**Title:** **The NCLEX-RN Leadership &
Management Capstone: Delegation, Prioritization,
and Professional Issues**
---
### Question 1 of 93
A charge nurse is assigning client care on a medical-surgical unit. Which client should be assigned to the
most experienced RN?
A) Client with pneumonia requiring IV antibiotics
B) Client newly diagnosed with DKA on an insulin drip
C) Client with a fractured femur needing pain medication
D) Client needing discharge teaching about warfarin
💫RATIONALE✔️✔️: Unstable DKA on insulin drip requires advanced clinical judgment (B). Stable
pneumonia, pain meds, discharge teaching can be delegated to less experienced RNs or LPNs.
💫ANSWER✔️✔️: B) Client newly diagnosed with DKA on an insulin drip
---
### Question 2 of 93
A nurse manager is reviewing delegation. Which task can be delegated to an unlicensed assistive
personnel (UAP)?
,A) Assessing a client's lung sounds
B) Administering oral metoprolol
C) Measuring intake and output
D) Teaching a client about insulin injection
💫RATIONALE✔️✔️: Measuring I&O (C) is routine within UAP scope. Assessment and teaching require
licensed nurse. Med administration is LPN/RN.
💫ANSWER✔️✔️: C) Measuring intake and output
---
### Question 3 of 93
**Select-All-That-Apply (SATA):** A nurse is providing a handoff report using SBAR. Which components
are included? (Select all that apply.)
A) Situation
B) Background
C) Assessment
D) Recommendation
E) Summary
💫RATIONALE✔️✔️: SBAR: Situation (A), Background (B), Assessment (C), Recommendation (D). Summary
not part of SBAR.
💫ANSWER✔️✔️: A, B, C, D
---
### Question 4 of 93
,A nurse is caring for four clients. Which client should the nurse assess first?
A) Post-op client requesting pain medication
B) Client with COPD and SpO2 88% on room air
C) Client with a new colostomy asking for supplies
D) Client needing PRN antiemetic for nausea
💫RATIONALE✔️✔️: SpO2 88% indicates hypoxemia requiring immediate intervention (B). Pain, nausea,
supplies are urgent but not life-threatening.
💫ANSWER✔️✔️: B) Client with COPD and SpO2 88% on room air
---
### Question 5 of 93
A charge nurse is making shift assignments. A float RN from the postpartum unit is assigned to medical-
surgical. Which client is appropriate?
A) Client with chest tube for pneumothorax
B) Client with new tracheostomy needing suctioning
C) Client with stable type 2 diabetes needing morning insulin
D) Client with acute stroke with unilateral neglect
💫RATIONALE✔️✔️: Stable client needing routine insulin (C) is appropriate. Chest tube, trach, acute
stroke require specialized med-surg/neuro skills.
💫ANSWER✔️✔️: C) Client with stable type 2 diabetes needing morning insulin
---
### Question 6 of 93
, A nurse observes a UAP taking a blood pressure on a client with an IV infusion in the same arm. Which
action should the nurse take?
A) Ignore it because the UAP is experienced
B) Report the UAP to the nursing supervisor immediately
C) Stop the UAP and explain why the cuff should not be on the same arm as an IV
D) Document the incident in the UAP's personnel file
💫RATIONALE✔️✔️: Correct the error immediately (C) to prevent harm. BP cuff can occlude IV flow or
dislodge catheter.
💫ANSWER✔️✔️: C) Stop the UAP and explain why the cuff should not be on the same arm as an IV
---
### Question 7 of 93
**Select-All-That-Apply (SATA):** A nurse manager is addressing lateral violence among staff. Which
interventions are appropriate? (Select all that apply.)
A) Ignore the behavior to avoid conflict
B) Establish a zero-tolerance policy
C) Provide education on professional communication
D) Encourage staff to report incidents
E) Role-model respectful behavior
💫RATIONALE✔️✔️: Zero-tolerance policy (B), education (C), reporting (D), role-modeling (E) address
lateral violence. Ignoring perpetuates it.
