NCLEX ® DELEGATION EXAM WITH WELL DETAILED QUESTION
& ANSWERS PERFECTLY A+ GRADED WITH RATIONALE
1. You are the charge nurse. A client with chronic pain reports to you that the nurses have not
been responding to requests for pain medication. What is your initial action?
1. Check the medication administration records (MARs) for the past several days.
2. Ask the nurse educator to provide in-service training about pain management.
3. Perform a complete pain assessment on the client and take a pain history.
4. Have a conference with the nurses responsible for the care of this client. CORRECT
ANSWER>>>>1. Ans: 4 As charge nurse, you must assess the performance and attitude of the
staff in relation to this client. After data are gathered from the nurses, additional information
can be obtained from the records and the client as necessary. The educator may be of
assistance if a knowledge deficit or need for performance improvement is the problem. Focus:
Supervision, prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
Edition.
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.
CORRECT 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
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
Edition.
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 CORRECT 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
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
Kindle Edition.
5. When care assignments are being made for patients with alterations related to
gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/
, LVN under the supervision of a team leader RN? 1. A patient with severe anemia secondary to
GI bleeding 2. A patient who needs enemas and antibiotics to control GI bacteria
3. A patient who needs preoperative teaching for bowel resection surgery
4. A patient who needs central line insertion for chemotherapy CORRECT
ANSWER>>>>5. Ans: 2 Administering enemas and antibiotics is within the scope of practice of
LPNs/ LVNs. Although some states an facilities may allow the LPN/ LVN to administer blood, in
general, administering blood, providing preoperative teaching, and assisting with central line
insertion are the responsibilities of the RN. Focus: Assignment
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
Kindle Edition.
1. A few minutes after you have given an intradermal injection of an allergen to a patient who is
undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and
dizzy. Which action included in the emergency protocol should you take first?
1. Start oxygen at 4 L/ min using a nasal cannula.
2. Obtain IV access with a large-bore IV catheter.
3. Give epinephrine (Adrenalin) 0.3 mL intramuscularly.
4. Administer 3 mL of nebulized albuterol (Proventil) 0.083%. CORRECT
ANSWER>>>>1. Ans: 3 Epinephrine is the initial drug of choice for treatment of anaphylaxis.
Giving epinephrine rapidly at the onset of an anaphylactic reaction may prevent or reverse
cardiovascular collapse as well as airway narrowing caused by bronchospasm and inflammation.
Oxygen use is also appropriate, but oxygen would be administered using a nonrebreather mask
in order to achieve a fraction of inspired oxygen closer to 100%. Albuterol may also be
administered to decrease airway narrowing but would not be the first therapy used for
anaphylaxis. IV access will take longer to establish and should not be the first intervention.
Focus: Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 170). Elsevier Health Sciences.
Kindle Edition.
& ANSWERS PERFECTLY A+ GRADED WITH RATIONALE
1. You are the charge nurse. A client with chronic pain reports to you that the nurses have not
been responding to requests for pain medication. What is your initial action?
1. Check the medication administration records (MARs) for the past several days.
2. Ask the nurse educator to provide in-service training about pain management.
3. Perform a complete pain assessment on the client and take a pain history.
4. Have a conference with the nurses responsible for the care of this client. CORRECT
ANSWER>>>>1. Ans: 4 As charge nurse, you must assess the performance and attitude of the
staff in relation to this client. After data are gathered from the nurses, additional information
can be obtained from the records and the client as necessary. The educator may be of
assistance if a knowledge deficit or need for performance improvement is the problem. Focus:
Supervision, prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
Edition.
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.
CORRECT 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
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 3). Elsevier Health Sciences. Kindle
Edition.
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 CORRECT 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
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
Kindle Edition.
5. When care assignments are being made for patients with alterations related to
gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/
, LVN under the supervision of a team leader RN? 1. A patient with severe anemia secondary to
GI bleeding 2. A patient who needs enemas and antibiotics to control GI bacteria
3. A patient who needs preoperative teaching for bowel resection surgery
4. A patient who needs central line insertion for chemotherapy CORRECT
ANSWER>>>>5. Ans: 2 Administering enemas and antibiotics is within the scope of practice of
LPNs/ LVNs. Although some states an facilities may allow the LPN/ LVN to administer blood, in
general, administering blood, providing preoperative teaching, and assisting with central line
insertion are the responsibilities of the RN. Focus: Assignment
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 168). Elsevier Health Sciences.
Kindle Edition.
1. A few minutes after you have given an intradermal injection of an allergen to a patient who is
undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and
dizzy. Which action included in the emergency protocol should you take first?
1. Start oxygen at 4 L/ min using a nasal cannula.
2. Obtain IV access with a large-bore IV catheter.
3. Give epinephrine (Adrenalin) 0.3 mL intramuscularly.
4. Administer 3 mL of nebulized albuterol (Proventil) 0.083%. CORRECT
ANSWER>>>>1. Ans: 3 Epinephrine is the initial drug of choice for treatment of anaphylaxis.
Giving epinephrine rapidly at the onset of an anaphylactic reaction may prevent or reverse
cardiovascular collapse as well as airway narrowing caused by bronchospasm and inflammation.
Oxygen use is also appropriate, but oxygen would be administered using a nonrebreather mask
in order to achieve a fraction of inspired oxygen closer to 100%. Albuterol may also be
administered to decrease airway narrowing but would not be the first therapy used for
anaphylaxis. IV access will take longer to establish and should not be the first intervention.
Focus: Prioritization
LaCharity, Linda A.; Kumagai, Candice K.; Bartz, Barbara (2013-11-22). Prioritization, Delegation,
and Assignment: Practice Excercises for the NCLEX Exam (p. 170). Elsevier Health Sciences.
Kindle Edition.
