In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of referrals in order to:

  • Assess the need to refer clients for assistance with actual or potential problems (e.g., physical therapy, speech therapy)
  • Recognize the need for referrals and obtain necessary orders
  • Identify community resources for the client (e.g., respite care, social services, shelters)
  • Identify which documents to include when referring a client (e.g., medical record, referral form)

Referrals, simply defined, are contacts that are initiated by the nurse and other members of the healthcare team in order to meet the needs of the client at the appropriate level of care and in the appropriate setting. Registered nurses manage and coordinate care along the continuum of care.

Assessing the Need to Refer Clients for Assistance with Actual and Potential Problems

Nurses and the entire healthcare team assess clients and determine their need for referrals relating to actual and potential problems.

Recognizing the Need for Referrals and Obtaining Necessary Orders

When clients have assessed needs that cannot be fulfilled and met by the registered nurse in collaboration with other members of the nursing care team, the registered nurse should then seek out resources, as well as utilize and employ different internal or external resources such as a physical therapist, a clergy member or a home health care agency in the community and external to the nurse's healthcare agency.

These resources are tapped into and, when considered appropriate for the client and their needs.

Identifying Community Resources for the Client

Common referral needs include resources and/or assistance in the community in respect to:

  • Crisis intervention
  • Anger management programs for perpetrators of abuse for example
  • Social work services for uninsured clients and those in need of assistance such as Meals on Wheels
  • Respite care for burdened caregivers
  • Community self-help groups
  • Housing, including emergency shelters, for victims and children affected with abuse
  • Transportation to and from medical appointments
  • Elder day care and in home care of an elderly patient
  • Parenting resources for fathers, young mothers and others who an assessed need for the same

Identifying and Using Appropriate Documents When Referring a Client

Medical data and information including referral forms and the client's medical record are shared with the person, department or community resource that is accepting the client according to their legal need to know this information in order to provide the client with their necessary care and treatments.


SEE – Management of Care Practice Test Questions

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