A nurse's responsibilities when initiating a controlled act include which of the following?

• A. Accept accountability for the decision to initiate and ensure that any potential outcomes are managed
• B. Delegate the decision to the physician
• C. Ensure the patient signs a consent form
• D. Keep initiation details confidential from the care team

Answer: (A)

Initiating a controlled act requires the nurse to be accountable for both the decision to perform it and for managing what happens afterward. In practice, this means the nurse must determine that the action is appropriate within their scope, use professional judgment, and ensure the patient is monitored for intended effects as well as potential complications. The nurse remains responsible for the act and its outcomes, even when another clinician oversees care or a physician has authorized the procedure. Delegating the decision to someone else would bypass this personal accountability. While informed consent and patient information are important, the fundamental duty here is to own the decision to initiate and to actively manage whatever may follow, including intervening if adverse effects occur and documenting what was done. Keeping initiation details secret from the care team would undermine patient safety and continuity of care.