Delegation to Unlicensed Personnel Practice Questions
19 free Delegation to Unlicensed Personnel 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.
The registered nurse (RN) is planning care for a group of clients. Which task is most appropriate for the RN to delegate to an unlicensed assistive personnel (UAP)?
- A Performing a sterile dressing change on a central line.
- B Assisting a stable client with a post-operative hip replacement to ambulate for the first time.
- C Recording the intake and output for a client with heart failure.
- D Providing discharge instructions to a client with a new prescription for warfarin.
Correct answer: Recording the intake and output for a client with heart failure.
Recording intake and output is a routine, non-invasive task that falls within the scope of practice for a UAP. Sterile procedures, initial ambulation of post-operative clients, and patient teaching require the clinical judgment and assessment skills of an RN.
A nurse delegates the task of obtaining vital signs to a UAP. Which action by the nurse demonstrates the 'right supervision' of delegation?
- A Asking the UAP to interpret the results and notify the doctor if they are high.
- B Checking the documented vital signs and following up on any abnormal values.
- C Telling the UAP to do the vital signs whenever they have a spare moment.
- D Assuming the UAP knows how to use the blood pressure equipment without checking.
Correct answer: Checking the documented vital signs and following up on any abnormal values.
The RN is responsible for supervising the delegated task and evaluating the outcome. This includes verifying that the task was completed accurately and interpreting the data collected to determine the appropriate clinical response.
The RN is caring for a client with a continuous pulse oximetry monitor. Which task can be delegated to the UAP?
- A Adjusting the oxygen flow rate if the saturation drops below 92%.
- B Evaluating the client's respiratory effort while at rest.
- C Reapplying the pulse oximetry sensor to the client's finger.
- D Teaching the client about the purpose of the monitor.
Correct answer: Reapplying the pulse oximetry sensor to the client's finger.
Reapplying a non-invasive sensor is a technical task that can be delegated to a UAP. Adjusting oxygen (medication), evaluating respiratory status (assessment), and teaching are all nursing responsibilities that cannot be delegated.
Which of the following describes the 'right circumstance' for delegating a task to unlicensed personnel?
- A The client is clinically stable and the task is routine.
- B The unit is short-staffed, so the UAP must perform a complex assessment.
- C The RN is too busy to perform a sterile procedure.
- D The UAP has worked on the unit for ten years and is very experienced.
Correct answer: The client is clinically stable and the task is routine.
Right circumstance refers to the health stability of the client and the complexity of the task. Delegation to a UAP is only appropriate if the client's condition is predictable and the task does not require nursing judgment.
A nurse delegates the task of feeding a client to a UAP. Which information is most important for the nurse to provide during the 'right communication' phase?
- A The client's favorite foods and preferred drink temperature.
- B Specific swallowing precautions, such as using thickened liquids.
- C The time the client's family usually arrives to visit each day.
- D The name and office number of the client's primary care physician.
Correct answer: Specific swallowing precautions, such as using thickened liquids.
Right communication must be clear, concise, and include specific safety instructions. Informing the UAP about swallowing precautions is essential to prevent aspiration and ensure client safety during the delegated task.
The RN is preparing to delegate tasks for the shift. Which client should the nurse personally assess rather than delegating vital signs to a UAP?
- A A client who was admitted 3 days ago for a skin infection.
- B A client who is being discharged in two hours.
- C A client who just returned from the postanesthesia care unit (PACU).
- D A client with chronic obstructive pulmonary disease (COPD) on 2L of oxygen.
Correct answer: A client who just returned from the postanesthesia care unit (PACU).
Clients who are newly post-operative or physiologically unstable require frequent, skilled assessment by an RN. While UAPs can take vital signs on stable clients, the initial post-operative assessment is the responsibility of the nurse.
A UAP reports to the RN that a client's blood pressure is 88/50 mmHg. What should the RN do first?
- A Tell the UAP to re-check the blood pressure in 30 minutes.
- B Ask the UAP to document the value in the electronic health record.
- C Personally assess the client and re-measure the blood pressure.
- D Call the healthcare provider to report the low blood pressure.
Correct answer: Personally assess the client and re-measure the blood pressure.
When a UAP reports an abnormal finding, the RN must personally assess the client to validate the data and determine the clinical significance. This ensures that interventions are based on accurate, professional assessment.
Which task is considered outside the scope of practice for a UAP?
- A Assisting a client with a tub bath.
- B Collecting a mid-stream urine specimen.
- C Administering a saline lock flush to a stable client.
- D Transporting a stable client to the radiology department.
Correct answer: Administering a saline lock flush to a stable client.
Administering medications or intravenous flushes is a nursing function and is not within the scope of a UAP. UAPs may assist with activities of daily living and collect non-invasive specimens.
The nurse is delegating a bed bath for a client with a fractured sacrum. Which instruction is part of 'right direction'?
- A 'Please give the client a bath sometime this morning.'
- B 'I will be busy, so just document the bath in the chart when you are done.'
- C 'Make sure the client is comfortable during the procedure.'
- D 'Perform the bath and let me know if you see any redness on the sacrum.'
Correct answer: 'Perform the bath and let me know if you see any redness on the sacrum.'
Right direction includes specific instructions and clear expectations for reporting. Asking the UAP to look for redness and report back allows the nurse to use that information for their formal skin assessment.
