Prioritization, Delegation, and Assignment
Download now
Johns Hopkins University
School of Nursing
HIGH YIELDS QUESTIONS
NEWEST MODEL 2026 EXAM LATEST
VERSION SOLVED QUESTIONS &
ANSWERS VERIFIED 100 %
Exam
, Page 2 of 56
Prioritization, Delegation, and Assignment Practice Exercises for the NCLEX ®
Examination
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.
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.
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?"
, Page 3 of 56
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.
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.
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)
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
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.
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
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
, Page 4 of 56
after ambulation begins. Focus: 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.
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
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