Who is the only one who can perform initial assessment and establish plan of care?

• A. LPN
• B. UAP
• C. Physician
• D. RN

Answer: (D)

In nursing practice, the initial assessment and the nursing care plan are created and coordinated by the registered nurse. The RN conducts a thorough assessment, identifies nursing diagnoses, sets patient-centered goals, and designs interventions to meet those needs. Licensed practical nurses provide care under supervision and may gather data or perform routine tasks, but they do not initiate the initial comprehensive assessment or write the initial nursing care plan. Unlicensed assistive personnel perform basic care activities and do not conduct assessments or develop care plans. Physicians diagnose and manage medical treatment, but the nursing care plan—shaped by the nursing assessment and responses to care—rests with the RN.