NCLEX-RN Delegation and Assignment Exam 2026: Leadership and Scope
Questions with Answers and Rationales
1. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Ambulate a stable postoperative client who has already
walked twice today?
A. UAP
B. Unit secretary
C. LPN/LVN
D. RN
Correct Answer: A. UAP
Rationale: The task is routine, has a predictable outcome, and does not require nursing
assessment or teaching. The RN should provide clear parameters and remain responsible for
supervision and evaluation.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
2. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Reinforce previously taught ostomy-care instructions to
a stable client?
A. LPN/LVN
B. UAP
C. RN
D. Unit secretary
Correct Answer: A. LPN/LVN
Rationale: Reinforcement of established teaching for a stable client is commonly appropriate
for the LPN/LVN, whereas initial teaching and evaluation remain RN responsibilities.
,NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
3. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Perform the initial assessment of a newly admitted client
with chest pain?
A. LPN/LVN
B. Unit secretary
C. UAP
D. RN
Correct Answer: D. RN
Rationale: Initial assessment of an unstable or potentially unstable client requires RN-level
assessment and clinical judgment and cannot be delegated.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
4. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Obtain routine vital signs on a stable client before
discharge?
A. Unit secretary
B. UAP
C. LPN/LVN
D. RN
Correct Answer: B. UAP
Rationale: Routine data collection can be delegated when the client is stable and the RN
provides reporting parameters for abnormal findings.
NCLEX Client Need: Management of Care
,Clinical Judgment Focus: Generate solutions; Take action
5. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Administer scheduled oral medications to a stable
client?
A. Unit secretary
B. UAP
C. LPN/LVN
D. RN
Correct Answer: C. LPN/LVN
Rationale: Medication administration to stable clients is generally within LPN/LVN scope,
subject to jurisdiction and facility policy. The RN retains responsibility for initial assessment
and care planning.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
6. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Develop the nursing care plan for a client with multiple
new problems?
A. UAP
B. RN
C. Unit secretary
D. LPN/LVN
Correct Answer: B. RN
Rationale: Care planning requires assessment, synthesis, prioritization, and nursing judgment.
These responsibilities remain with the RN.
NCLEX Client Need: Management of Care
, Clinical Judgment Focus: Generate solutions; Take action
7. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Assist a stable client with feeding after the nurse has
confirmed swallowing safety?
A. UAP
B. RN
C. Unit secretary
D. LPN/LVN
Correct Answer: A. UAP
Rationale: Feeding a stable client can be delegated after the RN has assessed swallowing
and aspiration risk. The UAP must report coughing, choking, or other changes.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
8. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Evaluate whether IV morphine relieved a client’s severe
pain?
A. UAP
B. Unit secretary
C. RN
D. LPN/LVN
Correct Answer: C. RN
Rationale: Evaluation of the response to a high-risk intervention is an RN responsibility
because it requires assessment and clinical judgment.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
Questions with Answers and Rationales
1. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Ambulate a stable postoperative client who has already
walked twice today?
A. UAP
B. Unit secretary
C. LPN/LVN
D. RN
Correct Answer: A. UAP
Rationale: The task is routine, has a predictable outcome, and does not require nursing
assessment or teaching. The RN should provide clear parameters and remain responsible for
supervision and evaluation.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
2. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Reinforce previously taught ostomy-care instructions to
a stable client?
A. LPN/LVN
B. UAP
C. RN
D. Unit secretary
Correct Answer: A. LPN/LVN
Rationale: Reinforcement of established teaching for a stable client is commonly appropriate
for the LPN/LVN, whereas initial teaching and evaluation remain RN responsibilities.
,NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
3. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Perform the initial assessment of a newly admitted client
with chest pain?
A. LPN/LVN
B. Unit secretary
C. UAP
D. RN
Correct Answer: D. RN
Rationale: Initial assessment of an unstable or potentially unstable client requires RN-level
assessment and clinical judgment and cannot be delegated.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
4. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Obtain routine vital signs on a stable client before
discharge?
A. Unit secretary
B. UAP
C. LPN/LVN
D. RN
Correct Answer: B. UAP
Rationale: Routine data collection can be delegated when the client is stable and the RN
provides reporting parameters for abnormal findings.
NCLEX Client Need: Management of Care
,Clinical Judgment Focus: Generate solutions; Take action
5. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Administer scheduled oral medications to a stable
client?
A. Unit secretary
B. UAP
C. LPN/LVN
D. RN
Correct Answer: C. LPN/LVN
Rationale: Medication administration to stable clients is generally within LPN/LVN scope,
subject to jurisdiction and facility policy. The RN retains responsibility for initial assessment
and care planning.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
6. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Develop the nursing care plan for a client with multiple
new problems?
A. UAP
B. RN
C. Unit secretary
D. LPN/LVN
Correct Answer: B. RN
Rationale: Care planning requires assessment, synthesis, prioritization, and nursing judgment.
These responsibilities remain with the RN.
NCLEX Client Need: Management of Care
, Clinical Judgment Focus: Generate solutions; Take action
7. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Assist a stable client with feeding after the nurse has
confirmed swallowing safety?
A. UAP
B. RN
C. Unit secretary
D. LPN/LVN
Correct Answer: A. UAP
Rationale: Feeding a stable client can be delegated after the RN has assessed swallowing
and aspiration risk. The UAP must report coughing, choking, or other changes.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
8. The charge nurse on a medical-surgical unit is assigning care. Which team member is
most appropriate for this task: Evaluate whether IV morphine relieved a client’s severe
pain?
A. UAP
B. Unit secretary
C. RN
D. LPN/LVN
Correct Answer: C. RN
Rationale: Evaluation of the response to a high-risk intervention is an RN responsibility
because it requires assessment and clinical judgment.
NCLEX Client Need: Management of Care
Clinical Judgment Focus: Generate solutions; Take action
