1|Page
MEDICAL-SURGICAL NURSING 11TH
EDITION — DELEGATION AND
ASSIGNMENT PRACTICE [QUESTION 1-
100] AND ANSWERS UPDATED 2026/2027 |
100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+
GRADED | INSTANT DOWNLOAD
INTRODUCTION
The Medical-Surgical Nursing 11th Edition — Delegation and Assignment Practice exam is
designed to develop advanced clinical judgment involving patient assignments, delegation,
prioritization, supervision, and scope of nursing practice. It is intended for nursing students
preparing for medical-surgical examinations, competency assessments, and NCLEX-style
questions in which safe distribution of patient-care responsibilities is essential. Effective
delegation requires more than identifying which tasks can be performed by another team
member; the nurse must consider patient stability, predictability of outcomes, complexity of care,
required assessment skills, education needs, and the delegatee's competency and legal scope.
This practice bank uses challenging clinical scenarios rather than simple definitions. Questions
require the learner to determine which patient should receive attention first, which assignment is
appropriate for an RN, LPN/LVN, or nursing assistant, when a task should not be delegated, and
how the registered nurse retains accountability for delegated care. Detailed rationales explain the
reasoning behind every answer and distinguish appropriate delegation from unsafe transfer of
nursing judgment. Repeated practice can strengthen prioritization, assignment-making,
communication, supervision, and recognition of situations requiring direct RN intervention.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
Five rights, accountability, competency,
1. Principles of Delegation 1–12 12%
supervision
2. RN vs. LPN/LVN Assessment, planning, implementation,
13–25 13%
Responsibilities evaluation
3. Nursing Assistant Assignments 26–37 ADLs, vital signs, mobility, reporting 12%
ABCs, unstable patients, clinical
4. Prioritization & Acuity 38–50 13%
deterioration
,2|Page
Content Area Questions Key Topics Weight
5. Complex Medical-Surgical Cardiac, respiratory, neurologic, renal
51–62 12%
Assignments patients
6. Delegation Communication & Instructions, follow-up, feedback,
63–72 10%
Supervision escalation
7. Legal, Ethical & Professional Scope, liability, documentation,
73–80 8%
Accountability advocacy
8. Emergency & High-Risk Rapid response, postoperative
81–90 10%
Assignments emergencies, sepsis
Multiple patients, competing priorities,
9. Integrated Clinical Judgment 91–100 10%
safe assignments
QUESTIONS 1-100
CONTENT AREA 1: PRINCIPLES OF DELEGATION
Q1:
The RN is assigning care to an experienced nursing assistant. Which task is most appropriate to
delegate for a stable patient?
A) Assessing a newly developed pressure injury
B) Assisting a stable patient with bathing and reporting any skin changes
C) Developing the patient's individualized pressure-injury prevention plan
D) Determining whether the patient requires a specialty wound consultation
Rationale: The correct answer is B because assisting with routine activities of daily living for a
stable patient is generally appropriate for a competent nursing assistant, with abnormal findings
reported to the RN. Option A requires nursing assessment and should not be delegated. Option C
requires clinical judgment and care planning. Option D requires professional assessment and
decision-making.
Q2:
A charge nurse asks an RN to delegate several tasks during a particularly busy shift. Which
principle should guide the RN's decision?
A) Delegate the most time-consuming tasks regardless of patient condition
B) Delegate all tasks that the RN personally dislikes
C) Match the patient's needs and task complexity with the delegatee's competence and
authorized scope
D) Delegate any task as long as the delegatee has worked on the unit for more than 1 year
,3|Page
Rationale: The correct answer is C because safe delegation requires matching the task and
patient situation with the individual's competence, scope, and ability to perform the activity
safely. Experience alone does not authorize every task. A and B disregard patient safety. D
incorrectly assumes that length of employment establishes competency for all activities.
Q3:
An RN delegates routine vital signs to a nursing assistant for a stable patient. The assistant
reports a blood pressure of 84/48 mm Hg. What should the RN do first?
A) Ask the assistant to document the value and continue with other tasks
B) Tell the assistant to notify the provider independently
C) Immediately assess the patient and determine the significance and cause of the
hypotension
D) Wait until the next scheduled vital-sign measurement
Rationale: The correct answer is C because the RN retains responsibility for assessment and
clinical judgment. Severe hypotension may indicate acute deterioration and requires prompt
evaluation. A and D delay necessary assessment. B improperly transfers the RN's assessment
responsibility to the assistant.
Q4:
Which patient would be inappropriate for assignment to an LPN/LVN?
A) A stable patient requiring routine oral medications
B) A patient with a chronic wound requiring an established dressing procedure
C) A stable patient requiring routine postoperative observations
D) A newly admitted patient with unexplained hypotension requiring comprehensive
assessment
Rationale: The correct answer is D because a newly admitted unstable patient requiring
comprehensive assessment and clinical judgment should generally be assigned to an RN.
Options A, B, and C may be appropriate for an LPN/LVN depending on jurisdiction, institutional
policy, and demonstrated competency.
Q5:
A nurse is delegating ambulation to a nursing assistant. Which patient should the nurse not
delegate for independent ambulation?
A) A stable patient who has ambulated independently before admission
B) A patient requiring routine assistance after prolonged bed rest
C) A patient who became dizzy and hypotensive during the previous transfer
D) A stable patient using a prescribed walker
, 4|Page
Rationale: The correct answer is C because recent dizziness and hypotension create an
unpredictable fall risk requiring nursing assessment and potentially individualized mobility
planning. Options A, B, and D may be delegated when the patients are stable and the assistant is
competent.
Q6:
An RN delegates a task to a nursing assistant but fails to explain the patient's limitations. The
patient subsequently falls. Which delegation principle was primarily violated?
A) Right time
B) Right documentation
C) Right direction and communication
D) Right medication
Rationale: The correct answer is C because delegation requires clear instructions regarding
what is expected, relevant patient-specific risks, and when to report findings. The other choices
do not address the primary delegation failure described.
Q7:
A nursing assistant tells the RN, “I have never performed this procedure before.” What should
the RN do?
A) Tell the assistant to watch another assistant and perform it independently
B) Tell the assistant that refusing the task is never permitted
C) Verify competency and arrange appropriate instruction or assign the task to someone
qualified
D) Perform the procedure only after the assistant attempts it unsuccessfully
Rationale: The correct answer is C because the RN must ensure that delegated activities are
within the individual's competency and authorized scope. A and B create unsafe practice. D
unnecessarily exposes the patient to risk.
Q8:
An RN delegates routine hygiene to an experienced nursing assistant. During care, the assistant
notices a new open area on the patient's sacrum. What is the appropriate response?
A) Apply a dressing independently without notifying the RN
B) Ignore it because skin assessment is never relevant to hygiene care
C) Stop and report the finding to the RN so the nurse can assess and plan care
D) Photograph the wound using a personal phone
MEDICAL-SURGICAL NURSING 11TH
EDITION — DELEGATION AND
ASSIGNMENT PRACTICE [QUESTION 1-
100] AND ANSWERS UPDATED 2026/2027 |
100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+
GRADED | INSTANT DOWNLOAD
INTRODUCTION
The Medical-Surgical Nursing 11th Edition — Delegation and Assignment Practice exam is
designed to develop advanced clinical judgment involving patient assignments, delegation,
prioritization, supervision, and scope of nursing practice. It is intended for nursing students
preparing for medical-surgical examinations, competency assessments, and NCLEX-style
questions in which safe distribution of patient-care responsibilities is essential. Effective
delegation requires more than identifying which tasks can be performed by another team
member; the nurse must consider patient stability, predictability of outcomes, complexity of care,
required assessment skills, education needs, and the delegatee's competency and legal scope.
This practice bank uses challenging clinical scenarios rather than simple definitions. Questions
require the learner to determine which patient should receive attention first, which assignment is
appropriate for an RN, LPN/LVN, or nursing assistant, when a task should not be delegated, and
how the registered nurse retains accountability for delegated care. Detailed rationales explain the
reasoning behind every answer and distinguish appropriate delegation from unsafe transfer of
nursing judgment. Repeated practice can strengthen prioritization, assignment-making,
communication, supervision, and recognition of situations requiring direct RN intervention.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
Five rights, accountability, competency,
1. Principles of Delegation 1–12 12%
supervision
2. RN vs. LPN/LVN Assessment, planning, implementation,
13–25 13%
Responsibilities evaluation
3. Nursing Assistant Assignments 26–37 ADLs, vital signs, mobility, reporting 12%
ABCs, unstable patients, clinical
4. Prioritization & Acuity 38–50 13%
deterioration
,2|Page
Content Area Questions Key Topics Weight
5. Complex Medical-Surgical Cardiac, respiratory, neurologic, renal
51–62 12%
Assignments patients
6. Delegation Communication & Instructions, follow-up, feedback,
63–72 10%
Supervision escalation
7. Legal, Ethical & Professional Scope, liability, documentation,
73–80 8%
Accountability advocacy
8. Emergency & High-Risk Rapid response, postoperative
81–90 10%
Assignments emergencies, sepsis
Multiple patients, competing priorities,
9. Integrated Clinical Judgment 91–100 10%
safe assignments
QUESTIONS 1-100
CONTENT AREA 1: PRINCIPLES OF DELEGATION
Q1:
The RN is assigning care to an experienced nursing assistant. Which task is most appropriate to
delegate for a stable patient?
A) Assessing a newly developed pressure injury
B) Assisting a stable patient with bathing and reporting any skin changes
C) Developing the patient's individualized pressure-injury prevention plan
D) Determining whether the patient requires a specialty wound consultation
Rationale: The correct answer is B because assisting with routine activities of daily living for a
stable patient is generally appropriate for a competent nursing assistant, with abnormal findings
reported to the RN. Option A requires nursing assessment and should not be delegated. Option C
requires clinical judgment and care planning. Option D requires professional assessment and
decision-making.
Q2:
A charge nurse asks an RN to delegate several tasks during a particularly busy shift. Which
principle should guide the RN's decision?
A) Delegate the most time-consuming tasks regardless of patient condition
B) Delegate all tasks that the RN personally dislikes
C) Match the patient's needs and task complexity with the delegatee's competence and
authorized scope
D) Delegate any task as long as the delegatee has worked on the unit for more than 1 year
,3|Page
Rationale: The correct answer is C because safe delegation requires matching the task and
patient situation with the individual's competence, scope, and ability to perform the activity
safely. Experience alone does not authorize every task. A and B disregard patient safety. D
incorrectly assumes that length of employment establishes competency for all activities.
Q3:
An RN delegates routine vital signs to a nursing assistant for a stable patient. The assistant
reports a blood pressure of 84/48 mm Hg. What should the RN do first?
A) Ask the assistant to document the value and continue with other tasks
B) Tell the assistant to notify the provider independently
C) Immediately assess the patient and determine the significance and cause of the
hypotension
D) Wait until the next scheduled vital-sign measurement
Rationale: The correct answer is C because the RN retains responsibility for assessment and
clinical judgment. Severe hypotension may indicate acute deterioration and requires prompt
evaluation. A and D delay necessary assessment. B improperly transfers the RN's assessment
responsibility to the assistant.
Q4:
Which patient would be inappropriate for assignment to an LPN/LVN?
A) A stable patient requiring routine oral medications
B) A patient with a chronic wound requiring an established dressing procedure
C) A stable patient requiring routine postoperative observations
D) A newly admitted patient with unexplained hypotension requiring comprehensive
assessment
Rationale: The correct answer is D because a newly admitted unstable patient requiring
comprehensive assessment and clinical judgment should generally be assigned to an RN.
Options A, B, and C may be appropriate for an LPN/LVN depending on jurisdiction, institutional
policy, and demonstrated competency.
Q5:
A nurse is delegating ambulation to a nursing assistant. Which patient should the nurse not
delegate for independent ambulation?
A) A stable patient who has ambulated independently before admission
B) A patient requiring routine assistance after prolonged bed rest
C) A patient who became dizzy and hypotensive during the previous transfer
D) A stable patient using a prescribed walker
, 4|Page
Rationale: The correct answer is C because recent dizziness and hypotension create an
unpredictable fall risk requiring nursing assessment and potentially individualized mobility
planning. Options A, B, and D may be delegated when the patients are stable and the assistant is
competent.
Q6:
An RN delegates a task to a nursing assistant but fails to explain the patient's limitations. The
patient subsequently falls. Which delegation principle was primarily violated?
A) Right time
B) Right documentation
C) Right direction and communication
D) Right medication
Rationale: The correct answer is C because delegation requires clear instructions regarding
what is expected, relevant patient-specific risks, and when to report findings. The other choices
do not address the primary delegation failure described.
Q7:
A nursing assistant tells the RN, “I have never performed this procedure before.” What should
the RN do?
A) Tell the assistant to watch another assistant and perform it independently
B) Tell the assistant that refusing the task is never permitted
C) Verify competency and arrange appropriate instruction or assign the task to someone
qualified
D) Perform the procedure only after the assistant attempts it unsuccessfully
Rationale: The correct answer is C because the RN must ensure that delegated activities are
within the individual's competency and authorized scope. A and B create unsafe practice. D
unnecessarily exposes the patient to risk.
Q8:
An RN delegates routine hygiene to an experienced nursing assistant. During care, the assistant
notices a new open area on the patient's sacrum. What is the appropriate response?
A) Apply a dressing independently without notifying the RN
B) Ignore it because skin assessment is never relevant to hygiene care
C) Stop and report the finding to the RN so the nurse can assess and plan care
D) Photograph the wound using a personal phone
