Ten free NCLEX delegation and prioritization practice questions with full rationales — RN vs LPN/LVN vs UAP scope, the Five Rights of Delegation, and ABC/Maslow priority order. Answer each one, then reveal the correct answer and see why every option is right or wrong. No sign-up needed to practice here.
Delegation & Prioritization Review
Delegation and prioritization questions are the heart of the Management of Care category, one of the most heavily weighted areas of the NCLEX. To answer them, first anchor the scope-of-practice split. The RN keeps the tasks that require nursing judgment: the initial or admission assessment, all client teaching, evaluation of care and outcomes, developing the plan of care, and any care of an unstable, acute, or unpredictable client. A useful memory aid is that the RN keeps Assessment, Teaching, Evaluation, and the unstable client. The LPN/LVN cares for STABLE clients with predictable outcomes and can give many routine medications, perform routine sterile and wound procedures (per state), and reinforce teaching the RN already started, but cannot do initial assessments, teaching, evaluation, or care of unstable clients. Unlicensed assistive personnel (UAP) handle standardized, non-invasive tasks with predictable outcomes on STABLE clients: ADLs, hygiene, feeding a client without swallowing risk, ambulation, positioning, routine vital signs, intake and output, and stocking. UAP never assess, teach, evaluate, or exercise judgment.
Before delegating, apply the Five Rights of Delegation (NCSBN/ANA): the right task, under the right circumstance, to the right person, with the right directions and communication, and the right supervision and evaluation. If any one is missing, do not delegate.
For prioritization, layer three frameworks. Use the ABCs first (airway, breathing, circulation), then Maslow's hierarchy (physiologic needs before psychosocial). Then apply the ordering rules: unstable before stable, acute before chronic, and actual problems before potential ones. When a question asks who to see or assess FIRST, look for the client whose airway, breathing, or circulation is most threatened, or whose condition is newly unstable.
Delegation and Prioritization NCLEX Practice Questions
Question 1 · Delegating to UAP
A charge nurse on a medical-surgical unit is delegating tasks. Which task is MOST appropriate to delegate to unlicensed assistive personnel (UAP)?
- A Assisting a stable postoperative client to ambulate in the hallway
- B Teaching a newly diagnosed diabetic client how to self-administer insulin
- C Assessing the lung sounds of a client admitted with pneumonia
- D Reinforcing dietary instructions for a client on a low-sodium diet
Show answer & rationale
Correct answer: A
Ambulating a STABLE postoperative client is a standardized, non-invasive task with a predictable outcome, which fits UAP scope. UAP may perform ADLs, hygiene, feeding, positioning, ambulation, routine vital signs, and intake/output on stable clients. Teaching a diabetic client how to inject insulin (option B) is client teaching, an RN-only task that cannot be delegated to UAP or LPN. Assessing lung sounds (option C) requires nursing judgment and is an assessment, which the RN keeps. Reinforcing dietary instructions (option D) is reinforcement of teaching; that falls within LPN/LVN scope, not UAP scope, because it still involves educating the client. The trap is that options C and D look 'almost' delegable, but any task requiring assessment, teaching, judgment, or evaluation is off-limits to UAP. Memory aid: the RN keeps Assessment, Teaching, Evaluation, and the unstable client; UAP get standardized ADL-type tasks on stable clients. When you see 'teach,' 'assess,' or 'evaluate' in a UAP option, eliminate it.
Question 2 · Assigning to LPN/LVN
An RN is making shift assignments. Which client is MOST appropriate to assign to an LPN/LVN?
- A A client newly admitted from the emergency department who needs an admission assessment
- B A stable client with chronic heart failure who needs routine oral medications administered
- C A client who requires discharge teaching about a newly prescribed medication
- D A client whose condition is deteriorating and who requires frequent reassessment
Show answer & rationale
Correct answer: B
The LPN/LVN scope centers on STABLE clients with predictable outcomes, including administering many routine medications. A stable chronic heart-failure client needing routine oral medications fits perfectly. Option A requires an admission (initial) assessment, which is an RN-only task the LPN cannot perform. Option C is client teaching, also reserved for the RN, who must assess learning readiness, teach, and evaluate understanding; the LPN may only reinforce teaching the RN already started. Option D describes an unstable, deteriorating client, and unstable/unpredictable clients belong to the RN. The distractors are plausible because LPNs do give meds and reinforce content, but the specific verbs here (admission assessment, discharge teaching) and the unstable status disqualify them. Memory aid: RN keeps Assessment, Teaching, Evaluation, and the unstable client; give the LPN the stable, predictable client with routine care. When an assignment question offers a 'new admission,' a 'teaching' need, or a 'deteriorating' client, those go to the RN.
