🎯 High-Yield Points for This Topic
- 5 Rights of Delegation: right task, right circumstance, right person, right direction, right supervision
- RN cannot delegate: assessment, teaching, evaluation, initial nursing diagnoses
- UAP can do: vital signs on stable patients, ADLs, ambulation, intake/output recording
- LPN can do: routine wound care, medication administration (select), monitoring stable patients
- Priority: unstable/deteriorating patients always before stable patients
[Infographic: Management of Care & Delegation NCLEX Questions Key Concepts — Clinical Manifestations, Nursing Interventions, Priority Actions]
Practice Questions
Question 1
A registered nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is APPROPRIATE to delegate?
✓ Correct: Taking vital signs on a stable post-operative client
Taking vital signs on a stable postoperative client falls within the UAP's scope of practice. Assessment, teaching, and evaluation are higher-level nursing functions requiring clinical judgment that cannot be delegated to unlicensed personnel. The key rule: delegates what is routine, non-complex, and does not require nursing judgment. The RN retains responsibility for assessment, interpretation, and evaluation.
Taking vital signs on a stable postoperative client falls within the UAP's scope of practice. Assessment, teaching, and evaluation are higher-level nursing functions requiring clinical judgment that cannot be delegated to unlicensed personnel. The key rule: delegates what is routine, non-complex, and does not require nursing judgment. The RN retains responsibility for assessment, interpretation, and evaluation.
Question 2
A nurse is prioritising care for four clients. Which client should receive care FIRST?
✓ Correct: A client with COPD whose oxygen saturation just dropped from 94% to 88%
An acute drop in SpO2 from 94% to 88% in a COPD patient represents a significant deterioration requiring immediate intervention. This is the most unstable presentation and the highest immediate safety risk. The other clients have stable, predictable needs. Airway and breathing changes always take priority per ABC prioritisation framework.
An acute drop in SpO2 from 94% to 88% in a COPD patient represents a significant deterioration requiring immediate intervention. This is the most unstable presentation and the highest immediate safety risk. The other clients have stable, predictable needs. Airway and breathing changes always take priority per ABC prioritisation framework.
Question 3
A charge nurse observes an LPN changing a client's sterile wound dressing incorrectly. Which action does the charge nurse take FIRST?
✓ Correct: Immediately intervene, correct the technique, and complete an incident report
The charge nurse's first priority is patient safety — intervene immediately to correct the dressing change technique before harm occurs. After the immediate intervention, education and documentation follow. Waiting to discuss it later allows a safety breach to continue. Asking for an explanation before stopping an incorrect sterile technique is also delayed. Act first, then educate.
The charge nurse's first priority is patient safety — intervene immediately to correct the dressing change technique before harm occurs. After the immediate intervention, education and documentation follow. Waiting to discuss it later allows a safety breach to continue. Asking for an explanation before stopping an incorrect sterile technique is also delayed. Act first, then educate.
Question 4
A nurse receives a SBAR report on a client. Which element of SBAR does 'The client's oxygen saturation is 89% and respiratory rate is 28' represent?
✓ Correct: Situation
SBAR framework: Situation = current status and immediate concern (what is happening right now). Background = client history, diagnosis, current medications. Assessment = nurse's clinical interpretation of what is happening. Recommendation = what you want from the provider. The described statement presents current vital sign abnormalities — this is the Situation component.
SBAR framework: Situation = current status and immediate concern (what is happening right now). Background = client history, diagnosis, current medications. Assessment = nurse's clinical interpretation of what is happening. Recommendation = what you want from the provider. The described statement presents current vital sign abnormalities — this is the Situation component.
Question 5
A nurse is receiving a new client from the emergency department. Which information is MOST important to verify during the handoff?
✓ Correct: Allergy status, current medications, and reason for admission
During client handoff/transfer, the most critical information is allergy status (to prevent anaphylaxis), current medications (to continue appropriate therapy without duplication or omission), and reason for admission (to ensure appropriate care planning). This information directly affects patient safety. Insurance details and scheduling preferences are administrative concerns handled separately.
During client handoff/transfer, the most critical information is allergy status (to prevent anaphylaxis), current medications (to continue appropriate therapy without duplication or omission), and reason for admission (to ensure appropriate care planning). This information directly affects patient safety. Insurance details and scheduling preferences are administrative concerns handled separately.
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[Clinical Concept Map: Management of Care & Delegation NCLEX Questions — Pathophysiology, Assessment Findings, Nursing Actions]