NCLEX-RN Management of Care 2026/2027
Practice Exam
60 Original Questions - Prioritization - Delegation - Leadership - Detailed Rationales
Purpose and alignment
Aligned to the 2026 NCLEX-RN Test Plan emphasis on safe, effective care environment and management of care.
Scenarios emphasize prioritization, delegation, supervision, advocacy, ethics, legal responsibilities, quality
improvement, and transitions of care.
How to use
Complete the questions before reviewing the highlighted answers. Study every rationale and repeat weak
domains. Use an 80% score as a B-level learning target, not as a prediction or guarantee of any examination
result.
Integrity notice
Every item in this document was newly written for practice. It is not an actual, recalled, leaked, proprietary, or
official examination and is not affiliated with or endorsed by the certifying organization.
Original independent practice material - not an official or recalled examination Page 1
, DELEGATION
Question 1 of 60: Which task is appropriate for the RN to delegate to an experienced
UAP?
A. Assess new confusion
B. Ambulate a stable postoperative client
C. Teach incentive spirometry
D. Evaluate pain relief
Correct answer: B - Ambulate a stable postoperative client
Rationale: Routine ambulation of a stable client may be delegated. Assessment, initial teaching, and evaluation remain RN
responsibilities.
DELEGATION
Question 2 of 60: Which client should the charge nurse assign to an LPN/LVN?
A. New admission with chest pain
B. Stable client needing a scheduled oral medication
C. Client requiring initial discharge teaching
D. Client with rapidly falling blood pressure
Correct answer: B - Stable client needing a scheduled oral medication
Rationale: An LPN/LVN can provide routine care and medications to a stable client; unstable assessment and initial
teaching require an RN.
Original independent practice material - not an official or recalled examination Page 2
, DELEGATION
Question 3 of 60: After delegating intake and output measurement, what must the RN
do?
A. Assume normal values
B. Evaluate and act on the reported findings
C. Ask the UAP to interpret trends
D. Document before data are returned
Correct answer: B - Evaluate and act on the reported findings
Rationale: The RN retains accountability for supervision, interpretation, follow-up, and evaluation of delegated care.
DELEGATION
Question 4 of 60: Which instruction to a UAP is most specific and safe?
A. Watch the patient closely
B. Report anything unusual
C. Measure urine output now and report if below 30 mL
D. Take care of room 12
Correct answer: C - Measure urine output now and report if below 30 mL
Rationale: A safe direction identifies the task, timing, and reportable threshold.
Original independent practice material - not an official or recalled examination Page 3
, STAFFING
Question 5 of 60: A float nurse from postpartum is assigned to medical-surgical care.
Which client is most appropriate?
A. Unstable GI bleed
B. Stable client awaiting discharge
C. Fresh tracheostomy
D. Client receiving titrated vasoactive infusion
Correct answer: B - Stable client awaiting discharge
Rationale: Assignments should match verified competence; a stable client with predictable needs is safest.
PRIORITIZATION
Question 6 of 60: Which client should the RN assess first?
A. Client requesting a sleep aid
B. Client with new stridor after thyroid surgery
C. Client awaiting routine dressing change
D. Client asking about discharge time
Correct answer: B - Client with new stridor after thyroid surgery
Rationale: New stridor signals possible airway obstruction; airway threats take priority.
Original independent practice material - not an official or recalled examination Page 4
Practice Exam
60 Original Questions - Prioritization - Delegation - Leadership - Detailed Rationales
Purpose and alignment
Aligned to the 2026 NCLEX-RN Test Plan emphasis on safe, effective care environment and management of care.
Scenarios emphasize prioritization, delegation, supervision, advocacy, ethics, legal responsibilities, quality
improvement, and transitions of care.
How to use
Complete the questions before reviewing the highlighted answers. Study every rationale and repeat weak
domains. Use an 80% score as a B-level learning target, not as a prediction or guarantee of any examination
result.
Integrity notice
Every item in this document was newly written for practice. It is not an actual, recalled, leaked, proprietary, or
official examination and is not affiliated with or endorsed by the certifying organization.
Original independent practice material - not an official or recalled examination Page 1
, DELEGATION
Question 1 of 60: Which task is appropriate for the RN to delegate to an experienced
UAP?
A. Assess new confusion
B. Ambulate a stable postoperative client
C. Teach incentive spirometry
D. Evaluate pain relief
Correct answer: B - Ambulate a stable postoperative client
Rationale: Routine ambulation of a stable client may be delegated. Assessment, initial teaching, and evaluation remain RN
responsibilities.
DELEGATION
Question 2 of 60: Which client should the charge nurse assign to an LPN/LVN?
A. New admission with chest pain
B. Stable client needing a scheduled oral medication
C. Client requiring initial discharge teaching
D. Client with rapidly falling blood pressure
Correct answer: B - Stable client needing a scheduled oral medication
Rationale: An LPN/LVN can provide routine care and medications to a stable client; unstable assessment and initial
teaching require an RN.
Original independent practice material - not an official or recalled examination Page 2
, DELEGATION
Question 3 of 60: After delegating intake and output measurement, what must the RN
do?
A. Assume normal values
B. Evaluate and act on the reported findings
C. Ask the UAP to interpret trends
D. Document before data are returned
Correct answer: B - Evaluate and act on the reported findings
Rationale: The RN retains accountability for supervision, interpretation, follow-up, and evaluation of delegated care.
DELEGATION
Question 4 of 60: Which instruction to a UAP is most specific and safe?
A. Watch the patient closely
B. Report anything unusual
C. Measure urine output now and report if below 30 mL
D. Take care of room 12
Correct answer: C - Measure urine output now and report if below 30 mL
Rationale: A safe direction identifies the task, timing, and reportable threshold.
Original independent practice material - not an official or recalled examination Page 3
, STAFFING
Question 5 of 60: A float nurse from postpartum is assigned to medical-surgical care.
Which client is most appropriate?
A. Unstable GI bleed
B. Stable client awaiting discharge
C. Fresh tracheostomy
D. Client receiving titrated vasoactive infusion
Correct answer: B - Stable client awaiting discharge
Rationale: Assignments should match verified competence; a stable client with predictable needs is safest.
PRIORITIZATION
Question 6 of 60: Which client should the RN assess first?
A. Client requesting a sleep aid
B. Client with new stridor after thyroid surgery
C. Client awaiting routine dressing change
D. Client asking about discharge time
Correct answer: B - Client with new stridor after thyroid surgery
Rationale: New stridor signals possible airway obstruction; airway threats take priority.
Original independent practice material - not an official or recalled examination Page 4
