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Delegation NCLEX Questions for Nursing

Great way to start the morning. Good morning. Good afternoon. Good evening to our friends around the world. My name is Luciana Da Silva. I'm in for Tanya Freedman today. She is traveling. If you look up into the sky, she might be flying over you right now. In the meantime, today, onwards and upwards, we are going to be discussing the NCLEX. Yes, this is onwards and upwards, the Connetics USA live show for global nurses. In the chat, please put in your name, tell us where you are from. We love seeing how people from all over the world are watching the show today. And we have the wonderful Paul. Dr. Paul, as we should say now, how are you doing, Paul? Good morning. I'm doing good. What about you? I'm good. Thank you so much. I know that you have some exciting news to share with some of our viewers here. Such an amazing accomplishment. I graduated with my doctorate finally two weeks ago after four years. It's been a long time in school and I'm happy to take a vacation. That's why we've got you on the show today because everyone watching right now. We are going to be having an NCLEX bonus class in the second half of the show today with the wonderful Paul. If you have not met him yet and his expertise. Paul, tell us a little bit about yourself and your background, Doctor. Paul. Yes. Oh, thank you. So I have an experience. I have more than ten years, actually, 14 years now. I have experience with NCLEX education. I was a licensure exam reviewer in the Philippines and an NCLEX instructor since 2008. I'm a BSN graduate in 2007, took my Masters in the Philippines, moved there to the United States to start my career in 2017, been here five years, finished my doctorate. I'm also a family nurse practitioner and I have a nurse educator certificate, so that's about me. I also practice as an ER nurse and currently transitioning to my nurse practitioner role. So it's going to be exciting. But my passion is really to teach and help nurses Bachelor and examine what I wanted to do since when I was in nursing school, a teacher. Being able to teach others is such a gift. Let's say hello to some of our audience here in the chat. We have Gisellene, I believe, Brazilians. How about that? And I got it from the UK is watching. We've got Kate from Phoenas, Hazel from the Philippines. I rent from the Philippines. Denise. Tony from London. I think I almost named every single continent just now. So let's get started. Paul, let's go with the basics here. Okay. What is the NCLEX? So the NCAA stands for the National Council for Licensure Examination. It's basically the licensure exam for nurses to be able to practice as an RN here in the United States, in Canada and Australia is already requiring enthusiasm for foreign graduates as well. So you won't become a nurse until you pass the NCLEX.


Okay. Now, there are several different parts of the NCLEX exam. Tell us about that. At for the blueprint of the exam, there's four major client categories, which are actually some of the categories of multiple items below it. It's a total of eight client categories depends on. So there's different percentage, for example, safety and infection control, about 17% to 23%, as well as management of care. And then we also have health promotion, which includes geriatrics and Pediatrics and normal Obgen. And then we have physiologic adaptations, which are the medical surgical conditions, psychological alterations, pharmacology, basic care and comfort and risk reduction potential. So those are the stuff that comes out in the NCLEX. But in the grand scheme of things, it's just all of your major nursing courses put together and combined together to make the eight client categories. And these client categories are dictated or created by the National Council of State Boards of Nursing, which are actually all the boards of nursing in the 50 States here in the United States. So they get to decide what comes into the exam, the passing rate, the passing standards. And they do that every three years. In fact, in 2023, there will be a significant change in that. I'd like to talk about that in the future. Options. Wonderful. Well, it's good. You definitely give us a heads up about that. And everyone knows that we do shows about NCLEX here pretty regularly. We try every few months to make sure that all of our nurses know about the NCLEX they're prepared about the NCLEX. Watch out because Paul will be back on the show to talk about that. Paul, tell me, why is it important for a nurse to have the NCLEX? Does a nurse need the NCLEX before coming to the United States and beginning to work? Well, that's a very good question. So as I said earlier, enclosed allows you to practice as a nurse. It's the life insurance examination, which means nurses are required to take it to get their licenses to register for the Board of Nursing. Without passing the inquest, you will not really be able to practice as a nurse. So that's your license now for foreign graduates, they're also allowed to take the NCLEX. There are different NCLEX testing centers or peers in the testing centers around the world, Europe and Asia. But for the integration purposes, I believe they have to pass the NCLEX first before the immigration process could be started. So it's very important for nurses, particularly foreign graduates, to pass the NCLEX as soon as they could because it will start the ball rolling. So without the NCLEX cannot be petitioned or hired by a US employer as well. And of course, here in the United States, as soon as the students graduate from BSN school, they take the effort within a few months to be able to practice as a nurse. And here at Connetics USA, we do have an NCLEX scholarship now to where our nurses can come and can take the NCLEX exam. We pay for it. It's free for you. You are working with wonderful people like Paul's company. Aspire for an NCLEX course completely paid for by Connetics, it is a scholarship, so you have to apply in order to see if you qualify. I'm all Rhyming today. Paul, go to Our recruiters right now are waiting for you, and they will be contacting you as soon as you fill out that application and give you more information on the NCLEX scholarship. If you have your NCLEX ready to rock and roll to come to the United States, I want to take a look at the chat really quick again before I hand it off to Paul. For your bonus class, we have Carl from the Philippines, Jeff from the UK, hello from Doha, Qatar. From Bosch, Carol from Kenya, Germany. In the house, Bonjang, Nepal. I could just keep reading this over and over. It's so amazing to see how many people from all over the world are watching right now for all of our viewers. I'm going to let Paul take it away with a special and collect bonus class from Dr. Paul from Aspire. Enjoy, everyone.


