If the patient needs admission, do we first change the location to the ER and then go to the inpatient ward or ICU or go directly to the inpatient ward or ICU?

You admit directly to where the patient needs to go. If the patient needs to go the ICU, you admit to the ICU. You do not need to go through the ER. You should rarely ever move the patient the ER because you have admitting privileges. The ER is typically just a starting location. You cannot move the patient from an inpatient setting (ICU or inpatient unit) to the ER as this is not allowed in the real test. Therefore, you will rarely move a patient to the ER.