Nursing Standards of Delegation

Every question here, with the answer

1. An RN is overwhelmed during a busy shift and asks another RN to perform several patient care tasks for one of the RN’s patients. How should this situation be understood according to delegation standards?

   1. This is delegation because one RN requested help from another RN.
   2. This is an assignment because all RNs have the same scope of practice.
   3. This is a transfer of care, and the RN accepting the tasks becomes responsible for the patient.
   4. This is delegation only if the charge nurse approves the request.

   Answer: This is a transfer of care, and the RN accepting the tasks becomes responsible for the patient.

   Delegation occurs when an RN asks an LPN/LVN or assistive personnel to perform a task on the RN’s behalf. When an RN asks another RN to perform tasks, it is considered a transfer of care, and the receiving RN becomes responsible for the patient.

2. An RN is preparing to delegate a task to assistive personnel (AP). Which actions reflect the five rights of nursing delegation? Select all that apply.

   1. Give clear instructions and allow the AP to ask questions.
   2. Assume supervision is unnecessary once the AP accepts the task.
   3. Consider whether the patient’s condition is stable with expected outcomes.
   4. Verify that the task is appropriate for delegation in the setting.
   5. Confirm that the AP has the required education and competencies.

   Answer: Give clear instructions and allow the AP to ask questions., Consider whether the patient’s condition is stable with expected outcomes., Verify that the task is appropriate for delegation in the setting., Confirm that the AP has the required education and competencies.

   The five rights require the RN to consider the task, circumstance, person, communication, and supervision. Accepting the task does not remove the RN’s responsibility to supervise and evaluate outcomes.

3. An RN delegated a care activity to an AP for a patient who was stable earlier in the shift. The patient’s condition now changes unexpectedly. What is the RN’s priority action?

   1. Allow the AP to continue because the task was already delegated.
   2. Reassess the patient to determine whether the delegation remains appropriate.
   3. Ask another AP to complete the same task instead.
   4. Reassign the patient to the AP until the end of the shift.

   Answer: Reassess the patient to determine whether the delegation remains appropriate.

   Delegation is appropriate only when the patient is stable with expected outcomes. If the condition changes, the RN must reassess before deciding whether the delegated activity should continue.

4. An AP is asked to perform blood draws but realizes they have not completed the required education and check-offs for that skill. Which responses are appropriate for the AP? Select all that apply.

   1. Maintain required competencies for activities they may be delegated.
   2. Accept the task because the RN remains accountable for delegated care.
   3. Decline to perform the activity until appropriately trained.
   4. Inform the RN that they have not been checked off to perform the blood draws.
   5. Perform the task once and ask for training afterward.

   Answer: Maintain required competencies for activities they may be delegated., Decline to perform the activity until appropriately trained., Inform the RN that they have not been checked off to perform the blood draws.

   Delegatees should accept only activities for which they have been appropriately trained and are responsible for maintaining competencies. The AP should not perform a skill without the required education or check-off, even though the RN remains accountable for the delegation decision.

5. An RN delegates vital signs to an AP. The AP reports that the patient’s blood pressure is substantially higher than previous readings. What should the RN do next?

   1. Ask the AP to recheck the blood pressure at the end of the shift.
   2. Tell the AP to decide whether the reading requires a care change.
   3. Return to the room and verify the elevated blood pressure personally.
   4. Document the value reported by the AP and continue with other tasks.

   Answer: Return to the room and verify the elevated blood pressure personally.

   The RN must supervise delegated activities and evaluate patient outcomes. A substantially higher blood pressure is a considerable change, so the RN should verify it directly.

6. An RN is deciding whether to delegate parts of care for a patient. Which statements reflect the principles for delegation? Select all that apply.

   1. Delegation should be respectful of both the delegate and the patient.
   2. The RN should consider whether appropriate supervision can be provided to the AP.
   3. The delegatee may make care changes independently after accepting the task.
   4. Elements of nursing care may be delegated, but the nursing process cannot be delegated.
   5. The decision should be based on the nurse’s judgment and the patient’s complexity and care needs.

   Answer: Delegation should be respectful of both the delegate and the patient., The RN should consider whether appropriate supervision can be provided to the AP., Elements of nursing care may be delegated, but the nursing process cannot be delegated., The decision should be based on the nurse’s judgment and the patient’s complexity and care needs.

   The principles emphasize that the RN may delegate elements of care but not the nursing process, and the decision must account for patient needs and the RN’s ability to supervise. The delegatee cannot make care-change decisions without consulting the delegating RN.