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NCLEX RN Exam Bank: Delegation Theory
Applications and Scope of Practice
Table of Contents
Subtopic 1: Principles of Safe Delegation in Nursing Practice ........................................... 2
Subtopic 2: Delegation to LPNs vs UAPs, Role Distinctions and Boundaries .................... 10
Subtopic 3: Legal and Ethical Accountability in Delegation ............................................. 18
Subtopic 4: Communication Strategies for Effective Delegation ..................................... 27
Subtopic 5: Interprofessional Collaboration and Delegation in Multidisciplinary Teams .... 35
Subtopic 6: Interdisciplinary Communication and Delegation Across Care Teams ........... 44
Subtopic 7: Delegation in Specialized Clinical Settings (ICU, ED, OR, Pediatrics, Mental
Health) ....................................................................................................................... 52
Subtopic 8: Cross-Disciplinary Delegation and Interprofessional Communication ........... 60
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Subtopic 1: Principles of Safe Delegation in Nursing
Practice
Question 1
A registered nurse (RN) is planning to delegate a task to a licensed practical nurse (LPN).
Which of the following tasks is appropriate to delegate?
A. Administering oral medications to a stable patient
B. Performing an initial assessment on a newly admitted client
C. Developing a nursing care plan for a complex patient
D. Providing discharge teaching to a client post-surgery
Correct Answer: A. Administering oral medications to a stable patient
Rationale: LPNs can administer oral medications to stable patients. Initial assessments,
care planning, and discharge teaching require the RN's expertise and critical thinking skills.
Question 2
Which of the following reflects the “right circumstance” in the five rights of delegation?
A. Assigning a UAP to administer insulin to a diabetic patient
B. Delegating ambulation of a post-op patient with stable vitals to a UAP
C. Asking an LPN to complete an initial assessment
D. Delegating patient education to a UAP
Correct Answer: B. Delegating ambulation of a post-op patient with stable vitals to a UAP
Rationale: The "right circumstance" ensures the situation is appropriate for delegation.
Ambulating a stable patient fits within the UAP’s scope.
Question 3
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A nurse assigns an unlicensed assistive personnel (UAP) to take vital signs for a group of
patients. Which action by the nurse reflects proper supervision?
A. Ignoring the task until shift end
B. Documenting the vital signs for the UAP
C. Following up on abnormal findings reported by the UAP
D. Assuming the UAP will complete the task correctly
Correct Answer: C. Following up on abnormal findings reported by the UAP
Rationale: Supervision includes ensuring the task was completed properly and intervening
if necessary, especially for abnormal findings.
Question 4
Which of the following tasks should NOT be delegated to a UAP?
A. Bathing a patient
B. Monitoring a patient receiving blood transfusion
C. Feeding a dementia patient
D. Taking daily weights
Correct Answer: B. Monitoring a patient receiving blood transfusion
Rationale: Monitoring for transfusion reactions requires clinical judgment and must be
performed by a licensed nurse.
Question 5
When delegating tasks to a UAP, what is the most important consideration for the nurse?
A. UAP’s years of experience
B. UAP’s personal preference
C. Patient stability and UAP's competency
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D. The unit's staffing ratio
Correct Answer: C. Patient stability and UAP's competency
Rationale: Delegation decisions must consider the complexity of care and the skill level of
the person being delegated to.
Question 6
Which situation demonstrates inappropriate delegation by a nurse?
A. Asking an LPN to perform wound care
B. Instructing a UAP to assess a patient's lung sounds
C. Assigning an LPN to give oral meds
D. Directing a UAP to reposition a bedbound client
Correct Answer: B. Instructing a UAP to assess a patient's lung sounds
Rationale: Assessment is a critical nursing function that must not be delegated to
unlicensed personnel.
Question 7
Which of the following tasks is appropriate for the RN to delegate to an LPN?
A. Discharge teaching
B. Dressing changes for a chronic wound in a stable patient
C. Interpretation of lab results
D. Development of care plans
Correct Answer: B. Dressing changes for a chronic wound in a stable patient
Rationale: LPNs may perform routine procedures like dressing changes on stable patients,
but teaching, interpretation, and care planning are RN roles.
