NDEE Exam 6 Final Exam Review 200 Practice
Questions with Detailed Rationales
2026/2027 Edition
SECTION 1: Management of Care (Questions 1-40)
Question 1
A charge nurse is making client assignments on a busy medical-
surgical unit. Which client should be assigned to the most
experienced registered nurse?
A) A 45-year-old client with community-acquired pneumonia
receiving IV antibiotics
B) A 68-year-old client with type 2 diabetes mellitus requiring
scheduled insulin
C) A 72-year-old client with a new tracheostomy following
laryngectomy
D) A 55-year-old client with hypertension and stable vital signs
Correct Answer: C
Rationale: The client with a new tracheostomy requires complex
assessment and intervention skills, including airway
management, suctioning, and emergency preparedness. This
client requires the most experienced nurse to ensure safe,
competent care. Options A, B, and D involve stable clients with
predictable outcomes who can be managed by nurses with less
experience. The charge nurse must consider the acuity of all
clients, staff competency, and continuity of care when making
assignments. The RN retains accountability for all delegated tasks
and must provide appropriate supervision.
,Question 2
A nurse is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
A) Measuring a client's intake and output
B) Assessing a client's pain level using a numerical scale
C) Administering oral medications from a medication cart
D) Performing a sterile wound dressing change
Correct Answer: A
Rationale: Measuring intake and output is a task that can be
delegated to UAP as it does not require nursing judgment or
clinical assessment. Option B requires assessment, which is
within the RN scope and cannot be delegated. Option C involves
medication administration, which is not within UAP scope in most
states. Option D requires sterile technique and clinical judgment.
The RN remains accountable for delegated tasks and must
provide appropriate supervision, including clear instructions,
monitoring, and evaluation. The five rights of delegation apply:
right task, right circumstance, right person, right
direction/communication, and right supervision/evaluation.
Question 3
A nurse is providing discharge teaching to a client with a new
colostomy. Which statement by the client indicates a need for
further teaching?
,A) "I will change the pouch when it is one-third to one-half full to
prevent leakage"
B) "I should avoid gas-producing foods like broccoli, cabbage, and
beans initially"
C) "I can resume all physical activities immediately, including
heavy lifting"
D) "I need to check the skin around the stoma daily for irritation
or breakdown"
Correct Answer: C
Rationale: Clients should gradually increase physical activity and
avoid heavy lifting (more than 10 pounds) for 6-8 weeks post-
surgery to prevent complications such as herniation and stoma
prolapse. Option A is correct (changing when ⅓-½ full prevents
leakage). Option B is correct (gas-producing foods may need to be
limited initially). Option D is correct (skin assessment is essential
to prevent peristomal dermatitis). The client's statement in
Option C indicates a significant misunderstanding of activity
restrictions post-surgery.
Question 4
A nurse is preparing to administer a blood transfusion to a client
with anemia. Which action should the nurse take first?
A) Obtain and document baseline vital signs
B) Verify the client's identity using two unique identifiers
C) Prime the blood administration tubing with 0.9% normal saline
D) Check the expiration date and blood product identification
number
Correct Answer: B
, Rationale: Verifying the client's identity using two unique
identifiers (e.g., full name and date of birth) is the priority action
to prevent transfusion errors and hemolytic reactions. Options A,
C, and D are important but should occur after patient
identification. The blood transfusion verification process requires
matching the client's identification band with the blood product
label, confirming blood type and Rh compatibility, and verifying
with another licensed professional according to facility policy.
The nurse should also obtain baseline vital signs before the
transfusion and monitor closely during the first 15 minutes when
most reactions occur.
Question 5
A nurse is caring for a client who has a valid do-not-resuscitate
(DNR) order. The client's family member requests that the nurse
"do everything possible" if the client arrests. Which response by
the nurse is most appropriate?
A) "I understand your concern, but I am legally and ethically
obligated to follow the DNR order"
B) "I will resuscitate the client if you, as the family member,
request it"
C) "Let me call the healthcare provider immediately to change the
order"
D) "DNR orders are not legally binding in emergency situations"
Correct Answer: A
Rationale: The nurse must follow the legally binding DNR order.
Option A validates the family's concern while explaining the legal
and ethical obligation. Option B would violate the DNR order.
