In this NCLEX guide, we’ll help you review and prepare for prioritization, delegation, and assignment in your nursing exams. For this nursing test bank, improve your skills in prioritization, delegation, and patient assignment by exercising with these practice questions. We will also be teaching you test-taking tips and strategies so you can tackle these questions in the NCLEX with ease. The goal of these practice quizzes and reviewer is to help student nurses establish a foundation of knowledge and skills on prioritization, delegation, and assignment.
Prioritization, Delegation, and Assignment Practice Quiz
In this section are the practice questions to exercise your knowledge on nursing prioritization, delegation, and assignment. As with other quizzes, be sure to read and understand the question carefully. For prioritization, delegation, and assignment questions, read each choices carefully before deciding on your answer. Good luck and answer these questions at your own pace. You are here to learn.
Quizzes included in this guide are:
- Part 1: Nursing Prioritization, Delegation, Assignment for NCLEX (25 Items)
- Part 2: Nursing Prioritization, Delegation, Assignment for NCLEX (25 Items)
- Part 3: Nursing Prioritization, Delegation, Assignment for NCLEX (25 Items)
- Part 4: Nursing Prioritization, Delegation, Assignment for NCLEX (25 Items)
- Read and understand each question before choosing the best answer.
- Since this is a review, answers and rationales are shown after you click on the "Check" button.
- There is no time limit, answer the questions at your own pace.
- Once all questions are answered, you'll be prompted to click the "Quiz Summary" button where you'll be shown the questions you've answered or placed under "Review". Click on the "Finish Quiz" button to show your rating.
- After the quiz, please make sure to read the questions and rationales again by click on the "View Questions" button.
- Comment us your thoughts, scores, ratings, and questions about the quiz in the comments section below!
Nursing Prioritization, Delegation, Assignment for NCLEX (Part 2: 25 Items)
This is the second part of the nursing test bank for nursing prioritization, delegation, and assignment. Remember to read the question carefully and note any strategic words like “immediate,” “best,” or “high priority” as these indicate they need you to prioritize.
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Looking for the rationales? Please click on the “View Questions” button below to review your answers and read through the rationales for each question.
Question 1 of 25
Nurse Channing is caring for four clients and is preparing to do his initial rounds. Which client should the nurse assess first?CorrectIncorrect
Question 2 of 25
Nurse Janus enters a room and finds a client lying on the floor. Which of the following actions should the nurse perform first?CorrectIncorrect
Question 3 of 25
Paige is a nurse preceptor who is working with a new nurse, Joyce. She notes that Joyce is reluctant to delegate tasks to members of the care team. Paige recognizes that this reluctance is most likely due to:CorrectIncorrect
Question 4 of 25
Nurse Paul is developing a care plan for a client after bariatric surgery for morbid obesity. The nurse should include which of the following on the care plan as the priority complication to prevent:CorrectIncorrect
Question 5 of 25
A client presents to the emergency room with dyspnea, chest pain, and syncope. The nurse assesses the client and notes that the following assessment cues: pale, diaphoretic, blood pressure of 90/60, respirations of 33. The client is also anxious and fearing death. Which action should the nurse take first?CorrectIncorrect
Question 6 of 25
Nurse Pietro receives an 11-month old child with a fracture of the left femur on the pediatric unit. Which action is important for the nurse to take first?CorrectIncorrect
Question 7 of 25
Nurse Skye is assigned to the cardiac unit caring for four clients. He is preparing to do initial rounds. Which client should the nurse assess first?CorrectIncorrect
Question 8 of 25
A nurse enters a room and finds a patient lying face down on the floor and bleeding from a gash in the head. Which action should the nurse perform first?CorrectIncorrect
Question 9 of 25
Nurse Adonai is working on the night shift with a nursing assistant. The nursing assistant comes to the nurse stating that the other nurse working on the unit is not assessing a client with abdominal pain despite multiple requests. Which of the following actions by the nurse is best?CorrectIncorrect
Question 10 of 25
Nurse Vivian is reviewing immunizations with the caregiver of a 72-year-old client with a history of cerebrovascular disease. The caregiver learns which immunization is a priority for the client?CorrectIncorrect
