NCLEX Management of Care questions
The PrepScore bank has 141 Management of Care questions, each with a rationale and two tags: the Client Needs category from the test plan and the clinical judgment step it tests. In this topic the items lean on Take action and Generate solutions, which is worth knowing before you practise it. Three worked samples are below, answers behind a reveal.
Informed consent, advance directives, HIPAA, error reporting, mass casualty triage, advocacy — NCLEX's largest single category.
Three worked questions
Q1. Which task is MOST appropriate to delegate to unlicensed assistive personnel (UAP)?
- A. Initial assessment of a newly admitted client
- B. Teaching insulin self-injection to a newly diagnosed diabetic
- C. Measuring vital signs on a stable post-op client
- D. Adjusting the IV infusion rate
Show answer and rationale
Answer: Measuring vital signs on a stable post-op client
UAP can perform routine, stable, predictable tasks. Cannot assess, teach, evaluate, or adjust treatments.
Q2. A nurse receives a verbal order from a provider over the phone. Which action ensures order accuracy?
- A. Write the order and read it back to the provider
- B. Repeat the order to a witness nurse
- C. Sign the order yourself as if the provider signed
- D. Wait until the provider arrives to clarify
Show answer and rationale
Answer: Write the order and read it back to the provider
Read-back verification of verbal orders is a National Patient Safety Goal. Provider co-signs within 24 hr.
Q3. Which clients should be assessed FIRST when a nurse begins the shift? Select all that apply.
- A. A post-op client with BP 88/52 + HR 122
- B. A stable client awaiting discharge
- C. A client with chest pain rated 8/10
- D. A new admission with sepsis + temp 39.8 + lactate 4
- E. A client requesting pain medication after lunch
Show answer and rationale
Answer: A post-op client with BP 88/52 + HR 122A client with chest pain rated 8/10A new admission with sepsis + temp 39.8 + lactate 4
ABCs + unstable hemodynamics + acute chest pain + septic shock = priority. Stable clients can wait.
The rules that decide these questions
From the pack's rule cards — the reasoning shortcuts a wrong answer usually means you were missing.
The provider performing the procedure obtains informed consent (procedure, risks, benefits, alternatives). The RN witnesses the signature, confirms the patient is alert/unsedated/uncoerced, and reinforces afterwards. If the patient is confused, doesn't understand, or has been sedated — STOP. RN does not substitute for the provider, does not 'just get the signature.'
When a patient cannot speak, the legally named healthcare proxy (DPOA) decides — using the patient's documented Living Will/advance directive as their guide. Other family members do NOT override. The RN's role is to advocate for the directive, facilitate family meetings with palliative + ethics consults, and document. The loudest voice in the room is not the legal authority.
Disclose patient health info only with explicit patient consent OR to internal care team members for Treatment, Payment, or Operations (TPO). Family members are not automatically authorized. Directory consent (someone can know you're here) is separate from release-of-info consent (who can be told specifics). PHI conversations belong out of public spaces — never the cafeteria.
After a medication error: (1) clinical response — assess, notify provider, monitor for harm; (2) ethical disclosure — patient and family told (typically with provider); (3) chart the clinical event in the medical record; (4) submit the incident report SEPARATELY to risk management/QI — it is NOT part of the medical record. Charge nurse preference cannot override disclosure duty; use chain of command if pressured.
A written order does not have to be administered. The RN has a duty to question unsafe orders. Hold the medication, document the hold, call pharmacy for verification, contact the prescriber (escalating up the provider hierarchy), and document the chain. Following an obviously wrong order does not protect the nurse from liability.
Disaster triage differs from single-patient ED priority. Categories: RED (immediate, life-threatening but salvageable) → YELLOW (delayed, significant but stable) → GREEN (minor / walking wounded) → BLACK (expectant or deceased — no resources). In mass casualty, you do NOT start CPR on the pulseless patient — that ties up rescuers needed for reds. Triage is by physiology, not age or anchor bias.
Practise the whole pack, tagged and explained
Every item carries its Client Needs category and clinical judgment step, so a wrong answer names the step that failed.
Frequently asked questions
How many Management of Care questions does the bank have?
141 multiple-choice items, plus 10 unfolding cases in the Management of Care pack, each with a rationale.
Are the samples real bank items?
Yes — the three questions above are drawn from the live bank, with their real rationales and tags.
Which clinical judgment steps does this topic train?
Most items in this topic test Take action and Generate solutions, though every step appears.
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