Free Delegation and Assignment (NCLEX) MCQs with Answers
50 Delegation and Assignment (NCLEX) MCQs from International Nursing Practice, each with the correct answer and a written explanation of why it is correct. Free and unlimited, with no account needed.
Delegation and assignment cover how the registered nurse allocates care according to patient stability, task complexity, staff competence and legal scope. The five rights of delegation, supervision, communication and follow-up are linked to the difference between an RN, LPN or LVN, and unlicensed assistive personnel, while accountability for overall nursing care remains with the RN.
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50 questions · page 2 of 3
- A. Explain the meaning of the test result
- B. Teach the client how to interpret the result
- C. Collect and label the specimen as instructed
- D. Decide whether the specimen is adequate
Explanation: Collecting a specimen from a stable client is within the usual role of unlicensed assistive personnel when directions are clear.
Correct answer: Collect and label the specimen as instructed- A. Ask the licensed practical nurse to apply a protective dressing
- B. Assess the client's skin and determine the nursing response
- C. Document that the licensed practical nurse completed the assessment
- D. Ask unlicensed assistive personnel to reposition the client hourly
Explanation: The registered nurse must assess a new clinical finding and determine the plan of care.
Correct answer: Assess the client's skin and determine the nursing response- A. A client whose condition is changing after a procedure
- B. A client receiving a first dose of a new medication
- C. A client with stable chronic heart failure and predictable care
- D. A client who needs initial teaching about a new ostomy
Explanation: A licensed practical nurse can care for a client with stable, predictable needs within the nurse's scope and facility policy.
Correct answer: A client with stable chronic heart failure and predictable care- A. Checking the skin before applying the stockings
- B. Removing the stockings during the scheduled skin check
- C. Reporting numbness or discoloration to the nurse
- D. Choosing a different size without notifying the nurse
Explanation: The delegated worker should not independently select equipment or change the care plan.
Correct answer: Choosing a different size without notifying the nurse- A. Finish the bath before reporting the symptom
- B. Give the client a prescribed rescue medication
- C. Stop the activity and report the symptom immediately
- D. Record the symptom after completing the assigned care
Explanation: The unlicensed worker should stop the activity and promptly report a new symptom to the RN.
Correct answer: Stop the activity and report the symptom immediately- A. Report the amount and any unusual appearance after each measurement
- B. Decide whether the amount indicates kidney failure
- C. Increase the client's fluids if the amount is low
- D. Omit the measurement when the client uses the toilet
Explanation: The UAP can measure and report objective data, including unusual urine appearance, when the client is stable.
Correct answer: Report the amount and any unusual appearance after each measurement- A. A client with a healed incision needing a routine dressing change
- B. A client with stable asthma receiving scheduled treatments
- C. A client returning from surgery with new confusion and hypotension
- D. A client with chronic arthritis needing assistance with hygiene
Explanation: New confusion and hypotension indicate an unstable change that requires RN assessment and intervention.
Correct answer: A client returning from surgery with new confusion and hypotension- A. Repeat the test later without telling the nurse
- B. Report the result promptly to the registered nurse
- C. Give the client food according to personal judgment
- D. Record the result as expected for the diagnosis
Explanation: The UAP reports abnormal data promptly so the RN can assess the client and determine the response.
Correct answer: Report the result promptly to the registered nurse- A. Tell the practical nurse to give the medication as scheduled
- B. Ask unlicensed assistive personnel to decide whether it is safe
- C. Review the client, order, and assessment before giving direction
- D. Tell the practical nurse to document the dose as refused
Explanation: The RN should review the assessment and prescription, then provide direction based on the ordered parameter and client condition.
Correct answer: Review the client, order, and assessment before giving direction- A. The client's complete medical history and all past treatments
- B. The exact activity, safety precautions, and findings to report
- C. The UAP's preferred method for completing the activity
- D. The client's likely diagnosis and expected long-term outcome
Explanation: Effective delegation includes a specific task, safety limits, expected observations, and when to report back.
Correct answer: The exact activity, safety precautions, and findings to report- A. Changing a sterile abdominal dressing
- B. Teaching crutch use to a new client
- C. Recording the amount eaten at lunch
- D. Evaluating progress toward mobility goals
Explanation: Recording food intake is a routine, predictable task that can be delegated to trained unlicensed assistive personnel.
Correct answer: Recording the amount eaten at lunch- A. Ask the nursing assistant to reassess the pain later
- B. Assign the licensed practical nurse to determine the cause
- C. Assess the client and notify the provider as indicated
- D. Delegate administration of the analgesic to the nursing assistant
Explanation: New or worsening pain after surgery requires assessment by the registered nurse before further treatment decisions are made.
Correct answer: Assess the client and notify the provider as indicated- A. Developing the initial nursing care plan
- B. Reinforcing teaching about a prescribed diet
- C. Performing the initial assessment of chest pain
- D. Determining whether discharge goals are met
Explanation: A licensed practical nurse may reinforce teaching that the registered nurse has already provided to a stable client.
Correct answer: Reinforcing teaching about a prescribed diet- A. Complete the task whenever the unit becomes less busy
- B. Call the nurse only if the client asks for help
- C. Report the client's response and any unexpected finding
- D. Use your usual method because the task is familiar
Explanation: The delegatee must know what findings to report, and the registered nurse must provide direction and supervision.
Correct answer: Report the client's response and any unexpected finding- A. Deciding whether the weight reflects fluid retention
- B. Obtaining the weight using the same scale each day
- C. Changing the diuretic schedule after a weight gain
- D. Explaining the purpose of the weight monitoring
Explanation: Obtaining and recording a daily weight is a routine, measurable task for a stable client and may be delegated.
Correct answer: Obtaining the weight using the same scale each day- A. Help the client walk back to the bed quickly
- B. Leave the client briefly to obtain a wheelchair
- C. Support the client safely and call the nurse
- D. Ask the client to continue while holding the rail
Explanation: The client may be experiencing instability or syncope, so the delegatee should protect the client from falling and summon the nurse.
Correct answer: Support the client safely and call the nurse- A. A client receiving a first dose of an unfamiliar medication
- B. A client with stable symptoms awaiting routine dressing care
- C. A client requiring interpretation of new neurological findings
- D. A client needing an initial plan for complex discharge teaching
Explanation: A stable client with predictable care needs is generally appropriate for assignment to a licensed practical nurse.
Correct answer: A client with stable symptoms awaiting routine dressing care- A. Reposition the client and report any nonblanching redness
- B. Choose a position that seems comfortable at each round
- C. Massage any reddened area until the skin appears normal
- D. Decide whether the client's risk has improved
Explanation: The nurse should give specific directions and require reporting of abnormal skin findings.
Correct answer: Reposition the client and report any nonblanching redness- A. Ask the licensed practical nurse to document the change
- B. Assess the client and determine the cause of the confusion
- C. Delegate neurological observations to unlicensed personnel
- D. Wait until the next scheduled round to reassess the client
Explanation: New confusion is an unexpected change that requires prompt assessment by the registered nurse.
Correct answer: Assess the client and determine the cause of the confusion- A. Whether the task is convenient for the current assignment
- B. Whether the client has requested a particular caregiver
- C. Whether the person has demonstrated competence for the task
- D. Whether the task was delegated to that person yesterday
Explanation: Safe delegation depends on the client's needs, the task's predictability, and the delegatee's demonstrated competence.
Correct answer: Whether the person has demonstrated competence for the task