Question 11 of 25
You are admitting a patient for whom a diagnosis of pulmonary embolism must be ruled out. The patient’s history and assessment reveal all of these findings. Which finding supports the diagnosis of pulmonary embolism?CorrectIncorrect
Question 12 of 25
You are assigned to provide nursing care for a patient receiving mechanical ventilation. Which action should you delegate to an experienced nursing assistant?CorrectIncorrect
Question 13 of 25
You are caring for a patient with emphysema and respiratory failure who is receiving mechanical ventilation through an endotracheal tube. To prevent ventilator-associated pneumonia (VAP), which action is most important to include in the plan of care?CorrectIncorrect
Question 14 of 25
You are evaluating and assessing a patient with a diagnosis of chronic emphysema. The patient is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you immediately?CorrectIncorrect
Question 15 of 25
You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to a nursing assistant?CorrectIncorrect
Question 16 of 25
You are making a home visit to a 50-year old patient who was recently hospitalized with a right leg deep vein thrombosis and a pulmonary embolism. The patient’s only medication is enoxaparin (Lovenox) subcutaneously. Which assessment information will you need to communicate to the physician?CorrectIncorrect
Question 17 of 25
You are providing care for a patient with recently diagnosed asthma. Which key points would you be sure to include in your teaching plan for this patient? Select all that apply.CorrectIncorrect
Question 18 of 25
You are providing nursing care for a newborn infant with respiratory distress syndrome (RDS) who is receiving nasal CPAP ventilation. What complications should you monitor for this infant?CorrectIncorrect
Question 19 of 25
You are responsible for the care of a postoperative patient with a thoracotomy. The patient has been given a nursing diagnosis of Activity Intolerance. Which action should you delegate to the nursing assistant?CorrectIncorrect
Question 20 of 25
You are supervising a nursing student who is providing care for a patient with thoracotomy with a chest tube. What findings would you clearly instruct the nursing student to notify you about immediately?CorrectIncorrect
Question 21 of 25
You are supervising a student nurse who is performing tracheostomy care for a patient. For which action by the student should you intervene?CorrectIncorrect
Question 22 of 25
You are supervising an RN who was pulled from the medical-surgical floor to the emergency department. The nurse is providing care for a patient admitted with anterior epistaxis (nosebleed). Which of these directions would you clearly prove to the RN? Select all that apply.CorrectIncorrect
Question 23 of 25
You are the preceptor for an RN who is undergoing orientation to the intensive care unit. The RN is providing care for a patient with ARDS who has just been intubated in preparation for mechanical ventilation. You observe the nurse perform all of these actions. For which action must you intervene immediately?CorrectIncorrect
Question 24 of 25
You have just finished assisting the physician with a thoracentesis for a patient with recurrent left pleural effusion caused by lung cancer. The thoracentesis removed 1800 mL of fluid. Which patient assessment information is important to report to the physician?CorrectIncorrect
Question 25 of 25
You have obtained the following assessment information about a 3-year old who has just returned to the pediatric unit after having a tonsillectomy. Which finding requires the most immediate follow-up?CorrectIncorrect
Nursing Prioritization, Delegation and Assignment Reviewer for Nurses
This is your guide to help you answer NCLEX priority, delegation, and assignment style questions.
NCLEX Tips for Nursing Prioritization, Delegation, and Assignment questions:
Here are six tips and strategies to help you ace NCLEX questions about delegation, assignment, and prioritization.
1. Do not make decisions based on resolutions
Do not make decisions concerning management of care issues based on resolutions you may have witnessed during your clinical experience in the hospital or clinic setting. As a student nurse, you are constantly reminded that NCLEX questions are to be solved and responded in the context of “Ivory Tower Nursing.” That is, if you only had one patient at a time, loads of assistive personnel, countless supplies, and equipment. This is what people mean when they refer to “textbook nursing.” But when you’re in the real world without the time and resources, you adjust. Your clinical rotation in management may have been less than ideal but remember that in NCLEX, the answers to the questions are seen in nursing textbooks or journals. Always bear in mind, “Is this textbook nursing care?”
