The charge nurse reviews the assignment record for a medical-surgical unit; each staff member has documented competency for routine assigned tasks. Which assignments require follow-up? Highlight the appropriate cells.
Highlight in Table
Choose your responses, then check the answer.
Explanation
Revise assignments that transfer initial assessment, care planning, interpretation, oxygen titration, or feeding before a swallow screen. Delegate predictable tasks only after considering client stability, worker competence, supervision needs, and local scope rules.
Quick answer Revise the new-admission assessment and care plan, feeding before a swallow screen, first ambulation after new chest pressure, and oxygen interpretation/titration. Each requires RN assessment or clinical judgment before a predictable task can be delegated.
Why this is correct Delegation decisions depend on the client's condition, the delegatee's competence, and the supervision required; state or jurisdiction rules still control actual scope.[1] New symptoms, an unscreened swallowing risk, and changes to oxygen therapy make the situation less predictable. Routine data collection or care for a stable client can be appropriate when the RN gives clear parameters and remains accountable.
Easy analogy or mental picture Think of delegation as handing someone a route on a map, not handing over the steering wheel for every decision. A trained team member can follow a known route, while the RN must reassess when the road changes. The analogy does not replace the nurse practice act or facility policy.
Memory hook Stable + standard + supervised can be delegated; assess + interpret + change the plan stays with the RN.
NCLEX decision rule When an assignment contains new instability, initial assessment, interpretation, teaching-plan creation, or treatment adjustment, think RN judgment; check jurisdiction, competency, directions, and supervision before delegating.
Why the other choices are wrong Routine vital signs with reporting limits, stable wound care within LPN/VN scope, reinforcement after RN teaching, intake measurement, and hygiene for stable clients are predictable activities. They may be delegated or assigned when local policy permits and the RN provides appropriate follow-up.
References
[1]
NCSBN and ANA: National Guidelines for Nursing DelegationNational Council of State Boards of Nursing and American Nurses Association
[2]
2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing