NCLEX Priority and Delegation Exam Review |
Comprehensive Nursing Prioritization Strategies,
ABCs Framework, Maslow Hierarchy Applications,
Stable vs Unstable Patient Decisions, RN vs LPN vs
UAP Delegation Rules, Scope of Practice Guidelines,
and Clinical Judgment Scenarios for RN & PN
Licensure Preparation | Updated 2026 NCLEX
Nursing Study Resource
Question 1:
A nursing supervisor is reviewing the assignments for the day. Which of the following
clients should the supervisor prioritize for the most experienced nurse?
A) A client with stable vital signs who is post-operative day 1 after a laparoscopic
cholecystectomy.
B) A client experiencing chest pain with a history of hypertension and diabetes.
C) A client scheduled for discharge who needs education on oral medications.
D) A client receiving IV antibiotics for a urinary tract infection.
Correct Option: B) A client experiencing chest pain with a history of hypertension
and diabetes.
Rationale: The client experiencing chest pain is at immediate risk for a cardiac event,
making this a high-priority situation requiring the skills of an experienced nurse. The
other clients, while still important, do not present the same level of urgency or potential
for deterioration.
Question 2:
A charge nurse is delegating tasks to a team of nurses and nursing assistants. Which
task is most appropriate to delegate to a nursing assistant?
A) Administering medications to a client who is unstable.
B) Monitoring vital signs of a post-operative client.
C) Assessing a newly admitted client's pain level.
D) Educating a client about their medication regime.
Correct Option: B) Monitoring vital signs of a post-operative client.
Rationale: Monitoring vital signs is a routine task that can be safely delegated to a
nursing assistant, given they have the necessary training. The other options require
higher-level critical thinking and assessment skills that should be performed by a
registered nurse.
,Question 3:
During a shift, the nurse receives report on four clients. Which client should the nurse
assess first?
A) A client with a fever of 101°F who had surgery 3 days ago.
B) A client with a heart rate of 120 bpm and hypotension.
C) A client exhibiting confusion and lethargy post-operatively.
D) A client requesting pain medication for postoperative discomfort.
Correct Option: B) A client with a heart rate of 120 bpm and hypotension.
Rationale: The client with tachycardia and hypotension is showing signs of potential
shock or significant hemodynamic instability, which requires immediate evaluation. The
other scenarios, while concerning, do not indicate immediate life-threatening issues.
Question 4:
A nurse is assessing four clients. Which client should the nurse prioritize for
intervention?
A) A client with pneumonia receiving antibiotics who has a slight productive cough.
B) A client with chronic obstructive pulmonary disease who is using accessory muscles
to breathe.
C) A client with diabetes who reports a blood glucose level of 150 mg/dL before lunch.
D) A client post-hip replacement who is complaining of mild pain.
Correct Option: B) A client with chronic obstructive pulmonary disease who is
using accessory muscles to breathe.
Rationale: The use of accessory muscles for breathing indicates respiratory distress
and requires immediate intervention. The other clients' conditions are stable and do not
reflect the same level of urgency.
Question 5:
The nurse is preparing to discharge a client with heart failure. Which of the following
pieces of information is crucial for the nurse to include in the discharge teaching?
A) The importance of maintaining a high sodium diet to help with hydration.
B) Signs and symptoms of potential complications, such as weight gain and dyspnea.
,C) The need to limit fluid intake to 4 liters per day.
D) The requirement of frequent rest periods during the day.
Correct Option: B) Signs and symptoms of potential complications, such as weight
gain and dyspnea.
Rationale: Educating the client on recognizing signs and symptoms of worsening heart
failure is critical for early intervention and prevention of readmission. The other options
do not support effective management of heart failure.
Question 6:
The nurse is caring for a client with a new diagnosis of heart failure. Which client
teaching should the nurse prioritize?
A) The importance of low potassium intake.
B) The signs and symptoms of worsening heart failure.
C) The necessity of regular aerobic exercise.
D) The need for a high-calorie diet.
Correct Option: B) The signs and symptoms of worsening heart failure.
Rationale: Teaching the client to recognize signs of worsening heart failure is critical to
prevent complications. The other options are less immediately relevant to managing the
condition effectively.
