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NCLEX Delegation and Assignment Questions for Nurses

Hello everybody and good morning good morning in the USA and good evening in the Philippines and in the rest of the world. My name is Darius Opada and I am going to render a short discussion about delegation and assignment for today. Before I start, I would like to thank Connetics USA Connetics College and I would like to thanks Aspire RN for giving me this wonderful chance again for giving me this wonderful opportunity to render a short discussion and to share my god given knowledge to everyone especially to those who want’s to become nurses in the USA. So without further ado, I'm going to share something I'm going to share a lot I'm going to share my slides to you so before we go in depth with before we go to the in depth discussion about delegation and assignment let's define first what is the term delegation and what is the term assignment okay, well before I before I actually start I would like to know who is with me today who's joining us Can you please comment in the Facebook can you tell me where you are and what time is that in your place?

Okay, I can still see for now maybe a lot of some people are still what the call desks are joining so let's give some time for people to join all right, let me see okay oh so far we have eight viewers as of this moment, please comment on the page or in the live page and let me know where you from and your time zone please. So I would know who are these participating right now? We have Cebu Kumar, Jai Kumar Hi, Mr. Kumar. Welcome. Hello Aspire RN thank you for joining Connetics USA thank you for joining Okay, so far we have 25 viewers and maybe I will give them time to you know, to join some people to join and you know, to comment in the live page please don't forget to comment. Your live page. Yes, yes ma'am.

Okay I will share my screen Yep. Okay, Okay, so for today's discussion, as I mentioned, we will actually be discussing delegation and assignment and again, let me introduce myself. My name is Darius Opada. I am a senior lecturer for previous senior lecturer for Philippine Nurse Licensure Exam, and I'm currently a senior lecturer for NCLEX RN Exam. I am also currently a charge nurse of a medical oncology unit in northeast Georgia Health System in Gainesville, Georgia, USA. So today, as I mentioned, we will be discussing portions of delegation and assignment which is part of your management of care. And before I start, as I mentioned, I would like to thank Connetics USA as per our and again for this wonderful opportunity. Thank you. Thank you so much.

Okay, now let's start. So before again, we go into details let's discuss first, what do you mean by delegation and assignment? So according to NCSBN, when you when you talk about delegation, so delegation is actually allowing a delegate, to perform a specific nursing activity or skill that is beyond the delegate is traditional role, and not routinely perform. So and this can apply to LPNs, LVNs, UAPs and PCTs. So actually, when you use the word delegation, it's actually similar to assigning a task to a person. But this task or these tasks are not traditionally performed by an RN and LPN, for example. For example, a nurse is busy and she wants to delegate to the blood transfusion to an LPN or LPN. She can actually delegate it to an LPN or LPN, provide that that the LPN and LB or LPN is trained to do blood transfusion. But for many states, LPNs and LVNs are not allowed to perform or initiate blood transfusion.

So before delegating a task, please make sure that it is in line with your hospital's policy or the Nursing Practice Act of your state. Okay, but another example is for another example could be like some nurses can delegate, medication administration like oral medications to CMAs, or certified medical assistants, and some of them have undergone training to provide oral medications. Or sometimes they are trained to give I am or IB Sorry, I am or sub key medications to select patients. So that's actually delegation. Now, when you speak about assignment is actually the routine practice or skills that are within the scope of practice of RNs. LPNs, or LVNs. We have your UAPs, your unlicensed attending personnel, and your CMAs now in your NCLEX exam, so not to confuse you, they would actually use the term delegation and assignment interchangeably. So I don't want you to be confused. So just make sure that you know, we've we follow policies with delegation and assignment and we have to make sure that we are delegating or assigning tasks correctly, according to policy and according to our nursing practice, act where you know you're practicing so that's delegation and assignment. Now, let's go to delegating principles Okay, before I continue with the delegation principles or the assignment principles, I'd like to know who's with me. Can you please comment in the comment section and tell me you know, and you know, comment your name and where you are from and your time zone. Oh, I have Miss Pascal, Yvonne versus Val from Suriname in South America. Hi, Miss PascaI. Thank you for joining.

All right, Mohammed quit there. Hi, Mr. Mohammed Maryanne Adeyemo from New York City. Hi welcome. Join me it's 3pm from Riyadh Melodie from the Philippines. Jovi from the Philippines. Diana hi Sardar from the Philippines, Gabrielle Alojado from the Philippines. Oh, wow. Alice from Kenya. Hello. Thank you for joining Mitch the wall from Riyadh from KSA Adria Legaspi from Philippines. Christian core Philippines. Oh, so actually most of my most of my audience today are from the Philippines Of course we have from at South Africa we have from of course from the USA from the from Riyadh in Saudi Arabia. There's also Maria Bella from Michigan USA Oh, someone from Pakistan. Wow. Welcome watching from Oman layer three layer history layer. My sister is actually working in Oman, from Japan. Okay, sir Ivan. Alright, so far, we have one. Oh, wow. Almost 200 viewers right now. Thank you. Thank you. Thank you for watching.

So going back, again, the term delegation and assignment can be used in the NCLEX exam interchangeably. So we just have to understand the principles. And you know, we need to know what tasks can RNs and LPNs or UAPs do? And that will guide you in how you will answer your NCLEX exam question. So let's go now to delegation principles. So when you talk about delegation, always remember that a delegate is allowed to perform tasks beyond his or her traditional role, provided that she underwent training as I mentioned a while ago, like an LPN or LPN can be delegated to perform blood transfusion or initiate blood transfusion provided a cheese train. Some LPNs are also trained to provide parenteral feedings for example, with your TPS provided that they are certified and they are being trained, if they are not trained and you cannot delegate such tasks. So that is, this is really, really important.

Um, number two, the delegate has obtained certification training or validation to perform the task being delegated, I guess I already mentioned this. So, this is an important factor when it comes to delegation. They are trained or they have been validated, they have been checked off. If we use if we talk about you know, in the US 30 have been checked off to perform such task.

Number three, the nurse cannot delegate tasks that require judgment and critical thinking to LPN or uA. So, nurses always remember this when you're trying to delegate a task if the past would require judgment, when you say judgment, that is assessment or evaluation or evaluation or critical analysis or thinking you cannot delegate this you have to perform such tasks. Why sir, because situations or circumstances that require judgment may lead to an unfortunate event or a sentinel event that or that could lead to patient harm. So, nurses should, should do the task which require critical thinking and judgment. Remember that a sweat the Delegated Task or within the delegate ORs and the delegate is scope of practice. So I think I mentioned that in the first part of this video that you know, even though that they are trained, even though that some people will have their own training or being checked off, it still depends on the policies of the institution.

And of course, it depends on the state Practice Act of the of the state where you are practicing For example, like Texas has different rules or regulations when it comes to practices of LPs or LV ns. And in Georgia, it's also different. Here in Georgia, for example, our LPs are allowed to, like push medications in IVs, but they can't push emergency medications. But in some states, they are allowed, you know, to push all types of medications. Even in central lines, or PICC lines, they are allowed. So it really depends on your state laws and your hospital policies.

Number five, the nurse with delegated a task has the authority to delegate. So if you're trying to delegate the task, make sure you have that authority and that need to delegate. So this authority can be given, of course, to the charge nurse, to the supervisor, nurse, to the director, you know, to APRN, advanced practice nurses, and of course, for regular nurses who really need to delegate tasks because, you know, they can't do everything. By the way, what's the bottom line? Why do we have to delegate tasks to other RNs to LP answer UAPs. Basically, it's that Eason is we can do everything. You know, there's sometimes because of our patient load. There's just too much to do, and we can't do everything. So sometimes we have to delegate past to other nurses or to our CO nurses.

So for example, I am a charge nurse. And as a charge nurse, one of my tasks everyday is to, you know, carefully delegate tasks to my co RNs to LPNs, and to my CNAs, or UAPs. But last, but never the knees, always remember this, the delegator will retain full accountability and responsibility. So when you're delegating a task, keep in mind that the account of the accountability is still yours. So whatever happens to the patient, that will be you will be liable for that you will be liable to charge, the director of the unit and the entire hospital could be liable under the principle of respondent, superior or vicarious liability. So keep in mind that when you're delegating, you're only delegating the task, but you are not delegating your accountability and responsive responsibility. Now in your NCLEX, actually, these principles can be summarized into five rights.

