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Home » My Account » NCLEX-RN Management of Care Exam

NCLEX-RN Management of Care Exam

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Question 1 of 20

1. Question

A new client is admitted to the surgical floor after an appendectomy.

> Which of the following interventions is most appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)?

1. Checking vital signs once the client arrives to the room.
Correct Incorrect Correct answer

2. Performing post-operative teaching about incision care.
Correct Incorrect Correct answer

3. Measuring and recording urine output 6 hours after surgery.
Correct Incorrect Correct answer

4. Assessing the client’s level of pain after ambulating.
Correct Incorrect Correct answer

Correct

Incorrect
Question 2 of 20

2. Question

A client with polycystic kidney disease has been admitted secondary to uncontrolled hypertension. Upon arrival to the room, the client’s blood pressure is 190/120. The healthcare provider places an order to consult both cardiology and nephrology to evaluate the client. The client asks the nurse, “Why do multiple doctors have to see me?”

> What is the most appropriate response by the nurse?

1. “It gives you the opportunity to have your questions answered by multiple doctors.”
Correct Incorrect Correct answer

2. “Having two specialists ensures that you will be discharged faster to continue treatment at home.”
Correct Incorrect Correct answer

3. “Your condition involves both the heart and kidneys, so the two specialists will coordinate care to ensure comprehensive treatment of your blood pressure.”
Correct Incorrect Correct answer

4. “Since you have a complex diagnosis, two specialists are needed to make sure everything goes right with your treatment.
Correct Incorrect Correct answer

Correct

Incorrect
Question 3 of 20

3. Question

A client is pronounced dead shortly after arrival in the emergency department. The provider informs the nurse that the death requires medical examiner notification. The spouse expresses distress and states they do not want an autopsy performed.

> Which response by the nurse is most appropriate?

1. “I can arrange for you to speak with the provider about your concerns, and I will stay with you during that conversation.”
Correct Incorrect Correct answer

2. “We will honor your wishes and cancel the autopsy.”
Correct Incorrect Correct answer

3. “This decision is required, and there is no alternative.”
Correct Incorrect Correct answer

4. “An autopsy helps advance medical research.”
Correct Incorrect Correct answer

Correct

Incorrect
Question 4 of 20

4. Question

The nurse manager is assigning staff to care for a client diagnosed with herpes zoster.

> Which staff members should not be assigned to this client? Select all that apply.

1. The nurse who has no history of varicella infection
Correct Incorrect Correct answer

2. The nurse who has never had measles
Correct Incorrect Correct answer

3. The nurse who reports never having chickenpox
Correct Incorrect Correct answer

4. The nurse who has not received the varicella-zoster vaccine
Correct Incorrect Correct answer

5. The nurse who is unsure of immunity to rubella
Correct Incorrect Correct answer

Correct / 3 Points

Incorrect / 3 Points
Question 5 of 20

5. Question

The nurse is preparing assignments for a group of assistive personnel.

> What is the nurse’s first step in the delegation process?

1. Review years of experience of each AP
Correct Incorrect Correct answer

2. Determine supervision requirements
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3. Identify which tasks may be delegated
Correct Incorrect Correct answer

4. Review staffing ratios
Correct Incorrect Correct answer

Correct

Incorrect
Question 6 of 20

6. Question

While riding an elevator during a shift change, a nursing student hears two nurses discussing a client’s diagnosis and recent test results. Several visitors are also present in the elevator.

> What is the most important principle the nurses must remember in this situation?

1. Confidentiality rules apply only during working hours
Correct Incorrect Correct answer

2. Discussing client information in public areas violates confidentiality
Correct Incorrect Correct answer

3. Client information may be shared freely among staff regardless of location
Correct Incorrect Correct answer

4. Nurses may share personal details as long as the client’s name is not used
Correct Incorrect Correct answer

Correct

Incorrect
Question 7 of 20

7. Question

Due to a community emergency, the nurse manager must identify stable clients for early discharge.

> Which clients can be safely discharged? Select all that apply.

1. Client several days post–myocardial infarction with stable rhythm
Correct Incorrect Correct answer

2. Client receiving IV fluids for persistent vomiting
Correct Incorrect Correct answer

3. Client requiring supplemental oxygen with low oxygen saturation
Correct Incorrect Correct answer

4. Client postoperative day 1 following uncomplicated hernia repair
Correct Incorrect Correct answer

5. Client with fever, hypotension, and leukopenia
Correct Incorrect Correct answer

6. Client one day post-cardiac catheterization with no complications
Correct Incorrect Correct answer

Correct / 3 Points

Incorrect / 3 Points
Question 8 of 20

8. Question

A nurse questions a newly written medication order because the dosage exceeds the recommended safe range. Attempts to reach the prescribing provider are unsuccessful, and the medication administration time is approaching.

> What action should the nurse take?

1. Administer the medication as prescribed
Correct Incorrect Correct answer

2. Hold the medication until the provider returns
Correct Incorrect Correct answer

3. Contact the nursing supervisor for guidance
Correct Incorrect Correct answer

4. Administer the usual recommended dose
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Correct

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Question 9 of 20

9. Question

Staff nurses describe their unit manager as highly directive and focused on task completion.

> Which leadership style does this description reflect?

1. Situational
Correct Incorrect Correct answer

2. Laissez-faire
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3. Democratic
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4. Autocratic
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Correct

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Question 10 of 20

10. Question

The nurse is assigning clients to staff members for the shift.

> Which client is most appropriate to assign to the assistive personnel (AP)?

1. A client requiring sterile wound dressing changes
Correct Incorrect Correct answer

2. A client enrolled in a bowel program that includes enemas and suppositories
Correct Incorrect Correct answer

3. A client with diabetes mellitus who needs insulin administration and diet teaching
Correct Incorrect Correct answer

4. A client who needs routine temperature monitoring every 4 hours
Correct Incorrect Correct answer

Correct

Incorrect
Question 11 of 20

11. Question

A nurse participates in disaster planning education and reviews the roles of national response organizations.

> Which activities are functions of the American Red Cross rather than the Federal Emergency Management Agency (FEMA)? Select all that apply.

1. Providing financial disaster assistance to states
Correct Incorrect Correct answer

2. Recruiting and training disaster response volunteers
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3. Declaring a federal state of emergency
Correct Incorrect Correct answer

4. Mobilizing military or National Guard resources
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5. Assisting families in locating missing loved ones
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6. Offering emotional support and crisis counseling
Correct Incorrect Correct answer

Correct / 3 Points

Incorrect / 3 Points
Question 12 of 20

12. Question

The nurse reflects on professional responsibilities related to advocacy.

> In which situations is the nurse acting as a client advocate? Select all that apply.

1. Promoting teamwork and respect among colleagues
Correct Incorrect Correct answer

2. Questioning a prescription that may harm the client
Correct Incorrect Correct answer

3. Supporting a client’s informed health care decision
Correct Incorrect Correct answer

4. Intervening to improve a client’s comfort
Correct Incorrect Correct answer

5. Teaching a professional development class
Correct Incorrect Correct answer

Correct / 3 Points

Incorrect / 3 Points
Question 13 of 20

13. Question

A nurse observes that a client appears confused about a surgical procedure but is preparing to sign the consent form.

> What is the most appropriate nursing action?

1. Ask a family member to sign the consent
Correct Incorrect Correct answer

2. Notify the provider and delay the signature
Correct Incorrect Correct answer

3. Ask whether the provider explained the procedure
Correct Incorrect Correct answer

4. Suggest the client ask questions later
Correct Incorrect Correct answer

Correct

Incorrect
Question 14 of 20

14. Question

The nurse on a labor and delivery unit has just received handoff reports on four clients.

