NCLEX Safe and Effective Care Environment 2 — Questions and Answers
Question 1: A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate to delegate?
- Assessing a new admission's pain level
- Assisting a stable client with ambulation (Correct answer)
- Administering an oral medication
- Developing the client's plan of care
Correct answer: Assisting a stable client with ambulation
Assisting a stable client with ambulation is a routine task within the UAP scope of practice.
Question 2: Which client should the charge nurse assign to a newly licensed RN?
- A client requiring complex discharge teaching
- A stable client awaiting routine post-op vital signs (Correct answer)
- A critically unstable client on multiple drips
- A client needing emergency code interventions
Correct answer: A stable client awaiting routine post-op vital signs
A stable client with predictable needs is appropriate for a new RN.
Question 3: A nurse notices a coworker diverting narcotics. What is the priority action?
- Confront the coworker directly
- Ignore it to avoid conflict
- Report to the nurse manager (Correct answer)
- Tell other staff members
Correct answer: Report to the nurse manager
Suspected drug diversion must be reported to the supervisor or manager per policy and law.
Question 4: Which situation requires the nurse to obtain informed consent before a procedure?
- Routine vital sign measurement
- Insertion of a peripheral IV per standing order
- A surgical operation under anesthesia (Correct answer)
- Administering a scheduled oral medication
Correct answer: A surgical operation under anesthesia
Invasive procedures such as surgery require documented informed consent.
Question 5: A nurse is caring for clients on a medical unit. Which client should be seen first?
- A client requesting pain medication for chronic back pain
- A client with new onset of shortness of breath (Correct answer)
- A client asking about discharge time
- A client needing help with a meal tray
Correct answer: A client with new onset of shortness of breath
New onset shortness of breath signals a potential airway/breathing emergency and is the priority.
Question 6: What is the correct action when a medication order is illegible or unclear?
- Interpret it based on the client's diagnosis
- Ask another nurse to guess
- Contact the prescriber for clarification (Correct answer)
- Administer the most likely dose
Correct answer: Contact the prescriber for clarification
Unclear orders must be clarified with the prescriber before administration.
Question 7: Which is an example of appropriate use of restraints?
- Restraining a client for staff convenience
- Using restraints as the first intervention for agitation
- Applying restraints with a current provider order after less restrictive measures fail (Correct answer)
- Restraining a client without documentation
Correct answer: Applying restraints with a current provider order after less restrictive measures fail
Restraints require a provider order and are used only after less restrictive measures fail.
NCLEX Safe and Effective Care Environment 2
A nurse is delegating tasks to unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?