Question 1

The charge nurse making assignment should avoid assigning:

Accepted Answer

Answer reason: Newly admitted clients often require comprehensive assessment, prioritization, and care planning, which may be inappropriate for a novice nurse depending on orientation and competence. A float nurse can safely care for stable clients within their competency and unit expectations. Assigning postoperative clients to an experienced nurse is appropriate, and discharge clients are typically stable (though assignment should still consider workload and complexity of teaching).
Category reason: This item evaluates safe assignment decisions based on nurse experience and patient care complexity. The core concept is matching client needs with staff competence during assignment.

Question 2

A charge nurse is making client assignments for a critical care step-down unit. Which client would be most appropriate to assign to a new graduate registered nurse (RN)?

Accepted Answer

Answer reason: A stable postoperative client receiving routine IV antibiotics requires ongoing monitoring but does not involve high-risk titration, complex teaching, or invasive procedures. DKA management, new ostomy education, and pacemaker insertion require higher-level clinical judgment or procedural coordination.
Category reason: This question focuses on safe client assignment based on nurse experience and patient acuity.

Question 3

When creating an assignment for a team consisting of a registered nurse (RN), 1 licensed practical nurse (LPN), and 2 unlicensed assistive personnel (UAP), which is the best client for the LPN?

Accepted Answer

Answer reason: D. A client with a spinal cord injury requiring urinary catheterization every 6 hours. This task is a predictable, routine sterile procedure that falls within typical LPN scope in many settings when the client is stable and not requiring complex assessment or clinical decision-making. Clients needing ventilator management and frequent assessments require RN-level assessment and critical thinking. Frequent ambulation is appropriate to delegate to UAP, and simple temperature checks are also generally appropriate for UAP when no immediate nursing assessment is needed. Therefore, the stable client requiring intermittent catheterization is the best fit for the LPN.
Category reason: This question tests safe assignment of clients/tasks among RN, LPN, and UAP based on scope of practice and client stability, which is Management of Care—Assignment.

Question 4

A nursing team consists of an RN, an LPN/LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN?

Accepted Answer

Answer reason: A 72-year-old patient with diabetes who requires a dressing change for a stasis ulcer This is a predictable, stable procedure within the typical scope of the LPN/LVN, who can provide routine wound care and reinforce teaching under the RN’s plan of care. By contrast, a new complaint of pain may require RN assessment and possible medication/titration decisions, and hospice transfer involves complex discharge planning, education, and coordination that are RN responsibilities. The urinal request is basic care that is appropriate to delegate to the nursing assistant.
Category reason: This question tests delegation/assignment decisions based on team member scope of practice and patient stability, which is a Management of Care function under Safe and Effective Care Environment.

Question 5

The registered nurse is planning assignments for the clients on a nursing unit. The RN needs to assign 4 clients and has 1 RN, 1 licensed practical nurse, and 2 unlicensed assistive personnel on a nursing team. Which client would the nurse most appropriately assign to the licensed practical nurse?

Accepted Answer

Answer reason: B. The client with an abdominal wound requiring frequent wound irrigations. This is a predictable, stable procedure-focused task that can be performed by an LPN under RN direction according to typical scope, with the RN retaining responsibility for initial assessment and overall care planning. A ventilated client needing frequent assessments and suctioning requires ongoing RN-level assessment and critical judgment. Assistance with bathing/ambulation is appropriate for unlicensed assistive personnel because it is basic care. A 24-hour urine collection is also largely collection/monitoring that can be delegated to unlicensed assistive personnel with RN oversight.
Category reason: This question tests nursing judgment about assigning tasks to team members based on scope of practice and patient acuity, which falls under Management of Care—Assignment.

Question 6

You are planning the assignment for the day. Which of the following would be the most appropriate assignment for the nursing assistant?

Accepted Answer

Answer reason: This task is routine, follows a standard procedure, and does not require nursing assessment, clinical judgment, or patient teaching. Nursing assistants can typically perform specimen transport (and sometimes collection, depending on facility policy) after the nurse ensures correct labeling and timing requirements. The other options involve higher-risk care and ongoing assessment (tube feeding management and dysphagia/aspiration risk) or skilled ostomy care that often requires evaluation of the stoma and peristomal skin.
Category reason: This question tests safe delegation/assignment of tasks based on staff scope and required clinical judgment, which is a Management of Care assignment decision.

Question 7

You are the of a health care team that consists of one licensed practical/vocational nurse, one nursing assistant, a nursing student and yourself. To whom is it appropriate to assign complete care for a client?

Accepted Answer

Answer reason: An LPN/LVN can be assigned complete care for a stable client with predictable outcomes because their scope includes collecting data, performing focused assessments, administering many medications, and providing routine treatments under RN supervision per facility policy. A nursing assistant cannot provide “complete care” because they cannot assess, plan, or administer medications and are limited to delegated ADLs and basic tasks. A nursing student requires direct supervision and is not an employee with an independent assignment. The RN retains accountability for the overall plan of care and should assign themselves to unstable or complex clients.
Category reason: This question tests RN delegation/assignment decisions within a care team, which is a Management of Care responsibility under Safe and Effective Care Environment.

Question 8

The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider the assignments appropriate if the nursing assistant is assigned to care for?

Accepted Answer

Answer reason: This task is routine, noninvasive, and can be safely performed by unlicensed assistive personnel after the RN assesses swallowing risk and provides necessary instructions. Clients with dementia often need supervision and physical help during meals, which fits within nursing assistant scope. The other options involve assessment of new symptoms (possible UTI), management of enteral feeding, or unstable respiratory patterns—situations requiring licensed nursing judgment and intervention.
Category reason: This question tests safe delegation/assignment of patient care tasks to a nursing assistant based on scope of practice and patient stability, which is Management of Care—Assignment.

Question 9

A nurse on a med-surg unit has received change-of-shift report & will care for 4 clients. Which of the following client's needs may the nurse assign to an assistive personnel (AP)?

Accepted Answer

Answer reason: C. Reapplying a condom catheter for a client who has urinary incontinence This is a routine, non-sterile, repetitive task for a stable client that can be safely delegated to AP after the nurse assesses the client and provides directions. In contrast, feeding a client with aspiration pneumonia carries high aspiration risk and requires nursing assessment and judgment during feeding. Reinforcing teaching is a nursing responsibility because it evaluates learning and requires clinical judgment. Applying a sterile dressing to a pressure ulcer requires sterile technique and ongoing assessment of the wound, which should be performed by the nurse.
Category reason: This item tests delegation/assignment decisions about which tasks can be safely delegated to assistive personnel versus requiring RN assessment, teaching, or sterile wound care, fitting Management of Care → Assignment.

Question 10

The charge nurse in a long-term care facility has made client care assignments for unlicensed assistive personnel (UAP). Which of the following statements provide the best direction to a UAP about the assignment?

Accepted Answer

Answer reason: This direction is specific, task-focused, and appropriate to delegate to UAP because it involves routine hygiene assistance within their scope. The other options are either too vague (“good skin care”), require nursing assessment/judgment or individualized teaching (encouraging fluids for UTI), or may involve higher risk needing clinical evaluation and safety planning (ambulation after stroke). Effective delegation uses clear, measurable instructions that match UAP competencies while preserving RN responsibility for assessment and teaching.
Category reason: This item tests nursing delegation/assignment to UAP and how to give appropriate task-level directions, which falls under Management of Care—Assignment.

Question 11

A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a licensed practical nurse?

Accepted Answer

Answer reason: This is a predictable, routine procedure for a stable client that falls within the typical scope of practice for an LPN/LVN when the plan of care is established and the client is not requiring complex assessment. Picking up meal trays is a non-nursing task appropriate for unlicensed assistive personnel. Planning break times involves supervisory/management responsibilities that belong to the RN charge nurse. Evaluating ventilator settings requires advanced assessment and clinical judgment and should be performed by an RN (and/or respiratory therapy per facility policy).
Category reason: This question tests delegation/assignment decisions based on scope of practice and required clinical judgment, which is an NCLEX Management of Care topic.

Question 12

A nursing team consists of an RN, an LPN/LVN, and an NAP. The nurse should assign which of the following clients to the LPN/LVN?

Accepted Answer

Answer reason: This is a predictable, stable task that falls within the LPN/LVN scope (performing sterile or clean dressing changes per established plan of care and monitoring for expected findings). The RN should manage situations requiring assessment and clinical judgment, such as new/worsening pain that may indicate complications, and complex discharge planning/coordination for hospice transfer. Assistance with a urinal is appropriate for NAP because it is basic care without assessment needs beyond reporting.
Category reason: The item tests safe delegation/assignment decisions among RN, LPN/LVN, and NAP in a patient-care scenario, which aligns with NCLEX Management of Care—Assignment.

Question 13

You are the RN of a health care team that consists of one licensed practical/vocational nurse, one nursing assistant, a nursing student and yourself. To whom is it appropriate to assign complete care for?

Accepted Answer

Answer reason: A) Ty’sound The appropriate team member for “complete care” depends on the client’s stability, predictability, need for assessment/teaching, and risk for complications. Because the image cuts off the key part of the stem that specifies which patient/task is being assigned, the required delegation analysis cannot be performed safely. Without knowing acuity and required skills (e.g., medication administration, sterile procedures, assessments), any selected option could be unsafe or incorrect. Therefore the item cannot be answered reliably from the provided image content.

Question 14

The charge nurse on a pediatric ward is making assignments for the shift. One of the clients admitted to the ward is a five-year-old with severe neutropenia and a fever. Which of the following clients would be most appropriate to assign with this client?

Accepted Answer

Answer reason: A stable post-op appendectomy client is the least likely to have a communicable infection that could be transmitted to an immunocompromised roommate. In contrast, suspected meningitis and cellulitis represent potentially significant infectious sources, and respiratory distress commonly involves viral/bacterial respiratory pathogens that can spread via droplets/contact. Cohorting with the lowest-infection-risk client best protects the neutropenic child while still allowing appropriate monitoring.

