NCLEX Delegation Questions
Delegation questions test whether you can assign the right task to the right team member — a core Management of Care skill on the NCLEX-RN.
Delegation is one of the highest-yield topics on the NCLEX-RN because Management of Care is the largest client needs category (17–23%). Every exam includes multiple delegation questions asking which task to assign to an LPN/LVN or UAP (unlicensed assistive personnel). These questions follow rules — not opinions. Once you understand the scope of practice boundaries and the 5 Rights of Delegation, you can answer these questions systematically.
The 5 Rights of Delegation
The NCSBN's 5 Rights of Delegation frame every delegation question: (1) Right Task — is this within the delegatee's scope? (2) Right Circumstance — is the patient stable enough for this to be delegated? (3) Right Person — is this team member competent for this specific task with this specific patient? (4) Right Direction/Communication — has the task been clearly described? (5) Right Supervision/Evaluation — will the RN follow up and evaluate? On any delegation question, if the answer violates one of these rights, it is wrong. Delegating a task that requires nursing judgment is always wrong, even if the delegatee is technically able to perform it.
What UAP (Unlicensed Assistive Personnel) Can Do
UAP can perform tasks that are routine, standardized, have predictable outcomes, and do not require assessment or judgment. Appropriate to delegate: vital signs on stable patients, ADLs (bathing, feeding, ambulating), positioning, intake and output measurement, weighing patients, applying oxygen at previously ordered rates, stocking supplies, transporting patients. NEVER delegate to UAP: assessment, teaching, evaluation, administering medications (except in specific states for medication technicians), sterile procedures, patient education, care of unstable patients, initial post-op vital signs, tube feedings involving assessment of placement or tolerance.
What LPN/LVN Can Do
LPN/LVN scope is broader than UAP but narrower than RN. Appropriate for LPN: administer PO, SubQ, IM medications (state-dependent for IV push), monitor stable patients, reinforce teaching that the RN has already provided, insert Foley catheters, perform sterile dressing changes, tracheostomy care on established trachs, tube feedings on stable patients. NOT appropriate for LPN: initial assessment, patient teaching (only reinforcement), IV push medications (in most states), blood administration (state-dependent), care of the acutely unstable patient, developing the plan of care, discharge teaching, care of a critically ill patient. Rule of thumb: LPNs care for stable patients with expected outcomes; RNs care for unstable or newly-admitted patients.
Assignment Making: Matching Patients to Nurses
Assignment questions ask which patient to assign to which staff member. Rules: (1) The most complex, unstable, or newly-admitted patient goes to the most experienced RN. (2) An LPN can care for stable patients with predictable trajectories. (3) A float nurse from a different specialty should be assigned patients in familiar clinical areas — do not assign a med-surg float to critical care. (4) A new graduate RN should not be assigned the highest-acuity patient. (5) Post-op day 1 = RN. Post-op day 3–4 stable = LPN acceptable. (6) Never assign a patient with an unstable airway, active bleeding, or unstable rhythm to anyone other than an experienced RN.