Delegation and Prioritization Practice Questions
20 free Delegation and Prioritization practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
Which patient should the RN see first on a med-surg unit?
- A The routine ambulation patient
- B The stable post-op patient awaiting discharge
- C The newly admitted patient with chest pain
- D The patient requesting assistance to the bathroom
Correct answer: The newly admitted patient with chest pain
The patient with chest pain is the highest priority (actual, potentially life-threatening problem) and should be addressed first.
When is delegation to a UAP appropriate for vital signs?
- A Delegating vital signs to a UAP for a patient newly admitted with unstable vitals
- B Delegating vital signs to a UAP for a stable patient post-op day 2 scheduled for discharge
- C Delegating vital signs + intake/output + teaching to a UAP
- D Delegating vital signs for a patient receiving a new blood transfusion
Correct answer: Delegating vital signs to a UAP for a stable patient post-op day 2 scheduled for discharge
Delegation to UAP is appropriate for routine tasks on stable patients; not for unstable/new or complex patients.
Which assignment is most appropriate for an LPN among four patients?
- A A patient newly admitted with acute MI and chest tube
- B A patient post-op day 1 after abdominal surgery with NGT on suction
- C A patient stable, post-hip replacement day 3, ambulating with walker
- D A patient with new onset stroke and altered LOC
Correct answer: A patient stable, post-hip replacement day 3, ambulating with walker
The LPN can safely care for the stable post-hip replacement patient; the others require RN interventions, assessments.
Which of the following tasks cannot be delegated by the RN?
- A Assist patient with ambulation after vital signs checked
- B Remove urinary catheter when ordered for stable patient
- C Teach patient about self-management of diabetes
- D Report vital signs to RN after UAP completes them
Correct answer: Teach patient about self-management of diabetes
Teaching, initial assessment, evaluation, and tasks requiring nursing judgment cannot be delegated.
Which task should the nurse prioritize first among four tasks?
- A Change wound dressing
- B Assist with breakfast
- C Administer antibiotics
- D Evaluate the new patient
Correct answer: Evaluate the new patient
New patient with chest pain and vomiting is high priority (unstable, actual problem) and must be evaluated first.
Which principle should guide prioritization when multiple patients need care?
- A Chronic issues before acute issues
- B Actual problems before potential problems
- C Psychosocial concerns before physiological needs
- D Delegate the worst case to UAP
Correct answer: Actual problems before potential problems
In prioritization, actual, existing problems take precedence over potential ones.
What should the RN attend to first when a patient's chest tube drainage increases suddenly?
- A Stable patient requesting pain meds
- B Patient with chest tube drainage change
- C Delegate pain meds request and go to chest tube
- D Wait until both tasks can be done together
Correct answer: Patient with chest tube drainage change
Sudden increase in drainage indicates possible hemorrhage—priority over routine pain management.
What should the RN do when a patient's bed alarm goes off and they are trying to get out unassisted?
- A Direct UAP to hold patient’s hand
- B Ignore since the patient just wants to go to the bathroom
- C Assist patient immediately and evaluate why alarm went off
- D Let UAP handle it alone
Correct answer: Assist patient immediately and evaluate why alarm went off
A patient attempting to get up unassisted is a fall risk and requires immediate RN or delegated staff intervention.
What is the RN's responsibility when an LPN requests assistance in administering a routine bowel-prep enema?
- A Allow the LPN to continue the procedure alone and check back later
- B Take over the task personally since the LPN is having difficulty
- C Notify the nursing supervisor and document that assistance was requested
- D Reassign the enema to a UAP so the LPN can move on to other duties
Correct answer: Take over the task personally since the LPN is having difficulty
The RN is responsible for supervising and intervening when the delegatee requests assistance or faces difficulty.
Which patient should the RN plan to see first, a discharge patient or a patient with newly diagnosed DKA starting insulin infusion?
- A Discharge patient
- B DKA patient starting insulin infusion
- C Both equally
- D Delegate both
Correct answer: DKA patient starting insulin infusion
The DKA patient on insulin infusion is unstable and requires RN priority over discharge of a stable patient.
What best describes the '5 Rights of Delegation'?