Question 15

A 25 year-old client, unresponsive after a motor vehicle accident, is being transferred from the hospital to a long term care facility. To which staff members should the charge nurse assign the client?

Accepted Answer

Answer reason: These responsibilities involve clinical judgment and potential need for immediate intervention, which must be performed by a licensed registered nurse. UAP and a nursing student cannot independently assess or manage an unstable, high-acuity patient, and an LPN/PN scope is typically limited for initial/complex assessment and unstable care decisions. Assigning an RN best ensures patient safety and appropriate coordination during the transition to long-term care.

Question 16

The charge nurse is planning assignments on a medical unit. Which client should be assigned to the PN?

Accepted Answer

Answer reason: g., wound care) per facility policy, with RN oversight as needed. Wound irrigation and dressing changes are routine, skill-based interventions that do not require the comprehensive assessment and care planning expected of the RN. In contrast, admitting a client from the emergency room requires an initial comprehensive assessment, medication reconciliation, and development of the plan of care, which are RN responsibilities. Ambulating a client with a chest tube carries higher risk and typically requires RN assessment/judgment regarding hemodynamic/respiratory stability and device management. Testing stool for occult blood is commonly delegated to UAP or ancillary staff rather than using PN time.

Question 17

The charge nurse is planning assignments on a medical unit. Which client should be assigned to the unlicensed assistive personnel (UAP)? A client with?

Accepted Answer

Answer reason: Administering enemas is a repetitive, standard skill that can be delegated with clear parameters and appropriate supervision, and it does not require nursing assessment or sterile technique. Dysphagia after stroke carries aspiration risk and requires ongoing assessment and nursing judgment about airway protection and safe feeding/swallow precautions. Post-op abdominal dressing changes often require sterile technique and assessment of the incision/wound drainage, and arranging transfers requires RN-level coordination and planning.

Question 18

A nurse from the surgical department is reassigned to the pediatric unit. The charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

Accepted Answer

Answer reason: Ongoing hypoxemia signals inadequate oxygen delivery and impending decompensation, requiring close monitoring and rapid interventions (airway support, oxygenation/ventilation) by the most experienced pediatric staff. By contrast, an acute febrile illness is typically lower acuity unless accompanied by respiratory distress or shock. Therefore, the child with prolonged hypoxemia is least appropriate for assignment to a reassigned nurse unfamiliar with pediatric-specific deterioration patterns.

Question 19

Which of these clients would be appropriate to assign to a PN?

Accepted Answer

Answer reason: PN/LPN assignments should be for stable clients with predictable outcomes and routine, non-complex care under RN supervision. A stable UTI with an indwelling catheter involves standard catheter care, monitoring urine characteristics, and reporting changes—tasks within PN scope in most settings. The trauma client needing complex dressings suggests higher risk for bleeding/infection and requires advanced assessment and wound management by an RN. Unstable neurologic signs and managing family complaints both require RN-level assessment, clinical judgment, and communication/advocacy skills.

Question 20

An unlicensed assistive personnel (UAP), who usually works in pediatrics is assigned to work on a medical-surgical unit. Which one of the questions by the charge nurse would be most appropriate prior to making delegation decisions?

Accepted Answer

Answer reason: Safe delegation is based on verified competence for the specific tasks and the patient population, not tenure, comfort level, or prior unit exposure alone. Reviewing a competency checklist provides objective documentation of what skills the UAP has been trained and validated to perform and helps match assignments to scope and facility policy. This reduces risk by ensuring tasks delegated on a medical-surgical unit align with demonstrated abilities and required supervision. Asking about years of experience or pediatric duties may be informative but does not confirm current competency for adult med-surg care, and “comfort” is subjective and insufficient for delegation decisions.

Question 21

A nurse from the maternity unit is floated to the critical care unit because of staff shortage on the evening shift. Which client would be appropriate to assign to this nurse? A client with?

Accepted Answer

Answer reason: A post-MI client who is pain-free and without dysrhythmias is relatively stable and mainly requires routine monitoring and standard post-event care. In contrast, a dopamine infusion with 5-minute vital signs is titratable vasoactive therapy requiring ICU expertise and continuous reassessment. A fresh tracheostomy with respiratory distress and a new pacemaker with intermittent capture both indicate potential airway/circulatory instability needing experienced critical-care management.

Question 22

A nurse is working with one licensed practical nurse (PN), a student nurse and an unlicensed assistive personnel (UAP). Which newly admitted clients would be most appropriate to assign to the UAP?

Accepted Answer

Answer reason: UAP assignments should be limited to routine, noninvasive tasks for stable clients and must not require initial assessment, clinical judgment, or management of high risk for harm. A newly admitted client with OCD is typically medically stable and can appropriately receive basic care (vital signs, hygiene, room orientation, reporting observations) with RN oversight. In contrast, severe depression carries significant suicide risk, dehydration/anorexia can involve unstable fluid/electrolyte status requiring skilled assessment, and opioid withdrawal with hallucinations poses acute safety and medical-emergency risks needing licensed nursing assessment and intervention. Therefore, this is the safest and most appropriate client for UAP care under supervision.

