Adult Health Chapter 2 Prep U

Results from the 2013 OASIS data study revealed that data from the study can be used to identify individuals at greatest risk for readmission to the hospital. Using this data, what can the nurse determine will decrease the readmission rate of hospitalizations? a) The shift of resources to the community b) Additional paid staff in the home c) Longer hospital stays d) Shift of funds to the hospital

The shift of resources to the community

The advance practice nurse is preparing to write a grant for a local homeless shelter. Based on the nurse's knowledge of a growing population of homeless people, the nurse includes funding for which of the following topics? a) Obesity b) Immunizations c) Skin cancer d) Driver's education

b) Immunizations

A home care nurse is visiting a new client and notes that the client's home is very messy. There are dirty dishes piled everywhere, the house smells of garbage, and there are very few surfaces that are clean. How should the nurse respond? a) Stand at the door and assess the client. b) Ask the client nicely to clean the home prior to another visit. c) Leave the home and call adult protective services. d) Enter the home and continue to treat the client.

Enter the home and continue to treat the client.

Which factor has resulted in a shift in the health care delivery setting? a) Fewer insurance regulations b) Increased hospital revenues c) Growing number of elderly

Growing number of elderly

What should the school nurse working in the elementary school setting be aware is one of the most frequent health care problems to affect this population? a) Eating disorders b) Infections c) Drug abuse d) Emotional problems

Infections

Which level of prevention focuses on minimizing deterioration and improving quality of life? a) Secondary b) Primary c) Outpatient d) Tertiary

Tertiary

Which of the following safety precautions should the nurse implement as a home care nurse? Select all that apply. a) Buy a new car to have reliable transportation. b) Become familiar with all exits from the patient's home. c) Conduct the visit regardless of personal safety concerns. d) Perform all visits alone to allow for patient privacy and confidentiality. e) Post the nurse's schedule of visits at the agency. f) Schedule visits during the day.

- Become familiar with all exits from the patient's home. - Post the nurse's schedule of visits at the agency. - Schedule visits during the day.

The school nurse at a local elementary school is administering a medication to a student. What additional role may the school nurse perform? Select all that apply. - Assist in performing health screening of students - Education of staff member on assessment of various conditions - Education of students regarding various illness or diseases - Education of staff members regarding various illnesses or diseases - Assist in development of health education curriculum

- Education of staff members regarding various illnesses or diseases - Assist in development of health education curriculum - Education of students regarding various illness or diseases

A client is admitted to an acute care facility after having a stroke. The client will require a variety of healthcare services throughout the hospital stay as well as coordination of care prior to discharge. What referral would be a priority for overseeing the client's care? a) Case management b) Physical therapy c) Occupational therapy d) Dietary services

Case management

A home care nurse is assessing a client's need for home visits. Which of the following would the nurse use as the primary determinant for future visits? a) Client's insurance provider b) Agency's policies c) Client's current health status d) Available community resources

Client's current health status

A novice nurse is learning the difference between community-based nursing and community-oriented nursing. Which scenario does the nurse recognize as a role of the community-oriented nurse? a) Nurse working a booth at a health fair performing blood pressure and glucose screenings b) Occupational health nurse immobilizing a fractured extremity of an injured employee c) Pediatric nurse teaching a group of parents on the treatments for cystic fibrosis d) Nurse working at a wound care clinic performing irrigation of a chronic wound

Nurse working a booth at a health fair performing blood pressure and glucose screenings

Which element is least likely to be a characteristic of an expected outcome of a nursing intervention? a) Measurable b) Realistic c) Behavior-centered d) Nurse-centered

Nurse-centered

Which of the following is the least likely to be a criterion of an expected outcome of a nursing intervention? a) Realistic b) Behavior-centered c) Nurse-centered d) Measurable

Nurse-centered

The nurse is providing a community education program about sexually transmitted infections for a group of 13- to 16-year-olds at the local YMCA. What type of prevention is the nurse targeting? a) Primary prevention b) Secondary prevention c) Tertiary prevention d) Community prevention

Primary prevention

Which of the following is a growing population of those who are homeless? a) Employed b) Adolescent males c) Functional families d) Women with children

Women with children

A major goal for home care nurses is to a) restore maximum health function. b) promote the health of populations. c) maintain the health of populations. d) minimize the progress of disease.

a) restore maximum health function.