Question 3 · RN-only tasks
The RN understands that which task CANNOT be delegated to an LPN/LVN?
- A Administering a routine scheduled oral analgesic
- B Reinforcing teaching about proper crutch walking
- C Performing the initial assessment of a new admission
- D Changing a routine sterile dressing on a stable client
Show answer & rationale
Correct answer: C
The initial (admission) assessment requires nursing judgment to establish a baseline and formulate the plan of care, so it is an RN-only task that cannot be delegated to an LPN/LVN or UAP. Administering a routine scheduled oral analgesic (option A) is within LPN scope. Reinforcing teaching (option B) is appropriate for the LPN as long as the RN performed the original teaching. Changing a routine sterile dressing (option D) is within LPN scope in most states. The correct answer is the one requiring initial judgment: the admission assessment. Distractors are plausible because they are all real LPN activities, but only option C crosses into RN-reserved territory. Memory aid: the RN keeps Assessment, Teaching, Evaluation, developing the plan of care, and the unstable client. Note the word 'initial' or 'admission'; ongoing data collection can be shared, but the first comprehensive assessment and the resulting care plan stay with the RN.
Question 4 · Five Rights of Delegation
Before delegating a task, the nurse verifies that the UAP has been trained and is competent to perform it. This action reflects which of the Five Rights of Delegation?
- A Right task
- B Right person
- C Right circumstance
- D Right supervision
Show answer & rationale
Correct answer: B
Confirming that the delegatee is trained and competent to perform the task is the 'right person' element: delegating the right task to the right person to be performed on the right client. The Five Rights of Delegation (NCSBN/ANA) are right task, right circumstance, right person, right direction/communication, and right supervision. 'Right task' (option A) refers to whether the task itself is delegable, not to who performs it. 'Right circumstance' (option C) considers the client's stability and the setting, ensuring conditions are appropriate for delegation. 'Right supervision' (option D) involves monitoring, evaluating, and providing feedback after the task is delegated, not verifying competence beforehand. The distractors are close because all five rights work together, but assessing the individual's skills and qualifications specifically maps to the right person. Memory aid: Task, Circumstance, Person, Direction/Communication, Supervision. If any one right is missing, do not delegate. Matching the competent worker to the job is the 'person' check.
Question 5 · Prioritization: ABCs
An RN receives report on four clients. Which client should the nurse assess FIRST?
- A A client requesting pain medication for a chronic condition, rated 4/10
- B A postoperative client due for a routine dressing change
- C A client with chronic kidney disease scheduled for dialysis this afternoon
- D A client with pneumonia who has increasing dyspnea and an SpO2 of 88%
Show answer & rationale
Correct answer: D
Apply the ABCs: airway, breathing, circulation. The pneumonia client with an oxygen saturation of 88% and worsening dyspnea has a breathing problem that is actual, acute, and potentially life-threatening, so this client is assessed first. A routine dressing change (option B) is a scheduled, stable task with no urgency. A client scheduled for dialysis this afternoon (option C) has a chronic condition with a planned intervention, not an immediate threat. A client requesting pain medication for a chronic 4/10 pain (option A) is a comfort need that ranks below physiologic airway/breathing threats on Maslow's hierarchy. The distractors are plausible because each represents a real need, but none threatens oxygenation. Memory aids: ABCs first, then Maslow (physiologic before psychosocial), and unstable/acute before stable/chronic, actual before potential. A falling oxygen saturation with rising dyspnea is a red-flag breathing problem; see that client before anyone with a routine, scheduled, or chronic need.
Question 6 · Blood/IV push scope
The RN is caring for several clients. Which task should the RN perform rather than delegate to the LPN/LVN?