Thank you. All right, guys. Well, Tanya already called everyone out and thank you for joining our show today. We're going to talk about nursing delegation. Delegation. It's one of the key topics for end clicks. It comes out under the management of care. So delegation is a legal process where nurses can handle their responsibility to other members of the healthcare team, such as the licensed practical nurse or the certified nurse assistant under the supervision of the nurse, of course. And there are quite a few questions in NCLEX about delegation. In my last show with Connetics USAvlast month, we talked about prioritization, and today we're going to talk about delegation. So give me a bit while I set up my slide real quick. And while we're doing that, I want you guys to participate with me. This is going to be a very interactive show. I'll be doing a quick lecture about delegation principles in about ten to 15 minutes, or probably 20 the most. And then after that, I'll be asking questions. I prepared five to ten questions today for you guys, and I want you guys to participate with me and tell me your answers through the chat box. I can see all your responses in Facebook right now on my screen, so please help me with that again after my mini lecture, we're going to do a question and answer kind of thing. I'm going to explain to you the answer, but you're going to have to participate with me in providing your answers. Okay? So let me just set up this thing real quick, and I should be good in a few. All right, so here we go. Should be good. 1 second. All right. So we have people watching from Ghana, from Hong Kong, from Saudi Arabia, from the Philippines. Is it applicable for international nurses? One of the questions. Yes. And NCLEX is applicable for international nurses. Like I said, if you want to practice here in the United States, it's the only way for you to get over here because it's the license to practice here. And Edward is not hard. It can attach to that. Even the NCLEX exam success is time and discipline. That's correct. And I think I've seen a question here. I would like to work in US. Can I bring my husband together with me? Yes. I'm not an immigration lawyer, but I believe Connetics USA have covered that question in many of their top shows in the past. But, yes, under the immigrant visa category, for nurses, for foreign nurses to come over here to the United States, you are able to bring your spouses and your kids under 21 years old. I may be wrong, but I think it's 21 years old. You can bring them over here. They would have green card as well, like you as a nurse. All right. And of course, for the scholarship. Yes. Connetics USA and Aspire and as partner in providing scholarships for NCLEX. And again, we will splash the link later where you can apply. Connetics will screen you first, and then once you qualify, they're going to submit you to Aspire to undergo this intensive program. After you pass, the recruiters are going to submit you to the hospital so we can get the petition started. And I would encourage everybody to really apply because the petition process right now, immigration process is moving really fast. Back in my time in 2008, when I started when I passed the influence and started the process, it took me nine years to get here today, but now it's only taking a year or two. So we flash that link at the bottom of the screen earlier, and we're going to do that again later So that's where you submit your information and the recruiters will screen you and will submit it to our end for a scholarship qualifying exam and stuff like that. But I would like for you to send your application to this link and we'll talk to you and run you through the process and let you know what's going to happen next. All right. So without further Ado, let me continue with my class for today. The other questions. We're going to try to answer that within the day where we're going to point you to resources where you can find the answers, because I believe we've covered that in a lot of the previous top shows. Antonia, Connecticut. They also do a lot of shows with immigration lawyers who can actually provide you like not legal advice, but sound advice from a professional, from an expert in immigration law. And we know it's very complicated. So I want to stick to what I'm expert with, which is the nursing curriculum, which is NCLEX classes. So I'll do that for now. And whatever we can help you with, we'll answer that later. Right. So delegation, like I said, is very important in Empire. There's going to be a couple of questions about delegation because it's part of the management of care, which is one of the largest percentage in your inquiry exam. And delegation is just basically passing on the responsibility to other members of health care team. But you are not passing the accountability, which means if you're the nurse and you're telling, for example, your certified nurse assistant, can you take my patient's vital sign? When your CNA takes the vital sign, the CNA is responsible to get that vital sign, but you're still accountable. Meaning if there's an abnormality in vital signs, it is your responsibility and accountability to recheck the patient and make sure everything's okay with the patient. So we're doing this so we can focus more on the nursing tasks, the tasks for scope that only nurses could do, and so we can provide efficient care. So before we start with delegation, let's talk about the different roles. First, let's begin with RNS. So there are two types of RNS depending on their education. Outside the United States, I believe most RNS are educated at the Baccalaureate level or BSN. Baccalaureate nurses are trained to provide care to individuals, to families, to communities. They can provide care in both structured, which means a hospital setting or a clinic