Now, I know that this is like this a lot to remember, sir. But the delegation principles could actually be summarized into five rights and what it's an what are these five rights of delegation, and you might encounter this in your NCLEX exam. So let's go to five rights of delegation. So it's easier for you to remember, now when you're delegating a task or assignment, for example, you need to remember to five rights of delegation on your right person, I'm sorry, the right task, assign the right task, to the right person, in the right situation or circumstance, with the right communication and direction. And of course, with the right supervision. And as I mentioned, when you say your right pass, make sure that the paths that you are going to delegate is within their scope of practice. So for example, if you want someone to clean a patient, so this is just cleaning a patient, then you can delegate this to a UAP or a CNA or n or in our case, we call them your patient care tech, because it's just cleaning the patient. But if you want to delegate for example, like you have to give an I Am.

I Am, for example, I'm sorry, a subcutaneous powhattan or insulin, then he could delegate this to the LPN because that is within their scope of practice. Now, if you don't have LPNs, then you can delegate this to an RN, you cannot delegate giving I m or IV to UAPs or CNAs, because basically that is beyond your scope of practice, correct, if it is outside your scope of practice, unless they are trained, unless they were validated, unless they were checked off, then they cannot perform such tasks or you cannot delegate such this. When you say right person again this person has sufficient training or experience or being validated or has a license to perform such tasks. And when I say right situation, the situation is not acute or will not lead to safety issue. So what do you mean by this? When you delegate, you need to make sure that the outcome of the task is very predictable.

What do you mean by that? You can be so sure you can be sure Are you are assured that after the past is carried out carried out, the patient will not be harmed? Or the patient will what, of course will remain alive or will not die? Can you follow? So if you think that the task is very dangerous, for example, if you think that succeeding the tracheostomy of the patient could lead to arrhythmia, of course, that is a sentinel event and the patient can die, then don't delegate it, what should they do it and do it yourself? Can you follow so when you delegate a task, make sure that the outcome is predictable, make sure that the circumstance is safe, and make sure that you are, you know, you're sure you're assured that the, again that the outcome is safe and predictable. And of course, when you delegate don't forget, you need to give right direction and communication.

So when you communicate, make sure it is clear, your communication should be clear, it's very, very wide, it's very understandable, it should be concise, and complete, you know. So when you when you delegate the task, for example, it has to be clear it has to be complete or concise. So, for example, if I want to delegate to someone, Hey, can you get a urine sample in bed? 12? Can you please get a urine sample for bed? Well, we need it for urine culture. Could you please let me know after you send it to the lab? So that is the complete direction and communication? You cannot just say like, Hey, can you get a urine sample to bet 12? And then he would ask what is it for just get a get a urine sample? No, it should be clear, it should be it should be concise. And it should be complete so that the person or the delegates can understand what he or she is going to do.

And of course, most importantly, and I'm always stressing this with a lot of nurses, when you delegate, you make sure that you're always available for the delegate P, there shouldn't be light supervision, you cannot delegate something, and then go for a break. No, you can't do that. Why there is a chance for a sentinel event and you will not be there to supervise your delegate be, remember, accountability and responsibility is still yours, it's conventionally to our job to our role. So you cannot just leave you have to supervise through a delegate be on how he or she performed the pass. So you have to make sure that they're doing it right or he or she's doing it right. So again, nurses remember that in, in your NCLEX, you might encounter this, there are five rights of delegation. So remember, it is the right pass, delegate the right pass to the right person, during the right situation or circumstance with the right direction and communication and of course, with the right supervision.

Now, of course, this after this one, of course, we need to know what tasks are safe to delegate or what tasks could we assign to of course, are RNs, LPNs, and CNAs, or UAPs. So in our NCLEX exam, we have three types of RMS, we have your we have your of course, the registered nurse, we have your licensed practical nurse or your LV EDS, and we have your CNAs or your PCTs they're called your unlicensed attending personnel. So that is what it means when you say UAP so they are unlicensed by the state but they can be certified don't get me wrong. CNAs PCTs CMAs basically, they have the same scope of practice. Oh, anyway, before I continue Oh, I see a lot of viewers right now. Are going almost Wow. 200 Thank you so much, you guys for watching and for tagging your friends by the way please tell your friends to join the join us okay, there they can still join and you know and follow. And thank you for your hard comments. Thank you. Thank you.

