NCLEX Delegation Rules: What an RN Can Never Hand Off
A registered nurse can never delegate assessment, nursing diagnosis, planning, evaluation, teaching, or the care of an unstable client. LPNs may take stable clients with predictable outcomes and give most medications; unlicensed assistive personnel may perform standard, unchanging tasks such as vital signs, hygiene, feeding, ambulation and intake and output on stable clients only.
Delegation questions look like management trivia. They are actually safety questions, and they turn on one rule: the RN keeps the thinking. Anything requiring assessment, judgement, teaching or evaluation stays with the RN — always, without exception on the NCLEX.
Step 1 — The four things an RN never delegates
Memorise these as a set. If an option hands any of them to someone else, it is wrong.
- Assessment — the initial one, and any assessment that requires interpretation
- Teaching — any client or family education
- Evaluation — judging whether an intervention worked
- Unstable clients — anyone whose condition is changing, and any nursing judgement about them
A useful shorthand: the RN owns the nursing process minus the parts that are pure task. Assess, plan, evaluate stay; some implementing can be shared.
Step 2 — Who can do what
| Task | RN | LPN / LVN | UAP |
|---|---|---|---|
| Initial assessment | Yes — only RN | No | No |
| Care plan, evaluation of outcomes | Yes — only RN | No | No |
| Client and family teaching | Yes — only RN | Reinforce taught material only | No |
| Unstable or newly admitted client | Yes — only RN | No | No |
| IV push medication, blood products | Yes — only RN | No (varies by state; NCLEX says RN) | No |
| Stable client, expected course | Yes | Yes | Partly |
| Oral and IM medications | Yes | Yes | No |
| Sterile dressing change, tracheostomy care, catheter insertion | Yes | Yes | No |
| Reinforcing teaching the RN already gave | Yes | Yes | No |
| Vital signs on a stable client | Yes | Yes | Yes |
| Bathing, feeding, toileting, positioning, ambulating | Yes | Yes | Yes |
| Intake and output, weights, specimen collection | Yes | Yes | Yes |
Step 3 — The five rights of delegation
When a question asks whether a delegation was appropriate, check it against these: the right task, the right circumstance, the right person, the right direction and communication, and the right supervision and evaluation. Most wrong answers fail on "right circumstance" — the task itself was fine, but the client was unstable.
The word that changes the answer
Watch for stable versus unstable, and for new. "Take vital signs on the client admitted this morning" is not a UAP task, because a newly admitted client has not been assessed and is not established as stable. Change one word and the correct delegate changes.
Delegation is not abandonment
Delegating a task does not transfer accountability. The RN who delegates remains responsible for the outcome, which is why "supervise and follow up" appears in correct answers so often. An option that delegates appropriately but never checks back is still incomplete.
NCLEX tip: Scan the options for the verbs assess, teach, evaluate and plan. If any of those verbs is attached to an LPN or a UAP, eliminate that option immediately — you have often just removed two of the four choices without reading the clinical detail at all.
Frequently asked questions
Common follow-up questions on Prioritization, Delegation & Management of Care.
What can an RN never delegate?
The nursing process itself: assessment, nursing diagnosis, care planning, evaluation of outcomes, and client teaching. The RN also keeps any client who is unstable, newly admitted, or whose condition is changing, and any task requiring nursing judgment.
What can be delegated to an LPN or LVN?
Stable clients with predictable outcomes: routine medication administration (excluding IV push in most states), wound care on established wounds, tracheostomy care, tube feedings, and reinforcing teaching the RN has already given. LPNs collect data but do not perform the initial assessment.
What can be delegated to unlicensed assistive personnel?
Standard, unchanging tasks on stable clients: vital signs, bathing and hygiene, feeding clients without swallowing difficulty, ambulating, positioning, transferring, and measuring intake and output. UAP may never assess, teach, evaluate, or care for an unstable client.
What are the five rights of delegation?
The right task, the right circumstance, the right person, the right direction and communication, and the right supervision and evaluation. On the exam, a delegation answer is wrong if any one of the five fails: even a task normally within scope becomes wrong if the client is unstable.
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