Delegation Practice Test 1
Delegation NCLEX Practice Test
Delegation is a key topic within the NCLEX test plan, located under Safe and Effective Care Environment → Management of Care → Establishing Priorities → Delegation. This section strengthens safe task delegation and prioritization aligned with role competence and institutional policy. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 1st part of the Delegation series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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Delegation Practice Test 1
To whom should you delegate a task?
- Someone whom you trust.
- Someone who is competent.
- Someone you work with regularly.
- All of the above
Explanation: Answer reason: Delegation follows the Five Rights: the "right person" is someone competent and authorized to perform the task. Trust or working together regularly are not criteria for safe delegation.
The nurse has just received a report on a group of patients and plans to delegate care of several of the patients to an LPN (licensed practical nurse). The first thing the RN should do before delegating care is?
- Provide a time frame for completing patient care.
- Assure the LPN that the RN will be available for assistance.
- Ask about prior experience with similar patients.
- Review the specific procedures unique to the assignment.
Explanation: Answer reason: Before delegating, the RN must assess the competency of the delegatee to ensure the right task is assigned to the right person. Asking about the LPN’s prior experience with similar patients verifies capability and safety before assigning tasks.
A newly admitted elderly client is severely dehydrated. When planning care for this client, which one of the following is an appropriate task for an Unlicensed Assistive Personnel (UAP) member?
- Obtain a history of fluid loss.
- Report output of less than 30 mL/hr
- Monitor response to IV fluids.
- Check skin turgor every four hours.
Explanation: Answer reason: UAPs can measure intake and output and report abnormal findings. Obtaining a history, monitoring response to IV fluids, and assessing skin turgor are assessment and evaluation tasks requiring RN judgment.
The registered nurse is planning the client assignments for the day. Which assignment is most appropriate for the unlicensed assistive personnel (UAP)?
- Client is scheduled to receive parenteral nutrition.
- Client requires assistance with ambulation every 4 hours.
- Client scheduled for discharge needs teaching about medications.
- Client with bladder cancer is scheduled for a cardiac catheterization.
Explanation: Answer reason: UAPs may perform noninvasive, routine tasks such as ambulation assistance or hygiene under supervision. Parenteral nutrition, client teaching, and pre-procedure care require nursing judgment and must be completed by licensed nurses.
The RN is making assignments for the day. Which one of the following duties can be assigned to the unlicensed assistive personnel?
- Notifying the physician of an abnormal lab value
- Providing routine catheter care with soap and water
- Administering two aspirin to a client with a headache
- Setting the rate of an infusion of normal saline
Explanation: Answer reason: UAPs can perform noninvasive, routine hygiene tasks such as catheter care. They cannot administer medications, set IV rates, or communicate clinical findings to the provider.
The RN is planning client assignments. Which is the least appropriate task for the nursing assistant?
- Assisting a COPD client admitted 2 days ago to get up in the chair
- Feeding a client with bronchitis who is paralyzed on the right side
- Accompanying a discharged emphysema client to the transportation area
- Assessing an emphysema client complaining of difficulty breathing
Explanation: Answer reason: Assessment of a client with respiratory complaints requires RN judgment; UAPs do not perform assessments. Assisting with mobility, feeding after RN assessment of swallowing, and escorting a discharged client are appropriate UAP tasks.
The nurse is caring for a client with ulcerative colitis who is experiencing frequent diarrhea. Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
- Assessing the client's bowel sounds
- Providing perineal skin care after bowel movements
- Evaluating the client's response to antidiarrheal medications
- Interpreting intake and output data
Explanation: Answer reason: Delegation to UAP includes routine, noninvasive tasks that do not require clinical judgment. Providing perineal skin care is a standard hygiene measure that can be safely performed by UAP. Assessment (bowel sounds), evaluation (medication response), and clinical interpretation or decision-making (intake/output analysis, dietary changes) require RN-level judgment and cannot be delegated.
Which of the following tasks can a nurse safely delegate to a nursing assistant (NA) on a busy medical-surgical unit?