or unstructured settings like mobile clinics like public health or community health. So that's what BSN degree is for. Associate Degree Nurses BSN degrees are usually four years. Other countries might be longer or shorter, but you can tell from your diploma at the time of your graduation. If you receive the bachelor's degree, it should stay there. Now here in the States, associate degree nurses, which undergo school for about two years, can also practice as a nurse. Both associate degree and Baccalaureate degree nurses are able to take the efforts for the NCLEX rule. So there are two types of nurses. The associate degree nurses are also nurses. Their scope. The Bachelor and the associate degree have equal responsibilities. They're equal in other scope of practices. So there's really not a lot of differences with associate and bachelor's degree, but by definition or competency, associate degree nurses can perform care with individuals and family. Let's include families in a structured health care environment, usually hospitals or clinics. Majority of nurses work in a structured health care environment anyway. But like I said, the roles or the scopes of these two types of nurses are the same. The only difference is the education. One is the Baccalaureate degree or bachelor's, and the other one is associate. Hello, guys. Hello, ma'am. Anna. Hello from Texas, by the way. I'm from Texas, guys. I'm here right now in Houston right now. It's about 09:18 a.m. All right. And thank you for joining us. Anyway, you have to remember that our end registered nurses cannot delegate initial assessment. So when you have a newly admitted patient, new patient in the ER, new patient coming into your unit, it should be you that will perform the assessment. You cannot delegate. That right. Because you're going to have to document your head to toe assessment. That is noneligible . All right. Evaluation of patient. For example, we gave a medication to the patient. When you evaluate the effects of the medicine, if it has been effective, that's the nursing responsibility. That is noneligible. Another example of evaluation is if the patient understood your teaching or if the patient can perform the skill or procedure like, for example, you're teaching how to insert an insulin or poke themselves with insulin on the tummy. It is your responsibility to evaluate that. It cannot be delegated nursing judgment. Of course, there are certain scenarios where the nurses would question the orders of the physicians or providers because they feel like it will put their patient in danger. So that is noneligible. Patient and family education is the responsibility of the RN. It cannot be delegated to any member of the healthcare team. And performing nursing diagnosis and nursing care plans. Charting stuff like that can never be delegated by our end. All right. And I'm going to show you a table later of what nurses can do and what the other people could do. Right now, aside from our end, we have LPN. They also take the NCLEX, but it's called NCLEX. We take the NCLEX RN. They take the NCLEX RN. Licensed practical or vocational. Nurses are in school for about a year or two. They're taught how to perform the nursing skills. So if you go back to a bachelor's degree, associate degree, if you remember your fundamentals nursing skills, they could do all of that because they are trained to do that, right? They assist in implementing a defined plan of care. The  assist the nurses in implementing a defined plan of care. The RN sets the plan of care. The LPN follow the plan of care. They cannot create their own nursing care plan. They work with the RNS for that defined plan of care. They can also perform procedures as long as it's within protocol. So protocol means there's a step by step guide on how to do it. What should be watched out for? How long do we need to monitor these patients after we give this medicine or perform this procedure or how to do EKG? This can be performed by LPNs. All right. They can also assess, but not initially. Initial assessment is solely for RNS and not LPN. You have to remember that. Can LPN success? Yes, but not initially. Right now, when LPN success, they can determine the abnormal versus normal. What is normal? What is abnormal? If it's abnormal, they have to cascade that information to the nurse or the RN. So the RN can verify and check out what's going on and report it to the physician. All right. So it's still the responsibility of the RN. And you have to remember when you're here in the state, LPN are also called nurses. So it's important to verify their certifications or licenses. So we can delegate appropriately because you might be delegating a lot of art and tasks to an LPN. And remember, your license is at take care because you're the marriage and you're the one delegating. Right. So they can differentiate between normal and abnormal. But to act on an abnormal finding, they have to report to them first for the provider and they can take care of physiologically stable patients. Unstable patients have to be taken care of. Now LPNs can also work in the hospital. I've worked with a lot of very good able LPN in the ER. We have different tasks. They can perform most of the nursing tasks except charting and the initial assessment exception, stuff like that. I'm going to go through it one by one. And some hospitals still employ LPN, but mostly I think LPNs are working in the clinic now and home health care where there is a nurse and it's like a teen nursing care kind of set up, but they are still existing and they're very much here in the United States. But the question is what can be delegated to them safely and legally and what cannot? So that's what we're talking about right now. And then later as we finish the class, we're going to go to the question and answers to apply our learning or knowledge about delegation. We now talk about the RN, and then we talked about the LPN. Now let's talk about UAPs are unlicensed assisted personnel. These include certified nurses assistants or CNAs, patient care technicians or PCTs text and scrub text or whatever. So there's different names that we use depending on the unit and depending on the state. So here I'm working with as an error here in Texas or in many areas that have worked at many different hospitals. We call them patient care techs. So they're still unlicensed assistive personal, but they're certified. They're certified. They aboard, but they're not licensed. The licenses and certifications are different licenses. You're held to a higher professional standards, code of ethics, ethical, legal consideration, and license is heavily scrutinized by the board. Certifications, on the other hand, are skills that you've learned on a school for about three or six months, and you're highly skilled to perform these procedures. So UAPs for certified nurses assistants, for example, that's what you will commonly encounter in the NCL have very limited scope of practice. They can only perform direct patient care, such as bathing, transferring ambulating, feeding patient toileting, vital signs, taking the height and weight, checking the Inose. They can do that. They can check urine specimen, they can check blood glucose, because those are skills that we can teach them. They can also perform indirect activities such as housekeeping in the area. They help us change our beds or clean up our rooms for the next patient. They can transport stable patients. If this is an unstable patient or ICU patient, it should be the RN, and they can also stock supplies. So basically everything that can be done by an unlicensed person without think about it as if this task can be safely delegated to someone and will not cost the patient to have severe complication or die from these procedures. Then we can safely delegate that to UAP. For example, a patient needs to emulate on the hallway with a Walker. That can be done by a UAP or a CAN or another example, we need to take a vital sign, a repeat vital sign for a patient that was here in the ER, for example, for hypertension. So if it's a repeat battle side, they can definitely do that, but their scope are very limited. Now on the next slide, I'm going to show you the different things that they can do. All right? We can compare them to our end, the LPN and the UAPs. If you guys have questions, please put it in the comments because I'm watching the comments and we're going to be done in a bit. We're going to do questions and answers after this slide. So let me know if you guys already okay, but we're going to run through it real quick. Our end can perform plans or create plans or care plans. Can provide nursing interventions for nursing diagnosis can assess patients specially. Initial assessment admission assessment. Can provide teaching and education. Can evaluate outcomes of care. Can discharge patients or provide discharge teaching and instructions. Can insert, manage IVs or intervene medications, blood transfusions, everything that's related to IVs are for our end. Any invasive procedure for our end, right pre op and post op care. That's for our end only, especially if it's the first day, 24 hours. You got a monitor for bleeding and infection, triaging or assessing the patient, checking if the patient is worsening or getting better. It should be the RN. All right. Receiving and giving report is what we call it. Or handoff report or bedside report or shift report. It's RN to RN. Of course, blood transmission verification is done by two nurses or two RNS. LPN cannot verify blood transmission. It should be two RNS applying restraints and monitoring restraints. Our responsibility of the RNS performing codes or ACLs codes or code Blues and rapid response is a responsibility of our end. And LPN definitely could not do that. I think we have a little question here. Should they be all ethnic factors or just our end? Hold on 1 second. What I said earlier is LPN also take the NFL, but it's a different and NCLEX. It has a different blueprint or client categories or percentage of client categories. They have different number of items. I think it's minimum 65. And their exam is called NCLEX RN. If you are an RN, you take NCLEX and you don't want to take RN because your scope is going to be narrower if you're a nurse, if you're an RN. And so just take the RN so you can practice as a nurse because LPN requires us to work with an RN. Right. So they take NCLEX RN. UAPs can take certifications for certified nurse assistant or patient care technician. Certified. But those are not licensure exams. Those are certification exams, particularly to the skills that they've learned. Right. So they have assessment skills, too, but very narrow. They're not allowed to assess critical patients or abnormal findings. And for LPN, they can take care of chronic but stable patients. Yes, chronic patients like eye protective patients, diabetic patients, congestive heart failure patients. As long as they're stable and there's no acute conditions affecting them, they can take care of both of patients, particularly after 24 hours. They can administer oral subcutaneous medications, including narcotics. But IV meds are solely for our end. I know when you get to practice here in the United States, some hospitals have a policy to allow LPN to give IV medications. That hospital policy, but let's focus on your ankle first. IV medications are only for nurses, RNS particularly. And they can take care of Mi patients as long as it's more than 72 hours. They can take care of CVR stroke patients, spinal cord injury patients. They're stable under conditions. They can manage ventilators or monitor ventilators. They can perform coma