💫ANSWER✔️✔️: B, C, D, E
Management Capstone: Delegation, Prioritization,
and Professional Issues**
---
### Question 1 of 93
A charge nurse is assigning client care on a medical-surgical unit. Which client should be assigned to the
most experienced RN?
A) Client with pneumonia requiring IV antibiotics
B) Client newly diagnosed with DKA on an insulin drip
C) Client with a fractured femur needing pain medication
D) Client needing discharge teaching about warfarin
💫RATIONALE✔️✔️: Unstable DKA on insulin drip requires advanced clinical judgment (B). Stable
pneumonia, pain meds, discharge teaching can be delegated to less experienced RNs or LPNs.
💫ANSWER✔️✔️: B) Client newly diagnosed with DKA on an insulin drip
---
### Question 2 of 93
A nurse manager is reviewing delegation. Which task can be delegated to an unlicensed assistive
personnel (UAP)?
,A) Assessing a client's lung sounds
B) Administering oral metoprolol
C) Measuring intake and output
D) Teaching a client about insulin injection
💫RATIONALE✔️✔️: Measuring I&O (C) is routine within UAP scope. Assessment and teaching require
licensed nurse. Med administration is LPN/RN.
💫ANSWER✔️✔️: C) Measuring intake and output
---
### Question 3 of 93
**Select-All-That-Apply (SATA):** A nurse is providing a handoff report using SBAR. Which components
are included? (Select all that apply.)
A) Situation
B) Background
C) Assessment
D) Recommendation
E) Summary
💫RATIONALE✔️✔️: SBAR: Situation (A), Background (B), Assessment (C), Recommendation (D). Summary
not part of SBAR.
💫ANSWER✔️✔️: A, B, C, D
---
### Question 4 of 93
,A nurse is caring for four clients. Which client should the nurse assess first?
A) Post-op client requesting pain medication
B) Client with COPD and SpO2 88% on room air
C) Client with a new colostomy asking for supplies
D) Client needing PRN antiemetic for nausea
💫RATIONALE✔️✔️: SpO2 88% indicates hypoxemia requiring immediate intervention (B). Pain, nausea,
supplies are urgent but not life-threatening.
💫ANSWER✔️✔️: B) Client with COPD and SpO2 88% on room air
---
### Question 5 of 93
A charge nurse is making shift assignments. A float RN from the postpartum unit is assigned to medical-
surgical. Which client is appropriate?
A) Client with chest tube for pneumothorax
B) Client with new tracheostomy needing suctioning
C) Client with stable type 2 diabetes needing morning insulin
D) Client with acute stroke with unilateral neglect
💫RATIONALE✔️✔️: Stable client needing routine insulin (C) is appropriate. Chest tube, trach, acute
stroke require specialized med-surg/neuro skills.
💫ANSWER✔️✔️: C) Client with stable type 2 diabetes needing morning insulin
---
### Question 6 of 93
, A nurse observes a UAP taking a blood pressure on a client with an IV infusion in the same arm. Which
action should the nurse take?
A) Ignore it because the UAP is experienced
B) Report the UAP to the nursing supervisor immediately
C) Stop the UAP and explain why the cuff should not be on the same arm as an IV
D) Document the incident in the UAP's personnel file
💫RATIONALE✔️✔️: Correct the error immediately (C) to prevent harm. BP cuff can occlude IV flow or
dislodge catheter.
💫ANSWER✔️✔️: C) Stop the UAP and explain why the cuff should not be on the same arm as an IV
---
### Question 7 of 93
**Select-All-That-Apply (SATA):** A nurse manager is addressing lateral violence among staff. Which
interventions are appropriate? (Select all that apply.)
A) Ignore the behavior to avoid conflict
B) Establish a zero-tolerance policy
C) Provide education on professional communication
D) Encourage staff to report incidents
E) Role-model respectful behavior
💫RATIONALE✔️✔️: Zero-tolerance policy (B), education (C), reporting (D), role-modeling (E) address
lateral violence. Ignoring perpetuates it.
💫ANSWER✔️✔️: B, C, D, E
