LI LE Course Study Guide 2026-2027 Complete Exam Prep,
Practice Questions & Verified Answers - 149 Questions
This exam assesses advanced understanding of management of care principles including delegation,
prioritization, resource allocation, quality improvement, and legal-ethical decision-making in complex healthcare
systems. It contains 149 multiple-choice questions, each with four distractors and a fully worked rationale that
explains why the keyed answer is correct. Content is organized into 8 focused sections: Management of Care,
Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, Basic Care and
Comfort, Pharmacological Therapies, Reduction of Risk Potential, Physiological Adaptation. Targeted learning
outcomes include: Apply evidence-based prioritization frameworks to manage multiple patient care needs.;
Evaluate delegation decisions based on scope of practice, competency, and supervision requirements.; Analyze
legal and ethical dilemmas in resource allocation and conflict resolution.. Every item has been reviewed for
clinical accuracy, current guidelines, and clarity so that students can study with confidence and self-correct as
they work through the bank. Use it as a high-yield review immediately before the exam, or as a structured practice
tool during the unit - the rationales double as concise teaching notes. The recommended writing time is 3 hours,
with a passing score of 85%. Aligned with Accredited by the Commission on Collegiate Nursing Education
(CCNE) and aligned with US university graduate-level standards. standards and reflects the question style
commonly seen on accredited program examinations. Students consistently achieving above the cut score on this
Section 1: Management of Care (Questions 1-19)
1 A nurse manager is reviewing the assignment of four staff members: RN1
(experienced), RN2 (new graduate), LPN (licensed practical nurse), and UAP
(unlicensed assistive personnel). Which task is appropriate to delegate to the
LPN?
A) Administering a blood transfusion to a stable patient
B) Performing a sterile dressing change on a surgical wound with a drain
C) Assessing a patient with chest pain and reporting findings
D) Developing the plan of care for a patient with diabetes
Answer: B
Rationale: LPNs can perform sterile dressing changes for stable patients within
their scope. Blood transfusions require RN assessment and monitoring.
Assessment and care planning are RN responsibilities.
2 A charge nurse must assign four patients to three RNs and one LPN. Patient
A: post-op day 1 with unstable vital signs; Patient B: receiving IV antibiotics
for pneumonia, stable; Patient C: requiring wound care and patient
education; Patient D: needing discharge planning. Which assignment best
utilizes staff while ensuring safety?
A) RN1: A and D; RN2: B; RN3: C; LPN: none
,B) RN1: A; RN2: B and C; RN3: D; LPN: assist with vital signs and hygiene
for all
C) RN1: A and C; RN2: B; RN3: D; LPN: vital signs and hygiene for B and
D
D) RN1: A; RN2: B; RN3: D; LPN: C
Answer: C
Rationale: Patient A (unstable) requires an experienced RN; Patient C (wound
care/education) needs an RN; LPN can assist with vital signs/hygiene for stable
patients. Option C appropriately pairs A with an RN and uses LPN for non-RN
tasks.
3 A nurse is caring for four patients. Which patient should the nurse assess first
after receiving shift report?
A) A patient with a history of heart failure who has a respiratory rate of 28
and oxygen saturation of 89% on room air
B) A patient who had a hip replacement 2 days ago and reports pain of 6/10
C) A patient with diabetes who has a blood glucose of 180 mg/dL
D) A patient awaiting discharge who needs a final wound check
Answer: A
Rationale: The patient with respiratory distress (tachypnea, low SpO2) is
unstable and requires immediate assessment. Pain, mild hyperglycemia, and
discharge needs are lower priority.
4 A nurse is leading a quality improvement project to reduce
catheter-associated urinary tract infections (CAUTI). After implementing a
new insertion protocol, the infection rate decreased from 8 to 6 per 1,000
catheter days. What should the nurse do next?
A) Discontinue the project because the goal was met
B) Continue monitoring and consider additional interventions
C) Increase the frequency of catheter changes
D) Compare the rate to national benchmarks and set a new target
Answer: D
Rationale: Quality improvement is ongoing. Comparing to benchmarks (e.g.,
national CAUTI rate of 2-4) helps set new targets. Simply discontinuing or
increasing catheter changes is not evidence-based.
,5 A nurse manager notices that staff are frequently missing documentation of
daily weights for heart failure patients. Which leadership action is most
effective to address this?
A) Post a memo reminding staff of the policy
B) Discuss the issue at the next staff meeting and solicit input
C) Reprimand individual staff members who missed weights
D) Implement an electronic alert system for daily weights
Answer: B
Rationale: Engaging staff in problem-solving promotes ownership and
sustainable change. Memos and reprimands are less effective for system issues.
An alert system may help but addressing the root cause with staff input is best.
6 A nurse is caring for a patient with a do-not-resuscitate (DNR) order who
develops ventricular tachycardia. The patient is conscious and says, "Please
do everything to save me." What is the nurse's best action?