The RN is caring for a client with an indwelling urinary catheter. Which task can be delegated to the UAP?
- A Providing perineal care around the catheter insertion site.
- B Assessing the color, clarity, and odor of the urine.
- C Irrigating the catheter to remove a suspected clot.
- D Replacing the catheter immediately if it becomes dislodged.
Correct answer: Providing perineal care around the catheter insertion site.
Perineal care is a routine hygiene task that can be delegated to a UAP. Assessing urine, irrigating catheters (a sterile procedure), and inserting/replacing catheters are nursing tasks.
A nurse is deciding whether to delegate a task. Which factor is the most important to consider regarding 'right person'?
- A The UAP's demonstrated competency and the facility's job description.
- B How long the UAP has been employed at this particular hospital or unit.
- C Whether the UAP is a student nurse or a certified assistant.
- D If the UAP is a friend of the nurse and easy to work with.
Correct answer: The UAP's demonstrated competency and the facility's job description.
The 'right person' refers to the delegatee's knowledge and skill level. The RN must ensure the UAP has the competency to perform the specific task safely as per facility policy and state regulations.
The RN is delegating tasks on a busy medical-surgical unit. Which task should NOT be delegated to a UAP?
- A Emptying a Jackson-Pratt (JP) drain and recording the volume.
- B Repositioning a client every 2 hours to prevent pressure ulcers.
- C Assisting a client with choosing items from a diabetic menu.
- D Performing the initial skin assessment on each new admission.
Correct answer: Performing the initial skin assessment on each new admission.
Initial assessments are a core part of the nursing process and cannot be delegated. While UAPs can assist with mobility and data collection (like drain output), the professional interpretation of skin integrity must be done by the RN.
Which of the following is one of the 'Five Rights of Delegation'?
- A Right Time
- B Right Assessment
- C Right Documentation
- D Right Communication
Correct answer: Right Communication
The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation.
A UAP is asked to weigh a client with congestive heart failure. Which instruction from the RN is most appropriate?
- A 'Weigh the client at 0700 using the same scale and clothing.'
- B 'Weigh the client sometime today whenever they are ready.'
- C 'Let me know if the weight has changed since yesterday.'
- D 'Document the weight in the chart under the daily weights section.'
Correct answer: 'Weigh the client at 0700 using the same scale and clothing.'
This demonstrates right direction/communication by being specific about the timing and method. Consistency in weighing (same time, scale, and clothing) is vital for accurate monitoring of fluid status in heart failure.
The RN is caring for a client who is being treated for a pressure ulcer. Which task is appropriate to delegate to the UAP?
- A Applying a prescribed antibiotic ointment to the wound.
- B Measuring the depth and diameter of the ulcer.
- C Evaluating if the wound is healing after one week of treatment.
- D Cleaning the skin around the ulcer during routine hygiene.
Correct answer: Cleaning the skin around the ulcer during routine hygiene.
Routine hygiene and skin care around a wound can be performed by a UAP. Medication application, wound measurement (assessment), and evaluation of healing are all nursing responsibilities.
A nurse is busy and delegates a task to a UAP that is usually performed by an RN. The UAP makes a mistake that harms the client. Who is primarily accountable?
- A The nurse, for delegating a task outside the UAP's scope.
- B The UAP, because they alone agreed to perform this task.
- C The hospital, for not providing enough qualified staff members.
- D The client, for not questioning the UAP's ability to do it.
Correct answer: The nurse, for delegating a task outside the UAP's scope.
The RN is accountable for the decision to delegate. If a nurse delegates a task that is outside the UAP's scope of practice or competency level, the nurse is primarily responsible for the inappropriate delegation and the resulting outcome.
The RN is caring for a client with a new diagnosis of type 2 diabetes. Which task is appropriate to delegate to the UAP?
- A Obtaining and recording a capillary blood glucose level.
- B Teaching the client how to use a glucose meter.
- C Explaining the signs and symptoms of hypoglycemia.
- D Developing a meal plan based on the client's preferences.
Correct answer: Obtaining and recording a capillary blood glucose level.
Obtaining a blood glucose level is a technical skill that UAPs are often trained and checked off for. Teaching, explaining clinical concepts, and planning care are nursing actions that cannot be delegated.
A UAP has been delegated the task of ambulating a stable client. During the walk, the client reports feeling dizzy. What should the UAP do first?
- A Help the client sit or lie down immediately.
- B Finish the walk and then tell the nurse.
- C Ask the client if they have taken their blood pressure medicine.
- D Leave the client to go find the RN.
Correct answer: Help the client sit or lie down immediately.
Client safety is the immediate priority. The UAP should stop the activity and ensure the client is in a safe, resting position before seeking assistance from the RN for further assessment.
Which task can be delegated to a UAP for a client receiving a blood transfusion?
- A Verifying the client's identity with the blood product.
- B Monitoring the client for the first 15 minutes of the transfusion.
- C Regulating the rate of the blood transfusion.
- D Taking a set of vital signs after the transfusion has started.
Correct answer: Taking a set of vital signs after the transfusion has started.
UAPs can take vital signs on stable clients, including those receiving blood, as long as the RN performs the initial 15-minute assessment and remains responsible for monitoring for reactions. Verification and rate regulation are strictly RN tasks.