Thank you as well for my previous student Hello, hello. I'm sorry. I'm sorry, I wasn't able to read you one by one. So anyway, let's continue let's go to be tax of each nurses. So we have your RMS of course RMS. So you this is you will need to RMS right after of course, passing your NCLEX exam. So I placed a note in here on the side. So when you're an RN, always remember when assigned inpatients all unstable patients should only be handled by an RN. So which also means that if you're going to delegate a task for and for an unstable patient, make sure that you will delegate these tasks or assign that task to an RN because the patient is unstable. Unstable when you say unstable, they have unstable blood pressure, unstable vital signs, they have breathing issues, they have arrhythmias. So, if the patient is unstable, give it to an experience RN, another node are interested in or Oriente should only be given stable patients not please I'm sorry for that that is a typographical error are interested in Oriente should only be given stable patients can you follow?

So if the patient is unstable, do not assign the patient to an RN resident, if the patient is unstable, give this to an experienced nurse? Anyway? What are the things that RNs can do, or you can safely delegate the RNs so of course, everything that requires assessment or evaluation, you can give this to the RN. So whatever it is, shape assessments are paid assessments, that is done by an RN, we have your history thinking, wait trends, you see weight trends, this is like daily weights and you need to compare them one evaluation if we want to, like evaluate the one before this evaluated by wound care. So if if it's, for example, if the patient is just submitted, and we want to identify if no one is stage one, stage two or a deep tissue injury that is done by the nurse. If you are required to assess a response to medication, to monitor a side effects or adverse effects, that is actually for an RN, do not delegate this to LPs. We will go through the tasks that are safely delegated to the LPS in a bit.

Reporting so our ads can also do reporting. They can report symptoms of abuse. If you suspect abuse, suspect abuse child abuse, elderly abuse neglect, excuse me, that is actually a job of the RN if you want to report this he says especially hospital acquired diseases, outbreaks, that is the job of the nurse if you want to report a crime, for example, to authorities, that is the job also of the RN and of course reporting directly to physicians or to your advanced practice practitioners. That is also a job of the RN so assessment or evaluation reporting, that's the job of the RN what else it's also their job to give all types of medications starting from oral to IVs. RNs are trained can give critical drips um medications that needs to be in central lines, including parenteral medications like your PICC lines, your midlines. procedures so our NS basically can do all types of procedures including blood transfusion of course, peritoneal dialysis if you're trained for that, continuous letter irrigation procedures that require validation for example, like your CRRT continuous renal replacement therapy, your hemodialysis, ECMO LVAD, and intra aortic balloon pump counter pulsation so, those complex procedures are usually assigned or delegated to a trained RN Okay, so, these things should actually be basically bases the scope of practice by an RN, or an RN. So anything that requires assessment or evaluation reporting meds, procedures from minor to complex procedures, delegate this to an RN.

Of course, as I mentioned in the in the last part, for those with critical drips with critical procedures, delegate them to an RN who underwent you know training for that for example, like I am trained to take care of a patient with LVAD and with balloon and with ECMO so, you know, if they needed someone to take care of it A patient that I can take care of that patient. Okay. Now let's go to the LPNs. Oh, sorry, I forgot how teachings are and should do help teachings. And that should include admission teaching and discharge teaching. Health Education should be the task of an RN. So if they're newly admitted, give them to the RN, why? Because they need admission teaching, if they're about to go home or go somewhere, like assisted living, nursing home, et cetera, et cetera, give them to the RN because they would require discharge teaching.

And you follow Okay, from the audience before I proceed to the RN and LPN, do you have any questions about the task or the scope of you know the practices common practices of an RS you have any questions? Like do you want to add anything? Or do you want to clarify anything? Oh, there's a question here. Sir. If it requires to assist a doctor in the procedure of course it shouldn't be done by an RN nine okay. Oh, thank you Marina. Thank you James. None so far. Since my discussion clear so far when it comes to the scope of practice when it comes to delegation guys, is it clear so far? Do you have any questions anything to clarify? Am I too fast or too slow or is my pace okay if not, again guys, thank you. Before we proceed again, I want to thank Connetics USA for this wonderful opportunity to share my god given knowledge and as far our and for giving me this chance again to share my expertise in delegation and assignment. I'm by the way, if you want to actually Connetics USA are looking for scholars, if you want to be scholars for WebConnect if you want to apply for scholarship, rather read Connetics USA, there is actually a link which I will provide later on. So I believe Connetics USA can sponsor your NCLEX application, your MCAT review and of course, if you if you pass then Connetics USA can help you with your plans to migrate and work in the USA or there was a question here like only RNs can provide healthy Qing Marion curves correct.

