NURSING PRIORITIZATION DELEGATION
AND ASSIGNMENT NCLEX CERTIFICATION
EVALUATION QUESTIONS WITH
ACCURATE ANSWERS
●● 2. Family members are encouraging your client to "tough out the
pain" rather than risk drug addiction to narcotics. The client is stoically
abiding. You recognize that the sociocultural dimension of pain is the
current priority for the client. Which question will you ask?
1. " Where is the pain located, and does it radiate to other parts of your
body?"
2. " How would you describe the pain, and how is it affecting you?"
3. " What do you believe about pain medication and drug addiction?"
4. " How is the pain affecting your activity level and your ability to
function?"
5. " What information do you need about pain, healing, and addiction?"
Answer: 2. Ans: 3
(Beliefs, attitudes, and familial influence are part of the sociocultural
dimension of pain. Location and radiation of pain address the sensory
dimension. Describing pain and its effects addresses the affective
dimension. Activity level and function address the behavioral dimension.
Asking about knowledge addresses the cognitive dimension. Focus:
Prioritization 3.)
,●● 3. A client with diabetic neuropathy reports a burning, electrical-type
pain in the lower extremities that is worse at night and not responding to
nonsteroidal anti-inflammatory drugs. Which medication will you
advocate for first?
1. Gabapentin (Neurontin)
2. Corticosteroids
3. Hydromorphone (Dilaudid)
4. Lorazepam (Ativan)
Answer: 3. Ans: 1
(Gabapentin is an antiepileptic drug, but it is also used to treat diabetic
neuropathy. Corticosteroids are for pain associated with inflammation.
Hydromorphone is a stronger opioid, and it is not the first choice for
chronic pain that can be managed with other drugs. Lorazepam is an
anxiolytic that may be ordered as an adjuvant nedication. Focus:
Prioritization)
●● 4. Which client is most likely to receive opioids for extended periods
of time?
1. A client with fibromyalgia
2. A client with phantom limb pain in the leg
3. A client with progressive pancreatic cancer
4. A client with trigeminal neuralgia
Answer: 4. Ans: 3
(Cancer pain generally worsens with disease progression, and the use of
opioids is more generous. Fibromyalgia is more likely to be treated with
,nonopioid and adjuvant medications. Trigeminal neuralgia is treated
with antiseizure medications such as carbamazepine (Tegretol). Phantom
limb pain usually subsides after ambulation begins. Focus:
Prioritization)
●● 5. As the charge nurse, you are reviewing the charts of clients who
were assigned to the care of a newly graduated RN. The RN has
correctly charted dose and time of medication, but there is no
documentation regarding nonpharmaceutical measures. What action
should you take first?
1. Make a note in the nurse's file and continue to observe clinical
performance.
2. Refer the new nurse to the in-service education department.
3. Quiz the nurse about knowledge of pain management and
pharmacology.
4. Give praise for correctly charting the dose and time and discuss the
deficits in charting.
Answer: 5. Ans: 4
(In supervision of the new RN, good performance should be reinforced
first and then areas of improvement can be addressed. Asking the nurse
about knowledge of pain management is also an option; however, it
would be a more indirect and time-consuming approach. Making a note
and watching do not help the nurse to correct the immediate problem. In-
service training might be considered if the problem persists. Focus:
Supervision, delegation)
, ●● 1. You are caring for a patient with esophageal cancer. Which task
could be delegated to a UAP?
1. Assisting the patient with oral hygiene
2. Observing the patient's response to feedings
3. Facilitating expression of grief or anxiety
4. Initiating daily weighings
Answer: 1. Ans: 1
(Oral hygiene is within the scope of duties of the UAP. It is the
responsibility of the nurse to observe response to treatments and to help
the patient deal with loss or anxiety. The UAP can be directed to weigh
the patient but should not be expected to know when to initiate that
measurement. Focus: Delegation)
●● 2. A 56-year-old patient comes to the walk-in clinic reporting scant
rectal bleeding and intermittent diarrhea and constipation for the past
several months. There is a history of polyps and a family history of
colorectal cancer. While you are trying to teach about colonoscopy, the
patient becomes angry and threatens to leave. What is the priority
diagnosis?
