National Council Licensure Examination for Registered Nurses (NCLEX-RN) Safe and Effective Care Environment: Management of Care Syllabus

Safe and Effective Care Environment: Management of Care syllabus: all 3 chapters

Expand any chapter to see its topics and sub-topics.

1. 1

   Coordination of Care and Interprofessional Practice

   5 topics

   • Establishing and managing the plan of care
     • Care planning, prioritization, and goal-setting
     • Interdisciplinary care conferences and continuity of care
   • Delegation and supervision
     • Five rights of delegation (right task, circumstance, person, direction, supervision)
     • Scope of practice for RN, LPN/LVN, and assistive personnel
   • Assignment and staffing decisions
     • Matching client acuity to staff competency
     • Avoiding inappropriate or unsafe assignments
   • Care transitions, handoff, and referrals
     • SBAR and structured handoff reporting
     • Discharge planning and community referrals
   • Resource management and cost-effective care
2. 2

   Legal Rights, Ethics, and Professional Responsibilities

   5 topics

   • Client rights and self-determination
     • Informed consent and refusal of treatment
     • Advance directives, living wills, and durable power of attorney
   • Ethical principles and ethical decision-making
     • Autonomy, beneficence, nonmaleficence, justice, fidelity, veracity
     • Identifying and resolving ethical dilemmas
   • Legal accountability and liability
     • Negligence, malpractice, and standards of care
     • Mandatory reporting and incident/variance reports
   • Advocacy and the nurse-client relationship
   • Professional regulation and Nurse Practice Acts
3. 3

   Confidentiality, Information Security, and Quality

   4 topics

   • Confidentiality and information privacy
     • HIPAA and protected health information
     • Electronic health record security and access
   • Documentation and informatics
     • Accurate, timely, legally sound charting
     • Information technology and telehealth in care delivery
   • Quality improvement and performance metrics
     • Plan-Do-Study-Act cycles and root cause analysis
     • Sentinel events and never events
   • Case management and utilization review

National Council Licensure Examination for Registered Nurses (NCLEX-RN) Safe and Effective Care Environment: Management of Care flashcards — 51 questions with answers

1. In the nursing process, what are the five sequential steps used to establish and manage a client's plan of care?

   Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE).

2. When writing client-centered goals/outcomes in a plan of care, what acronym describes the required quality of those outcomes?

   SMART — Specific, Measurable, Attainable, Realistic, and Time-bound.

3. What are the 'Five Rights of Delegation' a nurse must verify before delegating a task?

   Right task, right circumstance, right person, right direction/communication, and right supervision/evaluation.

4. Define delegation in nursing practice.

   Transferring authority to a competent individual to perform a selected nursing task in a selected situation, while the delegating nurse retains accountability for the outcome.

5. What five categories of tasks can NEVER be delegated by an RN (the 'Five Nots')?

   Nursing process steps requiring judgment (assessment, nursing diagnosis, planning, evaluation), client education, and any task requiring nursing clinical judgment.

6. Which types of clients/tasks are appropriate to assign to unlicensed assistive personnel (UAP)?

   Stable, predictable clients with routine tasks: ADLs, ambulation, feeding, bathing, vital signs, intake/output, and positioning.

7. What tasks fall within the scope of a Licensed Practical/Vocational Nurse (LPN/LVN)?

   Care of stable clients with predictable outcomes: medication administration (most routes), wound care, dressing changes, tube feedings, reinforcing teaching, and data collection — not initial assessment or IV push (in many states).

8. When making assignments, which client should the RN reserve for themselves rather than delegate?

   The unstable, acute, or unpredictable client, and any client requiring initial assessment, teaching, or clinical judgment.

9. In assignment-making, what principle governs assigning a client with an infection requiring isolation alongside a vulnerable client?

   Do not place an infectious client with an immunocompromised/post-op client; cohort like infections together and avoid cross-contamination.

10. What does the acronym SBAR stand for in handoff communication?

    Situation, Background, Assessment, Recommendation.

11. What is the primary purpose of a structured handoff (e.g., SBAR or I-PASS) during care transitions?

    To ensure accurate, complete transfer of client information and responsibility, reducing communication errors and adverse events.

12. What is a referral in case coordination, and who commonly initiates them?

    A formal request to direct a client to another provider or service (e.g., PT, social work, home health); initiated by the nurse, provider, or care team to meet a need outside current scope/setting.

13. What is medication reconciliation and at which points in care must it occur?

    Comparing a client's current medication list against new orders to avoid errors; performed at every transition — admission, transfer, and discharge.

14. Define cost-effective care in nursing resource management.

    Delivering the highest-quality care while minimizing unnecessary expenditures — using resources, supplies, and staff efficiently without compromising safety or outcomes.

15. List the four key resources a nurse manager must allocate effectively.

    Human resources (staff), time, equipment/supplies, and financial/budgetary resources.

16. What is the difference between client rights and self-determination?

    Client rights are legally protected entitlements (e.g., to information, privacy, refusal); self-determination is the client's autonomous right to make their own informed healthcare decisions.

17. What document allows a competent adult to specify future healthcare wishes if they become incapacitated?

    An advance directive (e.g., living will and durable power of attorney for health care).

18. What is a durable power of attorney for health care (health care proxy)?

    A legal document naming a surrogate decision-maker to make healthcare decisions on the client's behalf when the client is incapacitated.

19. Name the four core principles of biomedical ethics.

    Autonomy, Beneficence, Nonmaleficence, and Justice.

20. Define the ethical principle of autonomy.

    Respecting the client's right to make their own independent, informed decisions about their care.

National Council Licensure Examination for Registered Nurses (NCLEX-RN) Safe and Effective Care Environment: Management of Care FAQ