NCLEX Question of the Day – Monday, March 23, 2026

Today’s question targets Leadership, specifically safe delegation and supervision. This matters in real nursing because many errors do not come from lack of effort. They come from assigning the right task to the wrong person, or at the wrong time. A nurse who understands delegation protects patients, uses team members well, and keeps the unit moving without missing urgent care.

Clinical Scenario

You are the charge nurse on a busy 28-bed medical-surgical unit during the day shift. The team includes one RN who has worked on the unit for 6 months, one experienced LPN/LVN, and one unlicensed assistive personnel (UAP). Four patients need attention at the same time:

• A 72-year-old patient admitted overnight with community-acquired pneumonia who now has a temperature of 38.9 C, respiratory rate of 30/min, and new confusion.
• A 58-year-old patient with type 2 diabetes who is scheduled for discharge this afternoon and needs instruction on how to self-administer a newly prescribed bedtime insulin pen.
• A 67-year-old patient who is 1 day after a stroke and needs assistance with feeding and recording oral intake at lunch.
• A 45-year-old patient with heart failure who received IV furosemide 2 hours ago and has had 900 mL of urine output since then. The provider asked for a follow-up report on response to treatment.

The LPN/LVN has already completed morning medication passes. The UAP has experience taking vital signs, helping with hygiene, ambulation, feeding stable patients, and measuring intake and output.

The Question

Which task is most appropriate for the charge nurse to delegate to the UAP?

Answer Choices

1. A. Reassess the patient with pneumonia and report whether the confusion improves after oxygen is applied.
2. B. Teach the patient with diabetes how to use the new insulin pen before discharge.
3. C. Assist the post-stroke patient with lunch and document oral intake.
4. D. Evaluate whether the patient with heart failure is responding adequately to IV furosemide.

Correct Answer

C. Assist the post-stroke patient with lunch and document oral intake.

Detailed Rationale

This question is about matching the task to the team member’s scope and the patient’s stability.

The UAP can safely help a stable patient with routine care tasks. Feeding assistance and recording intake are standard UAP duties when the nurse has already determined the patient can eat safely and the patient does not require a skilled swallowing assessment during that meal. In this case, the patient is 1 day after a stroke, so the nurse must first know whether the patient has been cleared for oral intake. If that has already been established in the plan of care, the UAP can assist with feeding and document how much the patient eats and drinks.

The reason this is the best choice is that it involves predictable care, standard procedure, and no nursing judgment beyond basic observation and reporting. The UAP should be told exactly what to watch for, such as coughing, pocketing food, wet voice, or fatigue during the meal, and to report those findings right away. That is appropriate supervision.

Here is what the nurse should still do:

• Confirm the stroke patient is cleared for the ordered diet.
• Give the UAP clear instructions about positioning, pacing, and signs of aspiration.
• Follow up if the UAP reports poor intake, choking, or new weakness.

This is how safe delegation works in practice. The nurse does not hand off responsibility. The nurse hands off a task, gives direction, and remains accountable for the outcome.

Why the Other Options Are Wrong

A. Reassess the patient with pneumonia and report whether the confusion improves after oxygen is applied.

This is not appropriate for a UAP because it requires assessment and clinical interpretation. New confusion, fever, and rapid breathing in a patient with pneumonia suggest possible worsening hypoxia or sepsis. That patient may be unstable. Reassessment after an intervention, such as oxygen, must be done by a licensed nurse. The RN should assess breath sounds, work of breathing, oxygen saturation, mental status, and trends in vital signs, then decide whether to escalate care.

B. Teach the patient with diabetes how to use the new insulin pen before discharge.

Teaching is a nursing responsibility. A UAP cannot provide initial education about a new medication. This task requires assessment of readiness to learn, manual dexterity, vision, understanding of dosing, and ability to recognize hypoglycemia. The RN should perform the teaching. In some settings, an LPN/LVN may reinforce teaching already started by the RN, but initial discharge teaching remains an RN-level task.

D. Evaluate whether the patient with heart failure is responding adequately to IV furosemide.

Evaluation is part of the nursing process and cannot be delegated to a UAP. Even though the urine output number is useful, deciding whether the response is adequate requires nursing judgment. The nurse must interpret urine output, blood pressure, lung sounds, edema, respiratory status, potassium risk, and renal function. A UAP may measure and report output, but not evaluate treatment effectiveness.

Key Takeaways

• Delegate tasks, not nursing judgment.
• UAP tasks usually involve routine, predictable care for stable patients.
• Do not delegate assessment, teaching, evaluation, or clinical decision-making to a UAP.
• For any delegated task, give clear instructions about what to report immediately.

What you’d do on shift:

• First, see the pneumonia patient because new confusion and tachypnea may signal deterioration.
• Assign the UAP to help the cleared stroke patient with lunch and intake recording.
• Plan for the RN to complete insulin pen teaching before discharge.
• Personally assess the heart failure patient’s response to diuresis, including blood pressure, lungs, and symptoms.

Quick Practice Extension

1. Which task could the charge nurse delegate to the LPN/LVN for the patient with heart failure, and what part must remain with the RN?

2. If the UAP reports that the post-stroke patient starts coughing and has a wet voice during lunch, what should the nurse do first?

Safe delegation is not just about saving time. It is about putting the right eyes and hands on the right patient at the right moment. On NCLEX and in practice, the best delegation answer usually involves a stable patient, a routine task, and clear follow-up by the nurse.

Download