- Administer oral medications
- Assist a patient with ambulation
- Perform sterile dressing change
- Help a patient with feeding
- Take vital signs on stable patients
Explanation: Answer reason: Assisting with ambulation is an ADL and within the scope of practice for nursing assistants. Administering medications and performing sterile dressing changes require a licensed nurse.
Which client assignment is appropriate for the unlicensed assistive personnel (UAP)?
- A client requiring colostomy irrigation
- A client receiving continuous tube feedings
- A client who requires stool specimen collections
- A client who has difficulty swallowing food and fluids
Explanation: Answer reason: UAPs can perform routine, noninvasive tasks such as collecting stool specimens. Colostomy irrigation, managing continuous tube feedings, and caring for clients with dysphagia require nursing assessment and skill due to higher risk.
The nurse receives a report on an older adult client with middle stage dementia. What information suggests the nurse should do immediate follow up rather than delegate care to the nursing assistant? The client?
- Had difficulty recalling the names of staff
- Went to the bathroom to void twice during the night
- Was minimally responsive to voice and touch
- Wandered in the halls several times
Explanation: Answer reason: Minimal responsiveness indicates an acute change in level of consciousness, suggesting possible delirium and requiring immediate RN assessment rather than delegation. The other findings are typical behaviors in middle-stage dementia and are not urgent.
Which one of the following tasks, if delegated by the new charge nurse to a nursing assistant, would require intervention by the nurse manager?
- Helping an elderly client to the bathroom.
- Emptying a foley catheter bag.
- Bathing a woman with internal radon seeds.
- Feeding a two-year-old with a broken arm.
Explanation: Answer reason: Clients with internal radiation (radon or radioactive implants) require specific precautions and should only be cared for by trained personnel. Delegating this task to an unlicensed assistant endangers both staff and client.
Which task should be assigned to the nursing assistant?
- Placing the client in seclusion
- Emptying the Foley catheter of the preeclamptic client
- Feeding the client with dementia
- Ambulating the client with a fractured hip
Explanation: Answer reason: UAPs can perform routine, non-assessment tasks such as emptying a Foley and reporting output. Seclusion requires licensed nurse oversight, feeding a client with dementia may require assessment of swallowing/behavior, and ambulating a client with a fractured hip is unsafe and requires nurse supervision.
The nurse is assigning staff to care for a number of clients with emotional disorders. Which facet of care is suitable to the skills of the nursing assistant?
- Obtaining the vital signs of a client admitted for alcohol withdrawal
- Helping a client with depression with bathing and grooming
- Monitoring a client who is receiving electroconvulsive therapy
- Sitting with a client with mania who is in seclusion
Explanation: Answer reason: Assisting with activities of daily living is within the UAP/nursing assistant scope. Clients undergoing ECT or in seclusion require licensed staff monitoring, and a newly admitted alcohol-withdrawal client is unstable and needs RN assessment; thus those tasks are inappropriate to delegate to a nursing assistant.
The nurse is assigned to care for the client with a Steinmann pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?
- Assisting the LPN with opening sterile packages and peroxide
- Telling the LPN that clean gloves are allowed
- Telling the LPN that the registered nurse should perform pin care
- Asking the LPN to clean the weights and pulleys with peroxide
Explanation: Answer reason: Pin-site care requires sterile technique to prevent infection, and it is within the LPN scope with RN supervision. Since the LPN is using sterile gloves and sterile applicators appropriately, the RN should support and assist, not change the method or reassign the task.
Which assignment should NOT be performed by the nursing assistant?
- Feeding the client
- Bathing the client
- Obtaining a stool
- Administering a fleet enema
Explanation: Answer reason: Administering enemas is an invasive procedure requiring nursing assessment and skill; it is not delegated to unlicensed assistive personnel. Feeding, bathing, and collecting stool specimens are within their scope.
The primary cardiac nurse is delegating tasks to the unlicensed assistive personnel (UAP). Which delegation task warrants intervention by the charge nurse of the cardiac unit?