Question 23

The charge nurse on a cardiac step-down unit makes assignments for the team consisting of an RN, a PN, and an unlicensed assistive person. Which client should be assigned to the PN?

Accepted Answer

Answer reason: PNs are appropriate for caring for stable patients with predictable outcomes and can perform focused assessments and implement established care plans. This client is hemodynamically stable enough for routine monitoring, basic cardiovascular assessment, and carrying out ordered treatments while the RN remains available for escalation if symptoms worsen. New-onset atrial fibrillation with rapid ventricular response is potentially unstable and often requires immediate RN-level assessment and titratable IV medications. Pre-cardiac catheterization teaching and post-angioplasty discharge education require comprehensive assessment and patient teaching, which are RN responsibilities.

Question 24

A practical nurse (PN) from the pediatric unit is assigned to work in a critical care unit. Which client assignment would be appropriate?

Accepted Answer

Answer reason: A client who is several days into traction after an MVC is more likely hemodynamically stable and primarily needs monitoring of neurovascular status, skin integrity, and traction alignment—tasks that fit within PN scope with RN oversight. The other options involve high-acuity or potentially unstable conditions (multiple trauma with a recent pacemaker, new stroke admission with confusion, and cardiac arrest from suspected MI) that require rapid assessment, complex decision-making, and frequent provider collaboration best managed by an RN. Choosing the stable, established plan-of-care patient best supports safety and appropriate delegation in critical care.

Question 25

An RN from the women's health clinic is temporarily reassigned to a medical-surgical unit. Which of these client assignments would be most appropriate for this nurse?

Accepted Answer

Answer reason: Teaching basic diabetic foot-care is routine, non-emergent, and follows standard education protocols, making it a safe and appropriate assignment. In contrast, caring for a trauma client with an external fixator carries higher risk for neurovascular compromise, bleeding, infection, and complex assessments that require strong med-surg/orthopedic familiarity. Newly admitted clients with major diagnoses often require extensive initial assessment, complex coordination, and anticipatory planning that is better handled by staff familiar with unit routines and resources. Selecting the lowest-acuity, most standardized care need best protects patient safety while matching the nurse’s temporary role.

Question 26

A newly admitted elderly client is severely dehydrated. When planning care for this client, which task is appropriate to assign to an unlicensed assistive personnel (UAP)?

Accepted Answer

Answer reason: Checking skin turgor is a basic, repetitive observation that does not require analysis and can be reported to the nurse for evaluation in a dehydrated client. In contrast, determining whether mucous membranes are impaired is an assessment requiring nursing judgment, and monitoring movement in bed is more than simple observation because it often involves evaluating functional status and safety needs. For severe dehydration, the nurse should also directly evaluate trends and intervene for low urine output; a UAP can measure and report volumes, but assigning judgment-focused tasks is inappropriate.

Question 27

A client continuously calls out to the nursing staff when anyone passes the clients door and asks them to do something in the room. The best response by the charge nurse would be to?

Accepted Answer

Answer reason: This approach improves unit workflow, decreases interruptions to other patient care, and supports therapeutic communication through continuity. It is safer and more efficient than having multiple staff respond intermittently, which reinforces calling out and fragments care. Leaving the door cracked addresses noise only and does not meet the underlying need for reassurance or assistance.

Question 28

Which of these clients would be most appropriate to assign to a PN?

Accepted Answer

Answer reason: Enteral feeding via an established nasogastric tube and rehabilitation care after an amputation are typically stable tasks involving standard procedures, monitoring, and assistance with mobility/ADLs. By contrast, immediate post-op radical neck dissection and alcohol withdrawal have higher risk for rapid deterioration and require complex assessment and intervention that must be managed by an RN. Newly diagnosed diabetes also demands substantial initial teaching/assessment that is primarily the RN’s responsibility.

Question 29

An RN who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?

Accepted Answer

Answer reason: This client’s findings are consistent with opioid effect, but the presentation is clinically straightforward and commonly managed with focused respiratory assessment, sedation monitoring, and timely escalation if ventilation worsens. In contrast, stimulant toxicity with tachyarrhythmia symptoms, acute cocaine intoxication, and possible alcohol withdrawal with hallucinations and myoclonic jerking can rapidly deteriorate and require high-acuity emergency interventions and complex monitoring. Therefore this is the safest, most appropriate assignment for an RN floated from spinal rehab.

Question 30

THE IDEAL NURSE PATIENT RATIO IN ICU ...

Accepted Answer

Answer reason: A 1:2 ratio is commonly considered the standard ICU assignment because it allows frequent monitoring, timely titration of vasoactive/sedative infusions, and prompt response to instability while maintaining safety. A 1:1 assignment is typically reserved for the most unstable patients (e.g., active resuscitation, severe hemodynamic/ventilatory support) rather than being the default for all ICU patients. Ratios such as 1:3 or 1:4 generally increase risk for missed deterioration and delays in critical interventions in an ICU environment.

