NCLEX Prioritization and Delegation: Who Do You See First?
6 min read · Updated
Management of Care is the largest client-needs area on the NCLEX-RN, and much of it is prioritization and delegation. These questions rarely test a fact you do not know. They test whether you can tell which problem threatens life or safety soonest.
Frameworks for priority questions
- Airway, breathing, circulation: a threat to airway comes before breathing, and breathing before circulation.
- Acute before chronic, and unexpected before expected: new confusion matters more than long-standing dementia.
- Unstable before stable: changing vital signs or new findings come first.
- Physiological needs before psychosocial ones, unless safety is at risk, such as a client with suicidal intent.
- Assess before you act, unless the situation is an emergency that already calls for action.
Delegation basics
| Can usually be delegated to | Examples |
|---|---|
| Unlicensed assistive personnel (UAP) | Vital signs on stable clients, hygiene, feeding, ambulation, intake and output |
| Licensed practical nurse (LPN) | Medications for stable clients, wound care, data collection, reinforcing teaching |
| Registered nurse only | Initial assessment, care planning, initial teaching, evaluation and unstable clients |
Which task should the nurse delegate to unlicensed assistive personnel?
- ATeaching a client how to use an incentive spirometer
- BMeasuring vital signs on a client admitted 2 days ago in stable condition
- CAssessing a client who reports new chest pain
- DEvaluating a client's response to an opioid
Explanation
Routine vital signs on a stable client are within the UAP's role. Teaching, assessment and evaluation require the registered nurse's judgment.
Practice with real weighting
Management of Care makes up 15–21% of the NCLEX-RN, and our exams weight it the same way, with your score for the area shown after every exam.