- The UAP is instructed to bathe the client who is on telemetry.
- The UAP is requested to obtain a bedside glucometer reading.
- The UAP is asked to assist with a portable chest x-ray.
- The UAP is told to feed a client who is dysphagic.
Explanation: Answer reason: Feeding a dysphagic client has a high aspiration risk and requires RN assessment and supervision or specialized training. Bathing a telemetry client, obtaining glucometer readings, and assisting with a portable chest x-ray are appropriate UAP tasks per facility policy.
The charge nurse is making assignments for a 30-bed cardiac unit staffed with three registered nurses (RNs), three licensed practical nurses (LPNs), and three unlicensed assistive personnel (UAPs). Which assignment is most appropriate by the charge nurse?
- Assign an RN to perform all sterile procedures.
- Assign an LPN to give all IV medications.
- Assign an UAP to complete the a.m. care.
- Assign an LPN to write the care plans.
Explanation: Answer reason: AM care (hygiene, bathing, grooming) falls within the UAP’s scope. Sterile procedures and care plans require an RN, and LPNs typically cannot give IV push meds or write plans.
The nurse assesses erratic electrical activity on the telemetry reading while the client is talking to the nurse on the intercom system. Which task should the nurse instruct the UAP to implement?
- Call a Code Blue immediately.
- Check the client's telemetry leads.
- Find the nurse to check the client.
- Remove the telemetry monitor.
Explanation: Answer reason: If the patient is talking normally, the rhythm disturbance is likely artifact. A UAP can appropriately check lead placement.
The nurse is assigning staff for the day. Which client should be assigned to the nursing assistant?
- A 5-month-old with bronchiolitis
- A 10-year-old 2-day post-appendectomy
- A 2-year-old with periorbital cellulitis
- A 1-year-old with a fractured tibia
Explanation: Answer reason: UAPs are assigned stable clients needing routine care. A day-2 post-appendectomy child is stable and needs ADLs/ambulation. Bronchiolitis and periorbital cellulitis require nursing assessment and monitoring; a fractured tibia may need neurovascular checks.
The nurse is making assignments for the day. The staff consists of an RN, an LPN, and a nursing assistant. Which client could the nursing assistant care for?
- A client with Alzheimer's disease
- A client with pneumonia
- A client with appendicitis
- A client with thrombophlebitis
Explanation: Answer reason: UAPs care for stable clients with predictable needs and basic ADLs. Clients with pneumonia, appendicitis, or thrombophlebitis require assessment and monitoring by licensed staff. A stable client with Alzheimer's needing routine care is appropriate for the nursing assistant.
A confused client has been placed in physical restraints by order of the physician. Which one of the following tasks could be assigned to an unlicensed Assistive Personnel (UAP)?
- Assist with activities of daily living
- Evaluate the clients safety
- Assess basic comfort needs
- Document mental status
Explanation: Answer reason: UAPs can perform non-assessment tasks that meet basic needs, such as assisting with ADLs. Evaluating safety, assessing comfort needs, and documenting mental status involve assessment/clinical judgment and must be done by a licensed nurse.
You are providing care for a comatose diabetic on IV insulin therapy. Which task would be most appropriate to delegate to a certified nursing assistant?
- Assessing the patient's level of consciousness
- Obtaining regular blood glucose readings
- Regulating the insulin infusion rate
- Teaching the wife about plan of care
Explanation: Answer reason: Fingerstick blood glucose checks are within CNA scope with proper training. Assessment of consciousness, titrating IV insulin, and client/family teaching require the nurse.
Which of the following activities can the registered nurse ask a Unlicensed Assistive Personnel (UAP) to perform?
- Taking a history on a newly admitted client
- Adjusting the rate of an intravenous medication
- Checking the blood pressure of a post operative client
- Assessing a client receiving chemotherapy
Explanation: Answer reason: UAPs can perform routine, non-judgment tasks like obtaining vital signs on stable clients. The other options involve assessment or medication management, which require RN judgment.
