**THE PRIORITY & DELEGATION MASTERY
EXAM: 2026 NURSING LEADERSHIP DRILL**
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**Question 1**
A nurse is caring for four patients. Which patient should the nurse assess first?
A) Patient with a new tracheostomy, oxygen saturation 89%
B) Patient with diabetes, blood glucose 210 mg/dL
C) Patient with a fractured hip, pain 7/10
D) Patient with a fever of 38.0°C (100.4°F)
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💫RATIONALE✔️✔️: SpO2 89% in a new tracheostomy patient indicates possible tube obstruction or
mucous plug; this is an airway/breathing priority requiring immediate assessment.
💫ANSWER✔️✔️: A) Patient with a new tracheostomy, oxygen saturation 89%
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**Question 2**
A charge nurse is assigning tasks. Which task can be delegated to a UAP?
A) Assess a patient's pain level
B) Change a sterile wound dressing
C) Measure a patient's intake and output
D) Administer a tube feeding
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💫RATIONALE✔️✔️: Measuring intake and output is a basic measurement task within UAP scope;
assessment, sterile dressings, and tube feedings require nursing judgment.
💫ANSWER✔️✔️: C) Measure a patient's intake and output
,---
**Question 3**
A nurse receives report on four patients. Which patient should the nurse see first?
A) Patient with chest pain radiating to left arm
B) Patient with COPD, SpO2 91% on 2 L oxygen
C) Patient with diabetes, blood glucose 180 mg/dL
D) Patient with a fever of 38.2°C (100.8°F)
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💫RATIONALE✔️✔️: Chest pain radiating to the arm is a classic sign of myocardial infarction; this patient
requires immediate cardiac assessment and intervention.
💫ANSWER✔️✔️: A) Patient with chest pain radiating to left arm
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**Question 4**
A nurse is delegating to a UAP. Which statement by the UAP indicates a need for further teaching?
A) "I will report if the patient's blood pressure is 180/100 mmHg."
B) "I can apply a cold compress to a swollen ankle."
C) "I will tell the nurse if the patient is short of breath."
D) "I can change the patient's oxygen flow rate from 2 to 4 L."
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💫RATIONALE✔️✔️: UAPs cannot adjust oxygen flow rates; this requires nursing assessment and provider
orders. The UAP should report shortness of breath to the nurse.
💫ANSWER✔️✔️: D) "I can change the patient's oxygen flow rate from 2 to 4 L."
---
, **Question 5**
A nurse is prioritizing morning medications. Which medication should the nurse administer first?
A) Daily multivitamin
B) PRN acetaminophen for a headache
C) Regular insulin before breakfast
D) Bedtime dose of simvastatin
---
💫RATIONALE✔️✔️: Regular insulin must be given just before meals to match glucose rise; delaying can
cause postprandial hyperglycemia.
💫ANSWER✔️✔️: C) Regular insulin before breakfast
---
**Question 6**
A charge nurse is making assignments. Which patient should be assigned to the most experienced RN?
A) Patient with a newly inserted ventricular assist device
B) Patient with stable heart failure on diuretics
C) Patient with a urinary tract infection on oral antibiotics
D) Patient with a fractured ankle in a cast
---
💫RATIONALE✔️✔️: A VAD patient is critically unstable, requires complex monitoring, and can
decompensate rapidly; only an experienced critical care RN should manage this patient.
💫ANSWER✔️✔️: A) Patient with a newly inserted ventricular assist device
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**Question 7**
A nurse is caring for a patient with a central line. Which finding requires immediate action?
A) The patient reports a headache
EXAM: 2026 NURSING LEADERSHIP DRILL**
---
**Question 1**
A nurse is caring for four patients. Which patient should the nurse assess first?
A) Patient with a new tracheostomy, oxygen saturation 89%
B) Patient with diabetes, blood glucose 210 mg/dL
C) Patient with a fractured hip, pain 7/10
D) Patient with a fever of 38.0°C (100.4°F)
---
💫RATIONALE✔️✔️: SpO2 89% in a new tracheostomy patient indicates possible tube obstruction or
mucous plug; this is an airway/breathing priority requiring immediate assessment.
💫ANSWER✔️✔️: A) Patient with a new tracheostomy, oxygen saturation 89%
---
**Question 2**
A charge nurse is assigning tasks. Which task can be delegated to a UAP?
A) Assess a patient's pain level
B) Change a sterile wound dressing
C) Measure a patient's intake and output
D) Administer a tube feeding
---
💫RATIONALE✔️✔️: Measuring intake and output is a basic measurement task within UAP scope;
assessment, sterile dressings, and tube feedings require nursing judgment.
💫ANSWER✔️✔️: C) Measure a patient's intake and output
,---
**Question 3**
A nurse receives report on four patients. Which patient should the nurse see first?
A) Patient with chest pain radiating to left arm
B) Patient with COPD, SpO2 91% on 2 L oxygen
C) Patient with diabetes, blood glucose 180 mg/dL
D) Patient with a fever of 38.2°C (100.8°F)
---
💫RATIONALE✔️✔️: Chest pain radiating to the arm is a classic sign of myocardial infarction; this patient
requires immediate cardiac assessment and intervention.
💫ANSWER✔️✔️: A) Patient with chest pain radiating to left arm
---
**Question 4**
A nurse is delegating to a UAP. Which statement by the UAP indicates a need for further teaching?
A) "I will report if the patient's blood pressure is 180/100 mmHg."
B) "I can apply a cold compress to a swollen ankle."
C) "I will tell the nurse if the patient is short of breath."
D) "I can change the patient's oxygen flow rate from 2 to 4 L."
---
💫RATIONALE✔️✔️: UAPs cannot adjust oxygen flow rates; this requires nursing assessment and provider
orders. The UAP should report shortness of breath to the nurse.
💫ANSWER✔️✔️: D) "I can change the patient's oxygen flow rate from 2 to 4 L."
---
, **Question 5**
A nurse is prioritizing morning medications. Which medication should the nurse administer first?
A) Daily multivitamin
B) PRN acetaminophen for a headache
C) Regular insulin before breakfast
D) Bedtime dose of simvastatin
---
💫RATIONALE✔️✔️: Regular insulin must be given just before meals to match glucose rise; delaying can
cause postprandial hyperglycemia.
💫ANSWER✔️✔️: C) Regular insulin before breakfast
---
**Question 6**
A charge nurse is making assignments. Which patient should be assigned to the most experienced RN?
A) Patient with a newly inserted ventricular assist device
B) Patient with stable heart failure on diuretics
C) Patient with a urinary tract infection on oral antibiotics
D) Patient with a fractured ankle in a cast
---
💫RATIONALE✔️✔️: A VAD patient is critically unstable, requires complex monitoring, and can
decompensate rapidly; only an experienced critical care RN should manage this patient.
💫ANSWER✔️✔️: A) Patient with a newly inserted ventricular assist device
---
**Question 7**
A nurse is caring for a patient with a central line. Which finding requires immediate action?
A) The patient reports a headache
