NCLEX PN Exam Bank: Patient Assignment, Delegation & Teamwork in Long-Term Care Settings

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NCLEX PN Exam Bank: Patient Assignment,
Delegation & Teamwork in Long-Term Care
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Table of Contents
Subtopic 1: Fundamentals of Patient Assignment and Delegation in Long-Term
Care.................................................................................................................2
Subtopic 2: Legal and Ethical Considerations in Patient Assignment and
Delegation in Long-Term Care........................................................................11
Subtopic 3: Effective Communication and Teamwork in Patient Assignment
and Delegation...............................................................................................21
Subtopic 4: Prioritization and Time Management in Patient Assignment and
Delegation.....................................................................................................30
Subtopic 5: Supervising and Evaluating Delegated Care in Long-Term Care..39
Subtopic 6: Patient Safety and Risk Management in Delegation...................49
Subtopic 7: Roles and Responsibilities of Healthcare Team Members in
Delegation.....................................................................................................58
Subtopic 8: Legal and Ethical Considerations in Delegation..........................67
Subtopic 9: Communication Strategies in Delegation....................................76
Subtopic 10: Cultural Competency and Diversity in Delegation....................84

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Subtopic 1: Fundamentals of Patient
Assignment and Delegation in Long-Term Care
1. Which task is most appropriate for a Licensed Practical Nurse (LPN) to
delegate to a Certified Nursing Assistant (CNA) in a long-term care facility?



A) Administer oral medications

B) Perform wound dressing changes

C) Assist with activities of daily living (ADLs)

D) Assess vital signs and report abnormalities



Correct answer: C) Assist with activities of daily living (ADLs)



Rationale: CNAs are trained to assist patients with ADLs such as bathing,
dressing, and feeding, which are appropriate to delegate. Medication
administration and wound care require nursing licensure and assessment
skills.



2. When assigning a new resident with dementia to a CNA, which factor
should the nurse consider most important?



A) CNA’s experience with dementia care

B) CNA’s schedule preferences

C) CNA’s training in managing challenging behaviors

D) CNA’s availability



Correct answer: C) CNA’s training in managing challenging behaviors

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Rationale: Dementia patients may display challenging behaviors requiring
specific training. Assigning a CNA with relevant training ensures patient
safety and quality care.



3. An LPN is delegating care to a CNA. Which action by the LPN indicates
proper delegation?



A) Delegating medication administration to the CNA

B) Providing clear instructions and expected outcomes to the CNA

C) Leaving the CNA unsupervised after delegation

D) Ensuring the CNA understands and agrees to the assigned tasks



Correct answer: D) Ensuring the CNA understands and agrees to the assigned
tasks



Rationale: Proper delegation requires clear communication and confirmation
that the delegatee understands the responsibilities. Medication
administration cannot be delegated to CNAs.



4. Which situation requires the nurse to provide direct care rather than
delegate?



A) Assisting a patient with toileting

B) Monitoring blood glucose levels

C) Performing an initial patient assessment

D) Helping a patient with feeding



Correct answer: C) Performing an initial patient assessment

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Rationale: Initial assessments require nursing knowledge and judgment and
cannot be delegated to unlicensed personnel.



5. A CNA reports that a resident’s blood pressure is 90/50 mm Hg and the
patient feels dizzy. What is the nurse’s best action?



A) Tell the CNA to continue monitoring the patient

B) Assess the patient personally and notify the healthcare provider if needed

C) Instruct the CNA to increase fluid intake immediately

D) Delegate the task of reassessing blood pressure to another CNA



Correct answer: B) Assess the patient personally and notify the healthcare
provider if needed



Rationale: The nurse must perform a focused assessment to evaluate the
patient’s condition and take appropriate action.



6. What is the nurse’s responsibility when delegating a task to a CNA?



A) Completing the task if the CNA refuses

B) Ignoring any concerns once delegated

C) Supervising and evaluating the CNA’s performance

D) Allowing the CNA to use personal judgment without guidance



Correct answer: C) Supervising and evaluating the CNA’s performance



Rationale: The nurse remains accountable and must supervise and evaluate
the delegated task to ensure safe patient care.