Test-taking strategy
NCLEX delegation questions: who can you assign what to?
On the NCLEX, the registered nurse keeps assessment, teaching, evaluation and care of unstable patients, and can delegate routine, predictable tasks for stable patients to licensed practical or vocational nurses and assistive personnel. Most delegation items come down to one question: is the patient stable, and is the task routine and predictable?
Updated 28 October 2026·6 min read
Delegation is about the task and the patient together. A task that is fine to delegate for a stable patient can be inappropriate for the same patient when something has changed. The exam writes items around that change.
A working split
| Role | Generally appropriate | Generally not appropriate |
|---|---|---|
| Registered nurse | Initial assessment, care planning, teaching, evaluation, unstable patients, IV push of new medications in many settings | Nothing here is delegated up; the RN remains accountable for what is delegated down |
| LPN/LVN | Reinforcing teaching already given, focused data collection, routine care for stable patients, medications by routes within scope | Initial assessment, care planning, teaching new content, unstable or rapidly changing patients |
| Assistive personnel | Bathing, feeding, ambulating, vital signs on stable patients, intake and output, positioning | Assessment, interpreting findings, teaching, anything needing nursing judgement |
Always defer to the scope of practice in your own jurisdiction. This is the pattern the exam rewards, not legal advice.
Three questions to ask every time
- Is the patient stable and is the outcome predictable?
- Is the task routine, or does it need assessment, judgement or teaching?
- Is it within the scope of the person I am considering?
The accountability rule
Delegating a task does not delegate accountability. When an item asks what the RN should do after delegating, the answer is usually to follow up: confirm the task was done and review the result.
Common questions
- Can an LPN/LVN give medications?
- Generally yes for many routes within their scope, but scope varies by state or province. The exam tends to test the pattern: stable patients and established orders, not new assessments or unstable patients.
- Can assistive personnel take vital signs on any patient?
- Only on stable patients, and the nurse still interprets the results. For a patient who is new post-operative or who has a new complaint, the RN assesses first.
- What does "the RN remains accountable" mean for answers?
- The correct option often includes supervision or follow-up after assigning a task, rather than assuming it was done correctly.