NCLEX PART 1

CH 01. Management of Care
(Delegation & Prioritization)

This is the #1 most important topic on the NCLEX.
It covers roughly 20% of the exam.

You must think like a Charge Nurse.
Do not try to do everything yourself.
Focus on: "Who can do what?" and "Who needs me NOW?"

1. Delegation: Scope of Practice

Assign tasks based on legal scope. RNs never delegate clinical judgment.

Role	CAN DO (Scope)	CANNOT DO (Restrictions)
RN (Registered Nurse)	- E.A.T. (Evaluate, Assess, Teach) - Clinical Judgment - Unstable Clients - Blood Transfusions / IV Push	(Technically can do all, but should delegate simple tasks to maximize efficiency.)
LPN / LVN (Licensed Practical Nurse)	- Stable / Chronic Clients - Reinforce Teaching - Sterile Procedures (Foley, Wound) - Meds: PO, IM, SQ, Piggyback (state dependent) - Monitor IV flow rate / Ostomy care	- Initial Assessment - Initial Teaching - Unstable Clients - IV Push Meds - Blood Products
UAP (Unlicensed Assistive Personnel) CNA, Tech	- Routine / Standard Procedures - ADLs (Bathing, Toileting, Feeding) - Vital Signs (on Stable clients) - I&O, Weight, Ambulation - Specimen Collection (Urine/Stool)	- Medication Administration - Sterile Procedures - Assessment / Evaluation - Feeding clients with aspiration risk

2. Prioritization: Who do I see first?

When everyone needs you, use these frameworks to decide.

① The "Unstable" Client (Priority #1)

ABC + V Rule:
- Airway (Stridor, Obstruction)
- Breathing (Dyspnea, Retractions)
- Circulation (Shock, Hemorrhage, Chest Pain)
- Vital Signs (High Fever, Hypotension)
Unexpected vs. Expected:
- Unexpected findings are HIGH priority.
- Example: Post-op pain is expected (Low priority). Rigid abdomen post-op is unexpected (High priority/Bleeding).

② Tie-Breakers (Comparison)

Acute > Chronic:
New onset confusion (Acute) > History of Dementia (Chronic).
Systemic > Local:
Anaphylaxis (Systemic) > Broken Finger (Local).
Actual Problem > Potential Problem:
Treat the patient in pain now before the patient at risk for pain.

3. Assignment & Legal/Ethics

Floating Nurses:
Assign clients similar to their home unit or most stable/routine clients.
(e.g., OB nurse floating to Med-Surg → Assign a stable DVT patient, not a fresh Pneumonia patient.)
Rights of Delegation:
1. Right Task
2. Right Circumstance (Stable?)
3. Right Person (Competent?)
4. Right Direction/Communication (Clear?)
5. Right Supervision/Evaluation (Feedback?)

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CH 01. Management of Care
(Delegation & Prioritization)

1. Delegation: Scope of Practice

2. Prioritization: Who do I see first?

① The "Unstable" Client (Priority #1)

② Tie-Breakers (Comparison)

3. Assignment & Legal/Ethics

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제안하기

컨텐츠 수정하기

CH 01. Management of Care(Delegation & Prioritization)

1. Delegation: Scope of Practice

2. Prioritization: Who do I see first?

① The "Unstable" Client (Priority #1)

② Tie-Breakers (Comparison)

3. Assignment & Legal/Ethics

CH 01. Management of Care
(Delegation & Prioritization)