Typically, admission and discharge teaching would require expertise, it would require subject matter expert subject matter experts or expertise. So this should be given to experience RMS so are interested in orienteering are floats to the floor or to the unit. We discourage them from giving discharge teaching unless you know it's a basic discharge teaching. Like for example, if you just have to take your medication three times a day, they can do that. But if it's like a special teaching, like for, like, for example, like a post op teaching that this should be done by an Bennett by an experienced nurse or a proficient nurse from that unit. Are you with me? But that is a good question. Thank you for that.

Yep teaching should be given how teaching must be done by experience RNs both admission and discharge. Okay, let's go now to our LPN. So your licensed practical nurses and your LVNs now a lot of people will ask me sir, what are LPNs and LVNs? No, we don't have we don't have this kind of program in the Philippines. I think before we have this but in the US it's like a two year nursing course. And you they usually work with in doctors clinics, in in some long term care and in summer actually working in the hospitals actually, we're doing teen nursing right now. And, and as a charge, I have an RN. So I am discharged. I have an RN and they have an LPN. And they have a patient care tech. So we're doing actually team nursing in my unit right now as an, as an experimental, you know, to what do you call this to address the shortage of staff in our units?

So we hired a lot of LPNs. And our unit is actually the experimental unit for 14 nursing. So far, it's been working well. And but of course, you know, not the, the team nursing. There are, there are pros and cons with it. The same way your primary nursing, there are pros and cons. So, but we're working on it. Good. Let's go now to LPNs. So LPNs can do medication. So basically, most meds except IV in your NCLEX exam, in your NCLEX, specially with NCLEX. The NCLEX exam itself discourages the LPN to provide IV medications unless otherwise it is stated that they're being trained or validated to provide such and unless otherwise, they are allowed by the hospitals to provide IV medications, but we discourage them, it shouldn't be the RN who should give the IV meds, initiate IV therapy, blood transfusions should actually be initiated by RNs. But they can do oral don't get me wrong, they can do oral meds, I m sub q, intranasal, bucal, etc.

And of course, they can do routine procedures for stable patients. glucose monitoring, they can do that. They can do vital signs routine dressing change, guys remember this routine dressing change, they can do routine dressing change, can you follow if the patient is post op, and that is the first dressing change. The first dressing change should be done by the surgeon following the surgeon usually performs the first dressing change if the patient is supposed to up why? Because it requires assessment from them. Especially with skin grafts. It shouldn't be the it shouldn't be the doctor who performed a skin rash should assess first or should do the first dressing change for him or her to know if the graph has engrafted or not, or if the graph has been rejected. But subsequent dressing changes can be done by the LPN and RN for both but you know, for just regular wound care, like for deep tissue injury for pressure ulcers, that can be done by an RN or an LPN. Of course they can also do feeding with stable patients when you say stable they don't have active dysphasia or severe dysphasia assisting with ADLs they can insert Foley, they can insert a nasal gastric tube and perform two feeds. They can measure a cane or a walker or crutches. They can do subsequent dressing changes as I mentioned, and of course they can monitor chest tube output provided that the patient is stable.

Okay, when I say against the ball, they are stable, vital signs wise hemodynamically respiratory wise, their SATs are okay. So LPNs can handle them and LPNs can perform these procedures. Any questions with LPNs? Sir, can they do assessments they can they can do re assessments. So, initial or first shift assessment doesn't be done by the nurse, but they can do the assessments. They can also do pain reassessments and they can do history taking provided that they are being supervised by the nurse Serkan day chart of course, they can chart in reassessments, but the first assessment should be done by the nurses by the RNs rather. Washington so far RNs LPNs nine good.

Okay, let's proceed now to the third nurse. The third type of, you know, I think I should call them our CNAs or UAPs. Again, CNAs are certified nurse assistants and you ate their goal your UAPs, your unlicensed attending personnel. In some states, we call them your PCTs. Some states have CMA certified medical assistants, patient care tech, they have the same scope of practice. So usually they are supposed to do routine procedures with stable patients. So examples of these procedures, you have your vital signs monitoring, they can do weight and height measurement they can do assisting patients and ADLs. Of course, measuring intake and output that can be done by the CNAs we have blood glucose checks, keeping the patients and the room clean. So those basic stuff that we do for our patients. But in our case right now, because they're you know, we are, we are really understaffed, even with CNAs and with UAP. So, sometimes it's only me the charge and another RN, so, we do team nursing, and we do everything we do all the job for we do the jobs of the CNAs.

So once you're here in the States, do not expect that, you know, you will only function as senators, you will be functioning as a nurse. And as a tech most of the time. So you are supposed to be familiar with what our detects doing. So you could you know, you could guide them, especially the new hires or the residents. It's very, very unfortunate, but, but guys, that's what we are here for remember your you are becoming a nurse not only to earn, but also to help so that is our purposes only. It's not only about money, correct. But of course, you know, going here can provide and can open a lot of wonderful opportunities. Like, of course, being a US citizen can help you travel the world. You know, and of course, earn money for your family and, you know, as Filipinos and associations, we love our families so much that we send them you know, we share to them rather our blessings, right. So, I hope after this one, you will apply for the Connetics USA scholarship. And you would review with asked by RN, so that you would learn more for your NCLEX exam. Okay. Do you have any questions so far? Nine.

Anyway, this, I believe this base, short discussion is being recorded. And you can always review this video in the website of Connetics USA and with us our RN, again, as our RN, thank you so much if you want quality review, and if you want you know more discussion, especially for me, you could join us with Aspire and you could find our page and Facebook as for our ED and of course, you will be able to meet Dr. Paul Biluan our CEO and head lecturer. And of course some of our license in the US. Teachers, of course, are all of our T shirts are usr ads. And if you want to apply for direct hire for direct hiring process, you could of course, contact Connetics USA, Miss Tanya Fremont will be really happy to have you on board and help you with your application process. So there was a question here just ask are only provide help in application of your us? Well, I believe that question should be best answered from someone from Connetics, but I know that Connetics USA helps a lot of nurses specially Filipino nurses and nurses you know, outside the USA to fulfill their American dream.

So what are you waiting for? Join them and aspire and join us by our end for your review program. Okay, now let's try to test your knowledge about the things that we have discussed here. Okay, I'm going to give you just you know, five items. I'll give you time to answer. And then we will check afterwards. Okay. Let's see. And then we will rationalize the question and the answer. By the way before we go into that, so for Aspire RN, so we have three types of review, we have the Sparta review, which is only for $250. And this includes, you know, you being able to join the US by our NCLEX classes. The electoral cycle typically is around six months, excuse me, and this will give you modules, access to ask fine art and test bank comprehensive lecture video library, personal student advisor, you have your own personal student advisor, you can join the high impact tutoring or hip review, of course, the final coaching and you will have exam readiness assessment for an additional of $200 with just the 250 it will give you access for electoral cycle for two years unlimited plus you will get a personal mentorship and assure pass Garin P from Aspire RN.

But if you want like a more the most extensive review, you could pay extra for six $50. And that would give you two years unlimited for lecture cycle, plus all of those features that you could get from Pro and starter and a UWorld access for 90 days. So this is actually Aspire RN program from Asper art and it's actually a great way of saving for your review. And you know, especially most of us would want like accessible review, you know, when you're working, you don't have time to attend an actual review aspect Rn is actually a great solution for you. So join us today. Okay, join our Facebook page and you can chat with our representatives, we are more than willing to help you and assist you with your questions. And if you are already an NCLEX passer or are planning to apply for NCLEX you can also again, contact Connetics USA, and the representatives and staff are also more than willing to help you in the application process.

So we have upcoming schedules actually, we were I believe we are still accepting enrollees for the September schedule. So I'm by the way and as you can see Dr. Nurse Paul there, his Instagram, he's our CEO of Aspire, and you will get to meet and talk to him if you join us or RM so, so these are scheduled for July for August AP and September 6, September 15, the 16th and I guess you will have more schedules after September 15 and 16th. Yes, you can join us fire today. And you know join Connetics USA for the Nurse Scholarship Program and, you know, fulfill your American dream. So just like you guys, I just started ice. It just started with a dream. You know, I took my NCLEX exam in 2010. And, you know, I pursued teaching.

It was not really in my mind to go abroad. But you know, something just happened one day that, you know, an employer visited us in our town and you know, they were looking for nurses and here I am right now. I was able to arrive. I mean, I arrived here in the States three years ago, and that is actually may 2019 2019. Right? It's been three it's been more than three years. So and So far my experience here being a nurse, it's really fulfilling specially financial wise. Okay, so let's proceed. Let's go now to the questions. I'll give you time to answer all of the questions first and we will we will discuss the answers so remember this question is about the UAP unlicensed attending personnel so which task can be performed by the unlicensed attending personnel and you know when you say Saturday select all that applies right so in STATA it could be that only one is an answer it could be more than one or it could be everything right keep your answers to yourself first or you can type your answer if you want to then we will discuss one by one.

Okay let's go to number two remember are interested events are in residents are supposed to handle stable patients or situations right by the way, sir, what do you mean by our end residents? Our residents these are newly graduated nurses. They just they just recently graduated and then they pass their NCLEX Okay, let's go to number three. This is a question for an LPN. Remember LP hands question number three is not Assata so there's only one answer if it is not a SAPA a select all that apply question is so it only requires one answer all right let's go to number four question for number four question this has been a common board you know question on our end who floated to the unit remember floaties float who floated float these are considered supposedly ideally they're considered oriented these floaties are considered Orientis hence they should be considered they should be given stable patients.

Okay last question. I'm seeing different answers just a light, which means to say you know there's room for learning and improvement. So actually, I'm only giving you five questions. Okay, so if you have five out of five congratulations, I believe you are ready for your exam. We got three or four, maybe you need to study a little bit. If you get below two, when it's really the best, it's not the best thing to start reviewing for your NCLEX. All right, let's start answering your question. So let's start with number one. A patient is transferred from the intermediate care to the medical surgical floor. Which of the following tasks can be safely done by the UAP? Remember, this is an unlicensed attending personnel.

Question number one, can they secure the IV with tapes? Well, actually, with IVs, remember, when they are transfer IVs must be assessed for infiltration for phlebitis. And for you know, for positioning, so this is not actually a job for our UAP. So one is no. Number two checking the patient's vital signs. Yes, they can do that, too is check. Perform hand washing? Yes, of course. Number four, helping the patient to transfer to the bed. Yes, they can do that. Number five, transferring the oxygen tube from the portable back to the wall. Yes, they can do that. It's a simple task. Can they assess the patient's skin? No. Can they wait the patient using the bed scale? Yes. So the correct answer is number two, number three, number four, number five and number seven.

Why not? Number one, as I mentioned, it's because the nurse has to assess the IV site before you know actually securing the IV with tapes. Why? Number five, it's an easy task, you know, you just move the tube from one from the tank to the wall. Everybody can do that. Even the techs so the answer for number one again is number two, number three, number four, number five and number seven. Number two, which patient assignment is best for an are interested in who started two weeks ago, remember are interested in should take stable patients. One a patient with PCA morphine drip who had surgery 48 hours ago. Why is this patient not typically not ideal for a resident because some of the what PCA morphine, if they're in PCA, morphine, they have frequent monitoring, especially with our adjustments. Pain reassessments frequently so this is not good for and are interested in. Number two, a patient who is waiting for discharge who needs help teaching about new home medication and injectable so these are new home meds and injectables. So this is given to an expert or proficient nurse.

So number two is no. Number three, a patient who needs to wear eyepatch after cataract surgery. That is the answer number three, it's just an eyepatch. Anybody can provide an eyepatch. In eyepatch, you just had to cover your eyes that is very simple number for a patient with DKA whose anion gap is 30 Whose blood sugar is 540. The patient is clearly unstable having DKA with acidosis. So the correct answer is number 30. That is the most stable patient following number three, which tasks can be best assigned to an LPN. Number one a patient that requires assistance with a bedside commode they can, but that pass is also being given to CNAs or UAPs. Be a patient that requires sliding scale insulin, what is a sliding scale insulin, we check their sugar before they eat or after they eat or before they sleep and then we give them the insulin required. And that is, you know, a form of medication or routine medication that is scheduled so they can also do that.