Question 7:
During a morning assessment, the nurse finds that a client with diabetes has a blood
glucose level of 40 mg/dL. What is the priority nursing action?
A) Administer a dose of insulin as prescribed.
B) Provide the client with a glucose tablet or juice.
C) Notify the healthcare provider immediately.
D) Document the finding in the client's chart.
Correct Option: B) Provide the client with a glucose tablet or juice.
Rationale: The immediate priority is to treat the hypoglycemia to prevent adverse
effects such as loss of consciousness or seizures. The other options can follow once
the client's safety is assured.
Question 8:
, Which nursing task is best to delegate to a licensed practical nurse (LPN)?
A) Administering IV medications to a client in acute respiratory distress.
B) Teaching a client about a new anti-diabetic medication.
C) Performing a dressing change for a client with a surgical wound.
D) Assessing a client's pain level post-surgery.
Correct Option: C) Performing a dressing change for a client with a surgical wound.
Rationale: An LPN is trained to perform dressing changes under the supervision of an
RN. The other tasks require higher-level assessments or education.
Question 9:
A client presents to the emergency department with severe abdominal pain. Which
assessment should the nurse perform first?
A) Obtain a complete vital sign set.
B) Assess the client's medical history and allergies.
C) Perform a focused abdominal assessment.
D) Start an IV line for fluid replacement.
Correct Option: A) Obtain a complete vital sign set.
Rationale: Vital signs provide crucial information about the client's stability and
potential need for immediate interventions. The abdominal assessment can follow
based on the findings.
Question 10:
In a busy hospital setting, which situation requires the nurse’s immediate attention?
A) A newly admitted client needing medication education.
B) A client with stable vital signs requesting pain medication.
C) A client who suddenly becomes disoriented and is unable to follow commands.
D) A client with a labored respiratory rate who is resting comfortably.
Correct Option: C) A client who suddenly becomes disoriented and is unable to
follow commands.
Rationale: Sudden disorientation can indicate a serious underlying issue, such as a
stroke or hypoglycemia, requiring urgent assessment and intervention.
Comprehensive Nursing Prioritization Strategies,
ABCs Framework, Maslow Hierarchy Applications,
Stable vs Unstable Patient Decisions, RN vs LPN vs
UAP Delegation Rules, Scope of Practice Guidelines,
and Clinical Judgment Scenarios for RN & PN
Licensure Preparation | Updated 2026 NCLEX
Nursing Study Resource
Question 1:
A nursing supervisor is reviewing the assignments for the day. Which of the following
clients should the supervisor prioritize for the most experienced nurse?
A) A client with stable vital signs who is post-operative day 1 after a laparoscopic
cholecystectomy.
B) A client experiencing chest pain with a history of hypertension and diabetes.
C) A client scheduled for discharge who needs education on oral medications.
D) A client receiving IV antibiotics for a urinary tract infection.
Correct Option: B) A client experiencing chest pain with a history of hypertension
and diabetes.
Rationale: The client experiencing chest pain is at immediate risk for a cardiac event,
making this a high-priority situation requiring the skills of an experienced nurse. The
other clients, while still important, do not present the same level of urgency or potential
for deterioration.
Question 2:
A charge nurse is delegating tasks to a team of nurses and nursing assistants. Which
task is most appropriate to delegate to a nursing assistant?
A) Administering medications to a client who is unstable.
B) Monitoring vital signs of a post-operative client.
C) Assessing a newly admitted client's pain level.
D) Educating a client about their medication regime.
Correct Option: B) Monitoring vital signs of a post-operative client.
Rationale: Monitoring vital signs is a routine task that can be safely delegated to a
nursing assistant, given they have the necessary training. The other options require
higher-level critical thinking and assessment skills that should be performed by a
registered nurse.
,Question 3:
During a shift, the nurse receives report on four clients. Which client should the nurse
assess first?
A) A client with a fever of 101°F who had surgery 3 days ago.
B) A client with a heart rate of 120 bpm and hypotension.
C) A client exhibiting confusion and lethargy post-operatively.
D) A client requesting pain medication for postoperative discomfort.
