# Situation: The adult medical-surgical ward of a 150-bed provincial hospital has 28 clients on the day shift. The charge nurse works with three staff nurses and two nursing attendants. The nursing attendants are unlicensed workers trained through a health care services program and the hospital's orientation. When a staff nurse delegates a task to a nursing attendant, which element stays with the staff nurse and cannot be passed on?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630351  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: The adult medical-surgical ward of a 150-bed provincial hospital has 28 clients on the day shift. The charge nurse works with three staff nurses and two nursing attendants. The nursing attendants are unlicensed workers trained through a health care services program and the hospital's orientation.

When a staff nurse delegates a task to a nursing attendant, which element stays with the staff nurse and cannot be passed on?

## 보기

1. Accountability for the delegation decision **✔ 정답**
2. Responsibility for doing the task correctly
3. Obligation to report findings back to the nurse
4. Authority to carry out the selected task

**정답: 1**

## 해설

Delegation transfers the authority to perform a selected task, and the person who accepts the task becomes responsible for doing it correctly and reporting back. Accountability for the decision to delegate, the direction given, and the supervision provided is never transferred; it stays with the registered nurse.

## 심화 해설

Core concept: the non-transferable element in delegation

Delegation is a formal nursing decision that transfers selected activities to another worker, but it does not transfer everything. The element that stays permanently with the registered nurse is accountability for the delegation decision itself — including the judgment to delegate, the direction provided, and the supervision that follows [1][2].

Accountability means the nurse remains answerable for the outcome of the delegated task and for the overall nursing care of the client. It cannot be handed to a nursing attendant, because accountability is tied to the professional license and the legal scope of nursing practice [2][3]. The nursing attendant is an unlicensed worker trained through a health care services program, so the law and professional standards place the ultimate ownership of the delegated act on the registered nurse who made the decision [1].

By contrast, responsibility for performing the task correctly does transfer to the person who accepts the assignment. When the nursing attendant agrees to carry out a delegated activity, that worker becomes responsible for doing it properly and for reporting observations back to the nurse [1][3]. Similarly, authority to perform the selected task is transferred along with the delegation — the attendant is given the right to act within the specific limits of the assignment [1][2].

| Element | Transferred to nursing attendant? | Stays with the RN? |
| --- | --- | --- |
| Accountability for the delegation decision, direction, and supervision | No — never transferred | Yes — always retained |
| Responsibility for doing the task correctly | Yes — accepted with the task | No — transferred to the attendant |
| Authority to carry out the selected task | Yes — granted for that task | No — delegated to the attendant |
| Obligation to report findings back to the nurse | Yes — part of accepting the task | No — becomes the attendant's duty |

The distinction matters in clinical practice because the registered nurse uses professional judgment to decide what to delegate, to whom, and under what level of supervision. That judgment is based on patient safety, the needs of the client, the education and training of the nursing attendant, the extent of supervision required, and the current workload [1]. Assessment and planning remain nursing functions that are not delegated; only selected tasks are handed over [1].

Watch out! A common exam error is confusing accountability with responsibility. Responsibility can be shared or transferred; accountability for the delegation decision cannot. The charge nurse and staff nurse remain accountable even when the nursing attendant performs the task well.

Key point! The nursing attendant who accepts a delegated task becomes responsible for correct performance and for reporting back, but the registered nurse who delegated the task remains accountable for the decision, the instruction given, and the supervision provided [1][2][3].References (research sources)

- [1]Registered nurse utilization of nursing assistive personnel statement for adoption.Research articleCenter for American Nurses (2007)

- [2]Thoughtful nursing practice: reflections on nurse delegation decision-making.Research articleMcInnis LA, Parsons LC (2009) · DOI: 10.1016/j.cnur.2009.07.002

- [3]Transparent teamwork: The practice of supervision and delegation within the multi-tiered nursing team.Research articleWalker FA, Ball M, Cleary S, Pisani H (2021) · DOI: 10.1111/nin.12413

## 임상 시나리오

Delegation: What the RN Cannot Give AwayAccountability remains with the licensed nurse
When delegating to a nursing attendant, the authority to perform the task and the responsibility for doing it correctly transfer to the delegatee. The attendant must also report findings back to the nurse.

The accountability for the delegation decision, the direction given, and the supervision provided stays with the registered nurse. This is tied to the professional license and cannot be passed to unlicensed workers.

CautionEven when the attendant performs the task, the RN remains answerable for the client outcome. Delegation without adequate supervision does not reduce the nurse's legal accountability.

## 핵심 개념

- **Accountability** — The nurse's answerability for the outcome of delegated tasks and overall nursing care, tied to professional licensure and never transferable.
- **Delegation** — The transfer of authority to perform a selected task to another worker while the RN retains accountability for the decision and supervision.
- **Responsibility** — The obligation to perform a task correctly, which transfers to the person who accepts the delegated assignment.
- **Authority** — The right to act within specified limits, transferred to the delegatee as part of the delegation.
- **Unlicensed Personnel** — Workers such as nursing attendants trained through specific programs who can accept delegated tasks but do not hold professional nursing licensure.

## 같은 주제 문제

- [Situation: The adult medical-surgical ward of a 150-bed provincial hospital has 28 clients…](https://mymerci.kr/pages/nclex_q.php?qn_id=630352)
- [Situation: The adult medical-surgical ward of a 150-bed provincial hospital has 28 clients…](https://mymerci.kr/pages/nclex_q.php?qn_id=630353)
- [Situation: The adult medical-surgical ward of a 150-bed provincial hospital has 28 clients…](https://mymerci.kr/pages/nclex_q.php?qn_id=630354)
- [Situation: The adult medical-surgical ward of a 150-bed provincial hospital has 28 clients…](https://mymerci.kr/pages/nclex_q.php?qn_id=630355)
- [Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630451)
- [Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630452)
- [Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630453)
- [Situation: A 30-bed adult medical ward admits many clients with diabetes, liver disease, a…](https://mymerci.kr/pages/nclex_q.php?qn_id=630454)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._