Question 31

A charge nurse is assigning patients to a team that includes a registered nurse (RN), a licensed practical nurse (LPN), and an unlicensed assistive personnel (UAP). Which patient should be assigned to the RN?

Accepted Answer

Answer reason: Unstable or potentially unstable patients require RN-level assessment, clinical judgment, and rapid intervention. Shortness of breath with chest pain suggests a possible life-threatening condition (e.g., acute coronary syndrome, pulmonary embolism) needing immediate focused assessment, monitoring, and initiation of protocols. LPNs and UAPs are not appropriate for initial assessment of a newly admitted symptomatic patient or for managing evolving instability. In contrast, routine vital signs or ambulation assistance are predictable tasks that can be delegated when appropriate.

Question 32

A nursing team consists of an RN, an LPN/LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN?

Accepted Answer

Answer reason: A dressing change for a chronic stasis ulcer is a standard, ongoing intervention that fits LPN/LVN scope when the care plan is already established. In contrast, uncontrolled or new/worsening pain complaints typically require RN assessment and potential IV/opioid titration and evaluation of response. Transitioning to hospice involves complex teaching, psychosocial support, and coordination of care, which are RN responsibilities.

Question 33

A client care team consists of the nurse, LPN/LVN, and unlicensed assistive personnel (UAP). Which client will be assigned to the nurse?

Accepted Answer

Answer reason: The RN should be assigned the most unstable client and those requiring complex assessment, rapid clinical judgment, and potential for sudden deterioration. This condition can progress quickly to sepsis, hypotension, multi-organ dysfunction, and requires close monitoring of hemodynamics, labs, and response to IV fluids/antibiotics. LPN/LVN and UAP care is more appropriate for stable, routine postoperative recovery needs with predictable outcomes and no need for frequent high-level reassessment. A common delegation error is assigning high-risk infectious shock syndromes to non-RN staff because tasks (vitals, meds) seem routine, when the priority is the ongoing interpretation of changes and escalation of care.

Question 34

The 20-year-old female is being admitted to the hospital with exacerbation of Crohn’s disease. The client is alert and oriented and has been taking azathioprine for disease control. Into which room should the charge nurse place the client?

Accepted Answer

Answer reason: A private room reduces contact transmission opportunities, and a private bathroom is especially important because Crohn’s exacerbations commonly involve frequent diarrhea, which increases contamination risk in shared toilets. Cohorting with another client with the same diagnosis is not appropriate because it does not address differing infectious risks and increases exposure to others. Proximity to the nurse’s station is not the primary safety need here because the client is alert, oriented, and not described as a fall risk or requiring close observation.

Question 35

On a busy medical-surgical unit, a winter storm has prevented most of the staff members from getting to work. One registered nurse, two licensed practical nurses, and three nursing assistants have been able to get to work. What nursing care delivery system (NCDS) should be implemented in this situation?

Accepted Answer

Answer reason: This delivery model divides care into specific tasks (e.g., vital signs, hygiene, treatments) that can be assigned to LPNs and nursing assistants, while the RN coordinates and handles assessments, complex decisions, and IV/unstable patients. This approach is efficient and workable with limited RNs and a mix of assistive personnel. By contrast, primary nursing requires consistent RN coverage and continuity that is not feasible with only one RN present. Case management focuses on coordinating care across the continuum rather than staffing a shift during an acute staffing emergency.

Question 36

There has been a large disaster, and nurses have been floated to help with the large influx of clients. Which client is most appropriate to assign to the nurse floated from the mother–baby unit?

Accepted Answer

Answer reason: A straightforward post-op patient with an indwelling catheter primarily needs standard assessments, Foley care, intake/output monitoring, ambulation encouragement, and basic post-op surveillance that are within broad RN competencies. By contrast, command hallucinations with suicidal content requires high-risk safety precautions and specialized mental health assessment, making it inappropriate for a float unfamiliar with that setting. Pelvic traction in pregnancy adds orthopedic traction management plus maternal-fetal considerations, and herpes zoster may involve transmission-based precautions and higher infection-control complexity than the most basic assignment.

Question 37

The charge nurse is making assignments for clients on a medical unit. Which client should the charge nurse assign to the recent graduate nurse?

Accepted Answer

Answer reason: Assignment decisions prioritize client stability and match task complexity to the nurse’s competency level. Discharge teaching for a stable cardiac client is planned care with predictable needs and allows the recent graduate to practice education and reinforcement skills using standard instructions and supervision as needed. Unrelieved angina suggests possible acute coronary syndrome and requires rapid assessment and escalation, which is inappropriate for the least experienced nurse. A myocardial infarction with an oxygen saturation of 90% indicates potential hypoxemia/clinical instability, and pre-procedure cardiac catheterization care can involve higher-risk monitoring and preparation best handled by a more experienced nurse.

Question 38

A charge nurse is developing the client-care assignments for the shift. Which client is most appropriately assigned to a licensed practical nurse (LPN)?

Accepted Answer

Answer reason: A post-stroke client with a documented code status can often be managed with scheduled assessments, assistance with ADLs, safety measures, and medication administration per policy, without the need for complex RN-level decision-making. In contrast, clients 1 hour post-cerebral arteriography or 4 hours post–carotid endarterectomy require vigilant neurovascular assessment and rapid recognition/response to complications such as bleeding, stroke, airway compromise, or hematoma. A recent transfer from ICU after craniotomy also carries higher risk for deterioration and typically needs closer RN assessment and coordination of care.

Question 39

A charge nurse is preparing client care assignments for the next shift. A client who underwent femoral-popliteal bypass surgery is scheduled to return from the postanesthesia care unit. Which staff member should receive this client?

Accepted Answer

Answer reason: These needs fall within RN scope (full assessment, interpretation of findings, and initiation of appropriate interventions/notifications), whereas LPNs and nursing assistants cannot take primary responsibility for an unstable or high-risk immediate postanesthesia return. The charge nurse should maintain oversight of the unit and manage coordination/triage rather than take a routine assignment unless staffing demands require it. Given the choices, the RN is the appropriate staff member to receive and manage this returning post-op client.

Question 40

The day charge nurse is preparing to report to the oncoming shift nurse. Which action should be taken first by the charge nurse when learning that the unit will be short-staffed because two nurses called in ill and the hospital does not have any extra nurses?

Accepted Answer

Answer reason: Adjusting assignments and delegation right away helps ensure essential RN-only duties (assessment, teaching, IV meds, unstable patients) remain covered while routine, stable-care tasks can be shifted to NAs within their role. This is the most time-sensitive step the charge nurse can implement independently to maintain safe coverage at shift change. Notifying the manager and attempting to obtain additional staff are appropriate next steps, but they do not immediately optimize care delivery in the moment.

Question 41

The charge nurse is making assignments on a medical surgical unit. Which client should be assigned to the licensed practical nurse (LPN)?

Accepted Answer

Answer reason: LPN assignments should focus on stable clients with predictable outcomes and ongoing, routine care under RN supervision. Photophobia with aseptic meningitis is an expected symptom that typically requires comfort measures (e.g., dim lights), routine medication administration, and monitoring rather than complex assessment or immediate clinical decision-making. In contrast, new-onset disorientation, discharge teaching for a newly diagnosed condition, and a recent seizure indicate unstable status or needs that require RN-level assessment, teaching, and evaluation. Therefore the most appropriate LPN assignment is the stable client with an expected complaint that can be managed with standard interventions.

Question 42

The new nurse is discussing the organization of client care with the mentor. Which statement made by the new nurse requires immediate follow-up by the mentor?

Accepted Answer

Answer reason: ” Safe delegation and time management require the nurse to maintain appropriate supervision and not leave multiple clients in potentially unsafe situations simultaneously. Dangling and using a bedside commode are higher fall-risk activities and require close monitoring, especially if the client becomes dizzy, hypotensive, or weak. Managing three clients at once during mobility/toileting creates an unsafe environment and indicates poor prioritization and assignment of tasks. A safer plan would involve delegating and staggering care so that mobility and toileting occur with direct observation or appropriate assistance to prevent falls and injury.

Question 43

Which client would be most appropriate for the nurse to assign to an unlicensed assistive personnel (UAP) for morning care?

Accepted Answer

Answer reason: A client receiving chemotherapy may be immunocompromised but can still receive basic morning care by UAP as long as the client is otherwise stable and the RN provides guidance on infection-control measures and evaluates tolerance. By contrast, a recent laryngectomy is a high-risk airway situation requiring skilled assessment and prompt intervention, and suspected pulmonary embolus with chest pain is potentially unstable and needs RN-level assessment and rapid response. A client on oxygen with dyspnea may require ongoing respiratory assessment and titration/monitoring beyond routine care depending on stability.

Question 44

An RN who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?

Accepted Answer

Answer reason: This client’s findings are consistent with expected opioid effects in a patient already on pain medication, and the respiratory rate of 10 can be monitored with routine sedation/respiratory assessments and escalation per protocol. In contrast, stimulant toxicity (diet pills, crack) can rapidly deteriorate into life-threatening dysrhythmias, hypertension, hyperthermia, and agitation needing rapid interventions. Alcohol withdrawal with hallucinations and jerking suggests impending seizures/DTs, also requiring intensive monitoring and urgent management.

Question 45

A newly graduated nurse is working in the pediatric unit. Which client assignment is most appropriate for this nurse?

