# 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.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=556757&lang=en  
> language: en  
> subject: Assignment/Delegation/Supervision  
> category: MOC

## Question

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.

| Staff member | Assignment |
| --- | --- |
| LPN/VN | Perform the admission assessment and develop the plan of care for a newly admitted client. |
| Assistive personnel | Obtain routine vital signs for a stable client and report values outside the RN's written limits. |
| Assistive personnel | Feed a client with a new stroke before the prescribed swallow screen is completed. |
| LPN/VN | Change the sterile dressing for a stable chronic wound according to facility policy. |
| Assistive personnel | Measure and record oral intake for a stable client with chronic heart failure. |
| Assistive personnel | Ambulate a postoperative client who reported new chest pressure 10 minutes ago. |
| LPN/VN | Reinforce insulin-injection teaching after the RN completed the initial teaching and plan. |
| Assistive personnel | Interpret a pulse oximetry reading and adjust oxygen to a new flow rate. |
| Assistive personnel | Assist a stable client with bathing and report skin changes to the RN. |

## 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.

## In-depth explanation

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

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