NCLEX-RN® Delegation Questions: RN, LPN/VN, and UAP Roles Explained

The exact rules NCLEX® uses for who can do what — RN-only tasks, LPN/VN scope, UAP boundaries, and how to spot the wrong delegation in seconds.

Overview

Delegation questions are everywhere on the NCLEX-RN®. They sit inside Management of Care (15–21% of the exam) and they appear in nearly every NGN case study. The good news: delegation has a clear, learnable rule set. Once you know who can do what, the questions become almost mechanical.

This guide explains the three roles you will see on the exam — RN, LPN/VN, and UAP — and gives you the simple decision rules NCSBN expects you to apply.

The three roles

RN, LPN/VN, UAP Three boxes: RN at the top, LPN/VN in the middle, UAP at the bottom, with one-line role summaries. The three roles in delegation questions RN — Registered Nurse • Initial assessment • Care planning & teaching • Unstable clients • IV push, blood, titration LPN / VN • Stable clients • Routine meds (PO/IM/SC) • Reinforce teaching • Sterile dressings UAP / NA • Activities of daily living • Vitals on stable • I&O, ambulation • Bathing, feeding
Figure 1. Each role has a strict scope; the exam expects you to know it.
  • RN — Registered Nurse. First assessment, planning, teaching, evaluation, unstable clients, IV-push medications, blood products, titration, and any task that requires nursing judgement.
  • LPN/VN — Licensed Practical / Vocational Nurse. Stable clients, routine medications by mouth/IM/subcut, sterile dressing changes, reinforcing teaching the RN already gave, urinary catheter insertion, suctioning of established airways.
  • UAP — Unlicensed Assistive Personnel (also called nursing assistant, tech, or aide). Activities of daily living, vital signs on stable clients, intake and output, ambulation, bathing, feeding, weights, simple oral hygiene.

The five never-delegate rules

These belong to the RN only. If you remember nothing else, remember these five.

RN-only tasks Five RN-only items: assess, teach, plan, evaluate, unstable clients. RN only — never delegate AssessInitial & ongoingassessment TeachNew patienteducation PlanCare plan +discharge plan EvaluateResponse tocare & meds UnstableClients whomay decline
Figure 2. Memorise these — they appear on almost every delegation question.

The five rights of delegation

NCSBN frames safe delegation around five "rights". The exam often hides one of them as the key reason an option is wrong.

  • Right Task — the task is one the delegatee can legally and safely perform.
  • Right Circumstance — the client is appropriate (stable for an LPN, ADLs only for a UAP).
  • Right Person — this specific delegatee has the demonstrated competence.
  • Right Direction / Communication — clear instruction including what to do and what to report back.
  • Right Supervision / Evaluation — the RN follows up on the outcome.

Common scenarios

A few patterns repeat on the exam:

  • "Which task can the nurse delegate to the UAP?" — pick the ADL or vitals task on a stable client. Anything assessment, teaching, or unstable is wrong.
  • "Which client should be assigned to the LPN?" — pick the most stable client whose care is routine medication, dressing, catheter, or reinforced teaching.
  • "Which client should the RN see first?" — this is a prioritisation question, not delegation. Use ABCs / Safety / Acute vs Chronic.
  • "Which statement by the UAP requires intervention?" — pick the option where the UAP performs an out-of-scope action (e.g. inserts a urinary catheter, gives medication, teaches insulin).

A quick decision tree

Delegation decision tree Three questions: is the client unstable? does it need assessment, teaching or judgement? does it require nursing skill? Yes paths route to RN, LPN, UAP appropriately. Quick delegation decision tree Is the client unstable? Yes → RN only Need assess / teach / judge? Need nursing skill? Yes → RN Yes → RN · No → LPN/UAP Yes → LPN · No → UAP
Figure 3. Three yes/no questions resolve almost every delegation item.

A worked example

Question. The charge nurse is making assignments. Which client should be assigned to the LPN/VN? A. A new admit with chest pain awaiting troponin results. B. A stable post-op day 3 client needing a sterile dressing change and routine antibiotics. C. A newly diagnosed diabetic needing insulin teaching. D. A client requiring a blood transfusion that needs to be initiated this hour.

Apply the rules:

  • A is unstable — RN only.
  • B is stable + sterile dressing + routine meds — exactly the LPN scope. Correct.
  • C is initial teaching — RN only.
  • D is blood initiation — RN only.

Answer: B.

FAQ

Can a UAP take vital signs on the NCLEX®?

Yes — on stable clients with no recent change in condition. A UAP cannot take initial vitals on an unstable client, a fresh post-op, or a client who has just had medication that may affect vitals. Those belong to the RN or LPN.

Can an LPN do an initial assessment?

No. Initial assessment is RN-only. An LPN can collect ongoing data, perform focused assessments on stable clients, and report findings — but the first comprehensive assessment of any new client belongs to the RN.

Can an LPN give IV medications?

It depends on state law and facility policy, but for NCLEX® purposes the safe assumption is: LPNs do not give IV-push medications, blood, or titrate drips. They may give some IV piggyback antibiotics in some states. When in doubt, choose the RN.

Are delegation rules the same in every US state?

No — state nurse practice acts vary, especially around LPN scope. But NCSBN tests the most restrictive common framework so you get a consistent answer. Use the rules in this guide on the exam.

What if the RN is the only correct option?

Choose RN. There is no penalty for assigning a task to the RN on a delegation question. Many "wrong" answer choices on delegation items are tasks that technically could be done by an LPN or UAP but are not the safest choice for that client.

See also:

NCLEX-RN® Hub: Clinical Judgment Guide

Practice on RN Clarity: Question Bank · Diagnostic Quiz