LPN vs RN scope of practice, and how the NCLEX-PN tests it
Written and reviewed by Rachel Goldberg, MSN, RN, CEN · 4 min read · Updated November 2026
Checked against official sources: November 2026
Rules, fees and deadlines differ by state and change without notice. Check with your state board of nursing before you rely on them.
Short answer
The core difference is that an RN does the comprehensive assessment, nursing diagnosis and care plan, while an LPN collects data, does focused assessments and contributes to the plan under direction. The Texas and New York boards both write this down, and the NCLEX-PN tests it in Coordinated Care, 18 to 24% of items.
Side by side: what Texas and New York say
Scope is set by each state, so this comparison uses two boards that publish plain answers: the Texas Board of Nursing, which licenses LVNs, and the New York State Education Department, which licenses LPNs. Other states may draw the lines differently.
| Area | RN | LPN or LVN | Board |
|---|---|---|---|
| Assessment | Comprehensive assessment, initial and ongoing | Focused assessment and data collection only, even under supervision | Texas |
| Nursing diagnosis | Makes nursing diagnoses | Not legally allowed to determine nursing diagnoses | Texas and New York |
| Care plan | Develops the initial nursing care plan | Contributes to it; may not initiate, develop or change it | Texas and New York |
| Triage | Not listed as a limit by either board | Telephone or on-site triage is outside LPN scope | Texas and New York |
| Independence | May practice independently | Practices only under direction of an RN or other directing practitioner | New York |
| Supervising others | Directs LPN practice | May supervise CNAs in some settings, never an RN | New York |
Texas describes the LVN role as a directed scope of practice for patients with predictable health care needs. New York lists typical LPN work as giving most medications and some blood products, bedside care, recording and reporting data, and procedures such as catheterization, tracheal suctioning and starting a peripheral IV.
What can an RN do that an LPN cannot?
The clearest dividing line is independent judgment. Texas defines the RN comprehensive assessment as synthesizing the whole picture to make independent decisions and nursing diagnoses. The LVN appraises the situation at hand and reports it, and the board says an RN cannot assign a comprehensive assessment to an LVN and take ultimate responsibility.
A co-signature does not fix this either. The Texas FAQ says an RN co-signing for something beyond the LVN's scope does not legitimize it, because a nurse never practices under another nurse's license. If an assignment needs RN-level assessment, the LVN must tell the person who made it.
Can LPNs do care plans?
They contribute, but they do not write the plan. The Texas FAQ says LVNs may not initiate care plans, may contribute to planning and implementation, and that only the RN may develop the initial nursing care plan and make nursing diagnoses under Board Rule 217.11.
New York says the same thing in different words: the LPN identifies patient goals for the RN to consider for the care plan, and is not legally allowed to develop or change nursing care plans. For school health plans, Texas notes the LVN may assist but may not write the plan independently.
Where the line moves: training and employer policy
Within the LPN level, scope can grow with training. Texas says continuing education and on-the-job training can expand LVN competency to a degree, but not to tasks that need a different level of licensure, such as comprehensive assessment. IV therapy is a common example where training and employer policy decide what an LPN does.
Texas also recommends that new LVNs spend 12 to 18 months in structured settings such as hospitals, nursing homes or clinics before moving to settings where a supervisor may not be on site. New York allows an off-site directing practitioner only when the LPN is competent, the patients are highly unlikely to need the practitioner in person, and the practitioner can intervene within 15 minutes.
How the NCLEX-PN tests the LPN and RN line
The 2026 NCLEX-PN test plan puts scope questions in Coordinated Care, which makes up 18 to 24% of the exam. Its activity statements include contributing to the plan of care, participating in data collection, assigning tasks to assistive personnel or another LPN, recognizing self-limitations, and providing care within the legal scope of practice.
Read the verbs. The PN plan says contribute, participate, reinforce and monitor. When an answer option has the practical nurse create a care plan, make a nursing diagnosis or do the first full assessment of an unstable client, that option sits outside the role the test plan describes.
Sources
Texas Board of Nursing: Position Statement 15.27, The Licensed Vocational Nurse Scope of Practice. Directed LVN scope, focused vs comprehensive assessment, limits on expanding scope through CE, 12 to 18 months in structured settings
Texas Board of Nursing: Nursing Practice FAQ. LVNs may not initiate care plans, initial assessment guidance, triage beyond LVN scope, RN co-signing does not expand LVN scope
New York Office of the Professions: Practice Information for LPNs. Typical LPN and RN services, no LPN nursing diagnoses, care plans or triage, direction and 15-minute rule, LPN supervision limits
NCSBN: 2026 NCLEX-PN Test Plan. Coordinated Care 18 to 24% and its activity statements
Common questions
Can an LPN do an admission assessment?
Not if it requires a comprehensive assessment. Texas rules limit LVNs to focused assessments, and the board says it does not define an initial assessment, so it points nurses to the agency that licenses their facility to see whether an RN must do it.
Can an LPN supervise an RN?
No. New York's board states that LPNs are not legally allowed to supervise professional services provided by RNs. An LPN may supervise another LPN in limited cases, and may supervise CNAs in settings such as nursing homes.
Is LVN scope different from LPN scope?
LVN and LPN are two names for the same license level; Texas and California use LVN. NCSBN's test plan calls the role LPN/VN. What differs is the state, because each board writes its own scope rules.