Never delegate the initial assessment, care-plan development, evaluation, or initial teaching to an LPN/LVN.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse is delegating tasks but remains accountable for the outcomes. Which statement best reflects the nurse's accountability in delegation?
Answer: A. The nurse who delegates remains accountable for the appropriateness of the delegation, adequate supervision, and the overall client outcome. Delegation does not transfer professional accountability to the UAP or LPN/LVN.
Question 2 of 5
A nurse is delegating to a UAP at the start of the shift. Which instruction reflects appropriate delegation?
Answer: B. Appropriate delegation includes a specific task, the parameters, and what to report. Telling the UAP to report a temperature above 38.5 degrees Celsius gives a clear limit and reporting expectation. Vague directions, delegating assessment-level judgment, or delegating teaching are inappropriate.
Question 3 of 5
The nurse delegates a task to UAP. Which statement reflects an appropriate element of the delegation process?
Answer: A. Effective delegation includes clear, specific directions and the expectation that the UAP reports findings back to the nurse. The nurse remains accountable for the outcome, so simply assuming completion or delegating without instruction is unsafe.
Question 4 of 5
After delegating a task to a UAP, the RN remains responsible for:
Answer: B. The RN retains accountability for the outcome and must supervise, follow up, and verify the task was done correctly. Delegation does not transfer the RN's accountability.
Question 5 of 5
A nurse delegates vital signs to a UAP but the client is unstable. The nurse should:
Answer: B. Unstable clients require RN assessment — the nurse takes/verifies the vitals and assesses the unstable client rather than relying on delegation, because interpretation and judgment are needed.
Keep the streak going with more questions like these, each with a full rationale.
What is delegation to lpn/lvn?
They may not perform the initial assessment, develop the care plan, do the initial teaching, push IV medications (in most states), or care for unstable clients. Memory aid: LPNs handle the STABLE and the EXPECTED, not the new or the unstable.
Key points to remember
- LPN/LVN may administer oral, IM, and subcutaneous medications, monitor stable clients, perform sterile dressing changes, insert catheters, and do routine wound care.
- LPN/LVN cannot perform the admission/initial assessment, create or revise the care plan, do initial client teaching, or evaluate care outcomes.
- In most states LPNs cannot push IV medications, administer blood products, or manage central lines and titrated IV drips.
- LPN/LVN reinforce teaching the RN has already initiated but do not provide new teaching.
- Assign LPNs to clients who are stable with predictable, expected courses; keep new admissions and unstable clients with the RN.
- The RN remains responsible for the overall plan of care and for supervising the LPN.
Nursing priorities
- Assign stable, predictable clients and skilled tasks within the LPN scope.
- Perform the initial assessment and ongoing evaluation yourself, then direct the LPN's contributions.
- Specify what data the LPN must report back to the RN and when.
- Supervise medication administration and skilled procedures the LPN performs.
- Keep IV pushes, blood administration, and unstable clients with the RN unless state law and policy allow otherwise.
Red flags: report now
- Never delegate the initial assessment, care-plan development, evaluation, or initial teaching to an LPN/LVN.
- Report-now: do not assign an LPN to an unstable client or a client whose condition is changing unpredictably.
- Never have an LPN push IV medications or hang blood unless explicitly permitted by state practice act and facility policy.
References
Clinical references for this topic
