Delegation & Prioritization - 2026 Clinical Decision Making:
Final Exam (Comprehensive) - Questions with Correct Answers
100 questions
1. Advanced practice registered nurses include:
A. Only nurse practitioners
B. Nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and
certified nurse-midwives
C. CNAs and LPNs
D. Only school nurses
Correct Answer: B. Nurse practitioners, clinical nurse specialists, certified registered nurse
anesthetists and certified nurse-midwives
Rationale: APRNs have graduate education and expanded scope. State law defines their
authority.
2. An RN asked to perform a task outside their competence should:
A. Perform it anyway
B. Ask AP to do it
C. Ignore the request
D. Decline or seek training and supervision before performing it
Correct Answer: D. Decline or seek training and supervision before performing it
Rationale: Competence protects patients. Requesting help is professional.
3. Which nurse is the best choice to care for a patient with a chest tube?
A. An RN experienced with chest drainage systems
B. A new float nurse never trained in chest tubes
C. Assistive personnel
D. Unit clerk
Correct Answer: A. An RN experienced with chest drainage systems
Rationale: Competence must match patient needs. Chest tubes require specific skills.
,4. When assigning a patient with a severely immunocompromised condition, the charge nurse
should avoid also assigning that nurse to:
A. A stable patient
B. A patient awaiting discharge
C. A patient with chronic pain
D. A patient with an active infection when possible
Correct Answer: D. A patient with an active infection when possible
Rationale: Reducing cross-contamination risk protects vulnerable patients. Hand hygiene
remains essential.
5. The nursing process principle "assess before acting" means:
A. Gathering information first unless an immediate life-saving action is required
B. Never acting
C. Always calling the provider first
D. Documenting first
Correct Answer: A. Gathering information first unless an immediate life-saving action is
required
Rationale: Assessment guides correct action. Emergencies like airway obstruction require
immediate intervention.
6. A key principle when prioritizing pain management is:
A. Pain is never a priority
B. Uncontrolled severe pain is a priority after airway, breathing and circulation are secured
C. Pain is the first priority over airway
D. Pain should be ignored
Correct Answer: B. Uncontrolled severe pain is a priority after airway, breathing and
circulation are secured
Rationale: Pain affects recovery. Life threats come first.
,7. Which patient with kidney disease should the nurse see first?
A. A patient with a creatinine of 2.0 who is stable
B. A patient with potassium of 7.0 mEq/L and peaked T waves
C. A patient awaiting a dialysis schedule
D. A patient asking about fluid limits
Correct Answer: B. A patient with potassium of 7.0 mEq/L and peaked T waves
Rationale: Severe hyperkalemia risks cardiac arrest. Urgent treatment is needed.
8. Which patient with a stroke should be assessed first?
A. A patient whose symptoms began 45 minutes ago
B. A patient admitted 2 days ago who is stable
C. A patient awaiting rehabilitation
D. A patient asking about swallowing tests
Correct Answer: A. A patient whose symptoms began 45 minutes ago
Rationale: Early presentation may permit thrombolysis. Time-sensitive assessment is essential.
9. Which patient with asthma should be seen first?
A. A patient with mild wheeze after exercise
B. A patient asking about inhaler technique
C. A patient with a silent chest and decreasing wheeze who is drowsy
D. A patient with seasonal allergies
Correct Answer: C. A patient with a silent chest and decreasing wheeze who is drowsy
Rationale: A silent chest signals severe airflow obstruction. Respiratory failure may be
imminent.
, 10. In Tanner's model, "reflection-in-action" refers to:
A. Reflecting days later
B. Avoiding reflection
C. Monitoring the patient's response while providing care
D. Documenting only
Correct Answer: C. Monitoring the patient's response while providing care
Rationale: Real-time reflection allows adjustment. Reflection-on-action occurs afterward.
11. According to Benner, an expert nurse:
A. Has an intuitive grasp of situations based on deep experience
B. Relies only on rules
C. Lacks experience
D. Needs constant supervision
Correct Answer: A. Has an intuitive grasp of situations based on deep experience
Rationale: Experts recognize patterns quickly. They can still benefit from reflection.
12. The Eisenhower matrix categorizes tasks as:
A. Easy and hard
B. Short and long
C. Urgent and important, important but not urgent, urgent but not important, and neither
D. Morning and evening
Correct Answer: C. Urgent and important, important but not urgent, urgent but not
important, and neither
Rationale: It helps focus on what matters. Urgent and important tasks come first.
Final Exam (Comprehensive) - Questions with Correct Answers
100 questions
1. Advanced practice registered nurses include:
A. Only nurse practitioners
B. Nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and
certified nurse-midwives
C. CNAs and LPNs
D. Only school nurses
Correct Answer: B. Nurse practitioners, clinical nurse specialists, certified registered nurse
anesthetists and certified nurse-midwives
Rationale: APRNs have graduate education and expanded scope. State law defines their
authority.
2. An RN asked to perform a task outside their competence should:
A. Perform it anyway
B. Ask AP to do it
C. Ignore the request
D. Decline or seek training and supervision before performing it
Correct Answer: D. Decline or seek training and supervision before performing it
Rationale: Competence protects patients. Requesting help is professional.
3. Which nurse is the best choice to care for a patient with a chest tube?
A. An RN experienced with chest drainage systems
B. A new float nurse never trained in chest tubes
C. Assistive personnel
D. Unit clerk
Correct Answer: A. An RN experienced with chest drainage systems
Rationale: Competence must match patient needs. Chest tubes require specific skills.
,4. When assigning a patient with a severely immunocompromised condition, the charge nurse
should avoid also assigning that nurse to:
A. A stable patient
B. A patient awaiting discharge
C. A patient with chronic pain
D. A patient with an active infection when possible
Correct Answer: D. A patient with an active infection when possible
Rationale: Reducing cross-contamination risk protects vulnerable patients. Hand hygiene
remains essential.
5. The nursing process principle "assess before acting" means:
A. Gathering information first unless an immediate life-saving action is required
B. Never acting
C. Always calling the provider first
D. Documenting first
Correct Answer: A. Gathering information first unless an immediate life-saving action is
required
Rationale: Assessment guides correct action. Emergencies like airway obstruction require
immediate intervention.
6. A key principle when prioritizing pain management is:
A. Pain is never a priority
B. Uncontrolled severe pain is a priority after airway, breathing and circulation are secured
C. Pain is the first priority over airway
D. Pain should be ignored
Correct Answer: B. Uncontrolled severe pain is a priority after airway, breathing and
circulation are secured
Rationale: Pain affects recovery. Life threats come first.
,7. Which patient with kidney disease should the nurse see first?
A. A patient with a creatinine of 2.0 who is stable
B. A patient with potassium of 7.0 mEq/L and peaked T waves
C. A patient awaiting a dialysis schedule
D. A patient asking about fluid limits
Correct Answer: B. A patient with potassium of 7.0 mEq/L and peaked T waves
Rationale: Severe hyperkalemia risks cardiac arrest. Urgent treatment is needed.
8. Which patient with a stroke should be assessed first?
A. A patient whose symptoms began 45 minutes ago
B. A patient admitted 2 days ago who is stable
C. A patient awaiting rehabilitation
D. A patient asking about swallowing tests
Correct Answer: A. A patient whose symptoms began 45 minutes ago
Rationale: Early presentation may permit thrombolysis. Time-sensitive assessment is essential.
9. Which patient with asthma should be seen first?
A. A patient with mild wheeze after exercise
B. A patient asking about inhaler technique
C. A patient with a silent chest and decreasing wheeze who is drowsy
D. A patient with seasonal allergies
Correct Answer: C. A patient with a silent chest and decreasing wheeze who is drowsy
Rationale: A silent chest signals severe airflow obstruction. Respiratory failure may be
imminent.
, 10. In Tanner's model, "reflection-in-action" refers to:
A. Reflecting days later
B. Avoiding reflection
C. Monitoring the patient's response while providing care
D. Documenting only
Correct Answer: C. Monitoring the patient's response while providing care
Rationale: Real-time reflection allows adjustment. Reflection-on-action occurs afterward.
11. According to Benner, an expert nurse:
A. Has an intuitive grasp of situations based on deep experience
B. Relies only on rules
C. Lacks experience
D. Needs constant supervision
Correct Answer: A. Has an intuitive grasp of situations based on deep experience
Rationale: Experts recognize patterns quickly. They can still benefit from reflection.
12. The Eisenhower matrix categorizes tasks as:
A. Easy and hard
B. Short and long
C. Urgent and important, important but not urgent, urgent but not important, and neither
D. Morning and evening
Correct Answer: C. Urgent and important, important but not urgent, urgent but not
important, and neither
Rationale: It helps focus on what matters. Urgent and important tasks come first.
