NCLEX-RN Management of Care Practice Test
Prioritizing, delegating to AP and LPNs, consent, ethics and handoff. Here are 10 NCLEX-RN management of care questions, each with the answer and the reason.
Updated by the Tigertest team. Based on the NCSBN 2026 NCLEX-RN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.
- 1.
A client on a critical pathway after knee replacement cannot walk on postoperative day 1 as the pathway expects. How should the nurse classify this?
- A.
An adverse event from the surgery
- B.
A variance from the pathway
- C.
A sentinel event requiring review
- D.
A near miss for the safety report
Answer: B.A variance is any deviation from the expected outcome or timeline on a critical pathway, which the case manager reviews and addresses. A sentinel event involves death or serious harm, and a near miss is an error caught before it reached the client.
- A.
- 2.
The nurse receives handoff report on four clients. Which client should the nurse assess first?
- A.
COPD client, SpO2 89% on 2 L/min
- B.
Asthma client, wheezes gone, SpO2 88%
- C.
Heart failure client, 2+ ankle edema
- D.
New colostomy client, beefy red stoma
Answer: B.Wheezing that disappears while SpO2 falls during an asthma attack signals a silent chest from severe airflow obstruction and impending respiratory failure. An SpO2 near 89% is an acceptable target for many clients with COPD, ankle edema is a chronic heart failure finding, and a beefy red stoma is normal.
- A.
- 3.
The charge nurse is making assignments. Which client is most appropriate to assign to the licensed practical nurse (LPN)?
- A.
Client needing initial teaching on warfarin
- B.
Client starting a first unit of packed RBCs
- C.
Client with chest pain admitted 30 minutes ago
- D.
Client with stable diabetes due for insulin
Answer: D.An LPN can care for a stable client with a predictable condition, including giving scheduled subcutaneous insulin. A new admission with chest pain needs RN assessment, initial teaching is an RN responsibility, and the start of a transfusion, when reactions are most likely, is monitored by the RN.
- A.
- 4.
A client scheduled for a colectomy tells the nurse, "I'm not sure what the surgeon is going to remove." The consent form is not yet signed. Which action should the nurse take?
- A.
Ask the spouse to sign the consent
- B.
Explain the procedure to the client
- C.
Notify the surgeon before signing
- D.
Have the client sign and clarify later
Answer: C.The surgeon must explain the procedure, risks and alternatives, so the nurse holds the signing and notifies the surgeon when the client lacks understanding. Explaining the surgery is not the nurse's role in consent, which is to witness the signature and confirm the client understands.
- A.
- 5.
The nurse teaches a client about naming a durable power of attorney for health care. Which client statement indicates understanding?
- A.
"It only takes effect after I have died."
- B.
"My sister will decide for me if I can't decide."
- C.
"My sister can overrule me even while I'm alert."
- D.
"This also lets my sister pay my bills for me."
Answer: B.A health care agent makes decisions only when the client cannot, and the client's own choices govern while the client has capacity. Financial matters need a separate financial power of attorney, and the authority ends, rather than begins, at death.
- A.
- 6.
A client's 0900 antibiotic was missed and given at 1130. Which statement about the incident report is correct?
- A.
Chart that an incident report was completed
- B.
Have the client sign the completed report
- C.
Complete it only if the client is harmed
- D.
File it separately from the client's record
Answer: D.An incident report is a confidential quality improvement document kept out of the medical record, and the chart describes only the facts and the care given, not that a report was filed. Reports are completed for errors and near misses whether or not harm occurred.
- A.
- 7.
The nurse calls the HCP about a client with a possible postoperative bleed using SBAR. Which statement belongs in the Recommendation?
- A.
"He had a bowel resection yesterday."
- B.
"I think he may be bleeding internally."
- C.
"Please come see him within 15 minutes."
- D.
"I'm calling about Mr. Lee in room 4."
Answer: C.The Recommendation states what the nurse needs, such as a bedside evaluation within a set time. The other statements are the Situation, Background and Assessment.
- A.
- 8.
A client being treated for pneumonia tells the nurse, "I'm leaving now, I don't care what the doctor says." Which action is appropriate?
- A.
Keep the client's clothes until the HCP comes
- B.
Apply restraints until the HCP arrives
- C.
Tell the client insurance will not pay
- D.
Notify the HCP and explain the risks
Answer: D.A competent adult may leave against medical advice, so the nurse explains the risks, notifies the HCP and asks the client to sign the AMA form. Holding belongings or restraining the client is false imprisonment, and warning about insurance is a misleading pressure tactic.
- A.
- 9.
A nurse supports a competent client's decision to stop dialysis, although the nurse believes dialysis would help. Which ethical principle is the nurse upholding?
- A.
Nonmaleficence, avoiding harm
- B.
Justice in allocating care
- C.
Respect for autonomy
- D.
Beneficence toward the client
Answer: C.Autonomy is the client's right to make informed choices about their own care, including refusing treatment. Beneficence, doing good, is the principle the nurse sets aside here in favor of the client's choice.
- A.
- 10.
A unit's quality improvement team is tracking fall prevention. Which measure is an outcome measure?
- A.
Percent of clients screened for fall risk
- B.
Number of bed alarms on the unit
- C.
Hours of staff fall-prevention training
- D.
Falls per 1,000 client days
Answer: D.Outcome measures track results for clients, such as the fall rate. The percent of clients screened is a process measure, and equipment and staff training are structure measures.
- A.
Drill every management of care question in the NCLEX-RN Management of Care drill: questions you miss come back until you have mastered them. Then take a timed practice test with the NCLEX-RN section in it.
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