- A Collecting a routine clean-catch urine specimen for culture
- B Administering a scheduled oral antibiotic to a stable client
- C Reinforcing teaching about using an incentive spirometer
- D Initiating a blood transfusion for symptomatic anemia
Show answer & rationale
Correct answer: D
Initiating (starting) a blood transfusion is generally an RN responsibility: the RN verifies the product, confirms consent, performs the two-person identity check, and monitors for early reactions when the plan of care and initial administration require nursing judgment. Some states and facilities allow LPNs to monitor an already-running transfusion, but starting it is typically reserved for the RN, so this is the safest answer. Administering a scheduled oral antibiotic (option B) is squarely within LPN scope. Reinforcing incentive-spirometer teaching (option C) is appropriate for the LPN once the RN has taught it. Collecting a routine urine specimen (option A) is a standardized task appropriate for UAP. The distractors are plausible everyday tasks, but only initiating blood crosses into RN-reserved, higher-risk territory. Memory aid: high-risk 'first-time' actions, IV-push medications, and initiating blood products generally stay with the RN; routine, predictable care can be shared. Because LPN IV-push and blood-monitoring rules vary by state, focus on who INITIATES the transfusion, which is the RN.
Question 7 · Prioritization: Maslow
An RN is prioritizing care for four clients. Which need should the nurse address FIRST?
- A A client reporting new acute chest pain and shortness of breath
- B A client asking to speak with the chaplain about spiritual concerns
- C A client requesting help writing a letter to a family member
- D A client wanting to discuss discharge planning for tomorrow
Show answer & rationale
Correct answer: A
Using Maslow's hierarchy and the ABCs together, physiologic needs that threaten airway, breathing, or circulation come first. New acute chest pain with shortness of breath signals a possible cardiac or respiratory emergency, an actual, unstable, physiologic problem, so this client is addressed first. Speaking with the chaplain (option B) is a spiritual/psychosocial need. Help writing a letter (option C) is a love-and-belonging/self-esteem need. Discussing discharge planning (option D) is important but not urgent and is future-oriented. All three lower-priority options are psychosocial or planning needs that rank beneath physiologic threats on Maslow's pyramid. The distractors are plausible because they are legitimate client requests, but none competes with a possible cardiac event. Memory aids: ABCs first, then Maslow (physiologic before safety before psychosocial before self-actualization), and actual before potential. The word 'acute' plus a breathing or circulation symptom marks the top priority; comfort, spiritual, and planning needs wait.
Question 8 · Delegating to UAP
A charge nurse is delegating to experienced unlicensed assistive personnel (UAP). Which tasks are appropriate to delegate? Select all that apply.
- A Assessing a client's pain and response to analgesic
- B Feeding a stable client who has no swallowing difficulties
- C Assisting a stable client with a bed bath
- D Educating a client about a low-fat diet
- E Measuring and recording a client's intake and output
- F Obtaining routine vital signs on a stable client
Show answer & rationale
Correct answer: B, C, E, F
UAP perform standardized, non-invasive tasks with predictable outcomes on STABLE clients. Feeding a client without swallowing risk, measuring intake and output, assisting with a bed bath, and taking routine vital signs on a stable client all fit UAP scope. Assessing pain and the response to analgesic (option A) is an assessment and evaluation task requiring nursing judgment, so it is RN-reserved. Educating a client about a low-fat diet (option D) is client teaching, another RN-only task. The two distractors are tempting because UAP are around clients constantly, but any option using 'assess,' 'evaluate,' or 'teach/educate' is out. Note the safety caveat: feeding is delegable only when the client has NO swallowing difficulty (an aspiration risk would make it unsafe), and vital signs are delegable only on STABLE clients; an unstable client's vitals stay with the nurse. Memory aid: UAP get ADLs, hygiene, feeding (no aspiration risk), ambulation, positioning, routine vitals, and I&O on stable clients; the RN keeps Assessment, Teaching, and Evaluation.
Question 9 · RN-only tasks
An RN identifies tasks that cannot be delegated to an LPN/LVN or UAP. Which tasks must the RN keep? Select all that apply.
