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NCLEX RN Exam Bank: Prioritization & Delegation in
Multi Patient Care
Table of Contents
Subtopic 1: Principles of Prioritization in Acute Care Settings ........................................... 2
Subtopic 2: Delegation Responsibilities by Role (RN, LPN, UAP) ..................................... 10
Subtopic 3: Managing Multiple Patients and Competing Priorities ................................... 18
Subtopic 4: Time Management and Safe Task Delegation in High-Acuity Situations .......... 27
Subtopic 5: Delegation According to Scope of Practice (RN, LPN, UAP) ........................... 35
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Subtopic 1: Principles of Prioritization in Acute Care
Settings
(Questions 1–20)
Question 1
A nurse on a medical-surgical unit receives reports on four patients. Which patient should
the nurse assess first?
A. A 60-year-old patient with COPD who needs morning medications
B. A 45-year-old patient scheduled for physical therapy in 1 hour
C. A 70-year-old patient with pneumonia who is confused and attempting to get out of bed
D. A 55-year-old post-op patient requesting a sleeping pill
Correct Answer: C
Rationale: The confused pneumonia patient poses a fall risk and may be experiencing
hypoxia. This represents a safety and physiological priority that requires immediate
attention.
Question 2
Which of the following patients should the nurse prioritize first during morning rounds?
A. A patient complaining of new-onset chest pain rated 8/10
B. A diabetic patient asking for breakfast
C. A post-op day 2 patient requesting help ambulating
D. A patient waiting to be discharged later that afternoon
Correct Answer: A
Rationale: New-onset chest pain is a potential life-threatening emergency. Addressing this
patient first aligns with the ABCs (Airway, Breathing, Circulation).
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Question 3
You receive report on four patients. Which patient do you assess first?
A. A patient with a potassium level of 4.2 mEq/L
B. A patient complaining of a headache with BP 148/88
C. A patient receiving IV heparin with a sudden drop in hemoglobin
D. A patient awaiting an x-ray for suspected fracture
Correct Answer: C
Rationale: A sudden drop in hemoglobin while on heparin suggests internal bleeding, a
priority requiring immediate intervention.
Question 4
A nurse receives four calls at the start of shift. Who should be addressed first?
A. A patient requesting help getting to the bathroom
B. A patient with a tracheostomy who is coughing and has thick secretions
C. A patient requesting a PRN pain medication
D. A family member asking to speak with the nurse
Correct Answer: B
Rationale: The patient with a tracheostomy and thick secretions is at risk for airway
obstruction—an airway issue always takes priority.
Question 5
Which of the following patients should the nurse assess first after shift report?
A. A patient reporting 2/10 leg pain
B. A patient who is 30 minutes post-seizure and drowsy
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C. A patient who needs education before discharge
D. A patient with a stage II pressure ulcer
Correct Answer: B
Rationale: Post-seizure patients may be at risk for further neurological compromise or
airway issues, requiring close observation.
Question 6
A nurse receives the following four messages. Who should be prioritized?
A. A patient asking about lab results
B. A patient complaining about noise
C. A patient who pulled out their central line and is bleeding
D. A patient’s visitor asking for more blankets
Correct Answer: C
Rationale: Active bleeding from a central line site is a medical emergency and needs to be
addressed immediately.
Question 7
Which scenario demonstrates the best example of appropriate prioritization?
A. Treating a patient with low oxygen saturation before administering routine meds
B. Taking all vitals before checking blood glucose
C. Assisting with a shower before updating the care plan
D. Answering call lights before reviewing morning labs
Correct Answer: A
NCLEX RN Exam Bank: Prioritization & Delegation in
Multi Patient Care
Table of Contents
Subtopic 1: Principles of Prioritization in Acute Care Settings ........................................... 2
Subtopic 2: Delegation Responsibilities by Role (RN, LPN, UAP) ..................................... 10
Subtopic 3: Managing Multiple Patients and Competing Priorities ................................... 18
Subtopic 4: Time Management and Safe Task Delegation in High-Acuity Situations .......... 27
Subtopic 5: Delegation According to Scope of Practice (RN, LPN, UAP) ........................... 35
, 2
Subtopic 1: Principles of Prioritization in Acute Care
Settings
(Questions 1–20)
Question 1
A nurse on a medical-surgical unit receives reports on four patients. Which patient should
the nurse assess first?
A. A 60-year-old patient with COPD who needs morning medications
B. A 45-year-old patient scheduled for physical therapy in 1 hour
C. A 70-year-old patient with pneumonia who is confused and attempting to get out of bed
D. A 55-year-old post-op patient requesting a sleeping pill
Correct Answer: C
Rationale: The confused pneumonia patient poses a fall risk and may be experiencing
hypoxia. This represents a safety and physiological priority that requires immediate
attention.
Question 2
Which of the following patients should the nurse prioritize first during morning rounds?
A. A patient complaining of new-onset chest pain rated 8/10
B. A diabetic patient asking for breakfast
C. A post-op day 2 patient requesting help ambulating
D. A patient waiting to be discharged later that afternoon
Correct Answer: A
Rationale: New-onset chest pain is a potential life-threatening emergency. Addressing this
patient first aligns with the ABCs (Airway, Breathing, Circulation).
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Question 3
You receive report on four patients. Which patient do you assess first?
A. A patient with a potassium level of 4.2 mEq/L
B. A patient complaining of a headache with BP 148/88
C. A patient receiving IV heparin with a sudden drop in hemoglobin
D. A patient awaiting an x-ray for suspected fracture
Correct Answer: C
Rationale: A sudden drop in hemoglobin while on heparin suggests internal bleeding, a
priority requiring immediate intervention.
Question 4
A nurse receives four calls at the start of shift. Who should be addressed first?
A. A patient requesting help getting to the bathroom
B. A patient with a tracheostomy who is coughing and has thick secretions
C. A patient requesting a PRN pain medication
D. A family member asking to speak with the nurse
Correct Answer: B
Rationale: The patient with a tracheostomy and thick secretions is at risk for airway
obstruction—an airway issue always takes priority.
Question 5
Which of the following patients should the nurse assess first after shift report?
A. A patient reporting 2/10 leg pain
B. A patient who is 30 minutes post-seizure and drowsy
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C. A patient who needs education before discharge
D. A patient with a stage II pressure ulcer
Correct Answer: B
Rationale: Post-seizure patients may be at risk for further neurological compromise or
airway issues, requiring close observation.
Question 6
A nurse receives the following four messages. Who should be prioritized?
A. A patient asking about lab results
B. A patient complaining about noise
C. A patient who pulled out their central line and is bleeding
D. A patient’s visitor asking for more blankets
Correct Answer: C
Rationale: Active bleeding from a central line site is a medical emergency and needs to be
addressed immediately.
Question 7
Which scenario demonstrates the best example of appropriate prioritization?
A. Treating a patient with low oxygen saturation before administering routine meds
B. Taking all vitals before checking blood glucose
C. Assisting with a shower before updating the care plan
D. Answering call lights before reviewing morning labs
Correct Answer: A
