Delegation: RN, LPN/LVN and UAP on the NCLEX

Leadership · Delegation & Prioritization·Updated 2026-10-28

What it is

Delegation allows a delegatee to perform a specific nursing activity that is outside the delegatee's traditional role, while the RN keeps accountability for the client. Under the NCSBN/ANA National Guidelines for Nursing Delegation (2019), the RN delegates only tasks that are within the delegatee's scope and documented competence, for clients whose condition is stable and whose response is predictable. Assessment, clinical judgment, care planning, evaluation and initial teaching are never delegated.

What the NCLEX focuses on

The RN keeps: admission and ongoing assessment of unstable clients, care planning, evaluation, initial and discharge teaching, and any task requiring clinical judgment.
UAP: hygiene, feeding a client without swallowing problems, ambulation, positioning, intake and output, routine vital signs on stable clients, and fingerstick glucose after documented training.
LPN/LVN: stable clients with predictable outcomes; oral, subcutaneous and IM medications, dressing changes, catheter insertion, tube feedings, data collection and reinforcement of teaching the RN started.
When a UAP reports an abnormal finding, the RN assesses the client personally rather than asking for a recheck.
The delegatee is accountable for performing the accepted task correctly; the RN stays accountable for the decision to delegate and for the client's overall care.
A delegatee has the right to refuse a task outside competence; the RN reassigns it or arranges training.
When a client's condition changes, the RN reevaluates every delegated task.

Priority nursing actions

Assess the client's stability and needs.
Confirm that the task fits the delegatee's scope, job description, state law, agency policy and documented competence.
Give specific directions: what to do, when, which values to report, and by when.
Confirm the delegatee understands and accepts the task.
Supervise, follow up and evaluate the outcome; take the task back if the client becomes unstable.

Numbers to know

Right	Question the RN asks	Example
Right task	Is it repeatable, low-risk and free of judgment?	Intake and output on a stable client
Right circumstance	Is the client stable with a predictable outcome?	Not after a rapid response call
Right person	Does the delegatee have the scope and verified competence?	Not a new UAP without a compression-device checkoff
Right directions and communication	Are limits and reportable values stated?	"Report a heart rate above 100/min"
Right supervision and evaluation	Did the RN follow up on task and outcome?	RN reviews the transfusion vital signs

Common exam traps

Choosing the UAP to teach insulin self-injection: wrong because teaching requires RN assessment and evaluation.
Choosing to have the UAP recheck a low blood pressure: wrong because a change in condition needs RN assessment.
Choosing the LPN for a new admission or a client on a titrated vasoactive infusion: wrong because the client is unstable or needs initial assessment.
Choosing "Let me know if anything seems off" as the direction: wrong because it states no measurable reporting parameter.
Choosing that accountability transfers to the UAP once the task is accepted: wrong because the RN remains accountable for client care.

Try 2 NCLEX-style questions on this topic

From the NCLEXPace question bank. Pick your answers, then check them inside NCLEXPace.

Question 1 · QID 8377D0AB

A client is receiving a blood transfusion. For each task, indicate whether it may be delegated to unlicensed assistive personnel (UAP) or requires the RN.

For each task involving a client receiving a blood transfusion, indicate whether it may be delegated to unlicensed assistive personnel or requires the RN.

	May be delegated to UAP	Requires the RN
Reporting a change in vital signs to the RN promptly
Obtaining and recording vital signs at defined intervals per protocol
Verifying blood product compatibility and initiating the transfusion
Assessing the client for a transfusion reaction and determining the response

Question 2 · QID CF8D2505

An RN delegates blood glucose testing to a UAP but does not specify what value should be reported immediately. Which right of delegation is missing?

Select the best answer.

A. The right circumstance
B. The right task
C. The right supervision and evaluation of the delegated task
D. The right direction and communication

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More tips on Leadership

Prioritization: Which Client Does the Nurse See First?Rank clients with airway, breathing and circulation, acute versus chronic, and expected versus unexpected findings, and know when Maslow applies.Disaster Triage: START Tags and Incident CommandSort mass casualties with START and JumpSTART, assign red, yellow, green and black tags, and work within incident command and decontamination.

Sources

National Council of State Boards of Nursing, American Nurses Association. National Guidelines for Nursing Delegation. National Council of State Boards of Nursing; 2019.
Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of Nursing. 10th ed. Elsevier; 2021.

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