NCLEX-RN Management of Care Practice Test – Updated 2026 (100+ Questions)

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You are walking onto a busy medical-surgical floor for your first shift as a registered nurse. You have four patients, one is calling for pain meds, another needs discharge teaching, a third is due for blood, and the fourth is short of breath. Who do you see first? Can you ask the LPN to handle the teaching? What if the doctor gives an order that feels unsafe?

This is the reality of Management of Care (MOC), the “art” of nursing that determines not just how well you care for one patient, but how effectively you manage a system of care. MOC is the largest single category on the NCLEX-RN, accounting for 18-24% of your exam. It is less about “how to insert a Foley” and more about “who, what, when, and how” to ensure safety across your entire assignment.

In this guide, we will break down the coordinator of care role, explore the legal and ethical boundaries of your practice, and equip you with the frameworks you need to pass the “Manager of Care” questions on the NCLEX.

💡 NCLEX Insight: Management of Care is the backbone of the Next Generation NCLEX (NGN). Expect to see these concepts tested heavily in Bow-tie and Case Study formats, where you must prioritize actions and delegate tasks rather than just recalling facts.

Understanding Management of Care: Your NCLEX Blueprint

Management of Care falls under the Safe and Effective Care Environment client need category. It tests your ability to act as a patient advocate and a team manager. While other sections test your medical knowledge, this section tests your decision-making process. You cannot pass the NCLEX without mastering MOC.

Exam Weight Visualization – Topic Position

pie showData title Management of Care NCLEX Weight
    "Management of Care" : 21
    "All Other NCLEX Domains" : 79

This chart represents a significant portion of your exam. Roughly 1 out of every 5 questions will focus on how you manage the nursing process, legal issues, and healthcare resources.

Topic Structure Visualization – Subtopics

flowchart TD
    MAIN["🎯 Management of Care<br/>(Coordinator of Care Role)"]

    MAIN --> ST1["📌 Delegation & Assignment<br/><small>High Yield (NGN Bow-tie)</small>"]
    MAIN --> ST2["📌 Prioritization & Triage<br/><small>High Yield (Case Studies)</small>"]
    MAIN --> ST3["📋 Legal & Ethical Practice<br/><small>Medium Yield (SATA)</small>"]
    MAIN --> ST4["📋 Continuity of Care<br/><small>Medium Yield</small>"]
    MAIN --> ST5["📄 Performance Improvement<br/><small>Low Yield</small>"]
    MAIN --> ST6["📄 Documentation<br/><small>Low Yield</small>"]

    style MAIN fill:#1976D2,color:#fff,stroke:#1565C0
    style ST1 fill:#c8e6c9,stroke:#4CAF50
    style ST2 fill:#c8e6c9,stroke:#4CAF50
    style ST3 fill:#fff3e0,stroke:#FF9800
    style ST4 fill:#fff3e0,stroke:#FF9800
    style ST5 fill:#f5f5f5,stroke:#9e9e9e
    style ST6 fill:#f5f5f5,stroke:#9e9e9e

Key Takeaway:
Notice the “High Yield” areas. Delegation and Prioritization are the heavy hitters here. These are the areas where students often lose points because they rely on “real-world” shortcuts rather than the textbook standard of care. If your study time is limited, focus 60% of your energy here.

📋 NCLEX Strategy: When practicing MOC questions, stop asking “What do I want to do?” and start asking “What is the safest thing to do given the resources I have?”

High-Yield Cheat Sheet: Management of Care at a Glance

Let’s condense this massive topic into a memorable overview.

mindmap
  root((Management of Care))
    Delegation
      5 Rights of Delegation
      RN vs LPN vs UAP
      Supervision
    Prioritization
      ABCs (Airway, Breathing, Circulation)
      Maslow's Hierarchy
      Acute vs Chronic
      Unstable vs Stable
    Legal & Ethical
      Informed Consent
      HIPAA/Confidentiality
      Advocacy
      Torts (Negligence, Malpractice)
    Client Rights
      Advance Directives
      Refusal of Treatment
      Restraints/Seclusion
    System Processes
      Chain of Command
      Incident Reports
      Documentation
      Discharge Planning

