Legal and Regulatory Scope of Practice
What the exam expects
The state nurse practice act defines nursing scope and delegation; your facility job description defines your role. Perform only tasks you are trained for, currently competent in, and authorized to do by state law and facility policy - and you may refuse a task outside that boundary, reporting the refusal to the nurse. Delegation follows five rights: the right task, right circumstance, right person, right directions and communication, and right supervision and evaluation. The delegating nurse keeps accountability for the outcome, so you must report back. Follow the chain of command when a concern is not addressed.
Legal concepts
HIPAA and federal nursing home law protect privacy and rights. Informed consent is obtained by the provider or nurse, never by the assistant, and you do not sign as a witness unless your role explicitly allows it. Advance directives include living wills, durable power of attorney for health care, and do-not-resuscitate orders; a DNR must be a written order, and you honor it by following facility procedure. Negligence requires a duty, a breach, causation, and damages. Battery is unpermitted touching; assault is a threat; false imprisonment includes restraining or confining a resident improperly. Abuse and neglect are mandatory reports. The long-term care ombudsman advocates for residents.
Traps
Answer choices that have you accept a family member's instruction outside your role, sign as a witness to a will, act as a resident's power of attorney, or perform a task "because the nurse said so" without following policy are wrong. "The nurse told me on the phone" is not a substitute for proper order verification.
Rule of thumb
If it is not in your training, your job description, and your state's allowed tasks, do not do it - report it instead. Staying inside your scope protects the resident first and you second.