Delegation & Prioritization - 2026 Clinical Decision Making:
Midterm Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. The purpose of the 2019 National Guidelines for Nursing Delegation is to:
A. Replace state law
B. Eliminate assistive personnel
C. Increase workloads
D. Provide consistent guidance across practice settings for safe delegation
Correct Answer: D. Provide consistent guidance across practice settings for safe delegation
Rationale: The guidelines apply to all levels of nursing. State law still governs.
2. During a cardiac arrest, assistive personnel trained in CPR may:
A. Lead the resuscitation
B. Perform chest compressions as part of the team under direction
C. Push IV medications
D. Interpret rhythms
Correct Answer: B. Perform chest compressions as part of the team under direction
Rationale: BLS skills are within AP training. Licensed staff manage drugs and rhythms.
3. Delegation is a skill that requires:
A. Only authority
B. Only seniority
C. Only friendship
D. Knowledge of scope, communication skills and clinical judgment
Correct Answer: D. Knowledge of scope, communication skills and clinical judgment
Rationale: Delegation is learned and improves with practice. It is part of nursing leadership.
,4. Competency validation for assistive personnel should be:
A. Assumed from job title
B. Never documented
C. Documented and reassessed periodically by the employer
D. Done only once in a career
Correct Answer: C. Documented and reassessed periodically by the employer
Rationale: Competence must be verified. Policies outline training requirements.
5. Direct supervision means the supervising nurse is:
A. Available by phone only
B. Absent from the facility
C. Physically present and immediately available
D. Reviewing records later
Correct Answer: C. Physically present and immediately available
Rationale: Indirect supervision allows the nurse to be available but not on site. Required levels
vary by state and task.
6. Authority in delegation refers to:
A. Physical strength
B. Seniority alone
C. The legitimate right to act and to direct others, granted by law and the organization
D. Popularity on the unit
Correct Answer: C. The legitimate right to act and to direct others, granted by law and the
organization
Rationale: Licensed nurses have authority to delegate within law and policy. The delegatee
does not gain authority to delegate further.
,7. Effective delegation requires trust, which is built through:
A. Clear communication, respect, feedback and consistent follow-up
B. Avoiding interaction
C. Micromanaging everything
D. Criticizing publicly
Correct Answer: A. Clear communication, respect, feedback and consistent follow-up
Rationale: Teams function better with trust. Recognition improves morale.
8. According to the 2019 ANA/NCSBN National Guidelines for Nursing Delegation, delegation is:
A. Transferring all responsibility for a patient to another person
B. Allowing a delegatee to perform a specific nursing activity, skill or procedure beyond their
traditional role, for which they are trained and competent, while the delegator retains
accountability
C. Assigning routine care within a person's job description
D. Handing off a patient at shift change
Correct Answer: B. Allowing a delegatee to perform a specific nursing activity, skill or
procedure beyond their traditional role, for which they are trained and competent, while the
delegator retains accountability
Rationale: Delegation applies to tasks outside routine duties. Accountability for the patient
stays with the licensed nurse.
9. Overdelegation occurs when a nurse:
A. Delegates tasks beyond the delegatee's competence or that require nursing judgment
B. Performs all tasks personally
C. Delegates appropriate tasks
D. Asks for help
Correct Answer: A. Delegates tasks beyond the delegatee's competence or that require
nursing judgment
Rationale: Overdelegation endangers patients. It may result from heavy workloads.
, 10. A nurse who delegates a task to someone known to be incompetent may be:
A. Protected from liability
B. Praised
C. Not responsible
D. Held accountable for negligent delegation
Correct Answer: D. Held accountable for negligent delegation
Rationale: Knowing competence is part of the delegator's duty. Harm may lead to discipline or
lawsuits.
11. The delegatee's responsibilities include:
A. Accepting any task
B. Changing tasks independently
C. Re-delegating when busy
D. Accepting only tasks they are competent to perform, completing them correctly and
reporting changes
Correct Answer: D. Accepting only tasks they are competent to perform, completing them
correctly and reporting changes
Rationale: Delegatees must communicate concerns. They are accountable for their own
actions.
12. Effective delegation benefits patient care by:
A. Reducing nurse involvement in care
B. Eliminating supervision
C. Allowing licensed nurses to focus on assessment, judgment and complex care
D. Increasing errors
Correct Answer: C. Allowing licensed nurses to focus on assessment, judgment and complex
care
Rationale: Appropriate delegation improves efficiency. Poor delegation increases risk.
