The Management of Care category is one of the most heavily weighted sections on the NCLEX exam 2025, accounting for nearly 20% of total questions. It evaluates how well a nurse can make safe, ethical, and efficient decisions within the healthcare team. These questions often test critical thinking, prioritization, delegation, and leadership skills every nurse must demonstrate in clinical practice. Understanding how to navigate this section can significantly boost your NCLEX score and confidence. This guide provides a full breakdown of Management of Care NCLEX questions, including common question types, test-taking strategies, and 15 NCLEX-style practice questions with rationales to strengthen your preparation.
What Is the Management of Care Category?
The Management of Care section of the NCLEX evaluates your ability to coordinate nursing care that promotes the health and safety of clients. It focuses on leadership responsibilities and professional decision-making that go beyond basic clinical care.
Key Areas Covered in Management of Care
According to the NCSBN Test Plan, this category includes:
- Delegation and Supervision
- Prioritization of Care
- Ethical and Legal Responsibilities
- Informed Consent and Advocacy
- Confidentiality and HIPAA Compliance
- Case Management and Resource Allocation
- Continuity of Care and Discharge Planning
- Quality Improvement and Safety Initiatives
- Advance Directives and End-of-Life Decisions
Each of these topics reflects real-world nursing scenarios that require safe judgment and professional communication.
Common NCLEX Management of Care Question Types
Understanding how NCLEX tests management of care will help you recognize patterns during the exam.
| Question Type | Focus Area | Example |
|---|---|---|
| Prioritization | Determining which patient needs attention first | “Which client should the nurse assess first after shift change?” |
| Delegation | Assigning appropriate tasks to LPNs and UAPs | “Which task can be delegated to an unlicensed assistive personnel?” |
| Leadership | Handling conflicts, team communication | “How should the nurse respond to a coworker refusing a patient assignment?” |
| Legal/Ethical | Understanding rights, consent, reporting | “Which client statement requires the nurse to report to the provider?” |
| Quality & Safety | Reporting errors, chain of command | “Which action by the nurse manager improves patient safety?” |
How to Approach Management of Care NCLEX Questions
1. Use Maslow’s Hierarchy of Needs
Start with physiological needs (airway, breathing, circulation), then move to safety, love/belonging, and so on.
2. Apply the ABCs (Airway, Breathing, Circulation)
When multiple patients are presented, always prioritize based on life-threatening issues.
3. Remember Nursing Scope of Practice
Know what RNs, LPNs/LVNs, and UAPs can and cannot do:
- RNs: Assess, teach, evaluate, administer IV meds, manage unstable patients.
- LPNs: Monitor stable patients, administer oral meds, reinforce teaching.
- UAPs: Assist with ADLs, vital signs, hygiene, ambulation.
4. Consider Stability and Acute vs. Chronic
Stable, chronic conditions are lower priority. Acute, unstable, or newly admitted clients come first.
5. Think Safety and Infection Control
Preventing harm always takes precedence, especially with patient transfers, isolation, and medication administration.
15 Management of Care NCLEX Questions (with Rationales)
Question 1
The nurse has the following clients. Which should be assessed first?
- A. A client with pneumonia on 2 L O₂, reporting fatigue
- B. A client with COPD who is drowsy and difficult to arouse
- C. A postoperative client with pain rated 7/10
- D. A diabetic client asking for breakfast
Answer: B
Rationale: Altered level of consciousness in a COPD patient indicates CO₂ retention, a life-threatening airway/breathing concern.
Question 2
Which task can be safely delegated to a UAP?
- A. Checking blood glucose before insulin
- B. Ambulating a stable client after surgery
- C. Assessing pain after medication
- D. Teaching incentive spirometry
Answer: B
Rationale: Ambulation of a stable patient is within the UAP’s scope. Assessment and teaching require RN judgment.
Question 3
A client tells the nurse, “I don’t want any more treatment.” What should the nurse do first?
- A. Document the statement
- B. Ask if the client has an advance directive
- C. Notify the provider immediately
- D. Explain the benefits of continuing treatment
Answer: B
Rationale: The nurse must first determine if there’s an advance directive to respect patient autonomy.
Question 4
The charge nurse observes a staff member taking a patient’s narcotics. What is the priority action?
- A. Confront the staff member
- B. Notify the nurse manager immediately
- C. Document the incident in patient chart
- D. Ignore until end of shift
Answer: B
Rationale: This is a legal and ethical violation requiring immediate reporting to management.
Question 5
A client scheduled for surgery says, “I don’t understand why I need this operation.” What should the nurse do?
- A. Explain the surgical purpose
- B. Ask the surgeon to come and clarify
- C. Proceed with pre-op checklist
- D. Tell family to explain to the patient
Answer: B
Rationale: Only the surgeon is responsible for obtaining informed consent.
Question 6
Which client can the LPN/LVN be assigned to?
- A. A new diabetic patient needing insulin teaching
- B. A stable client 2 days post-appendectomy
- C. A client on IV heparin infusion
- D. A patient with new onset chest pain
Answer: B
Rationale: Stable post-op clients are within LPN scope.
Question 7
A nurse is planning assignments for the day. Which task can be delegated to a UAP?
- A. Feeding a client with dysphagia
- B. Measuring intake and output for a stable client
- C. Monitoring IV site for infiltration
- D. Performing sterile wound dressing change
Answer: B
Rationale: Measuring I&O for a stable patient is safe delegation.
Question 8
Which action reflects advocacy?
- A. Reporting unsafe staffing levels
- B. Delegating all routine care
- C. Ignoring patient complaints
- D. Avoiding conflict with physicians
Answer: A
Rationale: Advocacy involves promoting safe, ethical conditions for patients.
Question 9
A nurse makes a medication error. What should be done first?
- A. Notify the provider
- B. Assess the patient for adverse effects
- C. Complete an incident report
- D. Inform the family
Answer: B
Rationale: Patient safety comes first assess for harm before reporting.
Question 10
A new graduate is overwhelmed by workload. The charge nurse should:
- A. Reassign complex patients
- B. Tell them to manage independently
- C. Write them up for poor performance
- D. Ignore the situation
Answer: A
Rationale: Leadership involves supporting and mentoring new nurses for safe care.
Question 11
A nurse notices an IV pump malfunction. What should be done next?
- A. Attempt to fix the pump
- B. Tag and remove it from use
- C. Continue using until repair staff arrives
- D. Document and ignore
Answer: B
Rationale: Remove faulty equipment to prevent harm—part of quality and safety management.
Question 12
A patient’s spouse demands to read the medical record. What should the nurse do?
- A. Allow access immediately
- B. Ask the patient for permission
- C. Call the provider for approval
- D. Deny all access permanently
Answer: B
Rationale: HIPAA requires patient consent before sharing health information.
Question 13
A nurse receives report on four clients. Who should be seen first?
- A. Client with new confusion
- B. Client awaiting discharge
- C. Client who needs wound care
- D. Client asking for pain medication
Answer: A
Rationale: New confusion may indicate acute neurological changes priority for assessment
Question 14
A nurse witnesses another RN slap a patient’s hand. What is the immediate action?
- A. Report to nurse manager
- B. Document in patient’s chart
- C. Confront privately later
- D. Call security immediately
Answer: A
Rationale: This is abuse and must be reported immediately according to policy
Question 15
A nurse leader wants to improve patient outcomes. Which action best demonstrates quality improvement?
- A. Conducting chart audits for medication errors
- B. Reducing staff meetings
- C. Assigning extra shifts
- D. Limiting continuing education
Answer: A
Rationale: Chart audits help identify errors and enhance safety—core QI activity.
Strategies to Master Management of Care NCLEX Questions
| Strategy | Description | Example |
|---|---|---|
| Prioritize Using ABCs & Maslow | Always start with airway, breathing, circulation. | Respiratory distress > Pain. |
| Use the Nursing Process (ADPIE) | Assessment first unless action prevents harm. | Assess before implementing. |
| Know Delegation Rules | RNs assess, LPNs monitor, UAPs perform basic care. | Vital signs vs. assessments. |
| Ethical Framework | Autonomy, beneficence, justice, nonmaleficence. | Respecting informed consent. |
| Time Management | Organize care efficiently and safely. | Cluster care for stable patients. |
NCLEX 2025: What’s New in Management of Care
The Next Generation NCLEX (NGN) format continues in NCLEX 2025, emphasizing:
- Clinical judgment case studies
- Extended multiple-response and drag-and-drop items
- Scenario-based management questions
Expect Management of Care questions in case study format, requiring:
- Analyzing patient data
- Identifying priorities
- Delegating tasks
- Applying nursing judgment
Preparation Tips for NCLEX 2025
- Practice Daily: Aim for 25–30 NCLEX management questions per session.
- Use Rationales: Don’t just memorize answers—understand reasoning.
- Simulate Exam Environment: Use computer-adaptive mock exams.
- Study Leadership Concepts: Review ethical decision-making and teamwork.
- Review Nursing Scope Laws: Especially RN vs. LPN/LVN vs. UAP tasks.
- Focus on Real-world Scenarios: The NCLEX tests how nurses think, not recall.
Final Comments
Mastering Management of Care NCLEX questions is about more than memorization it’s about understanding leadership, prioritization, and patient safety. These skills define competent nurses in real-world practice.
By studying these examples, reviewing rationales, and practicing decision-making under pressure, NCLEX students can confidently approach this section and perform at their best on the NCLEX exam 2025.
Remember, safe and effective care management is the foundation of nursing—and mastering it ensures success both in the exam room and at the bedside
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