,COMPREHENSIVE NCLEX RN PRIORITIZATION DELEGATION
QUESTIONS AND ANSWERS GRADED A+
QUESTIONS AND ANSWERS GRADED A+
● Which clients must be assigned to an experienced RN?
(Select all that apply.)
1. Client who was in an automobile crash and sustained multiple injuries
2. Client with chronic back pain related to a workplace injury
3. Client who has returned from surgery and has a chest tube in place
4. Client with abdominal cramps related to food poisoning
5. Client with a severe headache of unknown origin
6. Client with chest pain who has a history of arteriosclerosis. Answer:
● You have received the shift report from the night nurse. Prioritize the
order in which you will check on the following clients.
1. Adolescent who is alert and oriented. He was admitted 2 days ago
for treatment of meningitis. He reports a continuous headache that is
partially relieved by medication.
2. Elderly man who underwent total knee replacement surgery 2 days
ago. He is using the patient-controlled analgesia (PCA) pump frequently
with good relief and occasionally asks for bolus doses.
3. Middle-aged woman who is demanding and needy. She was
admitted for investigation of functional abdominal pain and is scheduled
for diagnostic testing this morning.
,4. Elderly woman with advanced Alzheimer disease who requires
total care for all activities of daily living (ADLs). She struggles during
any type of nursing care and it is difficult to assess her subjective
symptoms. She is awaiting transfer to a long-term care facili. Answer:
● On the first day after surgery, a client receiving an analgesic via PCA
pump reports that the pain control is inadequate. What is the first action
you should take?
1. Deliver the bolus dose per standing order.
2. Contact the physician to increase the dose.
3. Try nonpharmacologic comfort measures.
4. Assess the pain for location, quality, and intensity.. Answer:
● Which clients can be appropriately assigned to an LPN/LVN who will
function under the supervision of an RN or team leader? Select all that
apply.)
1. Client who needs preoperative teaching for the use of a PCA pump
2. Client with a leg cast who needs neurologic and circulatory checks
and PRN hydrocodone
3. Client who underwent a toe amputation and has diabetic neuropathic
pain
4. Client with terminal cancer and severe pain who is refusing
medication
, 5. Client who reports abdominal pain after being kicked, punched, and
beaten
6. Client with arthritis who needs scheduled pain medications and heat
applications. Answer:
● You are caring for a client who had abdominal surgery yesterday. The
client is restless and anxious and tells you that the pain is getting worse
despite the pain medication. Physical assessment findings include the
following: temperature, 100.3° F (38° C); pulse rate, 110 beats/min;
respiratory rate, 24 breaths/min; and blood pressure, 140/90 mm Hg. The
abdomen is rigid and tender to the touch. You decide to notify the
client's provider. Place the following report information in the correct
order according to the SBAR format.
1. "He is restless and anxious: temperature is 100.3° F (38° C); pulse is
110 beats/min; respiratory rate is 24 breaths/min; blood pressure is
140/90 mm Hg. Abdomen is rigid and tender to touch with hypoactive
bowel sounds."
2. "He had abdominal surgery yesterday. He is on PCA morphine, but he
says the pain is getting progressively worse."
3. "I have tried to make him comfortable and he is willi. Answer:
● Which clients can be appropriately assigned to a newly graduated RN
who has recently completed orientation?
(Select all that apply.)
1. Anxious client with chronic pain who frequently uses the call button
QUESTIONS AND ANSWERS GRADED A+
QUESTIONS AND ANSWERS GRADED A+
● Which clients must be assigned to an experienced RN?
(Select all that apply.)
1. Client who was in an automobile crash and sustained multiple injuries
2. Client with chronic back pain related to a workplace injury
3. Client who has returned from surgery and has a chest tube in place
4. Client with abdominal cramps related to food poisoning
5. Client with a severe headache of unknown origin
6. Client with chest pain who has a history of arteriosclerosis. Answer:
● You have received the shift report from the night nurse. Prioritize the
order in which you will check on the following clients.
1. Adolescent who is alert and oriented. He was admitted 2 days ago
for treatment of meningitis. He reports a continuous headache that is
partially relieved by medication.
2. Elderly man who underwent total knee replacement surgery 2 days
ago. He is using the patient-controlled analgesia (PCA) pump frequently
with good relief and occasionally asks for bolus doses.
3. Middle-aged woman who is demanding and needy. She was
admitted for investigation of functional abdominal pain and is scheduled
for diagnostic testing this morning.
,4. Elderly woman with advanced Alzheimer disease who requires
total care for all activities of daily living (ADLs). She struggles during
any type of nursing care and it is difficult to assess her subjective
symptoms. She is awaiting transfer to a long-term care facili. Answer:
● On the first day after surgery, a client receiving an analgesic via PCA
pump reports that the pain control is inadequate. What is the first action
you should take?
1. Deliver the bolus dose per standing order.
2. Contact the physician to increase the dose.
3. Try nonpharmacologic comfort measures.
4. Assess the pain for location, quality, and intensity.. Answer:
● Which clients can be appropriately assigned to an LPN/LVN who will
function under the supervision of an RN or team leader? Select all that
apply.)
1. Client who needs preoperative teaching for the use of a PCA pump
2. Client with a leg cast who needs neurologic and circulatory checks
and PRN hydrocodone
3. Client who underwent a toe amputation and has diabetic neuropathic
pain
4. Client with terminal cancer and severe pain who is refusing
medication
, 5. Client who reports abdominal pain after being kicked, punched, and
beaten
6. Client with arthritis who needs scheduled pain medications and heat
applications. Answer:
● You are caring for a client who had abdominal surgery yesterday. The
client is restless and anxious and tells you that the pain is getting worse
despite the pain medication. Physical assessment findings include the
following: temperature, 100.3° F (38° C); pulse rate, 110 beats/min;
respiratory rate, 24 breaths/min; and blood pressure, 140/90 mm Hg. The
abdomen is rigid and tender to the touch. You decide to notify the
client's provider. Place the following report information in the correct
order according to the SBAR format.
1. "He is restless and anxious: temperature is 100.3° F (38° C); pulse is
110 beats/min; respiratory rate is 24 breaths/min; blood pressure is
140/90 mm Hg. Abdomen is rigid and tender to touch with hypoactive
bowel sounds."
2. "He had abdominal surgery yesterday. He is on PCA morphine, but he
says the pain is getting progressively worse."
3. "I have tried to make him comfortable and he is willi. Answer:
● Which clients can be appropriately assigned to a newly graduated RN
who has recently completed orientation?
(Select all that apply.)
1. Anxious client with chronic pain who frequently uses the call button
