Stage 4 — Generate solutions. Help has arrived for Patient A, and the RN has completed the initial assessment of Patient D's acute confusion. Which assignments or delegations are appropriate if allowed by jurisdiction, facility policy, and verified competency? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Four appropriate decisions Correct choices are 2, 3, 5, and 6. Stable, predictable vital signs and assisted toileting can be delegated to a competent UAP with explicit parameters and RN follow-up. A competent LPN/VN may provide established medication and teaching-reinforcement care for stable clients when permitted by the nurse practice act and facility policy. The RN performs Patient A's initial assessment and oxygenation decisions and cannot transfer a clinical anticoagulant-selection or titration decision that policy reserves for the RN.
Step 1 — Start with stability and predictability Patient A is unstable and requires RN assessment and judgment. Patients B and C have established plans and predictable care. Patient D's acute confusion first requires RN assessment; afterward, specific toileting and observation tasks can be delegated with immediate reporting instructions.
Step 2 — Match the person to the task UAP work is limited to non-assessment activities with defined observations and reporting. LPN/VN activities vary by jurisdiction and policy; the item explicitly conditions the assignment on verified scope, policy, and competency.
Step 3 — Retain RN accountability The RN sets directions, remains available, reviews the result, reassesses when findings change, and evaluates teaching and discharge readiness.
NCLEX rule Do not memorize a universal task list. Apply client stability, task predictability, law, policy, competency, direction, and supervision.
Scenario (Stage 4 — Generate solutions)Patient A's PE pathway is active, and Patient D's acute mental-status change has received initial RN assessment. The team must safely cover all four clients.
Clinical judgment targetApply delegation boundaries without treating LPN/VN scope as identical in every jurisdiction.
Delegation decision — A clinical judgment based on the client, task, delegatee, jurisdiction, facility policy, competency, communication, and available supervision.
Teaching reinforcement — Review of an established education plan; the RN retains responsibility for initial teaching, evaluation, and discharge readiness as required by policy.
RN accountability — The RN remains responsible for appropriate delegation, directions, availability, supervision, follow-up, and evaluation of outcomes.