A nurse in an emergency department is assisting with the care of a client who is unconscious and has trauma to multiple systems following a motor vehicle crash. Which of the following actions should the nurse take first?

Choice A reason: Irrigating and performing a dressing change for a client who has a pressure injury wound is not a task that the nurse should delegate to an AP. This task requires the nurse's clinical judgment, skill, and knowledge to assess the wound, select the appropriate dressing, and prevent infection. This task is also within the nurse's scope of practice, but not the AP's scope of practice.

Choice B reason: Administering oral PRN pain medication to a client who has arthritis is not a task that the nurse should delegate to an AP. This task involves the nurse's responsibility to evaluate the client's pain level, determine the need and the dosage of the medication, and monitor the client's response and side effects. This task is also within the nurse's scope of practice, but not the AP's scope of practice.

Choice C reason: Obtaining a daily weight on a client who has heart failure is a task that the nurse can delegate to an AP. This task is a routine and standardized procedure that does not require the nurse's clinical judgment, skill, or knowledge. This task is also within the AP's scope of practice, if the nurse provides clear directions and supervision.

Choice D reason: Reinforcing teaching the use of an incentive spirometer to a postoperative client is not a task that the nurse should delegate to an AP. This task involves the nurse's role to educate the client about the purpose, benefits, and technique of using the incentive spirometer, and to evaluate the client's understanding and compliance. This task is also within the nurse's scope of practice, but not the AP's scope of practice.

Choice A reason: This statement is true and should be included in the educational session. SDOH are the nonmedical factors that influence health outcomes, such as income, education, housing, food security, social inclusion, and access to health services. SDOH can affect a person's physical, mental, and social wellbeing, as well as their risk of developing certain diseases.

Choice B reason: This statement is false and should not be included in the educational session. SDOH are not determined by an individual’s ethnic background, but rather by the broader social, economic, and political context in which they live. However, ethnic background can influence how a person experiences SDOH, as some ethnic groups may face discrimination, racism, and marginalization that affect their access to resources and opportunities.

Choice C reason: This statement is false and should not be included in the educational session. Identifying SDOH does not increase disparities in health care, but rather helps to address them. Disparities in health care are the differences in the quality and accessibility of health services among different populations⁵. Identifying SDOH can help to understand the root causes of these disparities, and to design interventions that target the most vulnerable and disadvantaged groups.

Choice D reason: This statement is false and should not be included in the educational session. SDOH do not include psychological factors, but rather affect them. Psychological factors are the individual characteristics and behaviors that influence a person's mental health and wellbeing, such as personality, coping skills, self-esteem, and stress management. SDOH can influence psychological factors by creating stressful or supportive environments, and by facilitating or hindering access to mental health services.