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NCLEX 2025 Prioritization & Delegation Practice – 300
Questions with NGN Scenarios
1. Prioritization – Postoperative Clients
You are the nurse receiving four postoperative clients. Which client should you
assess first?
A. A client 1 hour post–appendectomy who reports nausea
B. A client 2 hours post–thyroidectomy with hoarseness and difficulty swallowing
C. A client 4 hours post–hip replacement who needs assistance to the bathroom
D. A client 8 hours post–cholecystectomy with a pain score of 6/10
Answer: B. A client 2 hours post–thyroidectomy with hoarseness and difficulty
swallowing
Rationale:
Airway compromise is the top priority using ABCs (Airway, Breathing,
, 2
Circulation). Hoarseness or difficulty swallowing post-thyroidectomy indicates
possible laryngeal edema or hematoma formation, which can quickly lead to
airway obstruction. Pain, nausea, or mobility needs are important but not
immediately life-threatening.
2. Delegation – UAP
Which task can be safely delegated to an unlicensed assistive personnel (UAP)?
A. Administering a fleet enema to a client with constipation
B. Checking blood glucose for a stable client
C. Assessing a client’s orientation after sedation
D. Teaching a client how to use an incentive spirometer
Answer: B. Checking blood glucose for a stable client
Rationale:
Delegation to UAPs involves tasks that are routine, predictable, and do not
require clinical judgment. Blood glucose checks on stable clients are within
their scope. Administering medications, assessing mental status, and client
teaching are nursing responsibilities.
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3. Prioritization – Chest Pain
Four clients call the nurse’s station. Which client should be seen first?
A. Client with COPD reporting chronic shortness of breath
B. Client with angina reporting new onset of chest pressure radiating to the jaw
C. Client with pneumonia requesting a warm blanket
D. Client with diabetes asking for a snack before insulin
Answer: B. Client with angina reporting new onset of chest pressure radiating
to the jaw
Rationale:
This client shows signs of myocardial infarction, a life-threatening emergency
requiring immediate assessment and intervention (MONA protocol:
Morphine, Oxygen, Nitroglycerin, Aspirin). Other clients are stable or non-
urgent.
4. Delegation – Postoperative Care
Which client care activity is appropriate to delegate to a UAP?
A. Monitoring for drainage at a chest tube insertion site
B. Teaching a client how to splint their incision while coughing
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C. Ambulating a stable client 12 hours post–cesarean section
D. Assessing a client’s pain level after medication administration
Answer: C. Ambulating a stable client 12 hours post–cesarean section
Rationale:
Ambulating a stable postoperative client is routine and predictable, making it
appropriate for UAP delegation. Assessment, evaluation, and teaching are
responsibilities that remain with the RN.
5. Prioritization – IV Infusion
Which client should the nurse assess first?
A. A client whose IV antibiotic infusion is 30 minutes behind schedule
B. A client receiving IV potassium who reports burning at the site
C. A client who requests assistance to the bathroom
D. A client who asks for pain medication before physical therapy
Answer: B. A client receiving IV potassium who reports burning at the site
Rationale:
IV potassium is a vesicant and can cause phlebitis or tissue damage if
extravasation occurs. Immediate assessment and intervention are required.
NCLEX 2025 Prioritization & Delegation Practice – 300
Questions with NGN Scenarios
1. Prioritization – Postoperative Clients
You are the nurse receiving four postoperative clients. Which client should you
assess first?
A. A client 1 hour post–appendectomy who reports nausea
B. A client 2 hours post–thyroidectomy with hoarseness and difficulty swallowing
C. A client 4 hours post–hip replacement who needs assistance to the bathroom
D. A client 8 hours post–cholecystectomy with a pain score of 6/10
Answer: B. A client 2 hours post–thyroidectomy with hoarseness and difficulty
swallowing
Rationale:
Airway compromise is the top priority using ABCs (Airway, Breathing,
, 2
Circulation). Hoarseness or difficulty swallowing post-thyroidectomy indicates
possible laryngeal edema or hematoma formation, which can quickly lead to
airway obstruction. Pain, nausea, or mobility needs are important but not
immediately life-threatening.
2. Delegation – UAP
Which task can be safely delegated to an unlicensed assistive personnel (UAP)?
A. Administering a fleet enema to a client with constipation
B. Checking blood glucose for a stable client
C. Assessing a client’s orientation after sedation
D. Teaching a client how to use an incentive spirometer
Answer: B. Checking blood glucose for a stable client
Rationale:
Delegation to UAPs involves tasks that are routine, predictable, and do not
require clinical judgment. Blood glucose checks on stable clients are within
their scope. Administering medications, assessing mental status, and client
teaching are nursing responsibilities.
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3. Prioritization – Chest Pain
Four clients call the nurse’s station. Which client should be seen first?
A. Client with COPD reporting chronic shortness of breath
B. Client with angina reporting new onset of chest pressure radiating to the jaw
C. Client with pneumonia requesting a warm blanket
D. Client with diabetes asking for a snack before insulin
Answer: B. Client with angina reporting new onset of chest pressure radiating
to the jaw
Rationale:
This client shows signs of myocardial infarction, a life-threatening emergency
requiring immediate assessment and intervention (MONA protocol:
Morphine, Oxygen, Nitroglycerin, Aspirin). Other clients are stable or non-
urgent.
4. Delegation – Postoperative Care
Which client care activity is appropriate to delegate to a UAP?
A. Monitoring for drainage at a chest tube insertion site
B. Teaching a client how to splint their incision while coughing
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C. Ambulating a stable client 12 hours post–cesarean section
D. Assessing a client’s pain level after medication administration
Answer: C. Ambulating a stable client 12 hours post–cesarean section
Rationale:
Ambulating a stable postoperative client is routine and predictable, making it
appropriate for UAP delegation. Assessment, evaluation, and teaching are
responsibilities that remain with the RN.
5. Prioritization – IV Infusion
Which client should the nurse assess first?
A. A client whose IV antibiotic infusion is 30 minutes behind schedule
B. A client receiving IV potassium who reports burning at the site
C. A client who requests assistance to the bathroom
D. A client who asks for pain medication before physical therapy
Answer: B. A client receiving IV potassium who reports burning at the site
Rationale:
IV potassium is a vesicant and can cause phlebitis or tissue damage if
extravasation occurs. Immediate assessment and intervention are required.