NCLEX RN Exam Bank: Delegation Theory
Applications and Scope of Practice
Table of Contents
Subtopic 1: Principles of Safe Delegation in Nursing Practice ........................................... 2
Subtopic 2: Delegation to LPNs vs UAPs, Role Distinctions and Boundaries .................... 10
Subtopic 3: Legal and Ethical Accountability in Delegation ............................................. 18
Subtopic 4: Communication Strategies for Effective Delegation ..................................... 27
Subtopic 5: Interprofessional Collaboration and Delegation in Multidisciplinary Teams .... 35
Subtopic 6: Interdisciplinary Communication and Delegation Across Care Teams ........... 44
Subtopic 7: Delegation in Specialized Clinical Settings (ICU, ED, OR, Pediatrics, Mental
Health) ....................................................................................................................... 52
Subtopic 8: Cross-Disciplinary Delegation and Interprofessional Communication ........... 60
, 2
Subtopic 1: Principles of Safe Delegation in Nursing
Practice
Question 1
A registered nurse (RN) is planning to delegate a task to a licensed practical nurse (LPN).
Which of the following tasks is appropriate to delegate?
A. Administering oral medications to a stable patient
B. Performing an initial assessment on a newly admitted client
C. Developing a nursing care plan for a complex patient
D. Providing discharge teaching to a client post-surgery
Correct Answer: A. Administering oral medications to a stable patient
Rationale: LPNs can administer oral medications to stable patients. Initial assessments,
care planning, and discharge teaching require the RN's expertise and critical thinking skills.
Question 2
Which of the following reflects the “right circumstance” in the five rights of delegation?
A. Assigning a UAP to administer insulin to a diabetic patient
B. Delegating ambulation of a post-op patient with stable vitals to a UAP
C. Asking an LPN to complete an initial assessment
D. Delegating patient education to a UAP
Correct Answer: B. Delegating ambulation of a post-op patient with stable vitals to a UAP
Rationale: The "right circumstance" ensures the situation is appropriate for delegation.
Ambulating a stable patient fits within the UAP’s scope.
Question 3
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A nurse assigns an unlicensed assistive personnel (UAP) to take vital signs for a group of
patients. Which action by the nurse reflects proper supervision?
A. Ignoring the task until shift end
B. Documenting the vital signs for the UAP
C. Following up on abnormal findings reported by the UAP
D. Assuming the UAP will complete the task correctly
Correct Answer: C. Following up on abnormal findings reported by the UAP
Rationale: Supervision includes ensuring the task was completed properly and intervening
if necessary, especially for abnormal findings.
Question 4
Which of the following tasks should NOT be delegated to a UAP?
A. Bathing a patient
B. Monitoring a patient receiving blood transfusion
C. Feeding a dementia patient
D. Taking daily weights
Correct Answer: B. Monitoring a patient receiving blood transfusion
Rationale: Monitoring for transfusion reactions requires clinical judgment and must be
performed by a licensed nurse.
Question 5
When delegating tasks to a UAP, what is the most important consideration for the nurse?
A. UAP’s years of experience
B. UAP’s personal preference
C. Patient stability and UAP's competency
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D. The unit's staffing ratio
Correct Answer: C. Patient stability and UAP's competency
Rationale: Delegation decisions must consider the complexity of care and the skill level of
the person being delegated to.
Question 6
Which situation demonstrates inappropriate delegation by a nurse?
A. Asking an LPN to perform wound care
B. Instructing a UAP to assess a patient's lung sounds
C. Assigning an LPN to give oral meds
D. Directing a UAP to reposition a bedbound client
Correct Answer: B. Instructing a UAP to assess a patient's lung sounds
Rationale: Assessment is a critical nursing function that must not be delegated to
unlicensed personnel.
Question 7
Which of the following tasks is appropriate for the RN to delegate to an LPN?
A. Discharge teaching
B. Dressing changes for a chronic wound in a stable patient
C. Interpretation of lab results
D. Development of care plans
Correct Answer: B. Dressing changes for a chronic wound in a stable patient
Rationale: LPNs may perform routine procedures like dressing changes on stable patients,
but teaching, interpretation, and care planning are RN roles.