scales. They can perform sterile procedures as well. They can take care of contagious patients like ours. They cannot teach patients. They cannot provide instructions. They can only reinforce teaching. All right. They can also take the routine data collection, such as doing assessments of patients. Or, for example, I want to do a respiratory assessment. LPN can do that. But again, the initial assessment should be the nurse. The follow up assessments can be done by LPN. Right. changes in and out. Foley can be done by LPN, nasal or oral suctioning, assisting healthcare provider with procedures if nurses are not available. All right, you guys are able to pick that up. Now for UAPs, they can take care of stable patients. They can feed patients, but oral feeding, nasogastric tube feeding can only be done by RNS and LPN. Again, nasogastric feeding or tube feeding. Whatever tube. If this is gastrostomy tube or whatever tube is only for RN and LPN UAPs or CNAs can provide oral feeding only for stable patients. Right? They can check in. They can check vital signs for you. They can do range of motion exercises for patients, activities of daily living. We talked about that earlier, like bathing or hygiene or sleeping or promoting elimination. They can do that. They can measure output from indwelling citators, but they cannot insert indwelling catheters. Only our ends can do that in dwelling foliage, they can transport stable patients. They can transfer patients from bed to chair, chair to bed. They can obtain urine specimen, glucose levels. Those are easy tasks or skills that if something happens, patient will not die. So always remember if I have a procedure or task that if something wrong, if something wrong happens, will not cause the patient to die or have severe complications or a permanent disability, I can safely delegate that to the UAP. If the skill that we need to delegate can have severe complications or can cause the patient to die or have permanent disability, then UAP certainly cannot perform those tasks. All right, so whenever you see the word show, explain, monitor, teach, check, assess, demonstrate, UAPs cannot do that. Only RN and LPN. All right? Particularly the teaching part is for RNS only. All right? So just keep popping your questions into the comments and we're going to try to answer. Our team members with Kinetics are providing answers right now into the comics, right? Any questions before we go to the question and answer part, I have ten questions here for you guys. I want you to provide to me the answers. The options are going to be ABCD. All right, if you guys are ready, can you go to the comments and type ready? Because I'm going to flash the questions next and then you're going to tell me your answers. All right? Ready. Can you say I'm ready so we can proceed with the questions? If you are still with me right now, I need your participation for this. All right. All right, so a few people are already ready to go to the question and answer. Don't worry, if you didn't understand the class, you can always review this later. We're going to upload it on Facebook and YouTube, okay. And we're going to apply what we've learned through the questions. I'm going to explain to you the answer. Right. But I need you to provide the answer to me first. All right? Before I explain what the answer is and if you can record your scores, I want to see your scores after we've gone through the ten questions. Okay? So make sure you tally your scores and we'll see your scores after the class. All right? All right. I think there's a lot of people who are ready to do the question and answers now. All right.


Okay, so question number one, a client has added a kiosk to me for two weeks after a motor vehicle or accident. Which tasks could RN safely delegate to a UAP? I'll give you about 30 seconds to process this question and you tell me your answers in the comments section. I need my coffee early here in the United States. All right. We have dissenting opinions, different answers. So definitely letter A is the responsibility of the nurse. Only the nurse can perform teaching. Correct. Monitor the client's shortness of breath can be done by both RN and LPN. Right? We're down to B and B, which is most of the answers are B and B. Guys, letter C is not a responsibility of the UAP. Remember, if you see the word monitor, UAPs cannot do that. All right? UAPs are unlicensed assistant personal. So the choice is between B and D. The answer is actually letter D. All right, let's splash it. Letter B changes the tracheostomy trait that can only be done by the nurse. All right? Because the tracheostomy can actually come out if performed incorrectly. There is a risk for the tracheostomy to come out when changing ties. All right? So therefore, if it comes out, the UAP is not allowed to put it back in or perform any procedures for breathing. We cannot delegate that. That's very risky. The patient can die when we do that, but that's only for our end right now, dressing care, they can do. All right, because dressing care is a skill that we can teach anyone. Even family members can be taught how to change dressing. Do you know what I mean? So UAP can do that as well, which means if they performed it incorrectly, there's no immediate harm to the patient and patients will not die. We just have to change the dressing. Right. So after letter D. Right. Remember, UAPs can only perform tasks that will not cause the patient to die or have permanent disability. All right? You cannot let them perform B, which is most of the answer here, because changing tracheostomy type puts the patient at risk for that, too to come out and can cause airway disturbance and the patient may not breathe. Remember to ask them if you're breathing. All right? So accurate. Letter D. That's all right. We still have nine questions.


Number two, which one of these tasks can be safely delegated to the LPN? Licensed practical nurse assess the function of a newly created ileotomy. Care for a client with recent complicated double barrel colostomy, provides stomach care per client with a well functioning ostomy or teach ostomy care for clients or to a client and their family members. What is your answer? I'm seeing some answers now. All right? I'm waiting for more answers before I say the correct answer. I think we all got this correctly. The answer is letter. Can we delegate? Assessing the function of a newly created illustrate for the LPN? Letter A. No, because it's a new ileostomy, you cannot delegate that. Remember, new patients with new procedures or newly admitted or needs first assessment can only be done by our end. So letter A, you cannot endorse that to the LPN. That's for the nurse. How about letter B? Care provides with complicated, colossally. You see the word complicated. Remember that LPN can only take care of stable patients, right. If it's complicated or critical cases, that's for the nurse. So A and B is for RN. All right. The answer is letter C. Very good. Most of you got it correctly, all right? Because it's only stomach care. Stomach care is cleaning the stomach around it and then changing the bags. That's something that's stable procedure. That's something that the LPN can do. All right. Teach offset letter D. Can LPN teach? Can LPN teach again? Can LPN provide teaching? Yes or no? What's your answer? Yes or no? Can LPN provide teaching? They cannot. The answer is no. Very good. But can they reinforce teaching provided by the RN? Can they reinforce teaching provided by the RN? Yes, they can reinforce teaching, but they cannot. Teach. Right. Nurses or RN provided teaching? LPNs can reinforce teaching. All right. Very good, guys. Thank you for your responses.


How about number three? All right. The charge nurse on a cardiac step down unit makes assignments for the team consisting of an RN, an LPN, and a UAP. Which client should be assigned to the LPN? Which do you think can be assigned to the LPN? Letter A, 49 year old with atrial fibrillation with RVR or rapid ventricular response, which means the ventricles or the heart rate is super fast. Letter B, 58 year old with diaper tension with possible angina. Letter C, 35 year old scheduled for cardiac catheterization or letter D, 65 year old for discharge, which can be safely delegated or assigned to the LPN. All right. I'm going to check my Facebook real quick to see how many nurses are online today. All right. Let me see because we're streaming it live in Facebook right now. Right. While waiting for your answers. All right. I think we have different we have about 150 students online right now watching us live. Nice. All right. And I think we have different opinions on this one. Right. But there is only one correct answer. Remember, LPN can only take care of stable patients, so letter A is not a table patient LPN cannot take care of that. If it was RPR, that has to be corrected immediately. Otherwise you can leave to VFA. Correct letter D. I'm going to remove letter D as well. Discharge teaching discharge instructions. Discharging a patient only for RN, not LPN. So your choice is between B or C. Your choice is between B or C. Guys. The answer is B. Hypertension with angina are stable patients. Letter C, we cannot endorse that or assign that to the LPN because the patient is going for a procedure, which means this is a pre operative or pre procedure. The patient's in the pre op phase, which means you need to perform certain tasks like cleaning the patient surgical area, providing teaching, asking patients if they have questions about the surgery, making sure that they understand the consent that they sign for, making sure that their vital times and labs are collected and they're normal. So letter C cannot be assigned to the LPN asterisk they can take care of 5% of patients. Yes, because they can give medications. Remember, PO meds and possible angina street is nitroglycerin, which is a pill or a patch. Definitely LPN can do that. Answer is letter B and not letter D, because I think a lot of you guys have answered D as well. But letter B is the answer. I'm going to show it letter B right there on the screen highlighted in red. That's okay.


Let's proceed to number four. I don't expect to have a perfect score because this is confusing for a lot of nurses, especially if this is the first time you've heard about delegation. And that's why we're doing this class. All right. A licensed practical nurse from the pediatric unit is assigned to work in a critical care unit. Which assignment would be appropriate? Letter A, we're talking about what can be delegated to LPN. Letter A, multiple trauma with newly implanted pacemaker. Letter B, new admission of left sided weakness, stroke. Letter C, 53 year old clients with cardiac arrest and suspected Mi or heart attack. Or letter D, 35 year old unbalanced traction, admitted six days ago after motor vehicle or accident. What is the answer? I think everybody got it correctly. Answers letter D. Very good. A, B and C, these options are only for the RN, all right? Because they're unstable, newly admitted patients, newly implanted pacemaker. Letter C, cardiac arrest. You definitely cannot endorse that to the LPN. Answers. Letter D. Very good. All right, I think we're picking up on the knowledge about delegation and we're getting things straightened up now.


Number five, which task for a client with Ania and confusion? Could the nurse delegate to the UAP? What can we delegate to the UAP? This is an unlikely assistive personnel. Can they document skin Turkey color changes? Can they test for stool, for cold blood and urine for glucose? Can they suggest food high and iron and those easily consumed? Or can they report mental status changes? What can the UAP do? What can the UAP do? Guys, let me tell you something. Remember, they cannot assess patients, right? LPNs and RN can assess patients, but they cannot assess, which means they also cannot document. Right. So letter A is for RN or LPN. Letter B cannot be performed by the UAP as well because that is a form of assessment that is out of their scope. They can perform skills, but they can never assess patients. Right. They probably could see something abnormal, but they could not. You see the statement it says, check the degree of mental clarity. You're checking LLC changes, or you're probably performing LLC neurologic assessments here. That's not irresponsibility of UAP. That's noneligible. The answer here is letter B. Right. Testing for school for a call. It's very easy. I don't know if you performed that, but it's a card. The doctors would get samples of the stool from what you call this from the rectum and then spread it out to the two parts in the card. All right? And then we just dropped some solution in there and look for change in color, super easy for UAPs to do. And urine for glucose is super easy. We have ice tabs for little machines in the units in the ear. And I see in the floor where they can just drop the urine and it can tell us if there's glucose or not or can do bedside. I forgot what it's called. Bed up. Your analysis is right there in the clinics. We do that as well. And in offices in the ER, some ERs are equipped to perform your analysis right at the bedside with the small machines. All right, so what I'm saying is letter B is just technical skills. We just teach them how to drop the thing on the card to check for a cold flood. And the year analysis is super easy. They just drop it on a strip and put it on a machine. So letter B is the answer. Letter C is wrong. That's teaching. That's only for RNS. So A, C and B can be done by RNS, but not UAP. Be very careful. Remember when it's UAP that we're talking about, only skills. No assessment, no evaluation, no teaching. It's only skills.All right, now next number.


This is number six. I think my slide says question number one. It's question number six. The care of which of the clients can the nurse safely delegate to a UAP? Peripheral vascular disease with an alteration of the lower left leg, preoperative patient waiting for adrenaline, an elderly client with hypertension and self reported non compliance to medication, or a newly admitted patient with a history of transient ischemic attack. What tasks can we safely delegate to them? What's the answer? Can I see your answers? Oh, my God, I'm sorry. I accidentally clicked it with my Apple pencil. I'm so sorry. Answer is letter A. Guy. All right, I've shown you the answer already. Private PVD and alterations. We're just basically providing skills here. There was no procedure that was mentioned. There was no assessment that was mentioned. It's just saying what can be safely delegated. All right, usually the care of these patients would require what? Checking if the wound is secreting fluids or checking if the dressings are intact? Checking vital, size if they're admitted that's it. But preoperative patient letter B, we cannot give that to the UAP. That's only for the nurse. Letter C, you see the word non compliance to medication. The nurse needs to perform teaching for that. UAPs cannot handle that. And the first letter, he says, new admission. That's only for the nurse. All right, next number. 725 year old client, unresponsive after a motor vehicle or accident is being transferred from the hospital to a long term facility. Which staff members should the charge assign this client? Who can take care of this client? This guy was unresponsive and had a motor vehicle or accident in the past. All right, it's being transferred to a long term care facility. This is a very unstable and kind of like high acuity patients. When it's a high acuity, they are at risk for complications or dying or permanent disability. Answer is this is only for very good. This is only for the RN. Very good.


All right, next number eight. Let me just have my copy. All right. The measurement and documentation of vital signs is expected for clients in a long term facility who can perform vital signs. The volunteer. Let's remove letter B if it's only vital signs for long term care patients. Long term care patients are patients with chronic conditions that they need to be in a long term facility. Who can perform it? It's vital. Thanks, guys. It's skills. Who can do it? I'm sorry. I have to drink my coffee and stay away. But I love coffee. I'm sorry. All right. Letter C. Very good. UAPs can do that. It's just vital signs. It didn't say there's an abnormal finding, all right? It didn't say battle sex and unstable patients. All right? So battle size can be performed by UAP. We're doing good. All right. We're almost done.


Number nine, as the RN responsible for a client in isolation, which can be delegated to APN, which can be safely delegated to an LPN. Reinforcement of isolation precautions, assessment of the client's attitude about infection control, evaluation of steps, compliance, observation of the client's environmental risk. This should be an easy answer. I think everybody got this correctly. Thank you for your responses. The answer is letter A. Without a doubt. I think everybody got it correctly. Reinforcement of teaching or isolation precautions can be done by LPN, B and C. Do you see the word assessment and evaluation? Who does that? Only the RN. Right letter B is observation of the client's total environment risks. That's evaluating the environmental hazard. That's only for our end. So the answer is letter A. Letter A, right letter A.


Now let's go to the last question and we'll wrap up in a few minutes. Which tasks could be safely delegated by the nurse to an unlicensed assistant? Personnel, I'd like you to answer this. We're talking about what can be delegated to a UAP. All right. This should be a super easy question for you at this point because this is the number ten question. I think people got confused because there's, like different answers popping on my screen right now in my comments section. We're now up to 160 people, all right? And that's good. And people, if they were not able to attend these meetings today, we're going to put it in social media. You can tag them later so they can watch it. So I know a lot of places are working. We have different ships. We're in different parts of the world. We have people from Africa here, from Europe, from Asia, and from Northern and Southern America. We're all over the world today.


And I know there are differences. And of course, nurses are busy working if they want to watch this later. Just tag them on this thread so they can watch this class later. What can be safely delegated as our last question? Letter A, B with a client who self administered insulin? No, we have to evaluate if the patient is performing it correctly, right. If the insulin administration subcutaneously on the tummy is being performed correctly. And plus, we need to be teaching that's only for the nurse. How about monitor letters and monitor a client respond to path is Rom. That's only for the nurse. So now you're down between B and D, which do you think at very least, complications and can be safely delegated to the UAP? Guys, we've already eliminated C. I said A and C are for the nurse. Remember, when you see the word monitor, evaluate, assess, teach, show, observe. That's only for Rs and not UAP, which has the least complications, like, no complications at all are very safe to do. Even if they make a mistake, it's not going to cause harm to the patient. Letter B is wrong. Letter B can be done by RNS and LPNs, but the answer here is letter B. Guys, I don't know if you know the recoil pouch, you can just, like, change it. It's just a pouch. It's a bag. All right, so they can safely do that. It's for elimination. All right, now we've done all the questions. Can you show me your answers on the thing? Be honest. I don't care if your score is low. I don't expect you to have very high scores, especially if nursing delegation is such a new concept for you. And I'm giving you a demonstration of what we do for Fax classes. All right. I teamed up with Connetics USA to provide scholarship for nurses, foreign graduate nurses who wants to live their American dream, just like me. It used to be just my dream when I was young to be in the United States. In fact, my parents sent me to nursing school to come over here to the United States, and it took a while, 910 years. But I'm here and I'm happy and glad with my choices, and I really want to encourage you guys to really look into it, pass your end clicks and let us help you with onboarding you to the process and getting you to the United States. Connetics USA has been very helpful to thousands of nurses over the years. So I'd like you to take advantage of that scholarship of that pre processing, and they can connect you to employer takes out the responsibility from you to look for your own employer, and they're pretty good at taking care of their nurses. All right, we got really good scores. People got six, 7810, which means you guys have very good knowledge about delegation. All right, so that was just a drill. Sometimes I do free classes as well. Please follow me on my social media as well for announcements about sometimes I do like full live lectures for like 4 hours. My full class is about 4 hours and this is just a demonstration. But thank you guys for sitting with me. I think Luciana is back with us. Wonder if I'm seeing some good scores in this chat. Yes, I think they enjoyed the class. Right. Did you guys enjoy it? Yes. If you enjoyed it, give us some sort of cool, emoji clapping hands, strong arms.  I'm loving all of these scores here. We have some very smart viewers. Yes. And I think that was a lot of information for 1 hour. The thing is with nursing you can have information overload in just 30 minutes. There's a lot to know. But this is why we're doing these classes to help you guys get those knowledge that you need for the exam. Right? Thank you for joining us today. Thank you so much, Paul. And happy nurses month. Thank you guys for all you do. You guys are awesome nurses. I can't imagine a world without nurses. Period. So thank you guys for all you do. Wherever you are, wherever you are practicing happy nurses months to everybody. To everybody out there. And one more thing to add for nurses months. Connetics USA for the last several months we have had a referral bonus program that is actually going to be ending. It's seriously ending on may the 31st. So you have about eleven days left to refer a nurse. The nurse must have NCLEX. Whenever you do refer the nurse give you $100. $1,000. Excuse me, I missed a zero there. $1,000. Simple as that. Just go to that is running out. So make your way over to the website now. If you are a nurse with NCLEX of course go to our website and apply Our website has a lot of information for you. All sorts of resources, videos. The video of this show of this wonderful class that Paul just completed will also be on our website so you can check it out there. Of course. Join us next week same place, same time. We're actually going to be doing an IELTS bonus class for you. So rounding out the nurses on all kinds of education coming your way. Thank you, sir, so much, Paul. Thank you. Everybody who watched today and participated. Onwards and Upwards. Take care. Goodbye, everyone.