Quick Reference Summary

• Delegation & Supervision: This is about assigning the right task to the right person. The key is knowing the Scope of Practice. RNs assess and teach; LPNs medicate stable patients; CNAs provide hygiene and vital signs.
• Prioritization & Time Management: This is about ordering care. Use ABCs (Airway, Breathing, Circulation) and Maslow (Physiological needs first) to decide who gets your attention first.
• Legal & Ethical Responsibilities: This is about protecting your license and your patient. Focus on Informed Consent, Confidentiality (HIPAA), and Advocacy. Remember, you can be sued for negligence (general) or malpractice (professional).
• Client Rights & Advocacy: The patient is the boss of their own body. You must honor Advance Directives, support Refusal of Treatment, and ensure they understand procedures.
• Interdisciplinary Care & Quality Improvement: You are part of a team. Use the Chain of Command for unsafe orders and Incident Reports for system errors—never chart blame in the patient’s record.
• Documentation: If it wasn’t charted, it wasn’t done. Stick to objective facts.

How Management of Care Connects to Other NCLEX Domains

Management of Care is the glue that holds the rest of the NCLEX together. You cannot prioritize effectively if you don’t understand the pathophysiology behind the patient’s condition.

flowchart TD
    subgraph CORE["Management of Care (The Framework)"]
        A["Prioritization Frameworks<br/>(ABCs/Maslow)"]
        B["Delegation Rules<br/>(Scope of Practice)"]
        C["Legal Standards<br/>(Consent/Advocacy)"]
    end

    subgraph RELATED["Connected Domains"]
        D["Safety & Infection Control"]
        E["Pharmacology"]
        F["Physiological Integrity"]
    end

    A -->|"impacts"| D
    B -->|"guides"| E
    C -->|"protects"| F

    style CORE fill:#e3f2fd,stroke:#1976D2
    style RELATED fill:#f5f5f5,stroke:#757575

Why These Connections Matter:

• Prioritization + Pathophysiology: You must know the physiology of a pneumothorax (Physiological Integrity) to know that patient is the priority over a patient with a headache (MOC Prioritization).
• Delegation + Safety: You must understand infection control protocols (Safety) to know that a patient with MRSA in Contact Precautions requires staff assigned who can strictly adhere to PPE protocols.
• Pharmacology + MOC: You must know that IV push medications (Pharmacology) have a higher risk of adverse reactions, which informs your decision to delegate oral meds to an LPN but keep the IV push for yourself.

📋 NCLEX Strategy: When you get a “Who do you see first?” question, ignore the social cues (like a demanding wife) and look strictly for the physiological breakdown connected to the MOC framework of stability.

What to Prioritize: Critical vs. Supporting Details

You cannot memorize every law or regulation. You need to prioritize the concepts that directly impact patient safety.

quadrantChart
    title NCLEX Priority Matrix
    x-axis "Low Complexity" --> "High Complexity"
    y-axis "Low Yield" --> "High Yield"
    quadrant-1 "Master These (Critical)"
    quadrant-2 "Know Well (Essential)"
    quadrant-3 "Basic Awareness"
    quadrant-4 "Review If Time"
    "Inappropriate Delegation": [0.25, 0.85]
    "Prioritizing Stability": [0.35, 0.90]
    "Informed Consent": [0.20, 0.80]
    "Advance Directives": [0.75, 0.75]
    "Chain of Command": [0.70, 0.70]
    "Performance Improvement Data": [0.80, 0.30]

Priority Table

🎯 Strategic Insight: If a question asks you to choose between a “legal” issue and a “safety” issue, Safety almost always wins first (save the life), then you deal with the legal aspect. However, “unsafe delegation” is a safety/legal hybrid that is frequently the correct answer in “which action requires intervention?”

Essential Knowledge: Management of Care Deep Dive

Delegation and Supervision

Delegation is not about dumping work; it is about resource management. The RN retains accountability for the outcome, even if the task was assigned to someone else. The core concept here is Scope of Practice.

Key Concepts:

• The 5 Rights of Delegation: Right Task, Right Circumstances, Right Person, Right Direction/Communication, Right Supervision.
• RN Scope: Assessment, Teaching, Blood Administration, IV Push, Unstable patients.
• LPN/LVN Scope: Stable patients, Wound care, Oral/IM/Subcut meds, Reinforcing teaching (not initial).
• CNA/UAP Scope: ADLs (hygiene), Vitals, I&O, Feeding.