Accepted Answer

Answer reason: Appropriate assignment for a novice nurse prioritizes stable clients with predictable outcomes and tasks that allow time for teaching with access to support. This situation is non-urgent and primarily involves routine education, which can be performed safely by a newly graduated nurse using standard teaching protocols and reinforcement from the team. In contrast, sudden decreased responsiveness in hemophilia suggests possible life-threatening intracranial bleeding, frequent swallowing after tonsillectomy suggests postoperative hemorrhage, and right lower quadrant pain in sickle cell disease could indicate acute abdomen requiring rapid assessment and escalation. These higher-acuity, potentially unstable presentations require a more experienced nurse due to the risk of rapid deterioration and need for advanced clinical judgment.

Question 46

The charge nurse in the psychiatric unit is reviewing group therapy assignments. Clients have been assigned to groups based on their diagnoses. Which group assignment requires modification by the charge nurse? A group of clients?

Accepted Answer

Answer reason: Group therapy composition should maximize safety and therapeutic benefit while minimizing risk of harm and disruption. Clients with antisocial personality disorder commonly display manipulation, lack of empathy, and boundary-violating behaviors that can exploit or intimidate vulnerable members, undermining group cohesion. This is especially problematic in groups that rely on trust and emotional disclosure, where such behaviors can retraumatize others and derail treatment goals. In contrast, early-stage dementia, major depressive disorder, and survivors of sexual assault can participate in appropriately structured, supportive groups with clear goals and facilitation. Therefore, this assignment is the one most likely to require modification for safety and therapeutic effectiveness.

Question 47

Which client should the charge nurse on the pediatric unit assign to the most experienced nurse?

Accepted Answer

Answer reason: This is an assignment/prioritization question where the most experienced nurse should manage the highest-risk therapy and potential for rapid deterioration. Factor VIII infusion carries significant safety concerns (dose accuracy, IV administration competence, monitoring for bleeding and for infusion reactions/inhibitor development) and a missed or incorrect dose can lead to life-threatening hemorrhage. A child scheduled for a CT and a child recovering from a sickle cell crisis are typically more stable and follow established monitoring pathways that can be handled by less experienced staff with standard support. New rheumatoid arthritis diagnosis involves education and chronic care planning, important but usually not as immediately high-risk as acute bleeding management.

Question 48

To make a medical-surgical bed available for a new admission, the charge nurse is asked to transfer a female client to the maternity unit. It would be most appropriate to transfer the client who is?

Accepted Answer

Answer reason: A client on established enteral feedings who is already awaiting long-term care is typically medically stable and requires routine maintenance care that can be managed while freeing a med-surg bed. In contrast, opioid withdrawal with profuse diarrhea poses immediate risks for dehydration, electrolyte imbalance, and need for close monitoring. Postoperative abdominal hysterectomy with a drain and a nephrostomy for renal abscess both imply higher acuity needs (infection monitoring, drain/tube assessment, and potential complications) that are better supported on a medical-surgical unit than a maternity unit.

Question 49

A client care team consist of the nurse, LPN/LVN, and unlicensed assistive personnel (UAP). Which client will be assigned to the nurse?

Accepted Answer

Answer reason: Toxic shock syndrome can progress quickly to shock and multi-organ dysfunction, demanding frequent reassessment, aggressive IV fluid resuscitation, close hemodynamic monitoring, and coordination of urgent therapies. Postoperative recovery clients are typically more predictable and can often be managed by an LPN/LVN with RN oversight once stable, while UAP can assist with routine, non-assessment tasks. The presence of a severe systemic infection makes this client higher acuity than routine postoperative gynecologic recoveries.

Question 50

A nursing team consists of an RN, an LPN/ LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN?

Accepted Answer

Answer reason: A venous stasis ulcer dressing change is a common, non-complex intervention that does not require initial comprehensive assessment or extensive teaching by the RN. In contrast, a client complaining of pain may require RN assessment and clinical judgment to evaluate severity, potential complications, and response to analgesics. Transfer to hospice involves complex coordination and teaching, which is primarily an RN role, and assistance with a urinal is typically delegated to a nursing assistant rather than the LPN/LVN.

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The charge nurse making assignment should avoid assigning:

A charge nurse is making client assignments for a critical care step-down unit. Which client would be most appropriate to assign to a new graduate registered nurse (RN)?

When creating an assignment for a team consisting of a registered nurse (RN), 1 licensed practical nurse (LPN), and 2 unlicensed assistive personnel (UAP), which is the best client for the LPN?

A nursing team consists of an RN, an LPN/LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN?

The registered nurse is planning assignments for the clients on a nursing unit. The RN needs to assign 4 clients and has 1 RN, 1 licensed practical nurse, and 2 unlicensed assistive personnel on a nursing team. Which client would the nurse most appropriately assign to the licensed practical nurse?

You are planning the assignment for the day. Which of the following would be the most appropriate assignment for the nursing assistant?

You are the of a health care team that consists of one licensed practical/vocational nurse, one nursing assistant, a nursing student and yourself. To whom is it appropriate to assign complete care for a client?

The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider the assignments appropriate if the nursing assistant is assigned to care for?

A nurse on a med-surg unit has received change-of-shift report & will care for 4 clients. Which of the following client's needs may the nurse assign to an assistive personnel (AP)?

