# A registered nurse (RN) is working on a busy medical-surgical unit with a licensed practical nurse (LPN) and unlicensed assistive personnel (UAP). Which task is most appropriate for the RN to delegate to the LPN? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=543583 > language: ko > subject: Next Gen NCLEX ## 문제 A registered nurse (RN) is working on a busy medical-surgical unit with a licensed practical nurse (LPN) and unlicensed assistive personnel (UAP). Which task is most appropriate for the RN to delegate to the LPN? ## 보기 1. Developing a discharge teaching plan for a patient with newly diagnosed diabetes 2. Performing initial assessment on a patient admitted with chest pain 3. Evaluating the effectiveness of pain medication for a postoperative patient 4. Administering prescribed oral medications to stable patients **✔ 정답** **정답: 4** ## 해설 LPNs can safely administer oral medications to stable patients under RN supervision, as this falls within their scope of practice and training. Other options require RN-level assessment, evaluation, or planning skills. ## 심화 해설 Understanding the RN’s Role in Delegation The core of this question lies in the legal and professional boundaries defined by the scope of practice for each nursing team member. The registered nurse (RN) retains ultimate accountability for the nursing process, which includes assessment, diagnosis, planning, and evaluation. These steps require the critical thinking and clinical judgment that are the foundation of RN-level education and licensure. In contrast, a licensed practical nurse (LPN) works under the RN’s direction and focuses on implementing established care plans and performing stable, standardized procedures. Unlicensed assistive personnel (UAP) are delegated tasks that do not require nursing judgment, such as activities of daily living. The RN must match the task to the team member whose legal scope and competency align with the patient’s stability and the complexity of the task. [1] Why the Other Options Are Incorrect for LPN Delegation The first three options represent core functions of the RN that cannot be delegated to an LPN. - Option 1 (Developing a discharge teaching plan): This is a planning function. Creating a teaching plan requires an initial, comprehensive assessment of the patient’s learning needs, readiness, and barriers—a process that demands RN-level clinical judgment to synthesize data and design an individualized strategy. - Option 2 (Performing initial assessment): The initial assessment is the critical first step of the nursing process. It involves collecting and interpreting a baseline set of data to identify problems and establish priorities. This is an exclusive RN responsibility that sets the trajectory for the entire plan of care. - Option 3 (Evaluating the effectiveness of pain medication): Evaluation is the final, dynamic step of the nursing process. It requires the RN to reassess the patient, compare the current status against expected outcomes, and use clinical judgment to decide if the care plan needs modification. This analytical process is beyond the LPN’s scope. These distinctions are not arbitrary; they are rooted in how scope of practice laws define autonomy and task delegation. Research examining these laws shows that the ability of nurses to delegate appropriately is a key element of professional autonomy and is linked to job satisfaction and retention. When RNs are forced to operate in environments with unclear delegation boundaries, it can lead to role confusion and increased turnover, underscoring the importance of getting these assignments right for both patient safety and team stability. [1] Why Administering Oral Medications to Stable Patients Is the Correct Task Administering prescribed oral medications to a patient whose condition is stable is a task that falls squarely within the LPN’s scope. This activity involves the implementation phase of the nursing process. The LPN can safely carry out this task by following the established “five rights” of medication administration and monitoring for common side effects, all while the RN remains responsible for the overall plan and for evaluating the medication’s therapeutic effect. The key qualifier here is “stable patients.” A stable patient’s condition is predictable, and the task is a standardized procedure that does not require the high-level, on-the-spot clinical judgment needed for an unstable patient or a complex initial assessment. Effective delegation to LPNs and UAPs is a cornerstone of team-based care in acute settings. A scoping review on teamwork highlights that clear role definitions and mutual trust are critical factors for successful collaboration. When an RN delegates a task like medication administration to an LPN, it functions smoothly when both parties understand the LPN’s legal scope and the RN’s supervisory responsibilities. This clarity prevents the confusion around roles that can otherwise compromise patient care and team efficiency. The international inconsistency in titles and regulation for assistive roles further emphasizes why RNs must be precise; the legal scope of an LPN is distinct from that of a UAP, and tasks must never be delegated to a team member whose role is not legally authorized to perform them. In long-term and acute care settings, the LPN’s role is consistently mapped to direct care implementation and monitoring of stable conditions, reinforcing that medication administration for a stable patient is a standard, appropriate delegation. References (research sources) - [1]The Relationship Between Scope of Practice Laws for Task Delegation and Nurse Turnover in Home Health.Research articleCandon M, Bergman A, Rose A, Song H, David G, Spetz J. (2023) · DOI: 10.1016/j.jamda.2023.07.023 ## 임상 시나리오 Delegation to LPNs: The 5 RightsMatching task to scope of practice An LPN can be delegated tasks involving standardized procedures for stable patients, such as administering prescribed oral, IM, and SQ medications (excluding IV push). The RN retains accountability for assessment, planning, and evaluation. Never delegate an initial assessment, discharge planning, or any task requiring clinical judgment or evaluation of outcomes to an LPN. These are core RN-only functions. CautionAlways verify your state's Nurse Practice Act for specific LPN scope limitations, especially regarding IV medications, as these regulations vary significantly. ## 핵심 개념 - **Delegation** — The process by which an RN transfers the authority to perform a selected nursing task to a competent individual while retaining accountability for the outcome. - **Scope of Practice** — The legal boundaries of practice for a healthcare provider, defined by state law, defining what tasks they are educated and authorized to perform. - **LPN (Licensed Practical Nurse)** — A nurse who provides basic medical care under the direction of an RN or physician, focusing on implementing care plans and stable, standardized procedures. - **Nursing Process** — A systematic, critical-thinking method used by RNs involving assessment, diagnosis, planning, implementation, and evaluation. - **Stable Patient** — A patient whose health condition is predictable and not rapidly changing, making standardized care tasks appropriate for delegation. ## 같은 주제 문제 - [A charge nurse is making assignments for the upcoming shift. 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