According to the 2013 OASIS data study, which client would be at greatest risk for re-hospitalization? a) Female client with mild cognitive decline b) Male client who requires assistance to ambulate c) Female client with a live-in caregiver d) Male client with controlled congestive heart failure

Male client who requires assistance to ambulate

A nurse acts as preceptor to a student nurse who is performing discharge planning for a client. What statement made by the student nurse about discharge planning indicates that the student needs additional teaching? a) "Discharge planning involves a multidisciplinary team." b) "Discharge planning involves the client." c) "Discharge planning occurs when the patient is discharged." d) "Discharge planning begins once the client is on the unit."

"Discharge planning occurs when the patient is discharged."

A nurse educator for a local home care company is teaching staff nurses on the use of the Outcome and Assessment Information Set (OASIS). What statement will the nurse include when teaching about the OASIS? a) "Demographic information remains confidential as required by HIPAA." b) "Results are used to improve overall quality improvement efforts." c) "This document is optional but provides important data." d) "This document is required but is only used for reimbursement."

"Results are used to improve overall quality improvement efforts."

A nurse is evaluating a client's discharge collaboration between the referring agency and the home care agency. What response by the client would indicate an understanding of the discharge planning process? a) "The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team" b) "The doctor provided a list of behavioral outcomes for me and the nurse faxed them to the home care agency." c) "My wife sat down with the discharge planner and established realistic and measurable goals for my recovery." d) "My daughter is my health care power of attorney and she decided when I left the hospital and selected my home care provider."

"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team"

A home care nurse is looking at ways that home care nurses can promote holistic care of the client. What action will the nurse implement in order to accomplish this task? a) Use of natural therapies and alternative medicine b) Encouragement of self-reflection techniques c) Collaboration with an interdisciplinary team d) Concept-based approach to care

Collaboration with an interdisciplinary team

The nurse is making an initial home visit to assess a patient for home health services. Which patients most frequently require home health services? a) Children with chronic, debilitating disorders b) Newborns who are sent home with apnea monitors c) The frail and elderly who need skilled care d) Young adults on prolonged intravenous therapy

The frail and elderly who need skilled care

A home care nurse is planning to visit a client newly diagnosed with diabetes. Further review of the chart reveals the client is of Japanese heritage. Upon arriving at the home, the home care nurse observes several pairs of shoes on a mat next to the door. Which of the following actions by the nurse demonstrates cultural competence? a) The nurse removes her shoes and announces her arrival. b) The nurse places shoe covers on her shoes and proceeds with the visit. c) The nurse removes her shoes then teaches the client the importance of wearing shoes because of peripheral neuropathy. d) The nurse leaves her shoes on and explains standard precautions to the client.

The nurse removes her shoes and announces her arrival.

A nurse who is considering the possibility of becoming involved in home care asks a home care nurse about the characteristics needed for this practice area. Which of the following would the home care nurse be least likely to include? a) Need for control over a situation b) Respect for client's differences c) Ability to improvise d) Nonjudgmental attitude

a) Need for control over a situation

Which tools do case managers commonly rely on to plan and coordinate client care? a) clinical pathways, practice guidelines, and standards of care b) clinical pathways and drug formularies c) standards of care, HIPAA regulations, and electronic medical records d) practice guidelines, outcome data, and staff rosters

clinical pathways, practice guidelines, and standards of care

Which setting has been the traditional site for the nursing work force? a) Same-day surgery units b) Clinics c) Dialysis units d) Inpatient units

d) Inpatient units

Which of the following factors have contributed to the shift in health care delivery from inpatient to outpatient settings? Select all that apply. a) Increasing hospital revenues b) More flexible insurance regulations c) Changes in federal legislation d) New population trends e) Alternative health care delivery systems

c) Changes in federal legislation d) New population trends e) Alternative health care delivery systems

A home care nurse is assessing a client's need for home visits. Which of the following would the nurse use as the primary determinant for future visits? a) Agency's policies b) Available community resources c) Client's current health status d) Client's insurance provider

c) Client's current health status

In what area of nursing practice does the nurse provide palliative care in the patient's home? a) Parish nursing b) Occupational nursing c) Hospice d) Rehabilitation

c) Hospice

Which of the following would be least helpful in ensuring the safety of a home care nurse? a) Having a charged cell phone readily available b) Being familiar with exits from the home c) Making visits in the late evening hours d) Parking near the client's home

c) Making visits in the late evening hours

Which of the following would be a role of the school nurse? a) Discussing a student's school performance b) Caring for major injuries c) Monitoring immunization status d) Performing comprehensive physical examinations

c) Monitoring immunization status

A client has end-stage chronic obstructive pulmonary disease (COPD) and is terminally ill. The family wants the client to spend her last days in a facility that will be able to keep the patient comfortable and control her severe dyspnea. What facility will meet the needs of the client and family? a) Rehabilitation care b) Hospice care c) Intermediate care facilities d) Ambulatory care

Hospice care

An advance practice nurse is preparing to write a grant for a local homeless shelter. Based on the nurse's knowledge that the population of homeless people is growing, the nurse includes funding for which topic? a) Immunizations b) Skin cancer c) Obesity d) Driver's education

Immunizations

A nurse is evaluating a patient's discharge collaboration between the referring agency and the home care agency. What response by the patient would indicate an understanding of the discharge planning process? a) "The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team." b) "My wife sat down with the discharge planner and established realistic and measurable goals for my recovery." c) "The doctor provided a list of behavioral outcomes for me and his nurse faxed them to the home care agency." d) "My daughter is my health care power of attorney and she decided when I left the hospital and selected my home care provider."

"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team."

What is the purpose of early discharge planning as explained to a client? a) "To ensure the hospital gets the reimbursement for your stay" b) "To ensure you have learned about the illness that brought you here" c) "To ensure you have the resources you need when you leave" d) "To ensure the hospital complies with quality improvement"

"To ensure you have the resources you need when you leave"

What is the purpose of early discharge planning as explained to a client? a) "To ensure you have the resources you need when you leave" b) "To ensure you have learned about the illness that brought you here" c) "To ensure the hospital complies with quality improvement" d) "To ensure the hospital gets the reimbursement for your stay"

"To ensure you have the resources you need when you leave"

The nurse case manager is planning care for a 5-year-old client recently diagnosed with asthma. The client's mother informs the nurse that her child had shown similar symptoms in the past and was diagnosed with asthma at age 2 years. The nurse noted the client's symptoms and medical history. What information is appropriate for the case manager to share with the client's mother related to community resources and referrals? Select all that apply. - A Web link to a popular free encyclopedia page related to asthma - Community support groups for parents of children with asthma - Asthma camp enrollment age requirements - Phone numbers for other parents of asthmatic children - The Web address to the Allergy & Asthma Network Mothers of Asthmatics - A list of pharmaceutical company assistance programs that may help pay for EpiPens

- Community support groups for parents of children with asthma - Asthma camp enrollment age requirements - The Web address to the Allergy & Asthma Network Mothers of Asthmatics - A list of pharmaceutical company assistance programs that may help pay for EpiPens

The home care nurse is in the process of deciding the need for future home visits. Which of the following factors does the home care nurse need to consider? Select all that apply. a) Current health status of the patient b) Educational needs of the patient c) Mental status of the patient d) Cleanliness of the patient home e) Level of patient self-care f) Existing cultural language barriers

- Level of patient self-care - Educational needs of the patient - Current health status of the patient - Mental status of the patient

A newly hired elementary school health nurse is reviewing the job description. Which activities can the school nurse expect to perform in this new role? Select all that apply. - Writing curriculum related to effects of chemotherapy - Educating teachers about HIV - Providing minor first aid - Establishing an Alcoholics Anonymous chapter - Organizing a visit from the mobile dentist - Developing a suicide risk assessment tool Submit Answer Exit quiz

- Providing minor first aid - Educating teachers about HIV - Organizing a visit from the mobile dentist - Writing curriculum related to effects of chemotherapy

A nurse working in an acute care facility is preparing to start a new job as a home care nurse. Which facts would be important for the nurse to keep in mind when transitioning to this new role? Select all that apply. - The nurse has full decision-making authority for the client in the home. - A client's home is typically as clean as that found in the acute care setting. - Infection control is as important in the home as in the acute care facility. - The nurse, a guest in the home, needs the client's permission to visit. - The nurse has minimal control over the health practices of the client visited.