1. Diarrhea/ Constipation related to altered bowel patterns 2. Deficient
Knowledge related to the disease process and diagnostic procedure
3. Risk for Deficient Fluid Volume related to rectal bleeding and
diarrhea
4. Anxiety related to unknown outcomes and perceived threats to body
integrity
Answer: 2. Ans: 4
AND ASSIGNMENT NCLEX CERTIFICATION
EVALUATION QUESTIONS WITH
ACCURATE ANSWERS
●● 2. Family members are encouraging your client to "tough out the
pain" rather than risk drug addiction to narcotics. The client is stoically
abiding. You recognize that the sociocultural dimension of pain is the
current priority for the client. Which question will you ask?
1. " Where is the pain located, and does it radiate to other parts of your
body?"
2. " How would you describe the pain, and how is it affecting you?"
3. " What do you believe about pain medication and drug addiction?"
4. " How is the pain affecting your activity level and your ability to
function?"
5. " What information do you need about pain, healing, and addiction?"
Answer: 2. Ans: 3
(Beliefs, attitudes, and familial influence are part of the sociocultural
dimension of pain. Location and radiation of pain address the sensory
dimension. Describing pain and its effects addresses the affective
dimension. Activity level and function address the behavioral dimension.
Asking about knowledge addresses the cognitive dimension. Focus:
Prioritization 3.)
,●● 3. A client with diabetic neuropathy reports a burning, electrical-type
pain in the lower extremities that is worse at night and not responding to
nonsteroidal anti-inflammatory drugs. Which medication will you
advocate for first?
1. Gabapentin (Neurontin)
2. Corticosteroids
3. Hydromorphone (Dilaudid)
4. Lorazepam (Ativan)
Answer: 3. Ans: 1
(Gabapentin is an antiepileptic drug, but it is also used to treat diabetic
neuropathy. Corticosteroids are for pain associated with inflammation.
Hydromorphone is a stronger opioid, and it is not the first choice for
chronic pain that can be managed with other drugs. Lorazepam is an
anxiolytic that may be ordered as an adjuvant nedication. Focus:
Prioritization)
●● 4. Which client is most likely to receive opioids for extended periods
of time?
1. A client with fibromyalgia
2. A client with phantom limb pain in the leg
3. A client with progressive pancreatic cancer
4. A client with trigeminal neuralgia
Answer: 4. Ans: 3
(Cancer pain generally worsens with disease progression, and the use of
opioids is more generous. Fibromyalgia is more likely to be treated with
,nonopioid and adjuvant medications. Trigeminal neuralgia is treated
with antiseizure medications such as carbamazepine (Tegretol). Phantom
limb pain usually subsides after ambulation begins. Focus:
Prioritization)
●● 5. As the charge nurse, you are reviewing the charts of clients who
were assigned to the care of a newly graduated RN. The RN has
correctly charted dose and time of medication, but there is no
documentation regarding nonpharmaceutical measures. What action
should you take first?
1. Make a note in the nurse's file and continue to observe clinical
performance.
2. Refer the new nurse to the in-service education department.
3. Quiz the nurse about knowledge of pain management and
pharmacology.
4. Give praise for correctly charting the dose and time and discuss the
deficits in charting.
Answer: 5. Ans: 4
(In supervision of the new RN, good performance should be reinforced
first and then areas of improvement can be addressed. Asking the nurse
about knowledge of pain management is also an option; however, it
would be a more indirect and time-consuming approach. Making a note
and watching do not help the nurse to correct the immediate problem. In-
service training might be considered if the problem persists. Focus:
Supervision, delegation)
, ●● 1. You are caring for a patient with esophageal cancer. Which task
could be delegated to a UAP?
1. Assisting the patient with oral hygiene
2. Observing the patient's response to feedings
3. Facilitating expression of grief or anxiety
4. Initiating daily weighings
Answer: 1. Ans: 1
(Oral hygiene is within the scope of duties of the UAP. It is the
responsibility of the nurse to observe response to treatments and to help
the patient deal with loss or anxiety. The UAP can be directed to weigh
the patient but should not be expected to know when to initiate that
measurement. Focus: Delegation)
●● 2. A 56-year-old patient comes to the walk-in clinic reporting scant
rectal bleeding and intermittent diarrhea and constipation for the past
several months. There is a history of polyps and a family history of
colorectal cancer. While you are trying to teach about colonoscopy, the
patient becomes angry and threatens to leave. What is the priority
diagnosis?
1. Diarrhea/ Constipation related to altered bowel patterns 2. Deficient
Knowledge related to the disease process and diagnostic procedure
3. Risk for Deficient Fluid Volume related to rectal bleeding and
diarrhea
4. Anxiety related to unknown outcomes and perceived threats to body
integrity
Answer: 2. Ans: 4
