Proctored Exam 2026
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Question:
A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN) on a
medical-surgical unit. The RN is considering delegating tracheostomy care to the LPN for
a client with pneumonia. Which of the following statements is correct regarding this
delegation?
a. The RN should not delegate tracheostomy care to an LPN under any circumstances
b. The RN may delegate tracheostomy care to the LPN if the client is stable and the LPN
is properly trained
c. The RN must perform all tracheostomy care personally
d. The LPN cannot perform tracheostomy care because pneumonia is present
✔️ Correct Answer: B
Rationale:
LPNs are generally trained and competent in performing tracheostomy care, including
suctioning and cleaning, especially in stable patients. As long as the client is stable and
the LPN has demonstrated competency, the RN may delegate this task. Option A is
incorrect because delegation is permitted under appropriate circumstances. Option C is
incorrect because RNs can delegate tasks within the LPN's scope of practice. Option D is
incorrect because the presence of pneumonia does not automatically preclude LPN
performance of tracheostomy care if the client is stable.
A nurse on a medical-surgical unit has received a change-of-shift report and is caring for
four clients. Which of the following tasks can be safely delegated to an assistive
personnel (AP)?
a. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
b. Reinforcing teaching with a client who is learning to walk using a quad cane
,c. Reapplying a condom catheter for a client who has urinary incontinence
d. Applying a sterile dressing to a pressure ulcer
✔️ Correct Answer: C
Rationale:
Reapplying a condom catheter is a noninvasive and routine procedure that the nurse
may delegate to the AP. Option A is incorrect because feeding a client with aspiration
pneumonia requires nursing judgment to prevent aspiration. Option B is incorrect
because teaching requires licensed nursing staff. Option D is incorrect because sterile
dressing application requires sterile technique and clinical assessment by licensed staff.
A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to
an AP. Which of the following information should the nurse share with the AP? (Select all
that apply.)
a. The roommate is up independently
b. The client ambulates with his slippers on over his antiembolic stockings
c. The client uses a front-wheeled walker when ambulating
d. The client had pain medication 30 minutes ago
e. The client is allergic to codeine
f. The client ate 50% of his breakfast this morning
✔️ Correct Answer: B, C, D
Rationale:
The AP should be informed about the client's use of a front-wheeled walker (C), how the
client is dressed (B), and recent pain management (D) to ensure safe and effective
ambulation. Option A is irrelevant to this client's care. Option E is not directly relevant to
ambulation. Option F does not relate to the AP's role in assisting with ambulation.
An RN is making assignments for client care to an LPN at the beginning of the shift.
Which of the following assignments should the LPN question?
a. Assisting a client who is 24 hours postop to use an incentive spirometer
b. Collecting a clean-catch urine specimen from a client who was admitted on the
previous shift
c. Providing nasopharyngeal suctioning for a client who has pneumonia
d. Replacing the cartridge and tubing on a PCA pump
, ✔️ Correct Answer: D
Rationale:
The RN is responsible for tasks related to PCA pumps as these require close monitoring
and assessment, which should not be delegated to an LPN. Options A, B, and C are
within the LPN's scope of practice. Option D requires RN-level assessment and clinical
judgment.
A nurse is preparing an in-service program about delegation. Which of the following
elements should she identify when presenting the 5 rights of delegation? (Select all that
apply.)
a. Right client
b. Right supervision/evaluation
c. Right direction/communication
d. Right time
e. Right circumstances
✔️ Correct Answer: B, C, E
Rationale:
The 5 rights of delegation include "Right supervision/evaluation," "Right
direction/communication," and "Right circumstances." Options A and D are rights of
medication administration, not delegation. Option B, C, and E are the correct
components of the 5 rights of delegation.
A nurse manager of a med-surg unit is assigning care responsibilities for the oncoming
shift. A client is awaiting transfer back to the unit from the PACU following thoracic
surgery. To which staff member should the nurse assign this client?
a. Charge nurse
b. RN
c. LPN
d. AP
✔️ Correct Answer: B
Rationale:
A client returning from surgery, particularly thoracic surgery, requires assessment and
establishment of a plan of care. RNs are responsible for these tasks, especially for