NCLEX Management of Care and Safety Practice Questions

What is Management of Care on the NCLEX?

The RN's work of directing and coordinating care: who does which task, who is seen first, whether the client has agreed to care, whose information can be shared, and what the nurse does when something is unsafe.

Management of Care topics and what the questions ask
Topic	What the questions ask
Delegation and assignment	Which task or client goes to an LPN or UAP, and what the RN must tell them
Establishing priorities	Which client to see first, which finding to report first
Informed consent and advance directives	Who obtains consent, when it is invalid, what a health care proxy can do
Client rights and confidentiality	Refusals, leaving against medical advice, HIPAA, interpreters
Legal and ethical practice	Restraints, incident reports, negligence, mandatory reporting, ethical principles
Collaboration and continuity	SBAR handoff, referrals, case management, read-back of telephone orders
Advocacy and supervision	Questioning an order, an impaired colleague, the chain of command

The 2026 Test Plan added a Management of Care activity statement on providing care that supports unbiased treatment and equal access, part of the advocacy topic. In practice the questions still turn on the same skill: deciding who should do what, in what order, so every client is safe.

How do I answer NCLEX delegation questions?

Keep the nursing process with the RN (assessment, planning, teaching, evaluation) and every unstable client. Give LPNs stable clients with predictable outcomes, and UAPs routine, standardized tasks on stable clients.

The five rights of delegation (NCSBN and ANA National Guidelines)
Right	Question to ask
Right task	Is it routine, with a predictable result, and allowed for this role?
Right circumstance	Is the client stable, and is the setting right?
Right person	Is this person trained and competent for it?
Right direction and communication	Have I said exactly what to do and what to report, and when?
Right supervision and evaluation	Will I follow up and check the outcome?

NCLEX-RN-style question 1 · Delegation
Which task is most appropriate for the RN to delegate to an unlicensed assistive personnel (UAP)?
1. ATeaching a client how to use a walker
2. BAssessing the skin of a client at risk of pressure injury
3. CHelping a stable client 3 days after knee surgery to the bathroom
4. DMonitoring a client during the first 15 minutes of a blood transfusion
Worked answer
C: Helping a stable client 3 days after knee surgery to the bathroom. Helping a stable client with toileting is a routine task with a predictable outcome. Teaching, assessment and monitoring a transfusion start need the RN's judgment.
1. Ask of each task: does it need assessment, teaching, evaluation or judgment?
2. Teaching, skin assessment and early transfusion monitoring do.
3. Assisting a stable client to the bathroom does not: delegate it, with instructions on what to report.
The trap: Delegating "monitoring" because it sounds like taking vital signs. Watching for a transfusion reaction is assessment, which stays with the RN.

Three traps catch most people. "Monitor" or "observe" in an option often hides assessment. A UAP may take vital signs on a stable client, but not on a client just back from a procedure. And the first time a client does something after surgery (walking, eating, using a new device) usually needs the RN.

Four more drills in each area

The Pass Pack has four 12-question drills each for Management of Care and Safety, plus two more full mocks.

The NCLEX-RN Pass Pack gives you 3 full mocks on the real clock, 32 drills of 12 questions for the sections that cost you points, and a predictor that turns your mocks into the odds of reaching your target. One payment, no subscription, and your free score stays free.

Prep courses for these tests usually cost $19 to $129. The NCLEX-RN Pass Pack is US$39 (£29), once.

See the NCLEX-RN Pass Pack How our questions are built and checked

3
timed mocks: 32
topic drills: 1
score predictor

That the provider doing the procedure explains it and obtains consent, the nurse witnesses the signature and checks understanding, and the nurse stops the process if the client does not understand, is sedated or is not legally able to consent.

NCLEX-RN-style question 1 · Informed consent
A client scheduled for surgery in an hour asks the RN, "What exactly will the surgeon be removing?" The consent form is signed. What should the RN do?
1. AExplain the procedure using the surgical consent form
2. BTell the client it is too late to ask questions
3. CNotify the surgeon that the client has questions before the procedure
4. DReassure the client that the surgeon is very experienced
Worked answer
C: Notify the surgeon that the client has questions before the procedure. A question like this shows the consent may not be fully informed. Explaining the procedure is the surgeon's job, so the nurse contacts the surgeon before the procedure goes ahead.
1. Who explains the procedure? The provider performing it.
2. A signed form does not mean the client understands.
3. So the nurse notifies the surgeon and the procedure waits until the question is answered.
The trap: Answering the question yourself because you know the answer. The nurse witnesses and advocates; the surgeon explains.