An unlicensed assistive personnel (UAP), who usually works on a surgical unit is assigned to float to a pediatric unit. Which one of these questions by the charge nurse would be most appropriate when making delegation decisions?
- How long have you been a UAP?
- What type of care do you give on the surgical unit?
- Are you comfortable caring for children?
- Can we review your competency checklist?
Explanation: Answer reason: Delegation requires verifying the UAP’s competency for assigned tasks. Reviewing the competency checklist objectively confirms skills, whereas experience length, prior unit tasks, or comfort are insufficient.
The charge nurse is planning assignments on a medical unit. Which one of the following clients could be assigned to the certified nursing assistant?
- A client who has difficulty swallowing after a stroke
- A client needing enemas until clear prior to colonoscopy
- A client with an order for a post-op dressing change
- A client who will be discharged to a long term facility
Explanation: Answer reason: CNA duties include routine, noninvasive tasks with predictable outcomes; administering/enforcing enemas before a colonoscopy fits this. The other options involve assessment, sterile procedures, or discharge planning, which require licensed nurses.
The nursing student is discussing with a preceptor the delegation of tasks to an unlicensed assistive personnel (UAP). Which one of the following tasks, delegated to a UAP, indicates the student needs further teaching about the delegation process?
- Assisting a patient to ambulate
- Feeding a two year-old in traction
- Providing discharge teaching
- Collecting a sputum specimen
Explanation: Answer reason: Education, assessment, and evaluation require RN judgment and cannot be delegated to UAP. Assisting with ambulation, feeding a stable patient, and collecting non-sterile specimens like sputum are within UAP scope.
The nurse is caring for a 69 year-old client with a diagnosis of hyperglycemia. Which one of the following tasks could the nurse delegate to the unlicensed assistive personnel (UAP)?
- Test blood sugar every two hours
- Teach signs of hyperglycemia
- Observe for mental status changes
- Assess circulation of extremities
Explanation: Answer reason: Blood glucose testing is a stable, predictable task appropriate for UAPs. Teaching, assessment, and evaluation require RN-level judgment and cannot be delegated.
Which one of the following statements by the nurse is appropriate when asking an Unlicensed Assistive Personnel (UAP) to assist a 69 year-old surgical client to ambulate for the first time?
- Have the client sit on the side of the bed before helping him stand.
- If the client is dizzy on standing, ask him to take some deep breaths.
- Assist the client to the bathroom at least twice.
- After you assist him to the chair, let me know how he feels.
Explanation: Answer reason: Asking the UAP to dangle the client before standing is a clear, safe, task-level instruction appropriate for delegation. The nurse cannot delegate assessment (dizziness, how he feels) or clinical decisions.
A nursing assistant reports to the RN that a patient with anemia is complaining of weakness. Which of the following responses by the nurse to the nursing assistant is BEST?
- Listen to the patient’s breath sounds and report back to me.
- Set up the patient’s lunch tray.
- Obtain a diet history from the patient.
- Instruct the patient to balance rest and activity.
Explanation: Answer reason: Assessment and teaching tasks (listening to breath sounds, obtaining a diet history, instructing on activity) are outside the nursing assistant’s scope. Setting up the lunch tray is an appropriate UAP task and supports nutrition for a patient with anemia.
You are the RN of a health care team that consists of one licensed practical/vocational nurse, one nursing assistant, a nursing student, and yourself. To whom is it appropriate to assign complete care for a new admission?
- Yourself
- The nursing student
- The licensed vocational nurse
- The nursing assistant
Explanation: Answer reason: A new admission requires initial assessment and clinical judgment, which cannot be delegated to an LPN/LVN, UAP, or student; the RN must provide the complete care initially.
You are the of a health care team that consists of one licensed practical/vocational nurse, one nursing assistant, a nursing student and yourself. To whom is it appropriate to assign complete care for?
- Yourself
- The nursing student
- The licensed vocational nurse
- The nursing assistant
Explanation: Answer reason: Complete care for a new or unspecified client requires full assessment, judgment, and planning—tasks that cannot be delegated to LPNs, UAPs, or students. The RN must assume responsibility for full client care.