- The nurse, a guest in the home, needs the client's permission to visit. - The nurse has minimal control over the health practices of the client visited. - Infection control is as important in the home as in the acute care facility.

The home nurse is planning visits to the following patients: a newly diagnosed diabetic patient, a patient with congestive heart failure (CHF) with a 3-pound weight gain overnight, a postoperative patient requiring a dressing change, and a patient on warfarin (Coumadin) scheduled for monthly international normalized ratio (INR) testing. Which patient is should be the first visit of the day? a) Postoperative patient requiring a dressing change b) A patient with CHG who has had a 3-pound weight gain overnight experiencing dyspnea c) Patient on warfarin (Coumadin) scheduled for monthly INR testing d) Newly diagnosed diabetic patient requiring teaching

A patient with CHG who has had a 3-pound weight gain overnight experiencing dyspnea

A nurse working in the community is involved in secondary prevention. Which activity would most likely apply? a) Teaching about a nutritious diet b) Health screening for diabetes risk c) Assisting with bowel retraining d) Providing rehabilitation exercises

Health screening for diabetes risk

In which situation is the nurse providing appropriate discharge planning? a) Assessing the client's support system at home during the admission assessment b) Contacting the client's insurance company 24 hours before discharge to review the client's medical coverage c) Providing take-home medication education to the client before discharge d) Contacting a home care agency by the third hospital day

Assessing the client's support system at home during the admission assessment

A home care nurse is caring for an older adult with multiple medications after being discharged from the hospital with acute coronary syndrome. Which nursing action best promotes self-management of the medication regimen for this client? a) Assist to identify non-therapeutic medications. b) Assist to identify duplicate medications. c) Call the health care provider for clarification. d) Place the oral medications in a medication organizer.

Assist to identify duplicate medications.

The home health nurse has been working with an elderly client with limited means who required long-term wound care. The client's wound is almost healed and the client tells the nurse that he will be sorry when she no longer comes around. He reveals that he no longer has anyone to take him to the grocery store and he just can't keep the house up like he used to. He also tells the nurse that he would like to be able to participate in some social activities. The nurse knows that what type of healthcare setting would be most appropriate for this client at this time? a) Boarding home b) Congregate housing c) Assisted living facility d) Intermediate care facility

Congregate housing

Which capability corresponds with home health care? a) Improvises when providing care b) Retains maximal control over the client's lifestyle c) Is unable to care for those living in substandard conditions d) Uses a wide variety of supplies and equipment

Improvises when providing care

What should the school nurse working in the elementary school setting be aware is one of the most frequent health care problems to affect this population? a) Eating disorders b) Emotional problems c) Infections d) Drug abuse

Infections

A nurse is working in a school health program that provides care to elementary school-aged children. The nurse would focus teaching on which area as being most problematic? a) Substance abuse b) Eating disorders c) Sexually transmitted infections d) Injuries

Injuries

A home care nurse enters the home of a client and notices that the client's son is noticeably intoxicated. The son, who is slurring his words, is becoming increasingly agitated. Which action by the home care nurse would be most appropriate? a) Ask the son to leave the home until the visit is completed. b) Ignore the son's behavior, focusing attention on the client. c) Leave the home after rescheduling the visit. d) Threaten to notify the police immediately of the situation.

Leave the home after rescheduling the visit.

Which of the following would be least helpful in ensuring the safety of a home care nurse? a) Parking near the client's home b) Making visits in the late evening hours c) Being familiar with exits from the home d) Having a charged cell phone readily available

Making visits in the late evening hours

A nurse who is considering the possibility of becoming involved in home care asks a home care nurse about the characteristics needed for this practice area. Which of the following would the home care nurse be least likely to include? a) Need for control over a situation b) Nonjudgmental attitude c) Respect for client's differences d) Ability to improvise

Need for control over a situation

A client in an acute care facility is assigned a case manager to oversee and coordinate care. What important function does a case manager have? a) Provide early, thorough discharge planning. b) Make sure the client is administered medications. c) Provide care to the client who is terminally ill and has less than 6 months to live. d) Make home visits to see that the client is taken care of after discharge.

Provide early, thorough discharge planning.

