NCLEX Delegation & Scope of Practice questions
The PrepScore bank has 96 Delegation & Scope of Practice questions, each with a rationale and two tags: the Client Needs category from the test plan and the clinical judgment step it tests. In this topic the items lean on Take action and Generate solutions, which is worth knowing before you practise it. Three worked samples are below, answers behind a reveal.
Match the task to the right team member — RN, LPN/LVN, or UAP. Learn the 5 rights of delegation and the patterns NCLEX uses to trap delegation errors.
Three worked questions
Q1. A staff RN on the med-surg unit is delegating tasks to the LPN at start of shift. The RN reviews LPN scope of practice. Which task should the RN NOT delegate to the LPN?
- A. Administering routine PO medications (WITHIN LPN scope in most states)
- B. Initial assessment of an unstable client (OUTSIDE LPN scope — initial assessment of unstable patient is RN role; LPN can perform focused reassessment of stable patient)
- C. Reinforcing previously taught discharge instructions (WITHIN LPN scope — reinforcement vs initial teaching)
- D. Performing a sterile dressing change (WITHIN LPN scope in most states)
Show answer and rationale
Answer: Initial assessment of an unstable client (OUTSIDE LPN scope — initial assessment of unstable patient is RN role; LPN can perform focused reassessment of stable patient)
RN-only tasks: initial assessment + assessment of unstable patient + initial teaching for new diagnosis + evaluation of response + complex/high-acuity care + first-time blood transfusion + IV push high-alert. LPN can do routine PO meds + sterile dressing + reinforcement teaching + focused reassessment stable.
Q2. A staff RN on the med-surg unit has delegated vital signs to the UAP. The UAP reports a client's BP is 88/52. The RN identifies the priority. What is the FIRST action?
- A. Document and continue (UNSAFE — abnormal vitals require RN assessment)
- B. Personally reassess the client (RN evaluates abnormal findings + assesses for changes in mental status + perfusion + symptoms + obtains additional vitals + notifies provider as needed)
- C. Tell UAP to recheck in 30 min (UNSAFE — delays RN assessment of abnormal finding)
- D. Call provider immediately (premature — assess patient first then notify provider)
Show answer and rationale
Answer: Personally reassess the client (RN evaluates abnormal findings + assesses for changes in mental status + perfusion + symptoms + obtains additional vitals + notifies provider as needed)
UAP reports abnormal finding: RN personally reassesses (evaluates + assesses mental status + perfusion + symptoms + additional vitals + notifies provider as needed). Documenting only, recheck delay, or premature provider call are wrong.
Q3. A staff RN on the med-surg unit is reviewing UAP scope of practice during orientation. The educator presents 5 tasks for identification. Which tasks are WITHIN UAP SCOPE? Select all that apply.
- A. Measuring vital signs in a stable client
- B. Assisting with ADLs (bath, ambulation, hygiene)
- C. Documenting I&O
- D. Teaching diabetic self-care (OUTSIDE UAP scope — teaching is RN role)
- E. Reporting client complaints to RN
Show answer and rationale
Answer: Measuring vital signs in a stable clientAssisting with ADLs (bath, ambulation, hygiene)Documenting I&OReporting client complaints to RN
UAP scope: vital signs on stable patients + ADLs + I&O documentation + reporting findings to RN + ambulation/transfer of stable patients + bedmaking + feeding stable patients. Teaching, assessment, medication administration are NOT UAP scope.
The rules that decide these questions
From the pack's rule cards — the reasoning shortcuts a wrong answer usually means you were missing.
Before delegating, ask all five: right TASK (within delegee's scope), right CIRCUMSTANCES (stable, predictable client), right PERSON (license + competency), right DIRECTION (clear, specific instruction), right SUPERVISION (oversight + evaluation of outcome). Missing any one is a delegation error, no matter how nice the answer feels.
Unlicensed assistive personnel can collect data — vital signs, intake/output, glucose values, weights — but only the licensed nurse can ASSESS the meaning. 'Routine task' is for UAP; interpreting findings or changing the plan is for the RN.
Initial teaching — especially for high-risk content (insulin, anticoagulants, new diagnoses, discharge med list) — is RN-only. LPN/LVN can REINFORCE material previously taught by the RN. UAP cannot teach.
The first nursing assessment of a new admission requires nursing judgment and synthesis of new data into a care plan. UAP can collect vitals; LPN can collect specific information AFTER the RN's initial assessment — never in place of it.
Match the client to the license. LPN/LVN excels at stable, predictable, scheduled care (chronic IV antibiotics, routine post-op). Vasopressors, drip titration, new admissions, and unstable physiology stay with the RN. 'Experience' does not extend an LPN's scope.
When a UAP reports an abnormal vital sign or unexpected finding, the RN goes to the bedside — not to the chart. UAPs cannot interpret, cannot recheck-as-treatment, and cannot escalate care. Verifying and acting are the RN's job.
Practise the whole pack, tagged and explained
Every item carries its Client Needs category and clinical judgment step, so a wrong answer names the step that failed.
Frequently asked questions
How many Delegation & Scope of Practice questions does the bank have?
96 multiple-choice items, plus 10 unfolding cases in the Delegation & Scope of Practice pack, each with a rationale.
Are the samples real bank items?
Yes — the three questions above are drawn from the live bank, with their real rationales and tags.
Which clinical judgment steps does this topic train?
Most items in this topic test Take action and Generate solutions, though every step appears.
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