Which action demonstrates appropriate use of the Five Rights of Delegation?
- Assigning the UAP to assess a newly admitted patient
- Instructing the LPN to administer oral medications to a stable patient
- Delegating ambulation assistance to the UAP for a post-op patient with stable vitals
- Supervising the UAP while they assist with feeding
- Delegating wound care for a stage 3 pressure injury to the LPN
Explanation: Answer reason: Ambulation of a stable postoperative patient is predictable, routine, and within the training of a UAP. Assessment, teaching, and sterile wound care require licensed nursing judgment and cannot be delegated.
A registered nurse is planning care for a group of clients on a medical-surgical unit. Which task is MOST appropriate to delegate to an unlicensed assistive personnel (UAP)?
- Administering oral medications to a stable postoperative client
- Assisting a stable client with ambulation in the hallway after surgery
- Assessing a client’s pain level after receiving an analgesic
- Teaching a client how to use an incentive spirometer
- Evaluating a client’s response to a new antihypertensive medication
Explanation: Answer reason: Ambulation of a stable patient is predictable, routine, and within UAP skill level. Assessment, teaching, and evaluation require nursing judgment and cannot be delegated.
A nurse is caring for a group of clients on a medical-surgical unit. Which of the following tasks is MOST appropriate to delegate to an unlicensed assistive personnel (UAP)?
- Explaining preoperative instructions to a client scheduled for surgery
- Performing an initial admission assessment on a newly admitted client
- Collecting a routine urine specimen from a stable client
- Titrating oxygen to maintain a client’s oxygen saturation
- Teaching a newly diagnosed diabetic client how to draw up insulin
Explanation: Answer reason: Collecting a routine urine specimen is predictable, non-invasive, and does not require nursing judgment, making it appropriate for delegation to UAPs. Tasks involving assessment, teaching, clinical evaluation, or adjusting treatments (such as titrating oxygen) cannot be delegated.
A nurse is working on a busy medical-surgical unit and needs to delegate tasks to a nursing assistant (NA). Which of the following tasks can the nurse safely delegate to the NA?
- Administer oral medications
- Assist a patient with ambulation
- Perform a sterile dressing change
- Take vital signs on unstable patients
- Help a patient with feeding
Explanation: Answer reason: Ambulating a stable patient is a predictable, routine intervention that does not require nursing judgment, making it appropriate for delegation to NAs. Sterile procedures, medication administration, assessments, and evaluation tasks cannot be delegated.
The RN is delegating tasks for the patient care technician (PCT) at the beginning of the shift. What task should NOT be delegated to the PCT?
- Giving a bed bath
- Emptying a Jackson-Pratt bulb drain
- Administering triamcinolone cream to rash
- Ambulating a patient with a gait belt
Explanation: Answer reason: PCTs/UAPs may perform routine, non-sterile, non-assessment tasks such as bathing and ambulating with appropriate safety equipment, and they may often measure/record drainage from devices like a Jackson-Pratt if facility policy allows. Applying a prescribed corticosteroid cream is medication administration, which requires nursing judgment (right medication, site/skin assessment, contraindications, response monitoring) and is not delegated to a PCT. Therefore administering triamcinolone cream is the task that should not be delegated.
A nurse on a pediatric unit is working with an assistive personnel. Which of the following tasks should the nurse have the AP perform first?
- Feed a school-age client who has burns on both upper extremities.
- Ambulate a preschooler who is postoperative to the playroom.
- Collect a stool sample for ova and parasites from a toddler.
- Bathe an adolescent client who is disabled.
Explanation: Answer reason: Assistive personnel may safely perform feeding for a stable client, and this child is unable to feed independently due to upper-extremity burns. Nutrition is a time-sensitive basic need. Postoperative ambulation requires nursing assessment, specimen collection involves infection-control judgment, and bathing can be delayed.
A new nurse is delegating a task to a nursing assistant. Which task is appropriate?
