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🤝 NCLEX guideUpdated October 20267 min read4 practice questions

NCLEX delegation: who can do what, and how to answer

Delegation items are prioritization's twin: instead of choosing which client, you choose which task goes to which person. The exam uses the ANA and NCSBN's 2019 delegation guidelines as its model, and the rules are consistent enough that four principles answer almost every item.

The Five Rights of Delegation

From the 2019 ANA/NCSBN joint statement:

  1. Right task: within the delegatee's role and competence, with a predictable outcome.
  2. Right circumstance: a stable client, an appropriate setting, resources available.
  3. Right person: this delegatee has the training and competence for this task with this client.
  4. Right directions and communication: what, when, how, and what to report back.
  5. Right supervision and evaluation: the licensed nurse follows up and evaluates the outcome.

The guidelines also separate delegation (allowing a delegatee to perform a specific activity beyond their routine role) from assignment (routine work already within the delegatee's authorized scope). The exam mostly uses "delegate" loosely for both; the scope questions are the same.

What can never be delegated

The licensed nurse "cannot delegate nursing judgment". In the ANA/NCSBN words, "clinical reasoning, nursing judgement and critical decision making cannot be delegated", and the licensed nurse "maintains overall accountability for the patient". In exam terms the RN keeps:

  • The initial assessment and any assessment of a change in condition.
  • Planning the care and setting goals.
  • Evaluation of whether the care worked.
  • Initial teaching and discharge teaching.
  • Unstable clients and anything with an unpredictable outcome.

The featured lesson Never Delegate What You EAT gives the mnemonic: Evaluate, Assess, Teach.

Who does what

RoleTypically takesTypically does not
Assistive personnel (UAP, CNA, PCT)ADLs, bathing, feeding stable clients, ambulating established clients, vital signs on stable clients, I&O, repositioning, specimen collectionAnything requiring assessment or judgment: the first vital signs after a change, a client's first time out of bed after surgery, feeding a client with new dysphagia
LPN/LVNStable clients with expected outcomes, medication administration within state scope, dressing changes, reinforcing teaching the RN already gave, collecting data and reporting itInitial assessments, care plans, initial teaching, unstable clients, blood and IV push medications in many states
RNEverything above plus assessment, planning, evaluation, teaching, unstable and complex clients, and accountability for what is delegatedRoutine tasks another role can do safely while the RN handles judgment

State scope varies, especially for LPN/LVN IV therapy and blood products. The exam avoids the gray zone: when an item hinges on a task that some states allow and others do not, the right answer usually turns on client stability or the need for assessment rather than the task itself.

The words that decide a delegation item

  • "Stable", "chronic", "expected", "routine", "established" point to the UAP or LPN.
  • "New", "first", "sudden", "unstable", "change", "post-op day 0" keep the task with the RN.
  • "Assess", "evaluate", "teach", "plan", "develop" are RN verbs. "Reinforce", "collect", "monitor", "report", "assist" fit the LPN/LVN. "Measure", "record", "ambulate", "bathe", "feed" fit the UAP.
  • If the stem asks which task to delegate, pick the most routine one for the most stable client. If it asks which client the RN should keep, pick the one whose situation requires judgment.

A worked delegation item

An RN is working with an LPN/LVN and an assistive personnel (AP) on a medical unit. Which task is appropriate to assign to the AP?

  1. Reposition a client who had a stroke 3 days ago and is on a two-hour turning schedule. Routine, stable, predictable: the AP's work. Appropriate.
  2. Take the first set of vital signs on a client just back from a cardiac catheterization. The first post-procedure vitals need interpretation and a check of the puncture site; the RN keeps them. Not for the AP.
  3. Help a client who had a hip replacement this morning out of bed for the first time. First ambulation after surgery is an assessment of tolerance; RN or therapy. Not for the AP.
  4. Reinforce the low-sodium diet teaching with a client being discharged tomorrow. Reinforcing teaching fits the LPN/LVN, not the AP. Not for the AP.

Only one option is both routine and for a stable client. Notice that two distractors are reasonable tasks for someone; the question was who. Reading the stem's exact ask ("assign to the AP") before the options saves most of the time.

On the PN exam

PN candidates see the mirror image: the stem's nurse is the LPN/LVN, and the question is what to accept, what to assign to assistive personnel, and what to report to the RN. The 2026 PN test plan's verbs are "collect", "contribute to", "reinforce" and "monitor"; new findings and changes go up the chain. RN vs PN covers the scope filter.

✅ Test yourself: 4 questions

Four delegation items. Decide who in the stem may do each task before you read the options. Every client is fictional; exam practice only, not medical advice.

Question 1 of 4

A client on a medical unit has a cardiac arrest. The code team has arrived and is managing the airway, the defibrillator, and medications, and the nurse is giving chest compressions. Which task should the nurse ask the assistive personnel (AP), who is certified in basic life support, to take on?

