1
Leadership & Delegation NCLEX Workbook (180 Qs) | RN & PN |
Priority, Maslow, ABCs, Delegation | ATI HESI NCLEX Prep 2025–
2026 | Verified A+ Bundle
1. A nurse is caring for a group of four clients during the morning shift. The
following clients are scheduled for medications and assessments within the next
hour. Which client should the nurse prioritize and assess first based on safety and
clinical urgency?
A. A 72-year-old client with pneumonia who is febrile and requesting a blanket
B. A 60-year-old post-op client who is 6 hours post-hernia repair and requesting
pain medication
C. A 66-year-old client who just received IV morphine 25 minutes ago and is now
difficult to awaken and breathing at 8 breaths per minute
D. A 58-year-old client with hypertension who needs discharge education and
medication reconciliation before noon
, 2
Correct Answer: C
Rationale: The client in option C is showing signs of opioid-induced respiratory
depression, which is a life-threatening emergency. According to the ABCs
(Airway, Breathing, Circulation) and time-sensitive prioritization, a respiratory
rate of 8 is dangerously low. The nurse should immediately assess oxygenation,
stimulate the client, and prepare to administer naloxone. Pain management, fever,
and education can wait — this client requires immediate intervention.
2. A nurse is supervising a UAP and an LPN on a medical-surgical unit. Which of
the following tasks is appropriate for the RN to delegate to the UAP during the
shift?
A. Feeding a client with Alzheimer’s disease who is at high risk for aspiration and
has a history of choking
B. Reassessing a client who reported feeling dizzy after ambulating to the
bathroom
C. Measuring and documenting daily weight for a client with heart failure
D. Administering oral medications to a stable client with cellulitis
Correct Answer: C
Rationale: UAPs can be delegated routine, non-complex tasks such as vital
signs, ambulation, hygiene, and daily weights. This helps the RN focus on
, 3
assessments and interventions. Feeding high-risk clients, reassessments, and all
medication administration are not within the UAP’s scope. Option C is safe,
appropriate, and enhances efficiency while maintaining patient safety.
3. The nurse is creating the assignment for the day shift on a surgical unit. Which
of the following clients is best to assign to an experienced LPN working under the
supervision of an RN?
A. A client who is 4 hours postoperative from a bowel resection and requires
frequent pain reassessments and IV narcotics
B. A client with new-onset atrial fibrillation being started on a heparin infusion
C. A client 1 day postoperative from a cholecystectomy who needs oral pain meds
and routine wound care
D. A client admitted with GI bleeding who needs blood transfusion monitoring
Correct Answer: C
Rationale: LPNs can manage stable clients with predictable outcomes, including
routine dressing changes and oral medications. Clients requiring IV medications,
titrations, blood transfusions, or newly unstable conditions (like GI bleeding or
new arrhythmias) must be managed by the RN. Option C falls safely within the
LPN's scope.
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4. A nurse manager observes a newly licensed nurse delegating tasks to a UAP
during a busy shift. Which delegation requires the nurse manager to intervene?
A. “Please assist the client in Room 204 to ambulate twice during the shift.”
B. “Let me know if the client in Room 212 reports chest pain.”
C. “Help reposition the client in Room 210 every 2 hours.”
D. “Take vital signs for the client in Room 208 and report anything abnormal.”
Correct Answer: B
Rationale: UAPs cannot assess or interpret symptoms. Chest pain is a clinical
emergency that requires immediate RN evaluation. The nurse must independently
monitor for changes in condition. While repositioning, ambulation, and vital signs
are appropriate tasks, delegating assessment responsibilities or clinical decision-
making to a UAP is unsafe and violates delegation principles.
5. A nurse is prioritizing care for four clients during morning rounds. Which of the
following clients requires immediate intervention by the nurse?