Number three, a patient that requires health teaching about a potent Neupogen. No, that is a job of an RN number for a patient who came from the war and requires first dressing change that is done by the surgeon who did the operation because the patient came from the OCR. So what is the best answer number one or number two? You're an LPN, what is the best given to you? The answer is, of course number two, the sliding scale insulin because they are trained to give insolence number one, we can do this for CNN is number four, which of the following tasks is best delegated to an RN who floated to the unit from a short surgical short state? Remember floaties are considered to be wide Orientis correct they are new to the unit so they are given stable patients. Number one, a patient who requires PRN opioid medication and PRN pain assessments.

What is PRN? As needed only can floatie do this Yes, because this is just a normal or a PRN medication. Number two, a patient with a colostomy, ureter ostomy and a PEG tube status post pelvic exenteration, the patient just had a pelvic surgery, we're in you know the bladder, a portion of the interceding or the testicles is removed that is what you call pelvic exenteration. Okay, that is very, very complicated. Number three, a patient who requires insulin drip nurses a patient who requires insulin drip would require sugar check every hour an electronic check every two hours. So this is too much for a afloat tea that should be given to a proficient or expert nurse and actually insulin drips should be transferred to critical work step down IMC units. So that's a no number four, a patient who uses the call bell often what is the best answer number one or number four? The answer is number one correct? Because number for this patient to use the call bell might have an underlying need that should be addressed by an expert RN or an expert what nurse and would require what further investigation because actually according to Linda charity The answer is number one.

Number five, the surgical floor is full for the day. Which of the following nurses is best assigned to a patient who requires administration of IV cyclosporine we toxin and as a thiopurine for multiple myeloma so these meds are actually chemo drugs or immunosuppressants. Number one, the RN who floated from the emergency unit for the day with five years of experience know why this is a flow t we don't expect the flow Ts to administer this many game with therapies and he she is from the ER just not from that unit. Number two, the RN who is from the surgical floor working a double shift today who is chemotherapy certified for one year with three years experience could be she could be number three, the LPN who was just from the surgical floor with 10 years experience but she cannot administer the chemo. So no. Use the process of elimination when you answer your exam number for the RN who just recently passed her certification for chemo and immunotherapy with 10 years of experience.

Now question there are two nurses who are qualified here number two and number four who is the best? Number for just faster certification even though she have she has 10 years experience the answer is number two. Why? Because she's been chemo certified for one year. So meaning to say she's been giving chemo drugs for one year already. Because he cannot provide chemo therapies without being certified. Just like 30 calories is certified for chemo so I can provide chemo medication. So this is actually a special form of delegation and assignment. So the answer is number two. Okay, who got the correct answer? Who got five out of five? What's your score, please type your score in the screen. Honestly, who got five out of five or four out of five, three out of five, two out of five.

Again, if you got if you got five out of five very good four out of five good a swell, but the double shape it doesn't matter. Jamel it doesn't matter the double shift. You know nurses can work or even triple shift. It did not see that she's tired. And you follow? It did not say that the double shift is 12 hours it could be eight hour shift. So let's not assume that that patient that nurse is fired. Following salsa got five out of five Claire got five out of five jobs. Stand up three out of five Gabriella to Maricar three. So guys, if you still if you think that you need help, especially with delegation and assignment if you want, if you want to learn more, and if you want to, you know to attend my lectures and allow me to share with you my expertise in this subject okay join us with Aspire RN so these are my references for these discussion, of course, the textbook of syllabus St. Saunders NCLEX comprehensive review, the NCSBN, the national guidelines for nursing delegation, and of course, the other lynnderella charity. It's a good book for private delegation and assignment practices. And of course you will is also a good way to practice your questions but I would highly suggested in the charity I'm not being paid for, by Miss Linda, the charity, but it's really it's really a good book for private delegation and assignment. Again, thank you Connetics USA. Thank you as far as I'm thinking Connetics college for this wonderful chance. This is Darius Opada. The second your lecture for today. I'll see you. I'll see you during the actual review in Aspire I hope to see all of you. God bless you and God bless your family. Stay safe, and see you in the United States. Bye