  1. Drawing up the next dose of epinephrine from the crash cart
  2. Taking a turn at chest compressions, switching about every 2 minutes
  3. Checking for a carotid pulse every 30 seconds to see whether compressions are working
  4. Watching the monitor and calling out when the rhythm changes
Show the answer and rationale

Answer: B

A rescuer certified in basic life support can give chest compressions, and AHA guidance is to switch compressors about every 2 minutes, during a planned pause, because compression quality falls as rescuers tire. Pulse checks every 30 seconds are the strongest distractor, since they sound like monitoring the effect of CPR, but every pause lowers blood flow to the heart and brain, so checks happen only at the planned rhythm checks and last no more than 10 seconds. Interpreting the rhythm on the monitor requires licensed judgment, and preparing medications is not an AP task.

📚 Learn it: The Five Rights of Delegation

Question 2 of 4

An RN in a primary care clinic works with a licensed practical nurse (LPN). Which task should the RN keep rather than assign to the LPN?

  1. Giving a stable client the monthly vitamin B12 injection the provider prescribed
  2. Calling a client to relay the provider's note that his cholesterol results are normal
  3. Reinforcing the inhaler technique the RN taught a client at last month's visit
  4. Returning a call from a client who reports new shortness of breath
Show the answer and rationale

Answer: D

Deciding how urgent a new symptom is, and whether the caller needs 911, a same-day visit or care at home, is telephone triage, which rests on assessment and nursing judgment, so the RN keeps the call; an LPN may collect data with a structured tool but does not independently assess. Relaying a result is the strongest distractor because it sounds like interpreting labs, but the provider has already interpreted it, and passing on the provider's message is within LPN scope. A scheduled injection for a stable client and reinforcing teaching the RN already gave are also LPN tasks.

📚 Learn it: Delegation Cheat Code: Never Delegate What You EAT

Question 3 of 4

A nurse who is precepting a newly licensed nurse discusses delegation to assistive personnel (AP). Which statement by the newly licensed nurse requires follow-up?

  1. 'An AP who isn't trained to do a task has the right to refuse it.'
  2. 'I can delegate taking vital signs on a stable client but not interpreting them.'
  3. 'If the AP gets too busy, the AP can pass the task to another AP.'
  4. 'The AP is responsible for doing the task right, but I'm still accountable.'
Show the answer and rationale

Answer: C

A delegatee may not pass a delegated task to someone else; an AP who cannot complete it informs the nurse right away, and the nurse decides how the work will get done. The statement that an untrained AP may refuse a task sounds like insubordination, but it is correct, because a delegatee accepts only tasks the delegatee is competent to perform. The AP is responsible for doing the task well while the nurse who delegates remains accountable for the client and the outcome, and the nurse keeps the interpretation of vital signs, because assessment cannot be delegated.

📚 Learn it: The Five Rights of Delegation

Question 4 of 4

A charge nurse hears an RN give these instructions to an assistive personnel (AP). Which instruction requires the charge nurse to intervene?

  1. 'Check the client's IV site, and stop the infusion if it looks swollen.'
  2. 'If the client says the IV site hurts or feels wet, tell me at once.'
  3. 'Recheck the stable client's BP 1 hour after the new drug and tell me.'
  4. 'Walk the stable client in the hall, and if he gets short of breath, sit him down and get me.'
Show the answer and rationale

Answer: A

Inspecting an IV site for infiltration and deciding to stop an infusion require assessment and judgment, so this task must stay with a licensed nurse. Asking the AP to report when the client says the IV site hurts or feels wet sounds like IV monitoring, but the AP is only passing on the client's complaint and the nurse does the assessment. Sitting a short-of-breath client down and getting the nurse is a safety step within the AP's role, and measuring a stable client's blood pressure is routine, with the nurse interpreting the reading.

📚 Learn it: Delegation Cheat Code: Never Delegate What You EAT

Practice 10 delegation and management questions →

Management of Care items with rationales, misses saved to Weak Spots. Free, no sign-up.

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❓ Frequently asked

What are the Five Rights of Delegation?

Right task, right circumstance, right person, right directions and communication, right supervision and evaluation (ANA/NCSBN, 2019).

What can an RN never delegate?

Nursing judgment: assessment, planning, evaluation, initial teaching, and care of unstable clients. The RN keeps accountability for anything delegated.

Can a UAP take vital signs?

On a stable client, yes. Not the first set after a change in condition, after a procedure, or when the stem implies the result needs interpretation right away.

Can an LPN/LVN do client teaching?

The LPN/LVN reinforces teaching the RN has already given. Initial and discharge teaching stay with the RN on the exam.

📝 Practice this topic

📚 Learn it in the app's lessons

Sources

  1. ANA and NCSBN, National Guidelines for Nursing Delegation / Joint Statement on Delegation (2019)
  2. NCSBN, NCLEX-RN Test Plan effective April 2026 (categories, 85–150 items, case studies, scoring methods, how the exam ends)
  3. NCSBN, NCLEX-PN Test Plan effective April 2026

Accessed October 2026. Yearly figures name their year; NCSBN publishes a new statistics brief each June and a new test plan every three years (next: April 2029). Exam preparation only, never medical advice. NCLEX® is a registered trademark of NCSBN, which does not endorse this site.

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