Leadership & Delegation NCLEX-Style
Practice Exam Review
Comprehensive Leadership and Delegation
in Nursing Practice Examination
1. A charge nurse is assigning patient care to the nursing team. Which task is appropriate to delegate
to a licensed practical/vocational nurse (LPN/LVN)?
A) Perform an initial admission assessment on a newly admitted patient
B) Administer a scheduled IV antibiotic to a stable patient
C) Develop a comprehensive care plan for a patient with diabetes
D) Perform a complex dressing change on a patient with a pressure injury
Answer: B) Administer a scheduled IV antibiotic to a stable patient
Rationale: LPNs/LVNs can administer IV medications to stable patients in many states. Initial
assessments and care plan development are the responsibility of the RN. Complex dressing changes
requiring assessment and evaluation should be performed by the RN.
2. A nurse manager is addressing a conflict between two staff nurses. Which conflict resolution
strategy is most effective?
A) Ignore the conflict and hope it resolves on its own
B) Use a collaborative approach to find a win-win solution
C) Take sides and support one nurse over the other
D) Assign the nurses to different units to avoid interaction
Answer: B) Use a collaborative approach to find a win-win solution
Rationale: Collaboration is the most effective conflict resolution strategy, allowing both parties to work
together to find a mutually acceptable solution. Ignoring conflict allows it to escalate, and taking sides or
avoiding the issue does not resolve the underlying problem.
3. A nurse is preparing to delegate a task to an unlicensed assistive personnel (UAP). Which of the
"Five Rights of Delegation" should the nurse consider first?
A) Right task
B) Right person
,C) Right circumstance
D) Right communication
Answer: A) Right task
Rationale: The first of the Five Rights of Delegation is the Right Task. The nurse must determine if the
task is appropriate to delegate based on the patient's stability, the complexity of the task, and the
potential for harm. Assessment, planning, and evaluation tasks should never be delegated.
4. A nurse is providing discharge teaching to a patient with heart failure. Which teaching method is
most effective for ensuring patient understanding?
A) Provide written materials only
B) Use the teach-back method
C) Have the family member read the instructions
D) Provide verbal instructions quickly before discharge
Answer: B) Use the teach-back method
Rationale: The teach-back method requires the patient to explain the instructions in their own words,
confirming understanding and allowing the nurse to clarify any misconceptions. Written materials and
verbal instructions alone do not verify comprehension.
5. A nurse manager is implementing evidence-based practice on the unit. Which step should the nurse
take first?
A) Implement the change immediately
B) Formulate a clinical question
C) Search the literature for evidence
D) Evaluate the outcomes of the change
Answer: B) Formulate a clinical question
Rationale: The first step in evidence-based practice is to formulate a clinical question using the PICO
(Population, Intervention, Comparison, Outcome) format. This guides the literature search and ensures a
focused approach to finding relevant evidence.
6. A nurse is caring for a patient who is refusing a blood transfusion. Which action should the nurse
take?
A) Administer the transfusion because it is medically necessary
B) Notify the healthcare provider and document the patient's refusal
C) Ask the family to convince the patient to accept the transfusion
D) Explain the benefits and risks and proceed with the transfusion
,Answer: B) Notify the healthcare provider and document the patient's refusal
Rationale: Patients have the right to refuse treatment. The nurse should notify the healthcare provider,
document the refusal, and continue to provide support and education. Informed consent is required for
treatment, and the patient's autonomy must be respected.
7. A charge nurse is making patient assignments. Which patient should be assigned to the most
experienced registered nurse?
A) A patient with a urinary tract infection requiring IV antibiotics
B) A patient with stable angina on telemetry
C) A patient newly diagnosed with diabetes requiring education
D) A patient with acute respiratory failure requiring mechanical ventilation
Answer: D) A patient with acute respiratory failure requiring mechanical ventilation
Rationale: The patient with acute respiratory failure on mechanical ventilation is the most unstable and
requires the highest level of nursing expertise. This patient should be assigned to the most experienced
RN. Stable patients with predictable needs can be assigned to less experienced nurses or LPNs.
8. A nurse is evaluating the effectiveness of a staff education program on fall prevention. Which
outcome indicates the program was effective?
A) Staff can describe fall prevention strategies
B) The fall rate on the unit has decreased by 30%
C) Patients report feeling safer on the unit
D) Fall risk assessments are being completed on admission
Answer: B) The fall rate on the unit has decreased by 30%
Rationale: The most important outcome of a fall prevention program is a reduction in the actual fall rate.
