The single heaviest category on the NCLEX-RN (15–21% of your exam) and the one that trips up the most candidates, because it rewards judgment over memorization. Master three skills here — delegating, prioritizing, and protecting client rights — and you protect a big slice of your score.
The five rights of delegation
Delegation questions are everywhere in this category, and they follow a predictable logic. The nurse delegates the task but never the accountability — you remain responsible for the outcome. Frame every delegation item around five rights:
- Right task — is it routine, standardized, and low-risk enough to hand off?
- Right circumstance — is the client stable and the situation predictable?
- Right person — is the delegatee’s scope and competency a match?
- Right direction — were clear, specific instructions given?
- Right supervision — can you follow up and evaluate the result?
The shortcut that works: the nurse keeps anything involving assessment, teaching, evaluation, or an unstable client. If a question asks what to delegate, eliminate every option containing those and you are usually left with the answer.
Who can do what: RN, LPN/LVN, and UAP
The exam expects you to know the boundaries between roles. These are general principles — actual scope is set by each state’s practice act, so always defer to the scenario’s own rules.
Registered Nurse (RN)
Owns the nursing process for complex or unstable clients: initial and ongoing assessment, nursing diagnosis, care planning, client teaching, and evaluation of outcomes. First IV medications, blood product administration, and unstable clients stay with the RN.
Licensed Practical/Vocational Nurse (LPN/LVN)
Can care for stable clients with predictable outcomes: reinforce (not initiate) teaching, monitor findings, give many routine medications, perform sterile procedures like dressing changes and catheter insertion. Cannot perform the initial assessment, develop the care plan, or push IV medications in most states.
Assistive Personnel (UAP / nurse aide)
Handles stable, routine, non-invasive tasks: activities of daily living, vital signs on stable clients, ambulation, feeding (of clients without swallowing risk), intake and output, and hygiene. UAP never assess, teach, evaluate, or judge.
Prioritization frameworks
When a question asks who you see first, or what you do first, apply these tie-breakers in order:
- ABCs — Airway, then Breathing, then Circulation. An airway problem outranks everything.
- Maslow — physiological needs before safety before psychosocial. A physical need usually beats an emotional one, but only after ABCs are secured.
- Acute over chronic, unstable over stable — the new, unexpected, or deteriorating client comes before the predictable one.
- Nursing process — assess before you act. If one option is “assess” and another is “intervene,” you usually assess first — unless the scenario is an obvious emergency demanding immediate action.
Watch the qualifier. Words like first, best, initial, priority, most important mean more than one answer is correct — they are asking which is most correct. Slow down when you see them.
Ethics & legal essentials
A steady share of this category is legal and ethical judgment:
- Informed consent — the provider explains the procedure and obtains consent; the nurse witnesses the signature and confirms the client understands. If the client is unsure, notify the provider — do not re-explain the procedure yourself.
- Advance directives — living wills and durable power of attorney guide care when the client can’t speak for themselves. Ask about them on admission.
- Advocacy — when answers conflict, the one that protects the client’s safety, autonomy, and dignity usually wins.
- Confidentiality — share protected information only with the care team and only as needed.
- Incident reports — document facts objectively; never chart in the medical record that an incident report was filed.
Common question traps
- Delegating an assessment. If an option hands assessment, teaching, or evaluation to an LPN or UAP, it is almost always wrong.
- Choosing the unstable client to delegate. Unstable or unpredictable clients stay with the RN.
- Acting before assessing. Unless it’s a clear emergency, gather data first.
- Ignoring the qualifier. “First” and “priority” change which correct-looking answer is actually right.
Practice it: reinforce this category with explained questions in the question bank, and see how much of your exam it fills on the test plan page.