> Which client should the nurse assess first?

1. A first-time pregnant client in active labor with regular contractions
Correct Incorrect Correct answer

2. A client who just completed an intravenous loading dose of magnesium sulfate for preterm labor
Correct Incorrect Correct answer

3. A multiparous client admitted earlier in the day for scheduled induction
Correct Incorrect Correct answer

4. A client at 35 weeks’ gestation reporting a sudden gush of fluid but no contractions
Correct Incorrect Correct answer

Correct

Incorrect
Question 15 of 20

15. Question

The nurse begins morning rounds after reviewing the client assignment list.

> Which client should the nurse care for first?

1. A client admitted for observation with absent bowel sounds
Correct Incorrect Correct answer

2. A client with heart failure who gained significant weight overnight and is short of breath
Correct Incorrect Correct answer

3. A client scheduled for surgery later in the morning
Correct Incorrect Correct answer

4. A postoperative client receiving a routine blood transfusion
Correct Incorrect Correct answer

Correct

Incorrect
Question 16 of 20

16. Question

The nurse is the first responder at the scene of a multi-vehicle collision on a rural highway.

> Which victim should the nurse assess first?

1. A victim struggling to breathe and using accessory muscles
Correct Incorrect Correct answer

2. A victim who is disoriented and asking repetitive questions
Correct Incorrect Correct answer

3. A victim with a heart rate of 130 beats per minute
Correct Incorrect Correct answer

4. A victim crying loudly with severe leg pain
Correct Incorrect Correct answer

Correct

Incorrect
Question 17 of 20

17. Question

Due to staffing needs, the charge nurse must transfer one antepartum client to another unit with a higher nurse-to-client ratio.

> Which client is most appropriate to transfer?

1. A 24-week gestation client monitored for preterm labor
Correct Incorrect Correct answer

2. A 38-week gestation client reporting decreased fetal movement
Correct Incorrect Correct answer

3. A 10-week gestation client with vaginal bleeding
Correct Incorrect Correct answer

4. A 42-week gestation client with a low biophysical profile score
Correct Incorrect Correct answer

Correct

Incorrect
Question 18 of 20

18. Question

A nursing student reviews the chart of an older adult admitted with fever and confusion. The urinalysis shows bacteria, and the urine culture is pending.

> Which statement by the student indicates a need for further review related to urosepsis?

1. “If untreated, a urinary infection can progress to systemic infection.”
Correct Incorrect Correct answer

2. “A urine culture is only reliable if the client has an indwelling urinary catheter.”
Correct Incorrect Correct answer

3. “Culture sensitivities help guide the most effective antibiotic choice.”
Correct Incorrect Correct answer

4. “The results should be communicated promptly to the primary health care provider.”
Correct Incorrect Correct answer

Correct

Incorrect
Question 19 of 20

19. Question

The nurse is preparing to begin rounds after receiving shift report.

> Which client should the nurse see first?

1. A client reporting bladder discomfort with a Foley catheter
Correct Incorrect Correct answer

2. A client with a mean arterial pressure of 95 mm Hg
Correct Incorrect Correct answer

3. A client with suspected ST-segment elevation noted on telemetry
Correct Incorrect Correct answer

4. A client requesting pain medication for rib discomfort
Correct Incorrect Correct answer

Correct

Incorrect
Question 20 of 20

20. Question

An older adult presents to the emergency department with a fractured arm. The nurse observes multiple bruises in various stages of healing. The client discloses that a family member frequently becomes physically abusive.

> What is the most appropriate nursing response?

1. “I am required to report this abuse and will support you through the process.”
Correct Incorrect Correct answer

2. “Let’s talk about how you might avoid upsetting them.”
Correct Incorrect Correct answer

3. “I’ll speak with your family member about this situation.”
Correct Incorrect Correct answer

4. “Do you have friends who can help while things calm down?”
Correct Incorrect Correct answer

Correct

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