A) Initiate CPR and defibrillation immediately
B) Contact the provider to clarify the DNR order
C) Respect the patient's request and begin resuscitation
D) Explain that the DNR order cannot be changed
Answer: B
Rationale: A competent patient can revoke a DNR order. The nurse should
contact the provider to discuss the patient's wishes. Initiating resuscitation
without clarification may violate the DNR if the patient changes their mind, but
the patient's current request suggests revocation.
7 A nurse is triaging victims of a multivehicle collision. Which victim should
be assigned the highest priority (red tag)?
A) A person with a fractured femur and palpable radial pulse
B) A person with an open skull fracture, unresponsive, with agonal
respirations
C) A person with a sucking chest wound and respiratory distress
D) A person with minor lacerations and abrasions
Answer: C
Rationale: In disaster triage, red tag (immediate) is for life-threatening but
survivable conditions. Sucking chest wound with respiratory distress is
immediately life-threatening. Open skull fracture with agonal respirations is
, likely expectant (black).
8 A nurse is reviewing a patient's medication administration record. The
patient is prescribed enoxaparin 40 mg subcutaneously daily. The nurse
notes that the patient is also receiving aspirin 81 mg daily and clopidogrel 75
mg daily. What is the nurse's priority concern?
A) Increased risk of bleeding due to triple antithrombotic therapy
B) Drug interaction reducing enoxaparin efficacy
C) Need for additional antiplatelet therapy
D) Increased risk of gastrointestinal ulceration
Answer: A
Rationale: Combining anticoagulant (enoxaparin) with dual antiplatelet therapy
(aspirin + clopidogrel) significantly increases bleeding risk. The nurse should
verify the indication and consider if the combination is appropriate, and
monitor for bleeding.
9 A nurse manager is evaluating a staffing model that uses a mix of RNs,
LPNs, and UAPs. Which outcome measure best indicates that the model is
effective?
A) Lower total nursing hours per patient day
B) Higher patient satisfaction scores
C) Decreased incidence of adverse events such as falls and infections
D) Reduced overtime hours for RNs
Answer: C
Rationale: The primary goal of staffing models is safe, quality care. Decreased
adverse events directly reflect safe care. While other metrics are important,
patient safety is the most critical indicator of effectiveness.
10 A nurse is precepting a new graduate who is struggling to prioritize care for
a group of patients. Which teaching strategy is most effective?
A) Provide the new graduate with a written list of tasks in order of priority
B) Ask the new graduate to verbalize their thought process and guide them
using a framework like ABCs or Maslow
C) Allow the new graduate to practice independently and provide feedback
afterward
D) Assign the new graduate only stable patients until they improve
Practice Questions & Verified Answers - 149 Questions
This exam assesses advanced understanding of management of care principles including delegation,
prioritization, resource allocation, quality improvement, and legal-ethical decision-making in complex healthcare
systems. It contains 149 multiple-choice questions, each with four distractors and a fully worked rationale that
explains why the keyed answer is correct. Content is organized into 8 focused sections: Management of Care,
Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, Basic Care and
Comfort, Pharmacological Therapies, Reduction of Risk Potential, Physiological Adaptation. Targeted learning
outcomes include: Apply evidence-based prioritization frameworks to manage multiple patient care needs.;
Evaluate delegation decisions based on scope of practice, competency, and supervision requirements.; Analyze
legal and ethical dilemmas in resource allocation and conflict resolution.. Every item has been reviewed for
clinical accuracy, current guidelines, and clarity so that students can study with confidence and self-correct as
they work through the bank. Use it as a high-yield review immediately before the exam, or as a structured practice
tool during the unit - the rationales double as concise teaching notes. The recommended writing time is 3 hours,
with a passing score of 85%. Aligned with Accredited by the Commission on Collegiate Nursing Education
(CCNE) and aligned with US university graduate-level standards. standards and reflects the question style
commonly seen on accredited program examinations. Students consistently achieving above the cut score on this
Section 1: Management of Care (Questions 1-19)
1 A nurse manager is reviewing the assignment of four staff members: RN1
(experienced), RN2 (new graduate), LPN (licensed practical nurse), and UAP
(unlicensed assistive personnel). Which task is appropriate to delegate to the
LPN?
A) Administering a blood transfusion to a stable patient
B) Performing a sterile dressing change on a surgical wound with a drain
C) Assessing a patient with chest pain and reporting findings
D) Developing the plan of care for a patient with diabetes
Answer: B
Rationale: LPNs can perform sterile dressing changes for stable patients within
their scope. Blood transfusions require RN assessment and monitoring.
Assessment and care planning are RN responsibilities.
2 A charge nurse must assign four patients to three RNs and one LPN. Patient
A: post-op day 1 with unstable vital signs; Patient B: receiving IV antibiotics
for pneumonia, stable; Patient C: requiring wound care and patient
education; Patient D: needing discharge planning. Which assignment best
utilizes staff while ensuring safety?
