Quick answerThe correct assignments reflect the legal and regulatory scope of each team member. The RN performs the initial assessment of the newly admitted client with uncontrolled diabetes because it requires clinical judgment and care planning. The LPN/VN reinforces teaching for the stable client with a new colostomy because reinforcement of teaching is within LPN/VN scope under RN supervision. The UAP obtains vital signs for the stable client who had a blood transfusion 2 hours ago because it is a routine, predictable task with clear parameters.
Why this is correctDelegation decisions are based on the stability of the client, the complexity of the task, and the scope of practice of each team member. The RN must assess and plan care for unstable or newly admitted clients. The LPN/VN can perform tasks for stable clients that do not require independent nursing judgment. The UAP can perform routine tasks with predictable outcomes under supervision.
Clinical pictureIn a medical-surgical unit, the charge nurse must assign tasks based on client acuity and team member competencies. The newly admitted client with uncontrolled diabetes requires immediate RN assessment to establish a baseline and initiate appropriate interventions. The stable client with a new colostomy needs reinforcement of previously taught information, which is within LPN/VN scope. The stable client post-transfusion requires routine vital sign monitoring, which can be delegated to UAP with clear reporting parameters.
Memory hookRemember the five rights of delegation: right task, right circumstance, right person, right direction/communication, and right supervision/evaluation. RNs retain tasks requiring assessment, planning, and evaluation. LPN/VNs can perform tasks for stable clients with predictable outcomes. UAPs perform routine, non-invasive tasks.
NCLEX decision ruleDo not delegate tasks that require nursing judgment, assessment, or evaluation to UAP. LPN/VN may perform tasks for stable clients as authorized by state law and facility policy. The RN is accountable for the delegation decision and must supervise and evaluate the care provided.
Why the alternatives are wrongAssigning the initial assessment to the LPN/VN would be inappropriate because the client is newly admitted and unstable, requiring RN-level assessment and care planning. Assigning reinforcement of teaching to the UAP would be inappropriate because teaching reinforcement requires nursing knowledge and is not within UAP scope. Assigning vital signs to the LPN/VN would be acceptable but not the best use of LPN/VN skills when a UAP can perform this routine task, allowing the LPN/VN to focus on other stable client care.
Sources
1NCSBN 2026 NCLEX-RN Test Plan
2NCSBN: Delegation
3NCSBN National Guidelines for Nursing Delegation