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Perfect for daily study, last-minute NCLEX prep, or capstone review.
This guide features 50 advanced-level questions focused on prioritization, delegation, and
assignment, one of the most critical and high-scoring topics on the NCLEX-RN.
Each question is paired with a clear, clinical rationale to help you develop not just test-taking
skills, but real-world nursing judgment. Use this resource to sharpen your decision-making, build
confidence, and prepare for the Clinical Judgment model in the 2025 NCLEX.
Question 1 – Prioritization
A nurse is caring for four clients. Which one should the nurse assess first?
A. A client with chest pain rated 4/10 relieved by antacids
B. A post-op client with a temperature of 100.4°F (38°C)
C. A client with shortness of breath and restlessness
D. A client who is requesting assistance to the bathroom
✅ Answer: C
Rationale: Shortness of breath and restlessness indicate respiratory compromise
(Airway/Breathing), which takes priority over mild chest pain or post-op fever.
Question 2 – Delegation
Which task is appropriate for the RN to delegate to an experienced UAP?
A. Ambulating a client 12 hours post hip replacement
B. Evaluating a client’s response to pain medication
C. Teaching a client how to use an incentive spirometer
D. Changing the dressing on a surgical wound
✅ Answer: A
Rationale: UAPs may assist with ambulation if the client is stable. Evaluation, teaching, and
wound care are not within a UAP’s scope.
Question 3 – Assignment
Which client is most appropriate to assign to an LPN?
A. A client newly diagnosed with stroke who has dysphagia
B. A client with pneumonia receiving IV antibiotics and needing frequent suctioning
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C. A client with diabetes who requires insulin administration and foot care
D. A client admitted for chest pain with a history of unstable angina
✅ Answer: C
Rationale: The diabetic client is stable with predictable care, suitable for LPN. New or unstable
clients need RN-level care.
Question 4 – Prioritization
Which of the following clients should the nurse assess first?
A. A client with a potassium level of 6.0 mEq/L
B. A client with BP of 90/60 and complaints of dizziness
C. A client post-op day 2 with 20 mL/hr urine output
D. A client with blood glucose of 250 mg/dL
✅ Answer: A
Rationale: Potassium of 6.0 is critically high and can lead to fatal arrhythmias, this client is the
top priority.
Question 5 – Delegation
Which task can the nurse delegate to a UAP for a client on contact precautions?
A. Teaching proper hand hygiene
B. Assisting with bed bath
C. Collecting a sputum specimen
D. Assessing skin integrity
✅ Answer: B
Rationale: UAPs can perform hygiene care for clients on precautions, but teaching, assessing,
and specimen collection are nursing tasks.
Question 6 – Assignment
A nurse is making assignments for the day. Which task can the RN safely assign to an
LPN?
A. Developing a plan of care for a client with heart failure
B. Assessing a client newly admitted with abdominal pain
C. Administering oral meds to a stable client
D. Titrating a dopamine drip in ICU
, 1
Perfect for daily study, last-minute NCLEX prep, or capstone review.
This guide features 50 advanced-level questions focused on prioritization, delegation, and
assignment, one of the most critical and high-scoring topics on the NCLEX-RN.
Each question is paired with a clear, clinical rationale to help you develop not just test-taking
skills, but real-world nursing judgment. Use this resource to sharpen your decision-making, build
confidence, and prepare for the Clinical Judgment model in the 2025 NCLEX.
Question 1 – Prioritization
A nurse is caring for four clients. Which one should the nurse assess first?
A. A client with chest pain rated 4/10 relieved by antacids
B. A post-op client with a temperature of 100.4°F (38°C)
C. A client with shortness of breath and restlessness
D. A client who is requesting assistance to the bathroom
✅ Answer: C
Rationale: Shortness of breath and restlessness indicate respiratory compromise
(Airway/Breathing), which takes priority over mild chest pain or post-op fever.
Question 2 – Delegation
Which task is appropriate for the RN to delegate to an experienced UAP?
A. Ambulating a client 12 hours post hip replacement
B. Evaluating a client’s response to pain medication
C. Teaching a client how to use an incentive spirometer
D. Changing the dressing on a surgical wound
✅ Answer: A
Rationale: UAPs may assist with ambulation if the client is stable. Evaluation, teaching, and
wound care are not within a UAP’s scope.
Question 3 – Assignment
Which client is most appropriate to assign to an LPN?
A. A client newly diagnosed with stroke who has dysphagia
B. A client with pneumonia receiving IV antibiotics and needing frequent suctioning
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C. A client with diabetes who requires insulin administration and foot care
D. A client admitted for chest pain with a history of unstable angina
✅ Answer: C
Rationale: The diabetic client is stable with predictable care, suitable for LPN. New or unstable
clients need RN-level care.
Question 4 – Prioritization
Which of the following clients should the nurse assess first?
A. A client with a potassium level of 6.0 mEq/L
B. A client with BP of 90/60 and complaints of dizziness
C. A client post-op day 2 with 20 mL/hr urine output
D. A client with blood glucose of 250 mg/dL
✅ Answer: A
Rationale: Potassium of 6.0 is critically high and can lead to fatal arrhythmias, this client is the
top priority.
Question 5 – Delegation
Which task can the nurse delegate to a UAP for a client on contact precautions?
A. Teaching proper hand hygiene
B. Assisting with bed bath
C. Collecting a sputum specimen
D. Assessing skin integrity
✅ Answer: B
Rationale: UAPs can perform hygiene care for clients on precautions, but teaching, assessing,
and specimen collection are nursing tasks.
Question 6 – Assignment
A nurse is making assignments for the day. Which task can the RN safely assign to an
LPN?
A. Developing a plan of care for a client with heart failure
B. Assessing a client newly admitted with abdominal pain
C. Administering oral meds to a stable client
D. Titrating a dopamine drip in ICU