Comparison Table: Who Does What?

💡 Memory Tip (5 Rights): Use the acronym “P.T.R.S.C.”

• Person (Right person)
• Task (Right task)
• Route/Circumstances (Right circumstances)
• Supervision (Right supervision)
• Communication (Right direction)

Prioritization and Time Management

This is the “Who do you see first?” category. The NCLEX tests your ability to ignore the “squeaky wheel” (the patient ringing the call light constantly) and find the unstable patient.

Key Concepts:

• ABCs: Airway, Breathing, Circulation. Always address these first.
• Maslow’s Hierarchy: Physiological needs before Safety, before Psychosocial.
• Acute vs. Chronic: Acute changes are always priority over chronic conditions. A patient with new onset chest pain is priority over a patient with chronic back pain.
• Unstable vs. Stable: Unstable patients get your time; stable patients can be delegated or wait.

💡 Memory Tip (Prioritization): Use “A.B.C. – M.A.S.T.”

• A.B.C. (Airway, Breathing, Circulation)
• M.ental status (Acute confusion)
• A.cute changes (New onset pain)
• S.afety risks (Suicide, Falls)
• T.ime (Routine tasks/Teaching)

Legal and Ethical Responsibilities

This pillar protects your license. You must know the rules of the game.

Key Concepts:

• Informed Consent: The physician explains and obtains consent; the nurse witnesses the signature and verifies the patient understands. If the patient doesn’t understand, you stop and notify the MD.
• Torts: Civil wrongs. Know the difference between Negligence (general lack of care) and Malpractice (professional negligence).
• HIPAA: Protect patient data. Do not discuss patients in elevators or with family not on the list.

Comparison Table: Legal Torts

💡 Memory Tip (Informed Consent): Use “P.P.P.P.”

• Procedure (What are we doing?)
• Purpose (Why are we doing it?)
• Problems (What are the risks?)
• Permissions (Alternatives and right to refuse)

Client Rights and Advocacy

The nurse is the patient’s liaison. Sometimes, this means protecting the patient from the doctor or the family.

Key Concepts:

• Advance Directives: DNR/Living Wills. Follow them. If a patient has a valid DNR, you do not start CPR.
• Restraints: Must be a last resort. Try alternatives (bed alarm, sitters first). Requires a doctor’s order (not PRN) and continuous monitoring.
• Refusal of Treatment: A competent adult can refuse anything, even life-saving treatment. Your job is to ensure they understand the consequences, not to force them.

Interdisciplinary Care and Quality Improvement

Nurses do not work in silos. You must know how to navigate the system to help the patient.

Key Concepts:

• Chain of Command: Charge Nurse -> Supervisor -> Medical Director. Use this when an MD gives an unsafe order or ignores a patient’s deterioration.
• Incident Reports: Fill them out for errors, falls, etc. Do not mention the incident report in the patient’s chart. Chart the facts of what happened, but document the incident report in a separate system.
• Sentinel Event: Unexpected death/serious injury. Requires a Root Cause Analysis (RCA).

Mastering Priority Questions for Management of Care

Prioritization Principles

graph TD
    A[MULTIPLE PATIENTS] --> B{Is anyone Unstable?}
    B -->|Yes| C[Assess Unstable Patient First]
    B -->|No| D{Is there an ABC issue?}
    D -->|Yes| C
    D -->|No| E{Is there a Pain/Meds issue?}
    E -->|Yes| F[Assess Pain/Give Routine Meds]
    E -->|No| G[Discharge Teaching/Charting]

Priority Practice Scenario

Scenario:

• Patient A: 2 days post-op from appendectomy, requesting pain meds (pain 4/10).
• Patient B: Admitted with pneumonia, O2 sat 88% on room air, coughing.
• Patient C: Discharge teaching scheduled for a patient going home on Coumadin.
• Patient D: New admission with history of CHF, awaiting bed assignment.

Your Priority: Patient B.

