Delegation And Assignment
Help Questions
NCLEX-RN › Delegation And Assignment
In a long-term care facility, an RN supervises an LPN and a UAP. A 90-year-old resident has a stage 2 pressure injury on the coccyx with a prescribed dressing change. The RN should assign which task to the LPN?
Perform the initial wound assessment and determine whether the wound is worsening
Debride necrotic tissue at the bedside
Develop the wound care plan and select appropriate products for treatment
Change the prescribed dressing and document the wound appearance, reporting any concerns to the RN
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, delegating stable wound care to LPNs. The correct answer, changing the dressing and documenting while reporting concerns, properly applies delegation principles as LPNs are trained for routine wound procedures. The distractors represent common delegation errors: initial assessments and determinations are RN responsibilities; debridement requires advanced skills; and developing plans is RN-led. Effective delegation in wound care relies on clear reporting protocols. RNs should oversee and evaluate healing progress. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
In an acute care medical-surgical unit, an RN is caring for four clients with the help of one licensed practical nurse (LPN) and one unlicensed assistive personnel (UAP). One client is a 68-year-old with chronic obstructive pulmonary disease who is stable on 2 L/min nasal cannula and needs assistance with morning hygiene. Which task can the RN delegate to the UAP?
Assist the client with a bed bath and oral care while monitoring for shortness of breath
Teach pursed-lip breathing to reduce dyspnea during activity
Administer a prescribed inhaled bronchodilator via metered-dose inhaler
Assess lung sounds and determine whether oxygen flow should be increased
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, ensuring tasks match the UAP's scope of practice for stable clients with predictable needs. The correct answer, assisting with a bed bath and oral care while monitoring for shortness of breath, properly applies delegation principles because it involves routine hygiene assistance and observation of obvious signs, which UAPs are trained to perform and report. The distractors represent common delegation errors: teaching pursed-lip breathing requires educational skills beyond UAP scope; assessing lung sounds and adjusting oxygen involves clinical judgment reserved for RNs; and administering bronchodilators is a medication task typically for LPNs or RNs. Effective delegation involves evaluating the client's stability and the task's complexity before assigning. RNs must supervise and follow up on delegated tasks to ensure safety. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
On an acute care unit, an RN is delegating to an LPN and a UAP. A 52-year-old client is 6 hours postoperative after an uncomplicated appendectomy and is stable; the client has a new order to advance diet as tolerated. Which delegation decision by the RN requires reconsideration?
Ask the UAP to assess bowel sounds and decide whether the diet can be advanced
Ask the LPN to administer prescribed oral analgesics for pain rated 4/10
Ask the LPN to monitor the incision dressing for increased drainage and report changes
Ask the UAP to assist the client to sit up and begin clear liquids, reporting nausea or vomiting
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, prohibiting UAPs from performing assessments or making clinical decisions. The correct answer, asking the UAP to assess bowel sounds and decide on diet advancement, requires reconsideration because assessment and judgment are RN responsibilities. The distractors represent common delegation errors by being appropriate: UAPs can assist with positioning and report symptoms; LPNs can administer oral analgesics; and LPNs can monitor dressings. Effective delegation postoperatively ensures tasks align with recovery protocols. RNs must verify readiness for advancements like diet. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
In an acute care unit, an RN is supervising an LPN and a UAP. A 56-year-old client with type 2 diabetes is stable and has a new order for pre-meal capillary blood glucose checks and sliding-scale insulin. Which delegation decision by the RN requires reconsideration?
Assign the LPN to administer the sliding-scale subcutaneous insulin per protocol
Assign the UAP to teach the client how to recognize signs of hypoglycemia
Assign the UAP to obtain the pre-meal capillary blood glucose and report the result to the RN
Have the RN verify the insulin dose calculation before administration
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, avoiding delegation of teaching to UAPs. The correct answer, assigning the UAP to teach signs of hypoglycemia, requires reconsideration because teaching is outside UAP scope and requires clinical knowledge. The distractors represent common delegation errors by being appropriate: UAPs can obtain blood glucose if trained; LPNs can administer insulin per protocol; and RNs should verify high-risk medications like insulin. Effective delegation for diabetes management prioritizes education by qualified staff. RNs must oversee protocols and correct improper assignments. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
On a medical-surgical unit, an RN is working with an LPN and a UAP. A 60-year-old client with heart failure is stable and has a daily weight order. Which task can the RN delegate to the UAP?
Teach the client about sodium restriction and fluid limitation strategies
Titrate supplemental oxygen based on respiratory assessment findings
Obtain the client’s weight using the same scale and time each morning and report significant changes
Assess for crackles and determine whether the diuretic dose should be held
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, delegating routine monitoring like weights to UAPs for stable clients. The correct answer, obtaining daily weights consistently and reporting changes, properly applies delegation principles because it involves standardized measurement and reporting within UAP scope. The distractors represent common delegation errors: assessing crackles and holding medications requires RN judgment; teaching restrictions is an RN or LPN role; and titrating oxygen involves RN assessment. Effective delegation in heart failure management ensures accurate data collection. RNs must interpret trends and adjust care. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
In a long-term care facility, an RN supervises an LPN and a UAP. An 86-year-old resident with chronic constipation is stable and has a scheduled stool softener and a new as-needed suppository order. The RN should assign which task to the LPN?
Develop a bowel program and evaluate dietary fiber needs for the resident
Insert the prescribed suppository after assessing for contraindications and documenting the result
Teach the resident and family about long-term constipation management and medication risks
Assess abdominal distention and decide whether to notify the provider for possible obstruction
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, delegating medication administration like suppositories to LPNs for chronic issues. The correct answer, inserting the suppository after assessing contraindications and documenting, properly applies delegation principles as LPNs can perform these tasks with basic checks. The distractors represent common delegation errors: developing programs is RN planning; assessing distention requires RN judgment; and teaching management is RN-led. Effective delegation for constipation focuses on routine interventions. RNs should evaluate overall bowel function. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
On a medical-surgical unit, an RN is caring for clients with an LPN and a UAP. A 66-year-old client has a peripheral intravenous catheter with maintenance fluids and reports pain and swelling at the site. Which client care task requires RN intervention?
Assess the intravenous site for infiltration or phlebitis and take appropriate action per policy
Ask the UAP to elevate the extremity and apply a warm compress without assessing the site
Ask the UAP to obtain vital signs and report any fever
Ask the LPN to document the client’s report of discomfort in the chart
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person while requiring RN intervention for IV complications. The correct answer, assessing the IV site for infiltration or phlebitis, requires RN intervention because it involves clinical judgment and potential actions like discontinuation. The distractors represent common delegation errors: UAPs should not apply treatments without assessment; LPNs can document but not assess; and UAPs can obtain vital signs. Effective delegation for IV care prioritizes RN evaluation of issues. RNs must act to prevent further complications. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
In a long-term care facility, an RN is supervising an LPN and a UAP. A 77-year-old resident with dysphagia has an order for thickened liquids and aspiration precautions. Which task can the RN delegate to the UAP?
Assist the resident with meals using prescribed aspiration precautions and report coughing or wet voice
Evaluate swallowing effectiveness and determine whether the diet consistency should be changed
Assess lung sounds after meals and determine whether aspiration pneumonia is developing
Teach the resident compensatory swallowing techniques and rationale for thickened liquids
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, delegating mealtime assistance to UAPs with precautions. The correct answer, assisting with meals using precautions and reporting symptoms, properly applies delegation principles because it involves routine support and observation. The distractors represent common delegation errors: evaluating swallowing is RN or specialist role; teaching techniques requires qualified staff; and assessing lungs is RN assessment. Effective delegation for dysphagia ensures safety protocols are followed. RNs must oversee and reassess risks. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
During a high-volume shift in the emergency department, an RN is working with an LPN and a UAP. A 45-year-old client with a simple laceration to the forearm is stable after triage and needs a tetanus booster as ordered. The RN should assign which task to the LPN?
Provide discharge teaching about wound care and signs of infection
Administer the intramuscular tetanus booster after verifying the order and allergies
Suture the laceration using sterile technique
Perform the initial focused assessment and determine triage priority
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, matching tasks to the LPN's scope for stable clients and routine procedures. The correct answer, administering the intramuscular tetanus booster after verifying the order and allergies, properly applies delegation principles because LPNs are licensed to administer injections and perform verifications under RN supervision. The distractors represent common delegation errors: performing initial assessments and triage requires RN judgment; providing discharge teaching involves comprehensive education typically led by RNs; and suturing lacerations is an advanced skill reserved for providers or specially trained RNs. Effective delegation requires assessing the team's competencies and the task's requirements. RNs should communicate clear instructions and expectations for reporting. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.
On an acute care telemetry unit, an RN is delegating tasks to an LPN and a UAP. A 72-year-old client is 1 day postoperative after a hip replacement and is stable; the client needs assistance ambulating to the chair with a gait belt. Which task can the RN delegate to the UAP?
Administer prescribed intravenous opioid analgesia before ambulation
Assist the client to the chair using a gait belt and report any dizziness or increased pain
Perform neurovascular assessment of the operative leg
Evaluate the client’s pain level and decide whether to request a medication change
Explanation
This question tests delegation and assignment principles. The key delegation principle is assigning the right task to the right person, delegating routine mobility assistance to UAPs for stable postoperative clients. The correct answer, assisting to the chair using a gait belt and reporting dizziness or pain, properly applies delegation principles as it involves basic ambulation support and observation within UAP scope. The distractors represent common delegation errors: evaluating pain and requesting medication changes requires RN judgment; performing neurovascular assessments is an RN responsibility; and administering IV opioids is typically for RNs due to monitoring needs. Effective delegation considers the client's postoperative status and task predictability. RNs should provide clear instructions and require immediate reporting of changes. A transferable strategy for safe delegation is to use the five rights of delegation: right task, right circumstances, right person, right direction, and right supervision.