2. Never delegate the functions of assessment, evaluation and nursing judgment.
Throughout your nursing education, you learned that assessments, nursing diagnosis, establishing expected outcomes, evaluating care and any other tasks and aspects of care including but not limited to those that entail sterile technique, critical thinking, professional judgment, and professional knowledge are the responsibilities of the registered professional nurse. You cannot give these responsibilities to nonprofessional, unlicensed assistive nursing personnel, such as nursing assistants, patient care technicians, and personal care aides.
3. Identify tasks for delegation based on the client’s needs.
Delegate activities for stable patients because some of these needs are relatively predictable and more frequently encountered. These are somewhat routinized and without the need for high levels of professional judgment and skill. But if the patient is unstable, the needs are acute and become unpredictable, ever-changing, and rarely, encountered as based on the changing status of the patient. These needs should not be delegated.
4. Ensure the appropriate education, skills, and experience of personnel performing delegated tasks.
Delegate activities that involve standard, consistent, and unchanged systems and procedures. The care of a patient with chest tubes and chest drainage can be delegated to either another RN or a licensed practical nurse, therefore, the RN who is authorizing must ensure that the nurse is qualified, skilled, and competent to perform this intricate task, to observe the patient’s response to this treatment, and to ensure that the equipment is operating suitably and accurately.
The care of a stable chronically ill patient who is comparatively stable and more anticipated than a seriously ill and unstable acute patient can be assigned to the licensed practical nurse; and assistance with the activities of daily living and basic hygiene and comfort care can be assigned and delegated to an unlicensed assistive staff member like a nursing assistant or a patient care technician. Activities that frequently occur in daily patient care can be delegated. Bathing, feeding, dressing and transferring patients are examples.
Procedures that are complex or complicated should not be delegated especially if the patient is highly unstable.
5. Remember priorities!
Recall and understand Maslow’s Hierarchy of Needs, the ABC’s (Airway, Breathing, Circulation), and stable versus unstable. It is necessary to know and understand the priorities when deciding which patient the RN should attend to first. Remember that you can see only one patient or perform one activity when answering questions that require you to establish priorities.
Always keep in mind that improper and inappropriate assignments can lead to inadequate quality of care, unexpected outcomes of care, the jeopardization of client safety, and even legal consequences. Right assignment of care to others, including nursing assistants, licensed practical nurses, and other registered nurses, is certainly one of the most significant daily decisions that nurses make.
6. Additional Test Taking Tips and Strategies
- Questions using keywords such as “best,” “essential,” “highest priority,” “primary,” “immediate,” “first,” or “initial response” are asking for your prioritizing skills.
- Know the patient’s purpose of care, current clinical condition, and outcome of care in order to determine and plan priorities.
- Identify the priority patient based on the following: patient’s age, day of admission/surgery, or the number of body systems involved.
- Unlicensed assistive personnel (UAP) such as nurses’ aides, certified nursing assistants, attendants, health aides are not allowed to delegate. Only a registered nurse can delegate tasks.
- In some states, Licensed Practical Nurses (LPN) may delegate to a UAP depending on the state nursing practice.
- Ensure the appropriate knowledge, skills, and experience of personnel performing the delegated tasks.
- Do not delegate teaching, assessment, planning, evaluating, and nursing judgment to an unlicensed nurse.
- A client with an unstable and unpredictable condition cannot be delegated to a UAP’s or LPNs.
- Delegate tasks that involve standard, simple procedures such as bathing, dressing, feeding, and transferring patients.
- Student nurses, float nurses, personal assistants, and other personnel may require levels of guidance and supervision.