Correct Option: B) A client with a heart rate of 120 bpm and hypotension.
Rationale: The client with tachycardia and hypotension is showing signs of potential
shock or significant hemodynamic instability, which requires immediate evaluation. The
other scenarios, while concerning, do not indicate immediate life-threatening issues.
Question 4:
A nurse is assessing four clients. Which client should the nurse prioritize for
intervention?
A) A client with pneumonia receiving antibiotics who has a slight productive cough.
B) A client with chronic obstructive pulmonary disease who is using accessory muscles
to breathe.
C) A client with diabetes who reports a blood glucose level of 150 mg/dL before lunch.
D) A client post-hip replacement who is complaining of mild pain.
Correct Option: B) A client with chronic obstructive pulmonary disease who is
using accessory muscles to breathe.
Rationale: The use of accessory muscles for breathing indicates respiratory distress
and requires immediate intervention. The other clients' conditions are stable and do not
reflect the same level of urgency.
Question 5:
The nurse is preparing to discharge a client with heart failure. Which of the following
pieces of information is crucial for the nurse to include in the discharge teaching?
A) The importance of maintaining a high sodium diet to help with hydration.
B) Signs and symptoms of potential complications, such as weight gain and dyspnea.
,C) The need to limit fluid intake to 4 liters per day.
D) The requirement of frequent rest periods during the day.
Correct Option: B) Signs and symptoms of potential complications, such as weight
gain and dyspnea.
Rationale: Educating the client on recognizing signs and symptoms of worsening heart
failure is critical for early intervention and prevention of readmission. The other options
do not support effective management of heart failure.
Question 6:
The nurse is caring for a client with a new diagnosis of heart failure. Which client
teaching should the nurse prioritize?
A) The importance of low potassium intake.
B) The signs and symptoms of worsening heart failure.
C) The necessity of regular aerobic exercise.
D) The need for a high-calorie diet.
Correct Option: B) The signs and symptoms of worsening heart failure.
Rationale: Teaching the client to recognize signs of worsening heart failure is critical to
prevent complications. The other options are less immediately relevant to managing the
condition effectively.
Question 7:
During a morning assessment, the nurse finds that a client with diabetes has a blood
glucose level of 40 mg/dL. What is the priority nursing action?
A) Administer a dose of insulin as prescribed.
B) Provide the client with a glucose tablet or juice.
C) Notify the healthcare provider immediately.
D) Document the finding in the client's chart.
Correct Option: B) Provide the client with a glucose tablet or juice.
Rationale: The immediate priority is to treat the hypoglycemia to prevent adverse
effects such as loss of consciousness or seizures. The other options can follow once
the client's safety is assured.
Question 8:
, Which nursing task is best to delegate to a licensed practical nurse (LPN)?
A) Administering IV medications to a client in acute respiratory distress.
B) Teaching a client about a new anti-diabetic medication.
C) Performing a dressing change for a client with a surgical wound.
D) Assessing a client's pain level post-surgery.
Correct Option: C) Performing a dressing change for a client with a surgical wound.
Rationale: An LPN is trained to perform dressing changes under the supervision of an
RN. The other tasks require higher-level assessments or education.
Question 9:
A client presents to the emergency department with severe abdominal pain. Which
assessment should the nurse perform first?
A) Obtain a complete vital sign set.
B) Assess the client's medical history and allergies.
C) Perform a focused abdominal assessment.
D) Start an IV line for fluid replacement.
Correct Option: A) Obtain a complete vital sign set.
Rationale: Vital signs provide crucial information about the client's stability and
potential need for immediate interventions. The abdominal assessment can follow
based on the findings.
Question 10:
In a busy hospital setting, which situation requires the nurse’s immediate attention?
A) A newly admitted client needing medication education.
B) A client with stable vital signs requesting pain medication.
C) A client who suddenly becomes disoriented and is unable to follow commands.
D) A client with a labored respiratory rate who is resting comfortably.
Correct Option: C) A client who suddenly becomes disoriented and is unable to
follow commands.
Rationale: Sudden disorientation can indicate a serious underlying issue, such as a
stroke or hypoglycemia, requiring urgent assessment and intervention.
