NCLEX Delegate & Prioritize: RN vs. LPN vs. UAP Scope

Delegation and prioritization are some of the most important and challenging topics on the NCLEX. The exam tests whether you understand the **scope of practice** for RNs, LPNs, and UAPs—and whether you can assign tasks safely. Mastering these rules can significantly boost your score, especially in high‑priority clinical judgment questions.

Why Delegation Matters on NCLEX

Delegation ensures:

• Safe and effective patient care
• Proper workflow management
• Clear role boundaries
• Prevention of errors

The NCLEX focuses on whether future nurses can make smart decisions about who should perform which task.

RN Scope of Practice (What RNs Can Do)

Registered Nurses handle higher‑level responsibilities involving:

• Assessment
• Teaching
• Evaluation
• Clinical judgment
• Care planning
• IV medications (most states)
• Blood transfusions
• Unstable or new‑onset conditions

RNs should always care for:

• Post‑operative patients
• Patients with new or worsening symptoms
• Those needing complex assessments
• Any unstable or high‑risk patient

LPN Scope of Practice (What LPNs Can Do)

LPNs assist with stable patients and predictable outcomes. They can:

• Perform wound care
• Administer most oral and some IV medications
• Monitor stable patients
• Reinforce teaching (NOT initial teaching)
• Collect data (NOT full assessment)

LPNs should NOT:

• Perform initial assessments
• Handle unstable patients
• Provide initial education
• Interpret clinical findings independently

UAP Scope of Practice (What UAPs Can Do)

Unlicensed Assistive Personnel can perform basic tasks such as:

• ADLs (bathing, feeding, grooming)
• Vital signs on stable patients
• Ambulation
• Positioning
• Transporting
• Collecting urine/stool samples

UAPs should NOT:

• Assess or interpret findings
• Handle unstable patients
• Administer medication
• Perform sterile procedures

NCLEX Prioritization Rules (High Yield)

Use the following frameworks:

• ABCs (Airway, Breathing, Circulation)
• Maslow’s Hierarchy of Needs
• Acute vs. Chronic
• Unstable vs. Stable
• Safety First

If a patient has difficulty breathing, they automatically come before someone with pain or nausea.

Sample NCLEX Delegation Questions

• 1. Which task can be delegated to a UAP?
  ✔ Ambulating a stable patient postop day 2.
• 2. Which patient should the RN see first?
  ✔ A patient with new confusion and low oxygen saturation.
• 3. Which task can an LPN perform?
  ✔ Administer oral antibiotics to a stable pneumonia patient.
• 4. Which task must remain with the RN?
  ✔ Initial postoperative assessment.

Tips to Master Delegation & Prioritization

• Memorize role boundaries
• Always consider patient stability
• Do not delegate assessments or education
• Prioritize life‑threatening problems first
• Use safety‑first thinking for every scenario

Final Thoughts

Understanding **NCLEX delegation and prioritization** is essential for passing the exam. When you know the exact scope of practice for RNs, LPNs, and UAPs, answering these questions becomes predictable and much easier. Review the rules, practice daily, and trust your clinical judgment—you’ll master this section with confidence.