Which of the following situations describes the accurate order of activities when making a home visit? a) Review agency policies regarding visits, ask permission to enter home, perform hand hygiene, and document care provided. b) Call patient to arrange time for visit, perform hand hygiene, ask permission to enter home, only bring required equipment into the home. c) Confirm need for visit with referring agency, park away from the home, perform hand hygiene, and document teaching and patient response to teaching. d) Investigate the neighborhood prior to visit, leave a message telling the patient the time and nature of the nurse's visit, ask permission to enter the home, and include patient behaviors in charting outcomes.

Review agency policies regarding visits, ask permission to enter home, perform hand hygiene, and document care provided.

a) Check the home care agency's policies about how to make a visit. b) Review the referral form for the pertinent information. c) Telephone the client to determine a visit schedule. d) Contact the referring agency to confirm receipt of the referral.

Review the referral form for the pertinent information.

In which situation is the nurse providing tertiary prevention? a) Teaching rehabilitation exercises to a client after a mastectomy b) Educating teens on the importance of sunscreen to reduce the risk of skin cancer c) Providing breast cancer screening information to a high-risk population d) Evaluating client understanding of discharge instructions

Teaching rehabilitation exercises to a client after a mastectomy Explanation: Tertiary prevention focuses on minimizing deterioration and improving quality of life, including rehabilitation to assist patients in achieving their maximum potential by working through their physical or psychological challenges. The focus on primary prevention is on health promotion and prevention of illness or disease. Secondary prevention centers on health maintenance and is aimed at early detection and prompt intervention to prevent or minimize loss of function and independence.

The nurse is caring for a patient who is to be discharged from the acute care facility to a rehabilitation unit after having a stroke. What type of prevention is this considered to be? a) Primary b) Secondary c) Tertiary d) Rehabilitation

Tertiary

After making the initial home visit, a nurse develops a plan of care for a client with diabetes. As part of the plan of care, the nurse identifies the nursing diagnosis "deficient knowledge related to daily insulin administration for diabetic self-care." Which outcome would be most appropriate? a) The client will improve his ability to self-administer insulin. b) The client will state the proper steps for insulin administration. c) The client will give himself an insulin injection. d) The client will demonstrate independence in daily insulin self-administration.

The client will demonstrate independence in daily insulin self-administration.

A nurse works in a community setting that deals with a large number of homeless individuals. Which of the following would be most important for the nurse to understand? a) The health problems faced by homeless people are often related to their living situation. b) The nurse's approach to the care of homeless clients is the same as for any client. c) The homeless population experiences high rates of trauma but lower rates for other health conditions. d) The homeless population typically seeks health care when a need first arises.

The health problems faced by homeless people are often related to their living situation.

Which statement corresponds with an action the nurse might take when providing home health care? a) The nurse uses a blood pressure cuff as a tourniquet to assist in locating a vein during a venipuncture. b) The nurse removes all high-sodium foods from the home of a client with congestive heart failure (CHF). c) The nurse refuses to visit a client who lives in a roach-infested home. d) Based on wound assessment, the nurse selects from a wide variety of dressing supplies.

The nurse uses a blood pressure cuff as a tourniquet to assist in locating a vein during a venipuncture.

A public health nurse administers influenza vaccines to a group of individuals during a community vaccination clinic. The nurse understands that this action is considered primary prevention due to which statement? a) The vaccination focuses on minimizing deterioration associated with illness. b) The vaccination is centered on health maintenance and prompt intervention. c) The vaccination focuses on health promotion and prevention of illness. d) The vaccination is centered on increasing innate immunity within the population.

The vaccination focuses on health promotion and prevention of illness.

The home health nurse and the parish nurse have separate roles in health care. What is the common factor that all community-based nurses share? a) They all take care of the patients in their home setting. b) They all take care of patients in a community setting. c) They focus on community needs as well as the needs of individual patients. d) They all take care of patients after they are discharged from the hospital.

They focus on community needs as well as the needs of individual patients.

