Answer: C. Registered dietician
,Expert Rationale:
Unexplained weight loss and low serum albumin levels indicate protein-energy malnutrition and
impaired nutritional status. Serum albumin is a marker of protein stores and can reflect poor
intake, malabsorption, or increased metabolic demand.
A registered dietician is the most appropriate professional to assess dietary intake, identify
nutritional deficiencies, and develop a therapeutic nutrition plan to restore adequate protein and
calorie intake. This intervention directly addresses the underlying physiological problem.
Option A (occupational therapist) focuses on functional ability and activities of daily living, not
nutritional optimization.
Option B (case manager) coordinates discharge planning and resource utilization but does not
provide nutritional therapy.
Option D (social worker) addresses psychosocial and financial barriers but does not manage
clinical nutrition therapy.
NCLEX focus: match client physiological needs with the correct interprofessional provider.
DIF: Application
REF: Nutrition Support / Malnutrition Management
OBJ: Identify appropriate interprofessional referrals
TOP: Basic Care and Comfort / Nutrition
A nurse is receiving change-of-shift report for a group of clients. Which of the following
clients should the nurse attend to first?
A. A client who is scheduled for discharge and requires teaching for wound care.
B. A client who is post-operative and requests medication before ambulation.
C. A client who is to receive an antibiotic in 1 hr and has a prescription for a peak and trough
level.
D. A client who has received nitroglycerin sublingual for chest pain and requires a 12-lead EKG.
Correct Answer: D. A client who has received nitroglycerin sublingual for chest pain and
requires a 12-lead EKG
Expert Rationale:
Prioritization follows the ABC framework (Airway, Breathing, Circulation) and immediate threat
to life. A client with chest pain requiring nitroglycerin and a 12-lead EKG is at risk for acute
coronary syndrome or myocardial infarction, which is a life-threatening cardiac condition
requiring urgent assessment and monitoring.
A 12-lead EKG is needed immediately to evaluate cardiac ischemia and guide further
intervention. Delays could result in worsening myocardial damage.
, Option A involves discharge teaching, which is important but not urgent.
Option B involves pain management and mobility support, but is not life-threatening.
Option C involves scheduled medication administration and lab monitoring, which is time-
sensitive but not emergent.
NCLEX prioritization principle: circulation and potential myocardial ischemia take priority over
routine or scheduled care.
DIF: Analysis
REF: Cardiovascular Emergencies / Acute Coronary Syndrome
OBJ: Prioritize client care based on ABC principles
TOP: Management of Care / Prioritization
A nurse in a rehabilitation facility is performing the role of a case manager for a group of
clients. Which of the following actions should the nurse take?
A. Offer the clients alternative therapies that differ from traditional western medicine.
B. Manage the day-to-day operation of a specific health care unit.
C. Ensure clients receive optimal care in a cost-effective manner.
D. Provide continuing education of nursing staff.
Correct Answer: C. Ensure clients receive optimal care in a cost-effective manner.
Expert Rationale:
The role of a case manager focuses on coordinating care across the continuum to achieve high-
quality outcomes while controlling costs. Case management involves collaboration with the
interprofessional team, appropriate resource utilization, discharge planning, and ensuring that
clients receive timely and efficient care without unnecessary duplication of services.
Option C correctly reflects this role because case managers are responsible for balancing quality
care with cost-effectiveness while ensuring appropriate resource allocation for each client’s
needs.
Option A is incorrect because offering alternative therapies is not a defining responsibility of
case management.
Option B describes the role of a nurse manager or unit manager, who oversees daily operations
of a nursing unit.
Option D relates to nursing education and staff development rather than case coordination.
NCLEX focus: differentiate between nursing leadership roles (case manager vs nurse manager vs
educator).
DIF: Knowledge
REF: Nursing Roles / Case Management
