NR 226
NR 226 Exam 1 Study Outline
The following is a list of concepts for you to understand to be successful on exam 1.
The Nursing Process
o Know and identify each step of the nursing process:
ADOPIE
o Assessment
● Phases of interview/assessment
● Methods of obtaining data
● Subjective vs objective data
o Diagnosis
● Identify components of the nursing diagnostic statement
● Identify assessment findings, goals, interventions, evaluations
appropriate to a specific nursing diagnosis.
o Planning
● Components of goal/outcome statement
● Identify assessment findings, nursing diagnosis, interventions, evaluations
appropriate to a specific outcome or goal.
o Implementation
● Independent vs. dependent nursing interventions
○ Autonomy is an essential element of professional nursing that involves the initiation of
independent nursing interventions without medical orders.
○ Dependent relies on the role of the nurse implementing care with a medical order from a
medical order.
● Direct vs. indirect care activities
○ Examples of Indirect Care Activities
○ • Documentation (electronic or written)
○ • Delegation of care activities to nursing assistive personnel (NAP)
○ • Medical order transcription
○ • Infection control (e.g., proper handling and storage of supplies, use of protective isolation)
○ • Environmental safety management (e.g., making patient rooms safe, strategically assigning
patients in a geographical proximity to a single nurse)
○ • Telephone consultations with physicians and other health care providers
○ • Hand-off reports to other health care team members
○ • Collecting, labeling, and transporting specimens
○ • Transporting patients to procedural areas and other nursing units
○ ExamplesofdirectCare:
○ Activities of direct Living
○ Physical care techniques
○ Life saving measures
, ○ Teaching
○ Counseling
○ Controlling adverse effects
○ Preventive Measures
● Identify assessment findings, nursing diagnoses, goals, evaluation
appropriate to specific interventions
o Evaluation
● Elements of the evaluation process
● Identify assessment findings, nursing diagnosis, goals, interventions
appropriate to specific goals
Professional Practice
o Delegation
Things you can delegate: personal care, hygiene, vital signs, feedings if patient does
not have a g tube or dysphagia.. Do not delegate the first vital signs after
Sx. and do not delegate vital signs if the patient is unstable. do not delegate the steps of
the nursing process of assessment, diagnosis, planning, and evaluation because these steps require nursing
judgment (Duffy and McCoy, 2014). Patient teaching is also the responsibility of an RN and should not be
delegated.
● The Five Rights of Delegation:
○ Right Task
■ The right tasks to delegate are ones that are repetitive, require little supervision, are
relatively noninvasive, have results that are predictable, and have potential minimal
risk (e.g., simple specimen collection, ambulating a stable patient, preparing a room
for patient admission).
○ Right Circumstances
■ Consider the appropriate patient setting, available resources, and other relevant
factors. In an acute care setting patients' conditions often change quickly. Use good
clinical decision making to determine what to delegate.
○ Right Person
■ The right person is delegating the right tasks to the right person to be performed on
the right person. A registered nurse (RN) knows which tasks to delegate to nursing
assistive personnel (NAP) for each specific patient.
○ Right Direction/Communication
■ Give a clear, concise description of a task, including its objective, limits, and
expectations. Communication needs to be ongoing between the RN and NAP during
a shift of care.
○ Right Supervision/Evaluation
■ Provide appropriate monitoring, evaluation, intervention as needed, and feedback.
NAP need to feel comfortable asking questions and seeking assistance.
NR 226 Exam 1 Study Outline
The following is a list of concepts for you to understand to be successful on exam 1.
The Nursing Process
o Know and identify each step of the nursing process:
ADOPIE
o Assessment
● Phases of interview/assessment
● Methods of obtaining data
● Subjective vs objective data
o Diagnosis
● Identify components of the nursing diagnostic statement
● Identify assessment findings, goals, interventions, evaluations
appropriate to a specific nursing diagnosis.
o Planning
● Components of goal/outcome statement
● Identify assessment findings, nursing diagnosis, interventions, evaluations
appropriate to a specific outcome or goal.
o Implementation
● Independent vs. dependent nursing interventions
○ Autonomy is an essential element of professional nursing that involves the initiation of
independent nursing interventions without medical orders.
○ Dependent relies on the role of the nurse implementing care with a medical order from a
medical order.
● Direct vs. indirect care activities
○ Examples of Indirect Care Activities
○ • Documentation (electronic or written)
○ • Delegation of care activities to nursing assistive personnel (NAP)
○ • Medical order transcription
○ • Infection control (e.g., proper handling and storage of supplies, use of protective isolation)
○ • Environmental safety management (e.g., making patient rooms safe, strategically assigning
patients in a geographical proximity to a single nurse)
○ • Telephone consultations with physicians and other health care providers
○ • Hand-off reports to other health care team members
○ • Collecting, labeling, and transporting specimens
○ • Transporting patients to procedural areas and other nursing units
○ ExamplesofdirectCare:
○ Activities of direct Living
○ Physical care techniques
○ Life saving measures
, ○ Teaching
○ Counseling
○ Controlling adverse effects
○ Preventive Measures
● Identify assessment findings, nursing diagnoses, goals, evaluation
appropriate to specific interventions
o Evaluation
● Elements of the evaluation process
● Identify assessment findings, nursing diagnosis, goals, interventions
appropriate to specific goals
Professional Practice
o Delegation
Things you can delegate: personal care, hygiene, vital signs, feedings if patient does
not have a g tube or dysphagia.. Do not delegate the first vital signs after
Sx. and do not delegate vital signs if the patient is unstable. do not delegate the steps of
the nursing process of assessment, diagnosis, planning, and evaluation because these steps require nursing
judgment (Duffy and McCoy, 2014). Patient teaching is also the responsibility of an RN and should not be
delegated.
● The Five Rights of Delegation:
○ Right Task
■ The right tasks to delegate are ones that are repetitive, require little supervision, are
relatively noninvasive, have results that are predictable, and have potential minimal
risk (e.g., simple specimen collection, ambulating a stable patient, preparing a room
for patient admission).
○ Right Circumstances
■ Consider the appropriate patient setting, available resources, and other relevant
factors. In an acute care setting patients' conditions often change quickly. Use good
clinical decision making to determine what to delegate.
○ Right Person
■ The right person is delegating the right tasks to the right person to be performed on
the right person. A registered nurse (RN) knows which tasks to delegate to nursing
assistive personnel (NAP) for each specific patient.
○ Right Direction/Communication
■ Give a clear, concise description of a task, including its objective, limits, and
expectations. Communication needs to be ongoing between the RN and NAP during
a shift of care.
○ Right Supervision/Evaluation
■ Provide appropriate monitoring, evaluation, intervention as needed, and feedback.
NAP need to feel comfortable asking questions and seeking assistance.
