
The one rule behind every delegation question is that the RN keeps assessment, teaching, evaluation, judgment, and unstable clients, and everything else can often be delegated. A UAP does routine tasks for stable clients with predictable results, while a licensed LPN or LVN can additionally give most oral, IM and subcutaneous medications and perform procedures such as sterile dressings, catheters, and tube feedings.
Delegation questions are common because Management of Care is the biggest category on the exam. They are also very learnable. The rules are clear.
Important: what an LPN/LVN may do is set by each state’s Nurse Practice Act, and it varies. The NCLEX tests a general national standard. Your own state’s rules govern your real job.
The RN keeps: assessment, teaching, evaluation, judgment, and unstable clients.
Everything else can often be delegated.
If you remember nothing else, remember those five things. They answer most delegation questions.
A UAP (unlicensed assistive personnel) is a nursing assistant, aide, or tech. They are not licensed.
UAPs can do routine tasks for stable clients with predictable results:
UAPs cannot:
An LPN/LVN is licensed. They can do more.
LPNs can usually do everything a UAP can, plus:
LPNs usually cannot:
| Task | UAP | LPN/LVN | RN only |
|---|---|---|---|
| Bathing, hygiene | ✔ | ✔ | |
| Feeding a safe swallower | ✔ | ✔ | |
| Vital signs — stable client | ✔ | ✔ | |
| Vital signs — unstable client | ✔ | ||
| Intake and output | ✔ | ✔ | |
| Helping a steady client walk | ✔ | ✔ | |
| Oral medications | ✔ | ||
| IM and subcutaneous injections | ✔ | ||
| IV push medications | ✔ | ||
| Sterile dressing change | ✔ | ||
| Urinary catheter insertion | ✔ | ||
| Tracheostomy care, suctioning | ✔ | ||
| Tube feeding | ✔ | ||
| Blood transfusion | ✔ | ||
| First assessment | ✔ | ||
| Focused data collection, stable client | ✔ | ||
| First teaching | ✔ | ||
| Reinforcing teaching | ✔ | ||
| Care plan | ✔ | ||
| Evaluating if care worked | ✔ | ||
| Any unstable client | ✔ |
1. Is the client stable? No → RN only. Stop here.
2. Does the task need assessment, teaching, evaluation, or judgment? Yes → RN only.
3. Does the task need a license? Yes → LPN or RN, not UAP.
Three questions. Almost every delegation question falls out of them.
Test writers hide the answer in one word.
“Assess” vs. “collect data” vs. “check.”
“Teach” vs. “reinforce teaching.”
“Stable” vs. “newly admitted” vs. “just returned from surgery.”
“Evaluate.” This word almost always means RN. Evaluating results is RN work.
Which task can be given to the UAP?
Which task can be given to the LPN?
At your job, the aide may do more than this list. That does not change the exam answer.
The exam tests the standard, not what happens on a busy night with short staffing.
If you catch yourself thinking “but our aides do that all the time” — that is the warning sign. See Article 37.
Sources
Scope of practice for LPN/LVN is set by each state’s Nurse Practice Act and varies. Check your own state’s rules for real practice.
Common follow-up questions on Prioritization, Delegation & Management of Care.
A UAP can do routine tasks for stable clients with predictable results, such as bathing and hygiene, feeding safe swallowers, routine vital signs on stable clients, intake and output, helping steady clients walk, turning and positioning, and applying compression stockings. A UAP cannot assess, teach, evaluate whether care worked, give medications in most settings, do sterile procedures, take vital signs on an unstable client, or care for an unstable client.
An LPN can usually do everything a UAP can plus give most oral, IM and subcutaneous medications, change sterile dressings, insert urinary catheters, manage nasogastric tubes, do tracheostomy care and suctioning, give tube feedings, reinforce teaching the RN already gave, and do focused data collection on stable clients. LPNs usually cannot do the first assessment, create the care plan, do the first teaching, give most IV push medications, manage blood transfusions, or care for unstable clients.
First, is the client stable? If no, RN only, stop there. Second, does the task need assessment, teaching, evaluation or judgment? If yes, RN only. Third, does the task need a license? If yes, LPN or RN, not UAP. Almost every delegation question falls out of these three.
Test writers hide the answer in one word. Assess the client's breathing is RN, but take the client's vital signs can be delegated if the client is stable; teach is RN first teaching, while reinforce teaching an LPN can do. A stable client can be delegated, but newly admitted or just returned from surgery is RN, and evaluate almost always means RN.
No. At your job the aide may do more than this list, but that does not change the exam answer. The exam tests the standard, not what happens on a busy night with short staffing. If you catch yourself thinking but our aides do that all the time, that is the warning sign.
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