Rationale: Patient B is unstable (Hypoxia – ABCs). Patient A is stable (pain is expected). Patient C is a lower priority (teaching is important but not life-saving). Patient D is stable (waiting is not an emergency).

Common Pitfalls & How to Avoid Them

Recognizing these traps will save you points on the exam.

⚠️ Pitfall #1: The “Nice Nurse” Trap
❌ THE TRAP: Prioritizing the patient who is demanding, crying, or ringing the call light constantly (but is medically stable) over a quiet patient who might be deteriorating.
✅ THE REALITY: The quiet patient is often the unstable one. Assess the unstable patient first. You can delegate comfort measures to the CNA for the demanding patient.
💡 QUICK FIX: Ask yourself, “Which patient will die first if I don’t walk in the room right now?”

⚠️ Pitfall #2: Delegating the “Teaching”
❌ THE TRAP: Asking an LPN to teach a patient about insulin administration because “they have time.”
✅ THE REALITY: Teaching requires evaluation of learning readiness and understanding the pathophysiology behind the “why”—this is an RN responsibility.
💡 QUICK FIX: “If it requires evaluation of understanding, it’s an RN task.”

⚠️ Pitfall #3: Violating HIPAA for Family
❌ THE TRAP: Giving a detailed update on a patient’s condition to a concerned spouse who calls the unit, even though the patient didn’t list them on the consent form.
✅ THE REALITY: You cannot disclose any Protected Health Information (PHI) without patient authorization.
💡 QUICK FIX: “I can tell them the patient is alive and stabilized, but I cannot give details. Please have them call the patient directly.”

⚠️ Pitfall #4: Documenting an Incident in the Medical Record
❌ THE TRAP: Writing “Patient fell because I forgot to put the bed rail up” in the narrative note.
✅ THE REALITY: Never admit liability or fault in the medical record. Complete an incident report objectively, but do not reference the incident report in the medical record.
💡 QUICK FIX: Chart the facts and patient status post-fall. Complete the separate Incident Report for the legal team.

⚠️ Pitfall #5: Ignoring the Refusal
❌ THE TRAP: Trying to convince a competent patient to take a medication because “it’s for their own good,” even after they say “No.”
✅ THE REALITY: A competent adult has the right to refuse. The nurse’s role is to ensure they understand the consequences (Informed Consent), not to force them.
💡 QUICK FIX: Document the refusal, the education provided regarding risks, and the notification of the provider.

⚠️ Pitfall #6: Assigning based on Friendship
❌ THE TRAP: Giving the “easy” patients to a friend and the “heavy” patients to a new nurse to be “nice.”
✅ THE REALITY: Assignments must be based on patient acuity, continuity of care, and staff skill mix/competency.
💡 QUICK FIX: “Match the patient’s needs to the nurse’s skills, not the nurse’s personality.”

🎯 Remember: Avoid “medical model” thinking (treat the disease) and embrace “nursing model” thinking (manage the response to the disease).

How This Topic Is Tested: NCLEX Question Patterns

📋 Pattern #1: The “Who Do You See First?” (Priority Delegation)

WHAT IT LOOKS LIKE: A standalone or case study stem describing 4 patients and their recent changes in status. You must rank them 1-4 or select the priority.

EXAMPLE STEM:

“The nurse is caring for four clients. Which client should the nurse assess first? 1. A client 2 days post-op requesting pain meds. 2. A client with pneumonia who has a pulse ox of 88%. 3. A client with diabetes reporting hunger. 4. A client with anxiety awaiting surgery.”

SIGNAL WORDS: “First,” “Priority,” “Initial action,” “Best.”
YOUR STRATEGY:

1. Check ABCs (Airway, Breathing, Circulation).
2. Check Maslow (Physiological needs before safety/psychosocial).
3. Check Stability (Unstable > Stable; Acute > Chronic).
   ⚠️ TRAP TO AVOID: Choosing the “teaching” or “comfort” option when an ABC issue exists. The patient with 88% O2 saturation is the priority.

📋 Pattern #2: The “Who Should You Assign?” (Delegation)

WHAT IT LOOKS LIKE: A list of staff members (RN, LPN, CNA) and a list of clients. You must match them or select which client the RN can assign to the LPN.