- A Performing an admission assessment
- B Assisting a client to the bathroom
- C Developing the client's plan of care
- D Evaluating the effectiveness of a newly prescribed medication
- E Administering a routine oral medication
- F Providing discharge teaching about wound care
Show answer & rationale
Correct answer: A, C, D, F
The RN cannot delegate tasks that require nursing judgment. Developing the plan of care, evaluating the effectiveness of a medication (evaluation), performing an admission (initial) assessment, and providing discharge teaching are all RN-only functions. Administering a routine oral medication (option E) is within LPN scope, so it is delegable. Assisting a client to the bathroom (option B) is a standardized ADL appropriate for UAP. The distractors are plausible because meds and toileting are common, but neither requires the initial judgment, teaching, or evaluation the RN must retain. Memory aid: the RN keeps Assessment (initial/admission), Teaching, Evaluation, developing the plan of care, and the unstable client. Scan each option for those verbs: 'develop the plan,' 'evaluate,' 'admission assessment,' and 'teaching' all stay with the RN, while routine medication administration and ADL assistance can be delegated down the ladder.
Question 10 · Assigning to LPN/LVN
An RN is assigning tasks to an LPN/LVN. Which tasks are within the LPN/LVN scope of practice? Select all that apply.
- A Conducting the initial admission assessment of a new client
- B Reinforcing teaching that the RN has already provided
- C Developing the client's individualized plan of care
- D Administering routine oral and subcutaneous medications to a stable client
- E Monitoring a stable client with a predictable condition
- F Performing a routine sterile dressing change per facility and state policy
Show answer & rationale
Correct answer: B, D, E, F
The LPN/LVN cares for STABLE clients with predictable outcomes. Administering routine oral and subcutaneous medications, reinforcing teaching the RN already gave, performing a routine sterile dressing change (per state and facility policy), and monitoring a stable, predictable client are all within LPN scope. Conducting the initial admission assessment (option A) and developing the plan of care (option C) require RN judgment and are RN-only. The distractors are plausible because LPNs do collect ongoing data and follow the plan, but they cannot perform the FIRST comprehensive assessment or create the plan. Note the state caveat: some LPN tasks (such as IV-push medications, IV starts, and certain sterile procedures) vary by state, so a dressing change is keyed here 'per policy.' Memory aid: give the LPN the stable client, routine meds, reinforced teaching, and routine procedures; the RN keeps Assessment (initial), Teaching (new), Evaluation, the plan of care, and the unstable client.
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Delegation & Prioritization FAQ
What can never be delegated to an LPN/LVN or UAP?
The RN must keep any task requiring nursing judgment: the initial or admission assessment, all client teaching, evaluation of care and outcomes, developing the plan of care, and the care of an unstable or unpredictable client. High-risk actions such as initiating a blood transfusion and giving IV-push medications are also generally RN responsibilities. Remember: the RN keeps Assessment, Teaching, Evaluation, and the unstable client.
How do I decide which client to see or assess first?
Layer three tools. Start with the ABCs (airway, breathing, circulation), then Maslow's hierarchy (physiologic needs before psychosocial). Then apply the ordering rules: unstable before stable, acute before chronic, and actual problems before potential ones. The client whose airway, breathing, or circulation is most threatened, or who has newly become unstable, is your first priority. Routine, scheduled, chronic, or comfort needs wait.
What is the difference between UAP scope and LPN scope?
UAP (unlicensed assistive personnel) perform standardized, non-invasive tasks on STABLE clients: ADLs, hygiene, feeding a client with no swallowing risk, ambulation, positioning, routine vital signs, intake and output, and stocking. They never assess, teach, evaluate, or use clinical judgment. LPN/LVNs care for stable, predictable clients and can give many routine medications, perform routine sterile and wound procedures (per state), and reinforce teaching the RN already started, but they cannot do initial assessments, teaching, or evaluation.
What is the trick to answering delegation and assignment questions?
First run the task or client through the scope ladder: does it require assessment, teaching, evaluation, or care of an unstable client? If yes, it stays with the RN. If it is stable and routine, it can go to the LPN; if it is a standardized ADL-type task on a stable client, it can go to UAP. Then confirm the Five Rights of Delegation (right task, circumstance, person, direction/communication, supervision). Watch for keywords like 'admission,' 'teach,' 'evaluate,' and 'unstable/deteriorating,' which flag RN-only work.