While knowledge, patient satisfaction, and process measures are important, the ultimate goal is to
reduce patient harm from falls.
9. A nurse manager is using transformational leadership. Which behavior is characteristic of this
leadership style?
A) Maintaining the status quo and following rules strictly
B) Inspiring staff to achieve their full potential
C) Making all decisions without input from staff
D) Focusing only on task completion
Answer: B) Inspiring staff to achieve their full potential
, Rationale: Transformational leadership is characterized by inspiring and motivating staff, fostering
innovation, and encouraging professional growth. It focuses on vision, change, and empowering others
to reach their full potential.
10. A nurse is caring for a patient who is experiencing a rapid deterioration in condition. Which action
should the nurse take first?
A) Call the healthcare provider
B) Assess the patient and initiate emergency measures
C) Document the findings in the chart
D) Wait for the next vital signs assessment
Answer: B) Assess the patient and initiate emergency measures
Rationale: The nurse's first priority when a patient deteriorates is to assess the patient and initiate
appropriate emergency measures (e.g., call a rapid response team, start CPR). Calling the provider is
important but follows the immediate assessment and intervention.
11. A nurse is delegating the task of ambulating a patient to a UAP. Which instruction should the
nurse include?
A) "Ambulate the patient as soon as possible"
B) "Ambulate the patient with a gait belt and call me if the patient's oxygen saturation drops below
90%"
C) "Ambulate the patient when I'm done with my other patients"
D) "Ambulate the patient if you think it's safe"
Answer: B) "Ambulate the patient with a gait belt and call me if the patient's oxygen saturation drops
below 90%"
Rationale: Right Communication includes providing clear, specific instructions including the task, safety
measures, and parameters for reporting. The nurse should specify what to do, how to do it, and when to
report concerns.
12. A nurse is leading a team of nurses in a quality improvement project. Which action is most
important for the nurse to take?
A) Make all decisions independently
B) Encourage open communication and collaboration
C) Complete the project without input from others
D) Focus only on the final outcome
Answer: B) Encourage open communication and collaboration
Practice Exam Review
Comprehensive Leadership and Delegation
in Nursing Practice Examination
1. A charge nurse is assigning patient care to the nursing team. Which task is appropriate to delegate
to a licensed practical/vocational nurse (LPN/LVN)?
A) Perform an initial admission assessment on a newly admitted patient
B) Administer a scheduled IV antibiotic to a stable patient
C) Develop a comprehensive care plan for a patient with diabetes
D) Perform a complex dressing change on a patient with a pressure injury
Answer: B) Administer a scheduled IV antibiotic to a stable patient
Rationale: LPNs/LVNs can administer IV medications to stable patients in many states. Initial
assessments and care plan development are the responsibility of the RN. Complex dressing changes
requiring assessment and evaluation should be performed by the RN.
2. A nurse manager is addressing a conflict between two staff nurses. Which conflict resolution
strategy is most effective?
A) Ignore the conflict and hope it resolves on its own
B) Use a collaborative approach to find a win-win solution
C) Take sides and support one nurse over the other
D) Assign the nurses to different units to avoid interaction
Answer: B) Use a collaborative approach to find a win-win solution
Rationale: Collaboration is the most effective conflict resolution strategy, allowing both parties to work
together to find a mutually acceptable solution. Ignoring conflict allows it to escalate, and taking sides or
avoiding the issue does not resolve the underlying problem.
3. A nurse is preparing to delegate a task to an unlicensed assistive personnel (UAP). Which of the
"Five Rights of Delegation" should the nurse consider first?
A) Right task
B) Right person
,C) Right circumstance
D) Right communication
Answer: A) Right task
Rationale: The first of the Five Rights of Delegation is the Right Task. The nurse must determine if the
task is appropriate to delegate based on the patient's stability, the complexity of the task, and the
potential for harm. Assessment, planning, and evaluation tasks should never be delegated.
4. A nurse is providing discharge teaching to a patient with heart failure. Which teaching method is
most effective for ensuring patient understanding?
A) Provide written materials only
B) Use the teach-back method
C) Have the family member read the instructions
D) Provide verbal instructions quickly before discharge
Answer: B) Use the teach-back method
Rationale: The teach-back method requires the patient to explain the instructions in their own words,
confirming understanding and allowing the nurse to clarify any misconceptions. Written materials and
verbal instructions alone do not verify comprehension.