EXAMPLE STEM:

“The charge nurse is making assignments for the shift. Which client is appropriate to assign to the LPN?”

SIGNAL WORDS: “Assign,” “Delegate,” “Supervise,” “Task,” “Report to.”
YOUR STRATEGY:

1. RN: Assessment, Teaching, Blood Products, IV Push, unstable patients.
2. LPN: Stable patients, Meds (oral/IV fluids), Wound care, Not teaching or initial assessment.
3. CNA: ADLs, Vitals, I&O, Not assessments or meds.
   ⚠️ TRAP TO AVOID: Delegating a stable patient who needs teaching. Even if the patient is physically stable, the teaching requirement makes them an RN patient.

📋 Pattern #3: Extended Multiple Response (SATA / Select All That Apply)

WHAT IT LOOKS LIKE: A scenario asking for multiple correct actions, often regarding legal rights or steps in a process.

EXAMPLE STEM:

“The nurse is witnessing the signing of an informed consent form. Which actions by the nurse are appropriate? Select all that apply.”

SIGNAL WORDS: “Select all that apply,” “Which of the following,” “Indicate.”
YOUR STRATEGY:

1. Treat each option as a True/False question.
2. Verify the answer against the specific Nursing Standard.
3. Ensure every option is strictly correct without “wiggle room.”
   ⚠️ TRAP TO AVOID: Including an option that is “nice” (e.g., “Explain the procedure in medical terms”) but incorrect (RN should verify understanding, not just lecture). Also, avoid “witnessing” if the patient is sedated.

📋 Pattern #4: Bow-tie / NGN Drag and Drop (Ordering)

WHAT IT LOOKS LIKE: A scenario (e.g., a fall or medication error) requiring you to drag steps into the correct chronological order or categorize them by priority.

EXAMPLE STEM:

“A nurse discovers a patient unresponsive on the floor. Place the following nursing actions in the correct order of performance.”

SIGNAL WORDS: “Order the steps,” “Sequence,” “Move to the correct column.”
YOUR STRATEGY:

1. Find the Immediate Safety action (Assess ABCs, call for help).
2. Follow the Nursing Process (Assess -> Diagnose/Analyze -> Plan -> Implement -> Evaluate).
3. Never leave the patient alone until safe.
   ⚠️ TRAP TO AVOID: Putting “Documentation” as an early step. It is always last.

🎯 Pattern Recognition Tip: For ordering questions, look for the “Assess” option first. You almost always have to look/listen/assess before you do anything else.

Key Terms You Must Know

Knowing the vocabulary is half the battle. The NCLEX writers use specific legal and management terms.

Red Flag Answers: What’s Almost Always Wrong

When you are stuck, eliminate these “Red Flags” first. They are almost never the correct answer.

Myth-Busters: Common Misconceptions

Let’s clear up some confusing areas that often trip up students.

❌ Myth #1: “If a task is delegated, the RN is no longer responsible for it.”
✅ THE TRUTH: The RN retains accountability for the overall care of the patient and the outcome of the delegated task. If the UAP fails to check blood sugar and the patient goes into a coma, the RN is liable.
📝 EXAM IMPACT: Selecting “I am not responsible” in a legal question results in an immediate fail.

❌ Myth #2: “The RN cannot perform tasks that can be delegated.”
✅ THE TRUTH: RNs can perform hygiene and vital signs; however, for the exam, we must assume optimal utilization of resources. If the question asks who should do it, pick the lowest level provider capable.
📝 EXAM IMPACT: Failing a delegation question because the student thinks the RN is “above” taking vitals.

❌ Myth #3: “A family member can sign the consent form if the patient is confused.”
✅ THE TRUTH: Generally, only the patient can sign, unless a legal guardian or Power of Attorney is established. A husband or adult child does not automatically have legal authority to consent for an incapacitated adult patient.
📝 EXAM IMPACT: Selecting “Have the wife sign” is a violation of legal rights.

❌ Myth #4: “If a patient refuses treatment, call the doctor immediately.”
✅ THE TRUTH: Your first action is to assess why they are refusing and educate them. You only notify the physician after the patient continues to refuse despite understanding the risks.
📝 EXAM IMPACT: Choosing “Call MD” over “Assess understanding” shows a lack of critical thinking and advocacy.

