An RN is deciding whether to delegate each activity. For each situation, select the best delegation decision.
Matrix
Choose your responses, then check the answer.
Explanation
Delegation is situation-specific. Routine, predictable activities for stable clients may be delegated when the activity is permitted by jurisdiction and policy, the delegatee is competent, directions and reporting parameters are clear, and the RN can supervise and evaluate the outcome. Initial assessment, interpretation of changing cues, clinical judgment, and evaluation remain with the licensed nurse responsible for those decisions. When scope, policy, or competency is unknown, the safe response is to clarify before delegating rather than to assume that a role may or may not perform the activity everywhere.
Correct Answer Delegate predictable ambulation and routine vital signs for stable clients when competency, directions, reporting parameters, and supervision are established. Retain initial assessment, clinical interpretation, evaluation, and care of a newly unstable client. Clarify jurisdiction, policy, and competency before assigning a task whose authorization is not provided.
Why It Fits The Five Rights require the right task, circumstance, person, directions and communication, and supervision and evaluation. A job title alone does not answer all five questions.
Clinical Picture Stable, predictable care with explicit limits can be delegated safely. New dyspnea, a treatment-response evaluation, or an acute change requires nursing judgment. An unspecified licensed activity cannot be classified safely until the applicable law, employer policy, and individual competency are known.
Memory Link Stable and specified can be delegated; judgment stays; uncertainty gets clarified.
NCLEX Rule Do not convert a state-dependent scope question into a universal rule. Use the client, task, setting, policy, competency, communication, and supervision cues supplied in the stem.
Why the Alternatives Fail Delegating an initial assessment or evaluation transfers judgment that must be retained. Assuming permission without checking scope and competency bypasses the right person and right circumstance. Refusing every routine task ignores safe team use and the Five Rights.
Source
1NCSBN National Guidelines for Nursing Delegation
2NCSBN Scope of Practice Decision-Making Framework
32026 NCLEX-RN Test Plan
The RN uses the applicable nurse practice act, facility policy, staff job descriptions, documented competency, client stability, clear directions, and available supervision. The stem does not assume that one licensed role has identical authority in every jurisdiction.
Assignment and Delegation — Assignment distributes work already within a team member's authorized role. Delegation authorizes another person to perform a selected activity while the licensed nurse retains accountability for the overall nursing decision and outcome.
Scope of Practice — The activities permitted by the applicable nurse practice act and rules, employer policy, education, licensure, and demonstrated competence. It is not identical in every jurisdiction or setting.
Clinical Judgment — The interpretation of client cues and selection, evaluation, or modification of nursing responses. Activities requiring clinical reasoning or critical decision making are not transferred as routine delegated tasks.