Home health nurses will be caring for a debilitated client in the home. The client will be discharged from an acute care facility to the care of family members. The client will require twice daily wound care for a large sacral decubitus ulcer. What will be the goal of the home health nurses in the care of this client? a) To have the client admitted to a long-term care facility if the ulcer does not heal in a timely manner b) To have client come to the home care agency twice daily for dressing changes c) To continue to see the client twice daily for dressing changes until the wound heals d) To encourage family members to develop self-care skills and perform dressing changes

To encourage family members to develop self-care skills and perform dressing changes

A community health nurse understands the importance and impact of cultural competence when caring for clients in the community. In what situation will the nurse find that cultural competence is particularly important? a) When members of the community request religious resources b) When the nurse works in a larger city versus a small community c) When the nurse is new to the job and the role within the community d) When members of the community share a heritage that is unfamiliar to the nurse

When members of the community share a heritage that is unfamiliar to the nurse

A client is going to be in a subacute care unit for approximately 30 days. The client will require frequent assessments and periodic review of the client's progress. What role will the registered nurse have in the care of this client? a) The RN will coordinate the client's care. b) The RN will order the various treatments for the client. c) The RN will ensure that the client eats 100% of the meals. d) The RN will provide direct care for the client.

a) The RN will coordinate the client's care.

A student nurse asks the nursing instructor, "What will my role as a nurse encompass after I graduate?"What is the best response by the nursing instructor? a) "You will take care of clients who are ill in a hospital or long-term care facility." b) "You will care for individuals and families and play a role in health education, illness prevention, and promotion." c) "It will all depend on where you want to work when you graduate. Nurses do different things in healthcare." d) "You will care for a variety of clients of all ages when they are ill."

b) "You will care for individuals and families and play a role in health education, illness prevention, and promotion."

The charge nurse is making assignments for a group of clients on a medical unit. When reviewing the acuity of the clients, the charge nurse assigns the RN to the clients with higher acuity levels. Why would the charge nurse assign the RN to the patient's with a higher acuity? a) Higher acuity clients request the services of an RN versus other care providers. b) A higher acuity client requires a greater need for highly skilled care. c) Assigning an LPN would allow them to provide care out of their scope of practice. d) LPNs do not understand how to care for clients with complex disorders.

b) A higher acuity client requires a greater need for highly skilled care.

Your client is an 11-year-old boy being treated for injuries that resulted from a skateboarding accident. He is very agitated as you clean several gashes on his head. Which of the nursing responsibilities outlined by the American Nurses Association are you fulfilling? a) Providing health promotion, counseling, and education b) Administering medications, wound care, and numerous other personal interventions c) Interpreting patient information and making critical decisions about needed actions d) Performing physical exams and health histories

b) Administering medications, wound care, and numerous other personal interventions

Your aunt is in end-stage renal failure. She has been moved to an inpatient hospice facility. What is the rationale for her being placed in hospice? a) She no longer requires skilled care. b) She is terminally ill and needs symptom control. c) She no longer has health insurance. d) She needs help to regain her ability to perform activities of daily living.

b) She is terminally ill and needs symptom control.

Which of the following nursing actions is appropriate for the home care nurse to do? a) Volunteering to administer flu vaccinations and the local free clinic b) Organizing a free breast cancer screening for homeless women c) Teaching pursed lip breathing to a client diagnosed with chronic obstructive pulmonary disease (COPD) d) Writing a grant to obtain funding to establish a homeless shelter

c) Teaching pursed lip breathing to a client diagnosed with chronic obstructive pulmonary disease (COPD)

Which of the following is true regarding safety during a nurse's home visit? a) The nurse should schedule visits according to the patient's lifestyle. b) The nurse should park his or her car away from the home. c) The nurse should never walk into a patient's home uninvited. d) The nurse should take reactive measures.

c) The nurse should never walk into a patient's home uninvited.

A home care nurse is planning to visit a 60-year-old client diagnosed with heart failure for the first time. Which of the following would be most appropriate for the nurse to do? a) Contact the client to say that the nurse is coming out to visit. b) Ask the client if he lives alone or with someone else. c) Obtain information about the client's health insurance. d) Telephone the client to obtain permission to visit.

d) Telephone the client to obtain permission to visit.

In a team meeting for a nursing home client, the client's development of a lower leg wound, including its potential cause and treatment, is being discussed. The nurse proposed a strategy for treating the wound and preventing its recurrence. This action reflects which of the nursing responsibilities outlined by the American Nurses Association? a) interpreting patient information and making critical decisions about needed actions b) performing health promotion, counseling, and education c) performing physical exams and health histories d) directing and supervising care delivered by other healthcare personnel such as LPNs, nurse aides, or unlicensed assistive personnel

interpreting patient information and making critical decisions about needed actions