❌ Myth #5: “Incident reports are legal documents used in court.”
✅ THE TRUTH: Incident reports are internal quality control tools. They are usually inadmissible in court to protect the process of quality improvement. The legal document is the medical record.
📝 EXAM IMPACT: Referencing the incident report in the patient chart creates a legal linkage and is dangerous.

💡 Bottom Line: Stick to the NCLEX “textbook world.” Even if real-world hospitals are messy, the exam expects perfection in delegation, legal compliance, and prioritization.

Apply Your Knowledge: Clinical Scenarios

Scenario #1: The Morning Rush
Situation: You have just received report on four patients.

1. Patient A: 2 hours post-op, BP 110/70, stable.
2. Patient B: Admitted with pneumonia, O2 sat 88% on room air, coughing.
3. Patient C: requesting discharge papers for surgery 3 days ago.
4. Patient D: NPO for colonoscopy, angry that water was not removed from bedside table.

Clinical Judgment Prompt:

• Who do you assess first?
• Who can you delegate the water removal to?

Key Principle: ABCs first. Patient B has an oxygenation problem (Breathing). Patient D’s complaint is not life-threatening. You can delegate the water removal to the CNA.

Scenario #2: The Unsafe Order
Situation: A physician orders Potassium Chloride (KCl) 40 mEq IV push for a patient with a K+ of 3.0. You know IV push KCl is dangerous and usually requires dilution/infusion. You call the MD to clarify. He yells, “Just do it, I’m the doctor!”

Clinical Judgment Prompt:

• What is your next action?
• What is the last resort action?

Key Principle: Patient safety > Doctor’s ego. Do not hang up. Do not administer. Next, contact the Charge Nurse (Chain of Command). Continue up the chain until the order is changed.

Scenario #3: The “No”
Situation: A patient with a severe infection refuses IV antibiotics. He says, “I’m tired of being stuck with needles. I want to go home and drink tea.” He is alert, oriented, and has a diagnosis of schizophrenia, but is currently stable on medication.

Clinical Judgment Prompt:

• Can he legally refuse?
• What is the RN’s specific role?

Key Principle: Yes, he can refuse if he is competent. Mental illness diagnosis does not automatically make him incompetent. The RN’s role is to ensure he understands the risks (sepsis, death) and document the refusal.

Frequently Asked Questions

Q: Can an LPN start a blood transfusion?

While scope of practice varies by state, the NCLEX standard is generally No. Blood transfusion administration involves high-risk monitoring and assessment for reactions. An LPN can monitor the vitals during the transfusion or disconnect it, but the RN should initiate and stay for the first 15 minutes.

• Exam Tip: If you see “Administer blood products,” choose the RN.

Q: What is the difference between negligence and malpractice?

Negligence is a general failure to act as a reasonable person would (breach of duty). Malpractice is negligence committed by a professional (nurse/doctor) where the standard of care was breached.

• Exam Tip: If the question involves a professional (nurse) failing to follow the “standard of care” (e.g., not checking an ID band before meds), it is malpractice.

Q: Who do I see first: The patient with chest pain or the patient with a tracheostomy obstruction?

The patient with the tracheostomy obstruction. Trach obstruction is an Airway emergency. Airway is always first in ABCs. Chest pain is Circulation (or Breathing if impacting it). You must secure the airway before addressing perfusion.

• Exam Tip: Remember A-B-C.

Q: Can I delegate a patient’s discharge teaching to the LPN?

No. Teaching requires evaluation of the learner’s readiness and understanding. An LPN can reinforce teaching initiated by the RN, but cannot do the initial comprehensive teaching.

• Exam Tip: If the task involves “teaching,” keep it with the RN.

Q: What do I do if a doctor gives an unsafe order?

Do not carry out the order. Inform the doctor of your concern (safe dose, contraindication). If the doctor insists, follow the Chain of Command (Charge Nurse, Supervisor, Medical Director).

• Exam Tip: Never hang up on the doctor in anger, but do not administer unsafe medication.

Q: Is it okay to restrain a confused patient to prevent falls?