Midterm Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. The purpose of the 2019 National Guidelines for Nursing Delegation is to:
A. Replace state law
B. Eliminate assistive personnel
C. Increase workloads
D. Provide consistent guidance across practice settings for safe delegation
Correct Answer: D. Provide consistent guidance across practice settings for safe delegation
Rationale: The guidelines apply to all levels of nursing. State law still governs.
2. During a cardiac arrest, assistive personnel trained in CPR may:
A. Lead the resuscitation
B. Perform chest compressions as part of the team under direction
C. Push IV medications
D. Interpret rhythms
Correct Answer: B. Perform chest compressions as part of the team under direction
Rationale: BLS skills are within AP training. Licensed staff manage drugs and rhythms.
3. Delegation is a skill that requires:
A. Only authority
B. Only seniority
C. Only friendship
D. Knowledge of scope, communication skills and clinical judgment
Correct Answer: D. Knowledge of scope, communication skills and clinical judgment
Rationale: Delegation is learned and improves with practice. It is part of nursing leadership.
,4. Competency validation for assistive personnel should be:
A. Assumed from job title
B. Never documented
C. Documented and reassessed periodically by the employer
D. Done only once in a career
Correct Answer: C. Documented and reassessed periodically by the employer
Rationale: Competence must be verified. Policies outline training requirements.
5. Direct supervision means the supervising nurse is:
A. Available by phone only
B. Absent from the facility
C. Physically present and immediately available
D. Reviewing records later
Correct Answer: C. Physically present and immediately available
Rationale: Indirect supervision allows the nurse to be available but not on site. Required levels
vary by state and task.
6. Authority in delegation refers to:
A. Physical strength
B. Seniority alone
C. The legitimate right to act and to direct others, granted by law and the organization
D. Popularity on the unit
Correct Answer: C. The legitimate right to act and to direct others, granted by law and the
organization
Rationale: Licensed nurses have authority to delegate within law and policy. The delegatee
does not gain authority to delegate further.
,7. Effective delegation requires trust, which is built through:
A. Clear communication, respect, feedback and consistent follow-up
B. Avoiding interaction
C. Micromanaging everything
D. Criticizing publicly
Correct Answer: A. Clear communication, respect, feedback and consistent follow-up
Rationale: Teams function better with trust. Recognition improves morale.
8. According to the 2019 ANA/NCSBN National Guidelines for Nursing Delegation, delegation is:
A. Transferring all responsibility for a patient to another person
B. Allowing a delegatee to perform a specific nursing activity, skill or procedure beyond their
traditional role, for which they are trained and competent, while the delegator retains
accountability
C. Assigning routine care within a person's job description
D. Handing off a patient at shift change
Correct Answer: B. Allowing a delegatee to perform a specific nursing activity, skill or
procedure beyond their traditional role, for which they are trained and competent, while the
delegator retains accountability
Rationale: Delegation applies to tasks outside routine duties. Accountability for the patient
stays with the licensed nurse.
9. Overdelegation occurs when a nurse:
A. Delegates tasks beyond the delegatee's competence or that require nursing judgment
B. Performs all tasks personally
C. Delegates appropriate tasks
D. Asks for help
Correct Answer: A. Delegates tasks beyond the delegatee's competence or that require
nursing judgment
Rationale: Overdelegation endangers patients. It may result from heavy workloads.
, 10. A nurse who delegates a task to someone known to be incompetent may be:
A. Protected from liability
B. Praised
C. Not responsible
D. Held accountable for negligent delegation
Correct Answer: D. Held accountable for negligent delegation
Rationale: Knowing competence is part of the delegator's duty. Harm may lead to discipline or
lawsuits.
11. The delegatee's responsibilities include:
A. Accepting any task
B. Changing tasks independently
C. Re-delegating when busy
D. Accepting only tasks they are competent to perform, completing them correctly and
reporting changes
Correct Answer: D. Accepting only tasks they are competent to perform, completing them
correctly and reporting changes
Rationale: Delegatees must communicate concerns. They are accountable for their own
actions.
12. Effective delegation benefits patient care by:
A. Reducing nurse involvement in care
B. Eliminating supervision
C. Allowing licensed nurses to focus on assessment, judgment and complex care
D. Increasing errors
Correct Answer: C. Allowing licensed nurses to focus on assessment, judgment and complex
care
Rationale: Appropriate delegation improves efficiency. Poor delegation increases risk.