- Teaching insulin injection
- Assessing postoperative pain
- Ambulating a stable post-op patient
- Interpreting lab values
Explanation: Answer reason: Tasks delegated to a nursing assistant must be routine, have predictable outcomes, and not require nursing assessment, teaching, or clinical judgment. Teaching insulin injection and interpreting lab values require RN-level knowledge and judgment, and assessing postoperative pain is an RN assessment function. Ambulating a stable postoperative patient is an appropriate assistive personnel task when the nurse has assessed stability and provides needed instructions and supervision.
The nurse begins an IV antibiotic and delegates a task to the nursing assistant. This action describes which part of the nursing process?
- Assessment/data collection
- Diagnosis
- Planning
- Implementation
- Evaluation
Explanation: Answer reason: Implementation is the phase in which the nurse carries out planned interventions, including administering medications and delegating appropriate tasks to assistive personnel. Assessment, diagnosis, planning, and evaluation occur before or after this action, not during task execution.
The nurse is delegating care to unlicensed assistive personnel (UAP). Which task is appropriate?
- Assess lung sounds
- Administer IV fluids
- Perform sterile dressing change
- Ambulate a postoperative client
Explanation: Answer reason: UAP may perform routine, noninvasive tasks with predictable outcomes such as ambulating stable postoperative clients per the plan of care. Assessment (lung sounds), IV therapy, and sterile dressing changes require nursing judgment and/or sterile technique and are not appropriate for UAP delegation.
A nurse assign task to unlicensed assistive personnel. Which task is appropriate?
- Administer insulin injection
- Measure blood glucose with glucometer
- Assess pain level
- Teach patient about diet
Explanation: Answer reason: Measuring capillary blood glucose is a standard, noninvasive task that may be delegated to UAP when the client is stable and the nurse provides appropriate supervision and follow-up. Administering insulin is medication administration and requires nursing judgment and is not delegated to UAP. Assessing pain is an assessment requiring RN clinical judgment, and teaching about diet is patient education that must be performed by licensed nursing staff.
When delegating task, nurse should?
- Delegate based on nurse workload only
- Ensure task is within delegatee scope
- Avoid follow-up after delegation
- Delegate assessment tasks freely
Explanation: Answer reason: Safe delegation requires verifying the task is appropriate for the delegatee’s role, competence, and permitted scope, and that the client’s condition is stable. Delegation decisions are not based only on workload; they must prioritize client safety. The nurse retains accountability and must provide direction and follow-up, and assessment tasks requiring nursing judgment are not delegated to UAP.
A nurse assign task to unlicensed assistive personnel. Which task is appropriate?
- Administer IV antibiotics
- Measure blood glucose with glucometer
- Teach wound care
- Assess pain level
Explanation: Answer reason: Measuring capillary blood glucose is a routine, noninvasive task that can be delegated to UAP when the client is stable and the nurse provides appropriate supervision. Administering IV medications, performing assessments, and teaching require nursing judgment and must be completed by licensed nursing staff.
When delegating task, nurse should?
- Delegate assessment to UAP
- Delegate based on workload only
- Ensure task within delegatee scope
- Avoid follow-up after delegation
Explanation: Answer reason: Safe delegation requires confirming that the task is within the delegatee’s legal scope and competence, and that the nurse provides appropriate direction and follow-up. The nurse remains accountable for the outcome of delegated care.
Which task is appropriate for the nurse to delegate to a licensed practical nurse (LPN)?
- Teaching a client how to use an insulin pump
- Administering IV push morphine
- Assessing a client after receiving new-onset chest pain
- Monitoring a client 2 hours after receiving an oral pain med
Explanation: Answer reason: Monitoring a client 2 hours after receiving an oral pain med LPNs can perform focused, routine monitoring and report findings to the RN, especially when the patient is stable and the intervention is expected (e.g., reassessing response to an oral analgesic after time has passed). Teaching about an insulin pump requires RN-level patient education and evaluation of learning. IV push opioid administration is typically restricted to RNs in many settings, and new-onset chest pain requires immediate RN assessment and clinical judgment.
Which tasks can the RN safely delegate to an experienced UAP?
- Teach a client how to use an incentive spirometer
- Obtain a clean-catch urine specimen
- Provide initial ostomy self-care teaching
- Ambulate a stable client 8 hours post-hip arthroscopy using a gait belt
- Monitor for bleeding after a heparin infusion is started
Explanation: Answer reason: Obtain a clean-catch urine specimen Obtaining a clean-catch urine specimen is a routine, noninvasive task with predictable outcomes that can be delegated to an experienced UAP, with the RN providing instructions and ensuring proper labeling/transport. Teaching (incentive spirometer use, initial ostomy self-care) requires RN-level assessment and education and is not appropriate for UAP delegation. Monitoring for bleeding after initiating a heparin infusion requires ongoing assessment and clinical judgment, which must be performed by a licensed nurse.
Which task can the RN delegate to the LPN (Licensed Practical Nurse)?
- Assessing a newly admitted patient with pneumonia.
- Teaching a patient how to use an incentive spirometer.
- Administering IV push morphine for pain relief.
- Monitoring a stable post-op patient and reporting abnormal findings.
Explanation: Answer reason: Monitoring a stable post-op patient and reporting abnormal findings. LPNs can provide routine, predictable care to stable clients, including monitoring and collecting data and then reporting changes to the RN. Initial assessment of a newly admitted patient requires RN-level assessment and clinical judgment. Teaching (initial education) is an RN responsibility, and IV push opioids are typically RN-only due to the higher risk and need for advanced assessment and monitoring.
The nurse is caring for a patient who has been admitted to the hospital with a leg ulcer that is infected with vancomycin-resistant Staphylococcus aureus. Which nursing action can be assigned to an LPN/LVN?
- Planning ways to improve the patient's oral protein intake.
- Teaching the patient about home care of the leg ulcer.
- Obtaining wound cultures during dressing changes.
- Assessing the risk for further skin breakdown.
Explanation: Answer reason: LPN/LVN scope commonly includes performing sterile procedures and collecting specimens such as wound cultures during routine dressing changes when a plan of care is established. The RN must perform initial and ongoing comprehensive assessments (e.g., risk for skin breakdown) and develop care plans, which cannot be delegated. Patient teaching about home care requires RN-level teaching and evaluation of learning, making it inappropriate for delegation to the LPN/LVN in this context. Planning nutritional interventions is part of care planning and requires RN judgment.
A charge nurse on a busy medical-surgical unit needs to delegate tasks to the nursing staff. Which task is appropriate for the charge nurse to delegate to a licensed practical nurse (LPN)?
- Assessing a client's pain level and administering pain medication as ordered.
- Initiating intravenous (IV) therapy for a dehydrated client.
- Developing a nursing care plan for a newly admitted client.
- Providing education to a client about postoperative wound care.
Explanation: Answer reason: LPNs can perform focused assessments on stable clients and administer medications per provider order, consistent with their scope and facility policy. Initiating IV therapy may be restricted to RNs depending on jurisdiction/facility policy and is often considered a higher-skill intervention. Developing the initial nursing care plan and providing comprehensive patient education require RN-level assessment, planning, and teaching responsibilities.
Which of the following should the RN not delegate to an LPN?
- Blood transfusion
- NG tube insertion
- Tracheostomy care
- Wound dressing change
Explanation: Answer reason: Blood transfusion Blood transfusions require RN-level assessment and clinical judgment due to the risk for acute transfusion reactions and the need for rapid recognition and intervention (e.g., stopping the transfusion, maintaining IV access with normal saline, notifying the provider/blood bank). Initiation of blood products and ongoing evaluation of patient response are typically not appropriate for delegation to an LPN. By contrast, tracheostomy care and routine wound dressing changes are commonly within LPN scope for stable patients (per facility policy), and NG tube insertion may be LPN-permitted in some settings but is less universally restricted than starting blood.
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