5. A nurse manager is implementing evidence-based practice on the unit. Which step should the nurse
take first?
A) Implement the change immediately
B) Formulate a clinical question
C) Search the literature for evidence
D) Evaluate the outcomes of the change
Answer: B) Formulate a clinical question
Rationale: The first step in evidence-based practice is to formulate a clinical question using the PICO
(Population, Intervention, Comparison, Outcome) format. This guides the literature search and ensures a
focused approach to finding relevant evidence.
6. A nurse is caring for a patient who is refusing a blood transfusion. Which action should the nurse
take?
A) Administer the transfusion because it is medically necessary
B) Notify the healthcare provider and document the patient's refusal
C) Ask the family to convince the patient to accept the transfusion
D) Explain the benefits and risks and proceed with the transfusion
,Answer: B) Notify the healthcare provider and document the patient's refusal
Rationale: Patients have the right to refuse treatment. The nurse should notify the healthcare provider,
document the refusal, and continue to provide support and education. Informed consent is required for
treatment, and the patient's autonomy must be respected.
7. A charge nurse is making patient assignments. Which patient should be assigned to the most
experienced registered nurse?
A) A patient with a urinary tract infection requiring IV antibiotics
B) A patient with stable angina on telemetry
C) A patient newly diagnosed with diabetes requiring education
D) A patient with acute respiratory failure requiring mechanical ventilation
Answer: D) A patient with acute respiratory failure requiring mechanical ventilation
Rationale: The patient with acute respiratory failure on mechanical ventilation is the most unstable and
requires the highest level of nursing expertise. This patient should be assigned to the most experienced
RN. Stable patients with predictable needs can be assigned to less experienced nurses or LPNs.
8. A nurse is evaluating the effectiveness of a staff education program on fall prevention. Which
outcome indicates the program was effective?
A) Staff can describe fall prevention strategies
B) The fall rate on the unit has decreased by 30%
C) Patients report feeling safer on the unit
D) Fall risk assessments are being completed on admission
Answer: B) The fall rate on the unit has decreased by 30%
Rationale: The most important outcome of a fall prevention program is a reduction in the actual fall rate.
While knowledge, patient satisfaction, and process measures are important, the ultimate goal is to
reduce patient harm from falls.
9. A nurse manager is using transformational leadership. Which behavior is characteristic of this
leadership style?
A) Maintaining the status quo and following rules strictly
B) Inspiring staff to achieve their full potential
C) Making all decisions without input from staff
D) Focusing only on task completion
Answer: B) Inspiring staff to achieve their full potential
, Rationale: Transformational leadership is characterized by inspiring and motivating staff, fostering
innovation, and encouraging professional growth. It focuses on vision, change, and empowering others
to reach their full potential.
10. A nurse is caring for a patient who is experiencing a rapid deterioration in condition. Which action
should the nurse take first?
A) Call the healthcare provider
B) Assess the patient and initiate emergency measures
C) Document the findings in the chart
D) Wait for the next vital signs assessment
Answer: B) Assess the patient and initiate emergency measures
Rationale: The nurse's first priority when a patient deteriorates is to assess the patient and initiate
appropriate emergency measures (e.g., call a rapid response team, start CPR). Calling the provider is
important but follows the immediate assessment and intervention.
11. A nurse is delegating the task of ambulating a patient to a UAP. Which instruction should the
nurse include?
A) "Ambulate the patient as soon as possible"
B) "Ambulate the patient with a gait belt and call me if the patient's oxygen saturation drops below
90%"
C) "Ambulate the patient when I'm done with my other patients"
D) "Ambulate the patient if you think it's safe"
Answer: B) "Ambulate the patient with a gait belt and call me if the patient's oxygen saturation drops
below 90%"
Rationale: Right Communication includes providing clear, specific instructions including the task, safety
measures, and parameters for reporting. The nurse should specify what to do, how to do it, and when to
report concerns.
12. A nurse is leading a team of nurses in a quality improvement project. Which action is most
important for the nurse to take?
A) Make all decisions independently
B) Encourage open communication and collaboration
C) Complete the project without input from others
D) Focus only on the final outcome
Answer: B) Encourage open communication and collaboration
