Delegation NCLEX questions for nursing.
Delegation is a topic found on the NCLEX exam, and it’s a skill the registered nurse must learn to do on the job. Therefore, the RN must be aware of what can and can NOT be delegated to an LPN/LVN or UAP (nursing assistants etc.).
This quiz on nursing delegation will test your ability to determine what tasks can be delegated to other members of the nursing team. Don’t forget to check out the NCLEX review quizzes too!
Don’t forget to watch the lecture on nursing delegation before taking the quiz!
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Delegation NCLEX Questions for Nursing
1. You’re making the patient assignments for the next shift. On your unit there are three LPNs, two RNs, and two nursing assistants. Which patients will you assign to the LPNs?
A. A 68 year-old male patient who is expected to be discharged home with IV antibiotic therapy.
B. A 25 year-old female patient newly admitted with diabetic ketoacidosis.
C. A 75 year-old male patient with dementia who has an ileostomy and scheduled tube feedings.
D. A 65 year-old female patient who has an order to remove a Foley catheter.
Answers are C and D. Option A: An RN is the best for this patient because the patient will need discharge teaching AND the nurse will need to teach the patient how to self-administer antibiotics. Option B: This is a new admission and the patient is UNSTABLE. Most patients with DKA (diabetic ketoacidosis) require insulin drips along with close monitoring of the blood glucose levels, which requires critical thinking and interpretation. Options C and D are best for the LPNs: these are standard routine procedures the LPN can perform and these patient cases are stable.
2. As the registered nurse, which tasks below should you NOT delegate to the LPN?
A. Performing an assessment on a new admission
B. Collecting a urine sample from an indwelling Foley catheter
C. Developing a plan of care for a patient who is admitted with Guillain-Barré Syndrome
D. Educating a patient about how to monitor for side effects associated with Warfarin
E. Auscultating lung and bowel sounds
F. Starting a blood transfusion
G. Administering IV Morphine 2 mg for pain
H. Providing wound care to a stage 3 pressure injury
Answers are A, C, D, F, G….these are all out of the scope of practice for an LPN. Remember anything that deals with assessments, educating, evaluating, developing a plan of care, IV medications, unstable patients, or invasive/complex procedures where there is unpredictability the RN is responsible for doing it, and these tasks can’t be delegated. An LPN can perform a focused assessment by listening to lung or bowel sounds and report the findings to the RN but a comprehensive assessment is done by the RN. In addition, the LPN can perform standard procedures that are predictable on stable patients like wound care for a pressure injury, Foley catheter insertion, obtaining an EKG, obtaining blood glucose level etc.
3. On your unit there are two RNs: one is a new RN while the other is an experienced RN. In addition, there are three LPNs and two nursing assistants. Which tasks delegated to one of the nursing assistants by the new RN needs to be re-evaluated?
A. Apply hydrocortisone cream to eczema on skin after giving the patient a bath.
B. Assist the patient with administering a Fleet Enema.
C. Empty an ostomy bag.
D. Collect and record patient’s blood pressure, heart rate, temperature, oxygen saturation, respirations, and pain rating.
E. Assist a patient with ambulating.
Answers: A and B Option A is a task for an LPN or RN…hydrocortisone cream is a medication and the nursing assistant can’t administer medications. Option B: is a task for an LPN or RN….it is a procedure. Option C, D, and E are all delegated tasks a nursing assistant can perform.
4. When delegating you know that as an RN you must follow the 5 Rights of Delegation to make sure you are delegating properly. Select all the 5 Rights of Delegation:
A. Right Credentials
B. Right Direction/Communication
C. Right Supervision
D. Right Experience
E. Right Task
F. Right Person
G. Right Patient
H. Right Circumstance
I. Right Time
J. Right Order
The answers are: B, C, E, F, and H. The 5 Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision.
5. True or False: An RN delegates to the LPN to administer a scheduled tube feeding to a patient. The RN has now transferred full accountability to the LPN for the task getting done, and the RN is no longer accountable for the task.
FALSE: The RN can delegate this task to the LPN BUT the RN is still ACCOUNTABLE for the task getting done even though the RN is not the one performing it.
1. An RN has a critical patient that needs constant monitoring. However, the RN also has other patients in need of care. Which tasks below could the RN delegate to the LPN to help continue the process of patient care?
A. Admitting and assessing the new admission
B. Completing the discharge teaching to a patient going home
C. Updating and evaluating the patient’s plan of care
D. Administering subcutaneous Heparin
E. Obtaining a routine 12-lead EKG
F. Collecting a stool specimen
G. Flushing a central line with normal saline
Answers: D, E, and F…these are all tasks an LPN can perform. They are routine procedures that usually have predictable outcomes. RNs are responsible for performing assessments on new admissions, teaching, evaluating, flushing and maintain central lines, and updating the patient’s plan of care.
2. Which patients below are best assigned to the LPN?
A. A 30-year-old male patient with active GI bleeding that requires multiple blood transfusions.
B. A 78-year-old female with osteoporosis who needs assistance performing range of motion exercises and ambulating with a walker.
C. A 29-year-old male patient who is post-op day 6 from a colostomy placement that is on a clear liquid diet.
D. A 55-year-old male patient who reports chest pain and has ST segment elevation on his EKG.
Answers are B and C. LPNs should be assigned STABLE patients with predicable outcomes and cases that don’t require critical thinking or complex analysis. The patients in options A and D are unstable and require constant care with decisions being based on how to interpret patient findings.
3. Select all the task you could delegate to a nursing assistant as the RN:
A. Wound dressing change
B. IV flush
C. Collecting vital signs
D. Weighing a patient
E. Mouth care
F. Suctioning a patient
G. Applying oxygen to a patient
H. Connecting a patient to their IV fluids
I. Assisting a patient with a bath
J. Applying denture paste to dentures
Answers C, D, E, I and J. These are all tasks the RN could delegate to a nursing assistant.
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