Restraints have serious risks (asphyxiation, skin breakdown, psychological trauma) and are a last resort. You must try less restrictive measures first (bed alarm, frequent rounding, low bed, mitts).

• Exam Tip: Restraints require a specific physician’s order and time-limited renewal. “PRN” restraints are illegal.

Recommended Study Approach for Management of Care

This approach is tailored to RN-level thinking (Application/Analysis). MOC is not about memorizing lists; it’s about applying frameworks to new situations.

Phase 1: Build Foundation (6-8 Hours)

Focus Areas:

• Scope of Practice (RN vs LPN vs CNA).
• The 5 Rights of Delegation.
• Legal terminology (Torts, HIPAA, Informed Consent).

Activities:

• Create a Delegation Grid (like the one in this guide) and memorize what each role can/cannot do.
• Make flashcards for legal terms (Battery vs. Assault, Malpractice vs. Negligence).
• Review the Nurse Practice Act concepts (generically).

Phase 2: Deepen Understanding (8-10 Hours)

Focus Areas:

• Prioritization Frameworks (ABCs, Maslow, Acute vs Chronic).
• Chain of Command.
• Ethical Principles (Autonomy, Beneficence, etc.).

Activities:

• Practice “Who do you see first?” questions. Focus on identifying “Cues” that indicate instability.
• Create a Chain of Command flowchart for your study area to visualize who to call when an MD refuses to cooperate.
• Compare and contrast Advance Directives types (Living Will vs Durable Power of Attorney).

Phase 3: Apply & Test (6-8 Hours)

Focus Areas:

• Application of frameworks to NGN-style questions.
• Pattern recognition (Identifying when a question is about delegation vs. legal ethics).

Activities:

• Practice NGN Case Studies specifically targeting Management of Care.
• Do SATA (Select All That Apply) drills on Legal Rights and Delegation criteria.
• Use the “Killer Question” mindset: “What kills the patient first?” for every priority question.

Phase 4: Review & Reinforce (3-4 Hours)

Focus Areas:

• Weak areas identified through practice.
• High-yield concepts for final review.

Activities:

• Review the “Red Flags” section right before the exam.
• Re-memorize mnemonics (P.T.R.S.C., A.B.C.-M.A.S.T.).
• Review the “Common Pitfalls” cards.

✅ You’re Ready When You Can:

• [ ] Look at a list of 4 patients and instantly identify the one with an Airway/Breathing issue.
• [ ] Identify exactly what an LPN can and cannot do based on the “5 Rights.”
• [ ] Recite the steps of Informed Consent and who is responsible for which part.
• [ ] Identify the “distractor” in a SATA question (e.g., the “nice” option that is legally wrong).
• [ ] Apply the Chain of Command to a scenario where an MD is unsafe.

🎯 NCLEX Tip: On exam day, if you feel torn between two answers, look for the one that ensures patient safety and advocacy. The NCLEX wants to know that you will protect the patient, even if it means being uncomfortable with a colleague or doctor.

Clinical Judgment & NGN Connection

The NGN heavily emphasizes Management of Care because it measures the “Coordinator of Care” role effectively. Unlike traditional questions that asked for a single fact, NGN questions ask you to manage the situation.

Wrapping Up: Your Management of Care Action Plan

Management of Care can feel abstract compared to the concrete steps of inserting a central line or assessing a heart murmur. However, it is the framework that allows you to practice safely. By mastering Delegation, Prioritization, and Legal/Ethical standards, you are proving to the NCLEX that you are ready to lead, manage, and protect your patients.

Review the Red Flags, memorize the Scope of Practice, and always trust your ABCs. You have the knowledge; now apply it with the confidence of a charge nurse.

Next Steps:

1. Take a practice quiz specifically focused on “Who do you see first?” questions.
2. Create your own “cheat sheet” for Scope of Practice based on your state’s Nurse Practice Act.
3. Review the “Informed Consent” process one more time before exam day.

🌟 Final Thought: The NCLEX doesn’t just test if you can care for one patient; it tests if you can care for all your patients safely. Be the manager of care.

Disclaimer: This content is for educational purposes and serves as a study guide for the NCLEX-RN. Always consult your official nursing textbooks and the NCSBN Test Plan for the most current information.