NCLEX Review Guide: Leadership Management, Prioritization and Clinical Judgment

Core Leadership Concepts

• Accountability means being responsible for decisions and actions, while delegation involves transferring authority but retaining accountability.
• Span of control refers to the number of subordinates a manager can effectively supervise, typically 3-7 direct reports in healthcare settings.
• The RN cannot delegate nursing judgment, assessment, teaching, or evaluation - these are core nursing responsibilities.

ABC Priority Framework

• Airway always takes highest priority - assess for obstruction, secretions, or compromised breathing patterns first.
• Breathing follows airway - evaluate respiratory rate, depth, oxygen saturation, and signs of distress.
• Circulation includes blood pressure, pulse, perfusion, and bleeding assessment after airway and breathing are secured.

Effective Time Management Strategies

1. Plan and organize at the beginning of each shift using report information and patient assignments
2. Cluster care activities to minimize interruptions and maximize efficiency while in patient rooms
3. Delegate appropriately based on scope of practice and patient needs to optimize team effectiveness
4. Document promptly to maintain accurate records and prevent delays in care continuity