Management of Care
What this domain tests
Management of Care questions ask who should do a task, in what order, and with what supervision. The single most tested idea is scope: the RN cannot delegate the nursing process. Initial assessment, nursing diagnosis, care planning, client teaching, evaluation of care, and any task requiring nursing judgment stay with the RN. The five rights of delegation - right task, right circumstance, right person, right direction/communication, right supervision and evaluation - give you a checklist for every delegation item. LPN/LVN scope varies by state but consistently excludes initial teaching and unstable clients. UAP can perform standard, repetitive tasks with predictable outcomes on stable clients (vital signs, ambulation, intake and output, hygiene, routine glucose checks) but never assessment, teaching, or evaluation.
Concepts to own
Client rights and advocacy; informed consent (the provider obtains it, the RN witnesses and clarifies, and the RN may not pressure); advance directives and DNR status; HIPAA and minimum-necessary disclosure; ethical principles (autonomy, beneficence, nonmaleficence, justice, fidelity, veracity); case management and continuity of care; and incident reports - objective facts, no blame, never described inside the progress notes.
Traps
Answers that are fastest rather than in-scope; a stable, pleasant client who nonetheless needs teaching (RN only); consent items where the nurse 'explains the surgery'; prioritization items where a chronic, stable problem competes with a new acute finding - acute and unstable win.
Rule of thumb
Ask two questions: does this require nursing judgment, and is the client stable with a predictable outcome? If judgment is needed or the outcome is unpredictable, the RN keeps the task.