The charge nurse in a long-term care facility has made client care assignments for unlicensed assistive personnel (UAP). Which of the following statements provide the best direction to a UAP about the assignment?

A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a licensed practical nurse?

A nursing team consists of an RN, an LPN/LVN, and an NAP. The nurse should assign which of the following clients to the LPN/LVN?

You are the RN of a health care team that consists of one licensed practical/vocational nurse, one nursing assistant, a nursing student and yourself. To whom is it appropriate to assign complete care for?

The charge nurse on a pediatric ward is making assignments for the shift. One of the clients admitted to the ward is a five-year-old with severe neutropenia and a fever. Which of the following clients would be most appropriate to assign with this client?

A 25 year-old client, unresponsive after a motor vehicle accident, is being transferred from the hospital to a long term care facility. To which staff members should the charge nurse assign the client?

The charge nurse is planning assignments on a medical unit. Which client should be assigned to the PN?

The charge nurse is planning assignments on a medical unit. Which client should be assigned to the unlicensed assistive personnel (UAP)? A client with?

A nurse from the surgical department is reassigned to the pediatric unit. The charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

Which of these clients would be appropriate to assign to a PN?

An unlicensed assistive personnel (UAP), who usually works in pediatrics is assigned to work on a medical-surgical unit. Which one of the questions by the charge nurse would be most appropriate prior to making delegation decisions?

A nurse from the maternity unit is floated to the critical care unit because of staff shortage on the evening shift. Which client would be appropriate to assign to this nurse? A client with?

A nurse is working with one licensed practical nurse (PN), a student nurse and an unlicensed assistive personnel (UAP). Which newly admitted clients would be most appropriate to assign to the UAP?

The charge nurse on a cardiac step-down unit makes assignments for the team consisting of an RN, a PN, and an unlicensed assistive person. Which client should be assigned to the PN?

A practical nurse (PN) from the pediatric unit is assigned to work in a critical care unit. Which client assignment would be appropriate?

An RN from the women's health clinic is temporarily reassigned to a medical-surgical unit. Which of these client assignments would be most appropriate for this nurse?

A newly admitted elderly client is severely dehydrated. When planning care for this client, which task is appropriate to assign to an unlicensed assistive personnel (UAP)?

A client continuously calls out to the nursing staff when anyone passes the clients door and asks them to do something in the room. The best response by the charge nurse would be to?

Which of these clients would be most appropriate to assign to a PN?

An RN who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?

THE IDEAL NURSE PATIENT RATIO IN ICU ...

A charge nurse is assigning patients to a team that includes a registered nurse (RN), a licensed practical nurse (LPN), and an unlicensed assistive personnel (UAP). Which patient should be assigned to the RN?

A nursing team consists of an RN, an LPN/LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN?

A client care team consists of the nurse, LPN/LVN, and unlicensed assistive personnel (UAP). Which client will be assigned to the nurse?

The 20-year-old female is being admitted to the hospital with exacerbation of Crohn’s disease. The client is alert and oriented and has been taking azathioprine for disease control. Into which room should the charge nurse place the client?

There has been a large disaster, and nurses have been floated to help with the large influx of clients. Which client is most appropriate to assign to the nurse floated from the mother–baby unit?

The charge nurse is making assignments for clients on a medical unit. Which client should the charge nurse assign to the recent graduate nurse?

A charge nurse is developing the client-care assignments for the shift. Which client is most appropriately assigned to a licensed practical nurse (LPN)?

A charge nurse is preparing client care assignments for the next shift. A client who underwent femoral-popliteal bypass surgery is scheduled to return from the postanesthesia care unit. Which staff member should receive this client?

The day charge nurse is preparing to report to the oncoming shift nurse. Which action should be taken first by the charge nurse when learning that the unit will be short-staffed because two nurses called in ill and the hospital does not have any extra nurses?

The charge nurse is making assignments on a medical surgical unit. Which client should be assigned to the licensed practical nurse (LPN)?

The new nurse is discussing the organization of client care with the mentor. Which statement made by the new nurse requires immediate follow-up by the mentor?

Which client would be most appropriate for the nurse to assign to an unlicensed assistive personnel (UAP) for morning care?

An RN who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?

A newly graduated nurse is working in the pediatric unit. Which client assignment is most appropriate for this nurse?

The charge nurse in the psychiatric unit is reviewing group therapy assignments. Clients have been assigned to groups based on their diagnoses. Which group assignment requires modification by the charge nurse? A group of clients?

Which client should the charge nurse on the pediatric unit assign to the most experienced nurse?

To make a medical-surgical bed available for a new admission, the charge nurse is asked to transfer a female client to the maternity unit. It would be most appropriate to transfer the client who is?

A client care team consist of the nurse, LPN/LVN, and unlicensed assistive personnel (UAP). Which client will be assigned to the nurse?

A nursing team consists of an RN, an LPN/ LVN, and a nursing assistant. The nurse should assign which of the following patients to the LPN/LVN?

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