Questions with Detailed Rationales
2026/2027 Edition
SECTION 1: Management of Care (Questions 1-40)
Question 1
A charge nurse is making client assignments on a busy medical-
surgical unit. Which client should be assigned to the most
experienced registered nurse?
A) A 45-year-old client with community-acquired pneumonia
receiving IV antibiotics
B) A 68-year-old client with type 2 diabetes mellitus requiring
scheduled insulin
C) A 72-year-old client with a new tracheostomy following
laryngectomy
D) A 55-year-old client with hypertension and stable vital signs
Correct Answer: C
Rationale: The client with a new tracheostomy requires complex
assessment and intervention skills, including airway
management, suctioning, and emergency preparedness. This
client requires the most experienced nurse to ensure safe,
competent care. Options A, B, and D involve stable clients with
predictable outcomes who can be managed by nurses with less
experience. The charge nurse must consider the acuity of all
clients, staff competency, and continuity of care when making
assignments. The RN retains accountability for all delegated tasks
and must provide appropriate supervision.
,Question 2
A nurse is delegating tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
A) Measuring a client's intake and output
B) Assessing a client's pain level using a numerical scale
C) Administering oral medications from a medication cart
D) Performing a sterile wound dressing change
Correct Answer: A
Rationale: Measuring intake and output is a task that can be
delegated to UAP as it does not require nursing judgment or
clinical assessment. Option B requires assessment, which is
within the RN scope and cannot be delegated. Option C involves
medication administration, which is not within UAP scope in most
states. Option D requires sterile technique and clinical judgment.
The RN remains accountable for delegated tasks and must
provide appropriate supervision, including clear instructions,
monitoring, and evaluation. The five rights of delegation apply:
right task, right circumstance, right person, right
direction/communication, and right supervision/evaluation.
Question 3
A nurse is providing discharge teaching to a client with a new
colostomy. Which statement by the client indicates a need for
further teaching?
,A) "I will change the pouch when it is one-third to one-half full to
prevent leakage"
B) "I should avoid gas-producing foods like broccoli, cabbage, and
beans initially"
C) "I can resume all physical activities immediately, including
heavy lifting"
D) "I need to check the skin around the stoma daily for irritation
or breakdown"
Correct Answer: C
Rationale: Clients should gradually increase physical activity and
avoid heavy lifting (more than 10 pounds) for 6-8 weeks post-
surgery to prevent complications such as herniation and stoma
prolapse. Option A is correct (changing when ⅓-½ full prevents
leakage). Option B is correct (gas-producing foods may need to be
limited initially). Option D is correct (skin assessment is essential
to prevent peristomal dermatitis). The client's statement in
Option C indicates a significant misunderstanding of activity
restrictions post-surgery.
Question 4
A nurse is preparing to administer a blood transfusion to a client
with anemia. Which action should the nurse take first?
A) Obtain and document baseline vital signs
B) Verify the client's identity using two unique identifiers
C) Prime the blood administration tubing with 0.9% normal saline
D) Check the expiration date and blood product identification
number
Correct Answer: B
, Rationale: Verifying the client's identity using two unique
identifiers (e.g., full name and date of birth) is the priority action
to prevent transfusion errors and hemolytic reactions. Options A,
C, and D are important but should occur after patient
identification. The blood transfusion verification process requires
matching the client's identification band with the blood product
label, confirming blood type and Rh compatibility, and verifying
with another licensed professional according to facility policy.
The nurse should also obtain baseline vital signs before the
transfusion and monitor closely during the first 15 minutes when
most reactions occur.
Question 5
A nurse is caring for a client who has a valid do-not-resuscitate
(DNR) order. The client's family member requests that the nurse
"do everything possible" if the client arrests. Which response by
the nurse is most appropriate?
A) "I understand your concern, but I am legally and ethically
obligated to follow the DNR order"
B) "I will resuscitate the client if you, as the family member,
request it"
C) "Let me call the healthcare provider immediately to change the
order"
D) "DNR orders are not legally binding in emergency situations"
Correct Answer: A
Rationale: The nurse must follow the legally binding DNR order.
Option A validates the family's concern while explaining the legal
and ethical obligation. Option B would violate the DNR order.