Prioritization is deciding which needs or problems require immediate action and which ones could be delayed until at a later time because they are not urgent. In the NCLEX, you will encounter questions that require you to use the skill of prioritizing nursing actions. These nursing prioritization questions are often presented using the multiple-choice format or via ordered-response format. For a review, in an ordered-response question format, you’ll be asked to use the computer mouse to drag and drop your nursing actions in order or priority. Based on the information presented, determine what you’ll do first, second, third, and so forth. Directions are provided with the question. To help you answer nursing prioritization questions, remember the three principles commonly used:
1. Remember ABC’s (airway, breathing, and circulation).
Patients with obvious respiratory problems or interventions to provide airway management are given priority.
2. Maslow’s Hierarchy of Needs
Use Maslow’s hierarchy of needs as a guide to prioritize by determining the order of priority by addressing the physiological needs first.
There are five different levels of Maslow’s hierarchy of needs:
- Physiological Needs. The basic physiological needs have the highest priority and must be met first. Some examples of physiological needs include oxygen, food, fluid, nutrition, shelter, sleep, clothing, and reproduction.
- Safety Needs. Safety can be divided into physical and physiological. These include health, property, employment, security of the environment, and resources.
- Social Needs. These include love, family, friendship, and intimacy.
- Esteem. These include confidence, self-esteem, respect, and achievement.
- Self-actualization. These include creativity, morality, and problem-solving.
3. Using the Nursing Process
The nursing process is a systematic approach to assess and give care to patients. Assessment should always be done first before planning or providing interventions.
Delegation in Nursing
Delegation is the transference of responsibility and authority for an activity to other health care members who are competent to do so. The “delegate” assumes responsibility for the actual performance of the task and procedure. The nurse (delegator) maintains accountability for the decision to delegate and for the appropriateness of nursing care rendered to the patient. The role of a registered nurse also includes delegating care, assigning tasks, organizing and managing care, supervising care delivered by other health care providers, while effectively managing time! The NCLEX includes questions related to this unique nursing role of delegation.
5 Rights of Delegation in Nursing
The following are the five rights of delegation in nursing:
- Right Person. The licensed nurse and the employer and the delegatee are responsible for ensuring that the delegatee possesses the appropriate skills and knowledge to perform the activity.
- Right Tasks. The activity falls within the delegatees’ job description or is included as part of the nursing practice settings established written policies and procedures. The facility needs to ensure the policies and procedures describe the expectations and limits of the activity and provide any necessary competency training.
- Right Direction and Communication.
- Each delegation situation should be specific to the patient, the licensed nurse, and the delegatee.
- The licensed nurse is expected to communicate specific instructions for the delegated activity to the delegatee; the delegatee should ask any clarifying questions as part of two-way communication. This communication includes any data that needs to be collected, the method for collecting the data, the time frame for reporting the results to the licensed nurse, and additional information pertinent to the situation.
- The delegatee must understand the terms of the delegation and must agree to accept the delegated activity.
- The licensed nurse should ensure that the delegatee understands that she or he cannot make any decisions or modifications in carrying out the activity without first consulting the licensed nurse.
- Right Circumstances. The health condition of the patient must be stable. If the patient’s condition changes, the delegatee must communicate this to the licensed nurse, and the licensed nurse must reassess the situation and the appropriateness of the delegation.
- Right Supervision and Evaluation.
- The licensed nurse is responsible for monitoring the delegated activity, following up with the delegatee at the completion of the activity, and evaluating patient outcomes. The delegatee is responsible for communicating patient information to the licensed nurse during the delegation situation. The licensed nurse should be ready and available to intervene as necessary.
- The licensed nurse should ensure appropriate documentation of the activity is completed.
If you need more information or practice quizzes, please do visit the following links:
- Nursing Test Bank: Free Practice Questions UPDATED!
Are you ready to learn? Check out our updated nursing test bank that includes over 3,500 practice questions covering a wide range of nursing topics that are absolutely free!
- NCLEX Questions Nursing Test Bank and Review UPDATED!
For this nursing test bank, we have included more than 1,000+ NCLEX practice questions covering different nursing topics! We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning.