NCLEX Prioritization & Delegation Practice Questions

15 free NCLEX-RN prioritization questions with answers and rationales — perfect for nclex priority questions practice. Want them as an interactive timed quiz?

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1. A nurse in the emergency department is assigned four clients. Which client should the nurse see first?
- A. A 45-year-old man with chest pain and a history of myocardial infarction. ✓
- B. A 60-year-old woman with a fractured wrist and moderate pain.
- C. A 30-year-old man with asthma reporting shortness of breath.
- D. A 25-year-old woman with a migraine headache.
Answer: A. A 45-year-old man with chest pain and a history of myocardial infarction. — Chest pain in a client with a history of myocardial infarction is a potential life-threatening condition that requires immediate assessment and intervention following the ABCs of prioritization (Airway, Breathing, Circulation).
2. You are the charge nurse on a medical-surgical unit. Which client should you assign to a float nurse from the pediatric unit?
- A. A 40-year-old client with pneumonia requiring frequent suctioning.
- B. A 50-year-old client post-cholecystectomy needing pain management.
- C. A 60-year-old client with COPD needing complex respiratory support.
- D. A 30-year-old client with stable diabetes requiring insulin administration. ✓
Answer: D. A 30-year-old client with stable diabetes requiring insulin administration. — The float nurse from the pediatric unit would be most familiar with insulin administration as it is a common task in pediatric care, while the other options involve more specialized adult care skills.
3. A nurse receives a shift report on four clients. Which client should the nurse assess first?
- A. A client with a potassium level of 5.0 mEq/L and stable vital signs.
- B. A client post-appendectomy reporting severe abdominal pain.
- C. A client with a blood glucose level of 140 mg/dL.
- D. A client with a new onset of confusion and disorientation. ✓
Answer: D. A client with a new onset of confusion and disorientation. — New onset confusion and disorientation can indicate a serious underlying condition such as a stroke or hypoxia and requires immediate assessment.
4. A nurse is caring for a client with congestive heart failure. Which task can be delegated to an experienced unlicensed assistive personnel (UAP)?
- A. Assessing the client's lung sounds.
- B. Administering oral medications.
- C. Measuring and recording the client's intake and output. ✓
- D. Developing a care plan for the client.
Answer: C. Measuring and recording the client's intake and output. — Measuring and recording intake and output is within the scope of practice for UAPs as it involves collecting data, not interpreting or analyzing it.
5. A nurse is working in the emergency department during a mass casualty incident. Which client should be prioritized for treatment?
- A. A client with a large head laceration and controlled bleeding.
- B. A client with a fractured arm and open wound.
- C. A client with respiratory distress and cyanosis. ✓
- D. A client with a sprained ankle and mild pain.
Answer: C. A client with respiratory distress and cyanosis. — Respiratory distress and cyanosis indicate compromised airway and breathing, which are prioritized first according to the ABCs of triage and emergency care.
6. A nurse is caring for four clients. Which client should the nurse assess first after receiving the shift report?
- A. A client with gastroenteritis experiencing diarrhea.
- B. A client with a newly inserted tracheostomy tube who is restless. ✓
- C. A client scheduled for discharge later today.
- D. A client with stable vital signs and a urinary catheter.
Answer: B. A client with a newly inserted tracheostomy tube who is restless. — Restlessness in a client with a newly inserted tracheostomy tube may indicate hypoxia or tube obstruction, which requires immediate attention.
7. A nurse is caring for a group of clients. Which task is appropriate for the nurse to delegate to an LPN?
- A. Developing a postoperative care plan for a client.
- B. Administering intravenous medications.
- C. Performing wound care and dressing changes. ✓
- D. Conducting an initial assessment on a new admission.
Answer: C. Performing wound care and dressing changes. — Performing wound care and dressing changes is within the scope of practice for an LPN, whereas developing a care plan and conducting initial assessments are responsibilities of the RN.
8. A nurse is caring for a client with chronic renal failure. Which task can be delegated to an unlicensed assistive personnel (UAP)?
- A. Monitoring the client's blood pressure.
- B. Educating the client about their diet.
- C. Assisting the client with bathing. ✓
- D. Evaluating the client's response to dialysis.
Answer: C. Assisting the client with bathing. — Assisting with activities of daily living, such as bathing, is an appropriate task for a UAP, while the other tasks require nursing judgment and assessment.
9. A nurse is working in a community health clinic. Which client should the nurse prioritize for further assessment?
- A. A client with a history of hypertension reporting a headache.
- B. A client with type 2 diabetes presenting with foot ulcers. ✓
- C. A client with a cough and low-grade fever for two days.
- D. A client with a history of asthma using an inhaler every four hours.
Answer: B. A client with type 2 diabetes presenting with foot ulcers. — Foot ulcers in a client with diabetes require prompt assessment due to the risk of infection and poor wound healing, potentially leading to serious complications.
10. A nurse is prioritizing care for four clients. Which client should the nurse attend to first?
- A. A client with a blood glucose level of 70 mg/dL and no symptoms.
- B. A client reporting chest pain and shortness of breath. ✓
- C. A client with a temperature of 100.4°F (38°C) and chills.
- D. A client with a headache and nausea post-lumbar puncture.
Answer: B. A client reporting chest pain and shortness of breath. — Chest pain and shortness of breath are signs of potentially life-threatening conditions such as myocardial infarction or pulmonary embolism, requiring immediate assessment.
11. A nurse is planning care for several clients on a busy medical-surgical unit. Which task can be safely delegated to a certified nursing assistant (CNA)?
- A. Teaching a client how to use a walker.
- B. Measuring a client's blood pressure. ✓
- C. Administering oral medications.
- D. Evaluating a client's pain level.
Answer: B. Measuring a client's blood pressure. — Measuring vital signs such as blood pressure is within the scope of practice for a CNA, while teaching, medication administration, and evaluation require nursing knowledge and licensure.
12. A nurse in a long-term care facility is about to administer morning medications. Which client should the nurse prioritize for medication administration?
- A. A client with Parkinson's disease requiring medications at precise times to manage symptoms. ✓
- B. A client with stable hypertension scheduled for routine antihypertensive medication.
- C. A client with constipation receiving a daily stool softener.
- D. A client with a multivitamin order for general health maintenance.
Answer: A. A client with Parkinson's disease requiring medications at precise times to manage symptoms. — Medications for Parkinson's disease need to be administered at precise times to maintain therapeutic levels and manage symptoms effectively, making this client a priority for timely administration.
13. In the emergency department, a nurse is triaging clients. Which client should be assessed first?
- A. A client with a sprained ankle and moderate pain.
- B. A client with a suspected fracture in the arm.
- C. A client with slurred speech and facial droop. ✓
- D. A client with a minor laceration needing sutures.
Answer: C. A client with slurred speech and facial droop. — Slurred speech and facial droop are signs of a possible stroke, which requires immediate assessment and intervention to prevent further neurological damage.
14. A nurse is preparing to administer medications to four clients. Which client should receive their medication first?
- A. A client with a history of seizures due for an anticonvulsant. ✓
- B. A client with hypertension due for a diuretic.
- C. A client with constipation due for a stool softener.
- D. A client with hyperlipidemia due for statin therapy.
Answer: A. A client with a history of seizures due for an anticonvulsant. — Anticonvulsants should be given on schedule to maintain therapeutic drug levels and prevent seizures, making this client a priority for medication administration.
15. A nurse is caring for a client post-operative day 1 after an appendectomy. Which task can be delegated to a nursing assistant?
- A. Changing the client's surgical dressing.
- B. Assisting the client with ambulation. ✓
- C. Assessing the client's incision site.
- D. Teaching the client about post-operative care.
Answer: B. Assisting the client with ambulation. — Assisting with ambulation is an appropriate task for a nursing assistant, while the other tasks require the skills and judgment of a licensed nurse.

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NCLEX Prioritization & Delegation Practice Questions

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