A client who has had an opioid or sedative cannot give valid consent until it wears off; tell the provider.
Emancipated minors consent for themselves; most other minors need a parent or guardian, with exceptions set by state law.
In an emergency, implied consent covers life-saving care when the client cannot consent and no surrogate is available.
A competent adult may refuse any treatment, including a blood transfusion, or leave against medical advice. Detaining them is false imprisonment.
Use a qualified medical interpreter, never a child or family member, for consent and teaching.

What is on the Safety and Infection Prevention and Control section?

Standard and transmission-based precautions, PPE, hand hygiene and asepsis, client identification, falls and restraint alternatives, fire and emergency response, hazardous materials and radiation, and safe use of equipment.

Transmission-based precautions (CDC), the most tested table in this section
Precaution	Common examples	What staff wear and the room
Airborne	Tuberculosis, measles, varicella (with contact), disseminated zoster	Fit-tested N95 or higher; negative-pressure airborne infection isolation room, door closed
Droplet	Influenza, pertussis, Neisseria meningitidis, mumps	Surgical mask on entry; private room or cohort
Contact	MRSA, VRE, C. difficile, scabies, RSV	Gown and gloves; dedicated equipment; soap and water for C. difficile
Protective environment	Severe neutropenia, stem cell transplant	No fresh flowers or plants; careful hand hygiene; visitors screened for illness

NCLEX-RN-style question 1 · Transmission-based precautions
A client is admitted with suspected measles. Which room and equipment does the RN request?
1. AA private room with the door open and a surgical mask
2. BAn airborne infection isolation room and an N95 respirator
3. CA semi-private room with a client who has influenza
4. DA standard room and gloves only
Worked answer
B: An airborne infection isolation room and an N95 respirator. Measles is airborne: a negative-pressure airborne infection isolation room with the door closed, and a fit-tested N95 or higher respirator for staff.
1. Name the route: measles spreads through the air.
2. Airborne precautions mean negative pressure and an N95.
3. Droplet (surgical mask) and contact (gloves) precautions are not enough.
The trap: Choosing droplet precautions because measles is "a respiratory virus". The airborne three to learn are measles, varicella and tuberculosis.
NCLEX-RN-style question 2 · Error prevention
Which action best prevents a wrong-client error when giving medications?
1. AChecking the room number on the medication record
2. BAsking the client "Are you Ms. Garcia?"
3. CComparing the client's name and date of birth on the wristband with the medication record
4. DRecognizing the client from earlier in the shift
Show the worked answer
C: Comparing the client's name and date of birth on the wristband with the medication record. Two identifiers, compared against the record, is The Joint Commission standard. Room numbers change and yes-or-no questions invite a confused client to agree.
1. The rule is two identifiers, such as name and date of birth.
2. A room number is never an identifier.
3. Compare against the record, not against memory.
The trap: Asking a yes-or-no question. A client who is confused, hard of hearing or sedated may say yes to any name.

PPE order is tested often: on, it is gown, mask or respirator, goggles or face shield, gloves; off, it is gloves first, then goggles or face shield, gown, and the mask or respirator last, then hand hygiene. For fire, remember RACE (rescue, alarm, contain, extinguish) and PASS (pull, aim at the base, squeeze, sweep).

How should I practise Management of Care questions?

In mixed sets, because the real exam never tells you which category a question belongs to. Use the drills to fix the rules, then take a full mock to check they hold among everything else.

Start with the two free drills above. Every miss teaches a rule (the five rights, who obtains consent, the airborne three), so write each rule on a card. When the rules come easily, take the free NCLEX-RN practice test: its 85 questions include 15 on Management of Care and 11 on Safety, mixed in with the rest as on the real exam.

Prioritization runs through this whole category. The frameworks (ABCs, acute before chronic, unexpected before expected) are worked through on NCLEX prioritization questions, and the six-week plan is in how to pass the NCLEX.

Frequently asked questions

What percentage of the NCLEX is Management of Care?

15-21% on the 2026 NCLEX-RN Test Plan, the largest of the eight subcategories.

What can an RN not delegate?

Assessment, care planning, teaching, evaluation and the care of unstable clients. Tasks can be delegated; the nursing process cannot.

Which diseases need airborne precautions?

Tuberculosis, measles and varicella (chickenpox, with contact precautions), and disseminated herpes zoster.

Who obtains informed consent?

The provider who will perform the procedure. The nurse can witness the signature and must stop the process if the client does not understand.

Make the biggest category your strongest

Three full NCLEX-RN-style mocks, four drills for each Client Needs area and a rationale for every answer, for one payment.