- A Right Task, Right Time, Right Person, Right Documentation, Right Supervision
- B Right Person, Right Task, Right Circumstance, Right Communication, Right Supervision
- C Right Nurse, Right Task, Right Outcome, Right Patient, Right Time
- D Right Order, Right Person, Right Equipment, Right Time, Right Documentation
Correct answer: Right Person, Right Task, Right Circumstance, Right Communication, Right Supervision
The 5 Rights: Right Person, Right Task, Right Circumstance, Right Communication (Direction), Right Supervision.
Which patient should the RN not give to UAP for vitals and hygiene among several options?
- A A stable patient day 4 post-op
- B A patient with newly inserted chest tube and hemodynamic changes
- C A stable patient with scheduled discharge tomorrow
- D A patient requiring routine ambulation assistance
Correct answer: A patient with newly inserted chest tube and hemodynamic changes
Patient with chest tube and hemodynamic changes is unstable and not appropriate for UAP assignment.
Which task is appropriately delegated to UAP?
- A Administering oral pain medication
- B Teaching patient how to use insulin pump
- C Assisting a stable patient with a bath and helping to toilet
- D Initiating IV for fluid resuscitation
Correct answer: Assisting a stable patient with a bath and helping to toilet
Bathing and toileting can be delegated to UAP for stable patients. Other tasks require RN or LPN.
Which patient should the RN visit first when prioritizing patients to see next?
- A A patient on scheduled meds awaiting discharge teaching
- B A patient new admission with shortness of breath and SpO₂ of 88% on 2 L NC
- C A stable patient requesting television remote
- D A patient with scheduled dressing change in 2 hours
Correct answer: A patient new admission with shortness of breath and SpO₂ of 88% on 2 L NC
The patient with low oxygen saturation and SOB is unstable and priority over routine tasks.
What should the RN do with a patient with post-op vitals BP 88/50, HR 124, RR 22, and wanting to schedule a shower?
- A Assist the patient to shower now
- B Delay shower, assess further and stabilize hemodynamics
- C Delegate shower to UAP immediately
- D Offer bed-bath instead and ignore vitals
Correct answer: Delay shower, assess further and stabilize hemodynamics
Unstable vital signs show hypovolemia/hypotension—address this before non-urgent tasks like a shower.
Which situation demonstrates poor delegation?
- A RN delegates UAP to weigh stable patients at admission
- B RN delegates LPN to monitor and administer routine oral medications to stable patients
- C RN delegates LPN to start blood transfusion on a critical patient
- D RN delegates UAP to assist patient with ambulation after mobility assessment
Correct answer: RN delegates LPN to start blood transfusion on a critical patient
Starting a blood transfusion is a complex nursing function requiring RN judgment—not appropriate for delegation to LPN in a critical patient.
Which patient should be the highest priority among four patients?
- A Patient with moderate back pain
- B Patient requesting discharge teaching
- C Patient needing routine bathroom assist
- D Patient with chest pain
Correct answer: Patient with chest pain
Chest pain could indicate life-threatening cardiac event—highest priority.
Which assignment is appropriate for an experienced RN among LPN and UAP?
- A LPN to admit new unstable patient
- B UAP to administer oral chemotherapy
- C LPN to turn and reposition a stable post-op patient
- D UAP to assess and follow up on chest tube output
Correct answer: LPN to turn and reposition a stable post-op patient
LPN can turn/reposition a stable patient; other tasks require RN or higher level responsibility.
What is the first step when prioritizing tasks during a nurse’s shift?
- A Delegate all tasks to others
- B Sort tasks by urgency—use ABC, Maslow, actual vs potential
- C Do lowest priority tasks first to get them out of the way
- D Ask another nurse to prioritize for you
Correct answer: Sort tasks by urgency—use ABC, Maslow, actual vs potential
Effective prioritization begins with recognition of urgency and using frameworks like ABC (Airway, Breathing, Circulation) and Maslow’s hierarchy.
Which patient should the RN go to first, a stable post-op patient walking or a newly admitted patient with altered mental status?
- A The stable post-op patient walking
- B The newly admitted patient with altered mental status
- C Both at the same time
- D Delegate both
Correct answer: The newly admitted patient with altered mental status
The newly admitted patient with altered mental status is unstable and priority over a routine ambulation of a stable patient.