RN vs LPN Scope of Practice
Registered Nurse (RN) vs Licensed Practical Nurse (LPN/LVN)
Understanding the differences in scope of practice between Registered Nurses (RNs) and Licensed Practical Nurses (LPNs/LVNs) is essential for safe delegation and is one of the most frequently tested NCLEX topics. Delegating tasks beyond a nurse's scope of practice is a patient safety violation. NCLEX tests delegation in the Safe and Effective Care Environment category.
Comparison Table
Key Differences
- →RNs perform initial assessments, create care plans, and teach new content; LPNs collect ongoing data, reinforce teaching, and follow established care plans
- →RNs can administer all IV medications; LPNs generally cannot give IV push medications (state-dependent)
- →RNs manage unstable, complex, and unpredictable patients; LPNs care for stable, predictable patients with known outcomes
- →RNs are responsible for delegation decisions and remain accountable for the outcomes of delegated care
Clinical Relevance
- •On NCLEX, never delegate initial assessment, care plan development, patient teaching of new information, or unstable patients to an LPN
- •The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision
- •Even after delegating, the RN retains accountability for patient outcomes and must supervise and follow up on all delegated care
Study Tips
- ✓For NCLEX delegation questions, ask: Is the patient stable and predictable? If yes, LPN may be appropriate. If unstable, complex, or new, assign to the RN
- ✓Remember that LPNs REINFORCE teaching but do not INITIATE new education plans; if the question says teach the patient about their new diagnosis, that is an RN task
- ✓The Five Rights of Delegation (Task, Circumstance, Person, Direction, Supervision) are a framework for answering every delegation question on NCLEX
FAQs
Common questions about this comparison
First, identify which patients are stable and predictable (assign to LPN) versus unstable, complex, or newly admitted (assign to RN). Second, check if the task involves initial assessment, care plan creation, new teaching, or IV push medications, as these are always RN tasks. Third, apply the Five Rights of Delegation. If the question asks which patient can the RN delegate to the LPN, choose the patient with the most stable, predictable condition.
LPNs can collect focused assessment data on stable patients as part of ongoing monitoring (such as taking vital signs, measuring I&O, or checking wound drainage on an established patient). However, LPNs cannot perform initial comprehensive assessments, interpret complex data, or make clinical judgments about changes in patient status. On NCLEX, if the question says initial assessment or admission assessment, it must be done by the RN.