Role of the Nurse Aide
What this domain covers
This domain tests the boundaries and duties of the role: scope of practice, delegation and chain of command, following the care plan, objective documentation, reporting, confidentiality, abuse and neglect, legal and ethical conduct, time management, and continuing education.
Concepts you must know
The nurse aide performs tasks delegated by a licensed nurse and works within the care plan. Assessment, evaluation, teaching a new skill, sterile procedures, and medication administration are outside the aide's scope. Report changes to the licensed nurse, who then decides what to do. Documentation must be objective, timely, accurate, and factual: describe what you saw, heard, and did, using the resident's own words in quotes when relevant. Never chart for someone else, never alter a record, and never document in advance. Abuse, neglect, mistreatment, and misappropriation of property must be reported immediately according to facility policy and state law, regardless of who is involved. Incident reports are not part of the medical record and are not mentioned to the resident or family by the aide. Know your chain of command and your state's certification and renewal requirements through your program.
Traps the exam uses
- "The aide should..." items with a tempting answer that exceeds scope (giving a medication, changing a sterile dressing, deciding a treatment).
- A family member or another aide asking the aide to do something outside scope: decline politely and report.
- Confidentiality items: discussing a resident in the elevator, hallway, or on social media is a violation even without names.
- Incident report items where the wrong answer is to chart the incident in the progress notes.
Worked example
A resident's daughter hands you an over-the-counter pain pill and asks you to give it. You explain that medication administration is not within your role, do not accept the pill, and report the request to the licensed nurse.
Rule of thumb
If an answer requires judgment about a condition, a medication, or a sterile procedure, it is not the aide's task: report, don't decide.