NCLEX Delegation: RN vs LPN/LVN vs UAP

On the NCLEX, delegation questions come down to one move: hand the task to the lowest team member who can do it safely, but keep with the RN anything that needs nursing judgment. The RN owns assessment, the care plan, evaluation, and the first round of teaching, plus any client who is unstable. The LPN/LVN takes stable, predictable clients and routine skilled tasks. The UAP takes routine care that needs no judgment. Learn who owns what, and the wording stops tricking you.

These items feel slippery because every option is a real task someone on the floor does. The question is never whether the task is legitimate, it is who may do it. That is a scope-of-practice call, and once you can sort a task into RN-only, LPN, or UAP on sight, the answer falls out. This is the same skill that shows up on prioritization and delegation items across the exam.

• The RN keeps the nursing process. Assessment, nursing diagnosis, planning, and evaluation stay with the RN. So does the first time a client is taught something, and any client who is unstable or unpredictable.
• The LPN/LVN takes stable and skilled. Stable clients with predictable outcomes, routine medications, sterile procedures, ongoing focused data collection, and reinforcing teaching the RN already started.
• The UAP takes routine and no-judgment. Bathing, feeding, ambulating, positioning, routine vital signs on a stable client, and measuring intake and output. Nothing that requires a nursing decision.

The one rule that answers most delegation questions

Delegate down to the lowest team member who can safely carry out the task, and never delegate the parts of care that require nursing judgment. The RN stays accountable for the outcome no matter who does the hands-on work, which is exactly why the judgment pieces cannot leave the nurse. Sort every option two ways: does it need a nursing decision, and is the client stable?

What the RN can never hand off

These belong to the RN on every question, in every setting. If an option asks someone else to do one of them, that option is wrong:

• Assessment. The initial or admission assessment, and any assessment of a client who may be unstable. A nurse must lay eyes on the new or changing client.
• Nursing diagnosis and the plan of care. Deciding what the problem is and what the plan should be is pure nursing judgment.
• Evaluation. Judging whether an intervention worked, or whether a client is getting better or worse.
• The first round of teaching. Initial client education belongs to the RN. Others may reinforce it, but the nurse does it first.
• Any unstable or unpredictable client. The moment a client's status is changing, their care comes back to the nurse.

What the LPN/LVN can take

The LPN/LVN is licensed and trained, so the line is not about skill, it is about judgment and stability. Assign the LPN a client who is stable with a predictable course, and routine skilled tasks:

• Routine medications for a stable client, such as scheduled oral, intramuscular, or subcutaneous doses.
• Sterile and skilled procedures on stable clients, such as a dressing change, catheter care, or tube feeding through an established tube.
• Ongoing, focused data collection on a stable client, and reporting changes back to the RN.
• Reinforcing teaching the RN has already begun.
• Monitoring a stable client for expected effects and complications.

What the UAP can take

Unlicensed assistive personnel handle routine care that requires no nursing judgment, on stable clients only. They can gather data, but they never interpret it:

• Activities of daily living: bathing, hygiene, feeding, dressing, and ambulating a stable client.
• Routine vital signs on a stable client. If the client is unstable, the nurse takes them.
• Measuring and recording intake and output, daily weights, and routine specimen collection.
• Positioning, turning, and basic comfort care.

The five rights of delegation

The national guidelines frame safe delegation as five rights. When a question asks whether delegation was appropriate, check the task against all five:

1. Right task. Is it routine, predictable, and within the delegate's scope and job description?
2. Right circumstance. Is the client stable and the setting appropriate right now?
3. Right person. Does this specific worker have the competence for this client and this task?
4. Right direction and communication. Were clear, specific instructions given, including what to report back?
5. Right supervision and evaluation. Does the nurse follow up, check the outcome, and stay accountable?

Try it: who can do this task?

Reading the rules is not the same as sorting tasks under pressure. Below is a free drill. You get a short assignment of tasks; for each one, tap the lowest team member who may safely do it, then check your answer and read why. Run it a few times until the sorting feels automatic.

The traps that make delegation questions miss

Delegation items are written to punish fast reading. The wrong answers look reasonable. Slow down on these:

• The hidden unstable client. A task that is normally fine for a UAP or LPN becomes RN-only the moment the client is unstable. Read the client's status before you place the task.
• Teaching dressed up as a chore. Anything that first shows a client how to do something is teaching, and initial teaching is the RN's. Reinforcing what the RN already taught can go to the LPN.
• The word assist. Helping a stable client walk or eat is a UAP task, but assisting with a procedure that needs judgment is not. Look at what the assisting actually involves.
• First time versus routine. A brand-new or unpredictable situation needs the nurse. The same task, once it is stable and routine, can move down the ladder.

See it on a real item

Here is a classic delegation stem worked with the framework, so you can watch the sorting play out.

• Sort by judgment, then by stability. Ask two questions of every task: does it need a nursing decision, and is the client stable? Those two answers place almost every task on the RN, LPN, or UAP.
• The RN keeps the process and the unstable client. Assessment, planning, evaluation, and initial teaching never leave the nurse, and neither does any client whose status is changing.
• Delegate down, but stay accountable. Hand the task to the lowest team member who can do it safely, then supervise and follow up. The RN owns the outcome regardless of who does the work.