A) RN1: A and D; RN2: B; RN3: C; LPN: none
,B) RN1: A; RN2: B and C; RN3: D; LPN: assist with vital signs and hygiene
for all
C) RN1: A and C; RN2: B; RN3: D; LPN: vital signs and hygiene for B and
D
D) RN1: A; RN2: B; RN3: D; LPN: C
Answer: C
Rationale: Patient A (unstable) requires an experienced RN; Patient C (wound
care/education) needs an RN; LPN can assist with vital signs/hygiene for stable
patients. Option C appropriately pairs A with an RN and uses LPN for non-RN
tasks.
3 A nurse is caring for four patients. Which patient should the nurse assess first
after receiving shift report?
A) A patient with a history of heart failure who has a respiratory rate of 28
and oxygen saturation of 89% on room air
B) A patient who had a hip replacement 2 days ago and reports pain of 6/10
C) A patient with diabetes who has a blood glucose of 180 mg/dL
D) A patient awaiting discharge who needs a final wound check
Answer: A
Rationale: The patient with respiratory distress (tachypnea, low SpO2) is
unstable and requires immediate assessment. Pain, mild hyperglycemia, and
discharge needs are lower priority.
4 A nurse is leading a quality improvement project to reduce
catheter-associated urinary tract infections (CAUTI). After implementing a
new insertion protocol, the infection rate decreased from 8 to 6 per 1,000
catheter days. What should the nurse do next?
A) Discontinue the project because the goal was met
B) Continue monitoring and consider additional interventions
C) Increase the frequency of catheter changes
D) Compare the rate to national benchmarks and set a new target
Answer: D
Rationale: Quality improvement is ongoing. Comparing to benchmarks (e.g.,
national CAUTI rate of 2-4) helps set new targets. Simply discontinuing or
increasing catheter changes is not evidence-based.
,5 A nurse manager notices that staff are frequently missing documentation of
daily weights for heart failure patients. Which leadership action is most
effective to address this?
A) Post a memo reminding staff of the policy
B) Discuss the issue at the next staff meeting and solicit input
C) Reprimand individual staff members who missed weights
D) Implement an electronic alert system for daily weights
Answer: B
Rationale: Engaging staff in problem-solving promotes ownership and
sustainable change. Memos and reprimands are less effective for system issues.
An alert system may help but addressing the root cause with staff input is best.
6 A nurse is caring for a patient with a do-not-resuscitate (DNR) order who
develops ventricular tachycardia. The patient is conscious and says, "Please
do everything to save me." What is the nurse's best action?
A) Initiate CPR and defibrillation immediately
B) Contact the provider to clarify the DNR order
C) Respect the patient's request and begin resuscitation
D) Explain that the DNR order cannot be changed
Answer: B
Rationale: A competent patient can revoke a DNR order. The nurse should
contact the provider to discuss the patient's wishes. Initiating resuscitation
without clarification may violate the DNR if the patient changes their mind, but
the patient's current request suggests revocation.
7 A nurse is triaging victims of a multivehicle collision. Which victim should
be assigned the highest priority (red tag)?
A) A person with a fractured femur and palpable radial pulse
B) A person with an open skull fracture, unresponsive, with agonal
respirations
C) A person with a sucking chest wound and respiratory distress
D) A person with minor lacerations and abrasions
Answer: C
Rationale: In disaster triage, red tag (immediate) is for life-threatening but
survivable conditions. Sucking chest wound with respiratory distress is
immediately life-threatening. Open skull fracture with agonal respirations is
, likely expectant (black).
8 A nurse is reviewing a patient's medication administration record. The
patient is prescribed enoxaparin 40 mg subcutaneously daily. The nurse
notes that the patient is also receiving aspirin 81 mg daily and clopidogrel 75
mg daily. What is the nurse's priority concern?
A) Increased risk of bleeding due to triple antithrombotic therapy
B) Drug interaction reducing enoxaparin efficacy
C) Need for additional antiplatelet therapy
D) Increased risk of gastrointestinal ulceration
Answer: A
Rationale: Combining anticoagulant (enoxaparin) with dual antiplatelet therapy
(aspirin + clopidogrel) significantly increases bleeding risk. The nurse should
verify the indication and consider if the combination is appropriate, and
monitor for bleeding.
9 A nurse manager is evaluating a staffing model that uses a mix of RNs,
LPNs, and UAPs. Which outcome measure best indicates that the model is
effective?
A) Lower total nursing hours per patient day
B) Higher patient satisfaction scores
C) Decreased incidence of adverse events such as falls and infections
D) Reduced overtime hours for RNs
Answer: C
Rationale: The primary goal of staffing models is safe, quality care. Decreased
adverse events directly reflect safe care. While other metrics are important,
patient safety is the most critical indicator of effectiveness.
10 A nurse is precepting a new graduate who is struggling to prioritize care for
a group of patients. Which teaching strategy is most effective?
A) Provide the new graduate with a written list of tasks in order of priority
B) Ask the new graduate to verbalize their thought process and guide them
using a framework like ABCs or Maslow
C) Allow the new graduate to practice independently and provide feedback
afterward
D) Assign the new graduate only stable patients until they improve