A. A client who has a low-grade fever of 100.8°F after an abdominal hysterectomy
B. A client with asthma who is short of breath and using accessory muscles to
breathe
Leadership & Delegation NCLEX Workbook (180 Qs) | RN & PN |
Priority, Maslow, ABCs, Delegation | ATI HESI NCLEX Prep 2025–
2026 | Verified A+ Bundle
1. A nurse is caring for a group of four clients during the morning shift. The
following clients are scheduled for medications and assessments within the next
hour. Which client should the nurse prioritize and assess first based on safety and
clinical urgency?
A. A 72-year-old client with pneumonia who is febrile and requesting a blanket
B. A 60-year-old post-op client who is 6 hours post-hernia repair and requesting
pain medication
C. A 66-year-old client who just received IV morphine 25 minutes ago and is now
difficult to awaken and breathing at 8 breaths per minute
D. A 58-year-old client with hypertension who needs discharge education and
medication reconciliation before noon
, 2
Correct Answer: C
Rationale: The client in option C is showing signs of opioid-induced respiratory
depression, which is a life-threatening emergency. According to the ABCs
(Airway, Breathing, Circulation) and time-sensitive prioritization, a respiratory
rate of 8 is dangerously low. The nurse should immediately assess oxygenation,
stimulate the client, and prepare to administer naloxone. Pain management, fever,
and education can wait — this client requires immediate intervention.
2. A nurse is supervising a UAP and an LPN on a medical-surgical unit. Which of
the following tasks is appropriate for the RN to delegate to the UAP during the
shift?
A. Feeding a client with Alzheimer’s disease who is at high risk for aspiration and
has a history of choking
B. Reassessing a client who reported feeling dizzy after ambulating to the
bathroom
C. Measuring and documenting daily weight for a client with heart failure
D. Administering oral medications to a stable client with cellulitis
Correct Answer: C
Rationale: UAPs can be delegated routine, non-complex tasks such as vital
signs, ambulation, hygiene, and daily weights. This helps the RN focus on
, 3
assessments and interventions. Feeding high-risk clients, reassessments, and all
medication administration are not within the UAP’s scope. Option C is safe,
appropriate, and enhances efficiency while maintaining patient safety.
3. The nurse is creating the assignment for the day shift on a surgical unit. Which
of the following clients is best to assign to an experienced LPN working under the
supervision of an RN?
A. A client who is 4 hours postoperative from a bowel resection and requires
frequent pain reassessments and IV narcotics
B. A client with new-onset atrial fibrillation being started on a heparin infusion
C. A client 1 day postoperative from a cholecystectomy who needs oral pain meds
and routine wound care
D. A client admitted with GI bleeding who needs blood transfusion monitoring
Correct Answer: C
Rationale: LPNs can manage stable clients with predictable outcomes, including
routine dressing changes and oral medications. Clients requiring IV medications,
titrations, blood transfusions, or newly unstable conditions (like GI bleeding or
new arrhythmias) must be managed by the RN. Option C falls safely within the
LPN's scope.
, 4
4. A nurse manager observes a newly licensed nurse delegating tasks to a UAP
during a busy shift. Which delegation requires the nurse manager to intervene?
A. “Please assist the client in Room 204 to ambulate twice during the shift.”
B. “Let me know if the client in Room 212 reports chest pain.”
C. “Help reposition the client in Room 210 every 2 hours.”
D. “Take vital signs for the client in Room 208 and report anything abnormal.”
Correct Answer: B
Rationale: UAPs cannot assess or interpret symptoms. Chest pain is a clinical
emergency that requires immediate RN evaluation. The nurse must independently
monitor for changes in condition. While repositioning, ambulation, and vital signs
are appropriate tasks, delegating assessment responsibilities or clinical decision-
making to a UAP is unsafe and violates delegation principles.
5. A nurse is prioritizing care for four clients during morning rounds. Which of the
following clients requires immediate intervention by the nurse?
A. A client who has a low-grade fever of 100.8°F after an abdominal hysterectomy
B. A client with asthma who is short of breath and using accessory muscles to
breathe
