Delegation, Prioritization, and Assignment
Examination
This comprehensive examination evaluates clinical judgment regarding the Five Rights of
Delegation, scopes of practice (RN, LPN/LVN, UAP), prioritization frameworks (ABCs,
Maslow's, Stability/Acuity), and workload distribution.
Question 1
A registered nurse (RN) is triaging several clients in an emergency department. Which
client requires immediate intervention by the RN?
● A. A 45-year-old client with a history of hypertension requesting a refill on
lisinopril.
● B. A 62-year-old client reporting a dull, aching knee pain rated 4/10 following a
walk.
● C. A 28-year-old client presenting with acute stride, intercostal retractions, and
cyanosis.
● D. A 50-year-old client requesting discharge instructions following an
uncomplicated incision repair.
Correct Answer: C
Explanation: Acute stridor and retractions indicate an airway emergency using the ABC
prioritization framework, requiring immediate RN assessment and life-saving intervention.
Option B is wrong because mild-to-moderate chronic joint pain is non-urgent and stable.
Question 2
The charge nurse is making shift assignments on a medical-surgical unit. Which client is
most appropriate to assign to a licensed practical nurse (LPN)?
● A. A stable client 2 days postoperative following a cholecystectomy who needs
oral pain medication administration and routine wound care.
● B. A newly admitted client experiencing severe chest pain and diaphoresis with
unstable vital signs.
, ● C. A client requiring initial discharge teaching regarding complex insulin pen
administration.
● D. An unconscious client newly transferred from ICU who requires initial baseline
neurological assessment.
Correct Answer: A
Explanation: LPNs are appropriately assigned stable clients with predictable outcomes
requiring routine skills like oral medication administration and dressing changes. Option C
is incorrect because initial client teaching must be performed by an RN rather than
delegated or assigned to an LPN.
Question 3
An RN delegates tasks to an unlicensed assistive personnel (UAP). Which task is within
the appropriate scope of practice for the UAP?
● A. Assessing the lung sounds of a client with pneumonia.
● B. Evaluating a client's response to an intravenous antihypertensive medication.
● C. Teaching a client how to perform clean intermittent self-catheterization.
● D. Assisting a stable, ambulating client to the bathroom postoperatively.
Correct Answer: D
Explanation: Assisting stable clients with activities of daily living, such as ambulation and
hygiene, falls squarely within the scope of practice of a UAP. Options A, B, and C all
involve nursing process components (assessment, evaluation, teaching) that cannot be
delegated to assistive personnel.
Question 4
A nurse manager observes an RN delegating a complex sterile dressing change on a
central venous line to an experienced UAP. What action should the nurse manager take
first?
● A. Document the incident as a formal disciplinary action in the UAP's personnel
file.
● B. Intervene immediately and inform the RN that sterile line care is outside the UAP
scope of practice.
● C. Wait until the procedure is finished to privately discuss the error with the UAP.
● D. Reassign the UAP to a different unit for the remainder of the shift.
, Correct Answer: B
Explanation: Patient safety is paramount, and central line sterile care requires
professional nursing assessment and execution, making immediate intervention
necessary to prevent harm and breach of scope. Option C is incorrect because allowing
an unauthorized procedure to complete exposes the client to infection and harm.
Question 5
Which client condition represents the highest priority for the nurse when planning
morning care?
● A. A client scheduled for a routine chest X-ray in two hours.
● B. A client with diabetes whose capillary blood glucose reading is 42 mg/dL.
● C. A client requesting assistance with a bed bath and linen change.
● D. A client asking for clarification about their home medication schedule.
Correct Answer: B
Explanation: Severe hypoglycemia (42 mg/dL) presents an immediate physiological
threat requiring rapid administration of fast-acting glucose under the acute/unstable
priority framework. Option C is wrong because basic hygiene is low priority compared to
a life-threatening biochemical instability.
Question 6
An RN is working with an LPN and a UAP. Which duty is most appropriately assigned to
the LPN?
● A. Formulating the comprehensive plan of care for a newly admitted client.
● B. Obtaining routine morning vital signs on four stable medical clients.
● C. Providing bedside hygiene and complete bed bath to an immobilized client.
● D. Administering subcutaneous heparin injections to a stable postoperative client.
Correct Answer: D
Explanation: LPNs are licensed to administer subcutaneous medications and perform
invasive technical skills on stable clients. Option B is better suited for a UAP, while Option
A involves care planning, which is exclusively an RN responsibility.
Examination
This comprehensive examination evaluates clinical judgment regarding the Five Rights of
Delegation, scopes of practice (RN, LPN/LVN, UAP), prioritization frameworks (ABCs,
Maslow's, Stability/Acuity), and workload distribution.
Question 1
A registered nurse (RN) is triaging several clients in an emergency department. Which
client requires immediate intervention by the RN?
● A. A 45-year-old client with a history of hypertension requesting a refill on
lisinopril.
● B. A 62-year-old client reporting a dull, aching knee pain rated 4/10 following a
walk.
● C. A 28-year-old client presenting with acute stride, intercostal retractions, and
cyanosis.
● D. A 50-year-old client requesting discharge instructions following an
uncomplicated incision repair.
Correct Answer: C
Explanation: Acute stridor and retractions indicate an airway emergency using the ABC
prioritization framework, requiring immediate RN assessment and life-saving intervention.
Option B is wrong because mild-to-moderate chronic joint pain is non-urgent and stable.
Question 2
The charge nurse is making shift assignments on a medical-surgical unit. Which client is
most appropriate to assign to a licensed practical nurse (LPN)?
● A. A stable client 2 days postoperative following a cholecystectomy who needs
oral pain medication administration and routine wound care.
● B. A newly admitted client experiencing severe chest pain and diaphoresis with
unstable vital signs.
, ● C. A client requiring initial discharge teaching regarding complex insulin pen
administration.
● D. An unconscious client newly transferred from ICU who requires initial baseline
neurological assessment.
Correct Answer: A
Explanation: LPNs are appropriately assigned stable clients with predictable outcomes
requiring routine skills like oral medication administration and dressing changes. Option C
is incorrect because initial client teaching must be performed by an RN rather than
delegated or assigned to an LPN.
Question 3
An RN delegates tasks to an unlicensed assistive personnel (UAP). Which task is within
the appropriate scope of practice for the UAP?
● A. Assessing the lung sounds of a client with pneumonia.
● B. Evaluating a client's response to an intravenous antihypertensive medication.
● C. Teaching a client how to perform clean intermittent self-catheterization.
● D. Assisting a stable, ambulating client to the bathroom postoperatively.
Correct Answer: D
Explanation: Assisting stable clients with activities of daily living, such as ambulation and
hygiene, falls squarely within the scope of practice of a UAP. Options A, B, and C all
involve nursing process components (assessment, evaluation, teaching) that cannot be
delegated to assistive personnel.
Question 4
A nurse manager observes an RN delegating a complex sterile dressing change on a
central venous line to an experienced UAP. What action should the nurse manager take
first?
● A. Document the incident as a formal disciplinary action in the UAP's personnel
file.
● B. Intervene immediately and inform the RN that sterile line care is outside the UAP
scope of practice.
● C. Wait until the procedure is finished to privately discuss the error with the UAP.
● D. Reassign the UAP to a different unit for the remainder of the shift.
, Correct Answer: B
Explanation: Patient safety is paramount, and central line sterile care requires
professional nursing assessment and execution, making immediate intervention
necessary to prevent harm and breach of scope. Option C is incorrect because allowing
an unauthorized procedure to complete exposes the client to infection and harm.
Question 5
Which client condition represents the highest priority for the nurse when planning
morning care?
● A. A client scheduled for a routine chest X-ray in two hours.
● B. A client with diabetes whose capillary blood glucose reading is 42 mg/dL.
● C. A client requesting assistance with a bed bath and linen change.
● D. A client asking for clarification about their home medication schedule.
Correct Answer: B
Explanation: Severe hypoglycemia (42 mg/dL) presents an immediate physiological
threat requiring rapid administration of fast-acting glucose under the acute/unstable
priority framework. Option C is wrong because basic hygiene is low priority compared to
a life-threatening biochemical instability.
Question 6
An RN is working with an LPN and a UAP. Which duty is most appropriately assigned to
the LPN?
● A. Formulating the comprehensive plan of care for a newly admitted client.
● B. Obtaining routine morning vital signs on four stable medical clients.
● C. Providing bedside hygiene and complete bed bath to an immobilized client.
● D. Administering subcutaneous heparin injections to a stable postoperative client.
Correct Answer: D
Explanation: LPNs are licensed to administer subcutaneous medications and perform
invasive technical skills on stable clients. Option B is better suited for a UAP, while Option
A involves care planning, which is exclusively an RN responsibility.
