Guide — NCLEX Success
Delegation for Nurses
Delegation is a high-yield NCLEX topic and a daily clinical skill. Knowing what you can and cannot delegate — and to whom — keeps patients safe and maximizes team efficiency. This guide covers delegation rules, team roles, and the five rights of delegation.
9 min read · NCLEX Success
Educational use only. Delegation rules vary by state nurse practice act and facility policy. The RN retains accountability for all delegated tasks. Always delegate within your jurisdiction's scope of practice guidelines. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Overview
Delegation is the process by which a registered nurse (RN) transfers responsibility for performing a nursing task to another team member while retaining accountability for the outcome. The RN can never delegate accountability — only the performance of the task.
Key principle: The RN always remains responsible. If a UAP performs a delegated task incorrectly, the RN is accountable for delegating appropriately and providing adequate supervision.
Five Rights of Delegation
The NCSBN five rights of delegation provide a framework for safe delegation decisions:
Team Member Roles
RN — Registered Nurse
The RN has the broadest scope of practice and cannot delegate activities that require nursing judgment, assessment, and professional decision-making.
RN responsibilities that cannot be delegated:
- Initial nursing assessment and ongoing comprehensive assessments
- Nursing diagnosis and care plan development
- Patient and family teaching and discharge education
- Evaluation of patient outcomes and care plan effectiveness
- Administration of IV push medications, blood products, and high-alert drugs
- Telephone or verbal orders from providers
- Documentation of nursing assessments and professional judgments
LPN/LVN — Licensed Practical / Vocational Nurse
The LPN/LVN works under the supervision of an RN or provider and can perform many technical nursing tasks. The LPN performs focused assessments (collecting data) but does not perform comprehensive assessments or make nursing diagnoses.
Tasks appropriate for LPN/LVN:
- Focused data collection and reporting changes to the RN
- Medication administration — oral, IM, SQ, topical (varies by state)
- Routine wound care and dressing changes
- Urinary catheter insertion and care
- Nasogastric tube feeding (established tubes, not initial placement assessment)
- IV fluid maintenance (in many states; not initiation of IV therapy independently)
- Reinforcing patient teaching provided by the RN (not initial teaching)
- Care of stable, predictable patients
LPN/LVN scope varies significantly by state. Always check your state's nurse practice act.
UAP/CNA — Unlicensed Assistive Personnel / Certified Nursing Assistant
UAPs perform delegated tasks under direct RN supervision. They do not assess, plan, teach, or make clinical decisions. They perform supportive care tasks and report observations to the RN.
Tasks appropriate for UAP/CNA:
- Vital signs on stable patients
- Intake and output measurement and recording
- Ambulation of stable patients
- Personal hygiene — bathing, grooming, oral care, perineal care
- Positioning and turning
- Non-sterile dressing changes (facility-specific)
- Specimen collection (urine, stool) — not interpretation
- Feeding stable patients without swallowing concerns
- Applying sequential compression devices (SCDs)
UAPs report findings to the RN but do not interpret them. “Report vital signs — don't interpret them” is the guiding principle.
Tasks That Cannot Be Delegated
The following nursing functions require RN judgment and cannot be delegated to LPN/LVN or UAP:
Never delegate (RN only):
- Initial and comprehensive nursing assessment
- Nursing diagnosis formulation
- Care planning and goal-setting
- Initial patient and family teaching
- Evaluation of patient response to care
- Administration of blood and blood products
- IV push medications and chemotherapy (in most states)
- Care of unstable patients with unpredictable outcomes
- Interpretation of assessment data and clinical decision-making
Supervision Responsibilities
- Provide clear direction: State exactly what task to perform, when, how, and what to report
- Ensure competency: Do not delegate to someone who lacks the training to perform the task safely
- Remain available: Supervision requires accessibility — the RN must be reachable if the delegatee has questions or the patient's condition changes
- Follow up: Check back after the task is completed to evaluate outcome and gather reported data
- Never abandon: Delegating a task does not relieve the RN of accountability for the outcome
Common NCLEX Delegation Scenarios
| Task | Delegate To | Rationale |
|---|---|---|
| Vital signs on stable post-op day 1 patient | UAP | Routine, predictable task; stable patient |
| Initial assessment of newly admitted patient | RN only — do not delegate | Comprehensive assessment requires RN judgment |
| Oral medication administration for stable patient | LPN/LVN | Within LPN scope; stable patient, routine medication |
| Teaching patient newly diagnosed with diabetes | RN only — do not delegate | Initial patient education requires RN assessment and judgment |
| Ambulating a stable patient recovering from hip replacement | UAP (trained in gait belt/assist) | Routine assistive task; patient is stable and cleared for ambulation |
| IV push pain medication for patient in acute pain | RN only — do not delegate | IV push medications require RN assessment; patient unstable or potentially unstable |
| Wound care — routine clean dressing change on healing wound | LPN/LVN | Routine wound care of a stable, healing wound is within LPN scope |
| Reinforcing discharge instructions the RN already provided | LPN/LVN | Reinforcing (not initiating) education is within LPN scope under RN supervision |
NCLEX Pearls
- Assessment, planning, teaching, and evaluation are RN-only functions — never delegate these
- Stable, predictable patients with routine tasks are appropriate for LPN/LVN or UAP
- Unstable, newly admitted, newly changed, or complex patients require RN care
- UAPs collect data; RNs interpret data — never delegate interpretation
- LPN/LVN can reinforce teaching but cannot initiate new patient education
- The RN always retains accountability regardless of who performs the delegated task
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with NCSBN — NCLEX-RN Test Plan · Clinical Judgment Measurement Model (NCJMM). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →