Priority and Delegation Updated Exam 2026 WITH Recent
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A practical nurse begins the shift and receives reports on four clients.
Which client should be assessed first?
Answer: The client with sudden onset shortness of breath and an
oxygen saturation of 84%.
Rationale: Airway and breathing always take priority using the ABC
framework. Sudden hypoxia indicates impaired oxygenation and
requires immediate assessment and intervention before attending to
clients with less urgent conditions.
The practical nurse has completed morning assessments. Which finding
should be reported to the RN immediately?
Answer: A postoperative client who has a blood pressure of 84/52 mm
Hg and a heart rate of 128 beats/min.
,Rationale: Hypotension accompanied by tachycardia may indicate
shock or internal bleeding. Early recognition and prompt intervention
are essential to prevent deterioration.
Which task is appropriate for the practical nurse to delegate to an
experienced assistive personnel (AP)?
Answer: Obtaining routine vital signs for stable clients.
Rationale: Routine, predictable tasks that do not require nursing
judgment may be delegated to assistive personnel. The practical nurse
remains responsible for evaluating the findings.
A client reports crushing chest pain that radiates to the left arm. What
is the nurse's priority action?
Answer: Assess the client immediately and notify the RN while
initiating emergency protocols.
Rationale: Symptoms are consistent with an acute coronary syndrome.
Rapid assessment and escalation of care improve outcomes and reduce
myocardial damage.
Which client is the highest priority?
, Answer: A client with diabetes who is confused and diaphoretic.
Rationale: Confusion and diaphoresis strongly suggest hypoglycemia,
which can rapidly progress to seizures or coma if untreated.
A newly admitted client develops inspiratory stridor following thyroid
surgery. What is the priority action?
Answer: Notify the RN immediately while preparing emergency airway
equipment.
Rationale: Stridor indicates upper airway obstruction, a life-threatening
emergency requiring immediate intervention.
Which nursing activity should never be delegated to assistive
personnel?
Answer: Assessing a client's pain following administration of
analgesics.
Rationale: Pain reassessment requires nursing judgment to determine
treatment effectiveness and identify complications.