NCLEX - Management of Care

Can LPNs do teaching?

Yes, but it's basic standardized teaching or reinforcing teaching. The teaching consists of information that is the same for everyone, such as TCDB, oral care, or dressing changes.

The charge nurse on a surgical unit is assigning tasks to an LPN float nurse. What client(s) would be most appropriate for the LPN? Select All That Apply 1. Client with Gardner-Wells tongs scheduled for pin care. 2. Client needing straight-cathed for a stat urine sample. 3. Client to be ambulated following open cholecystectomy. 4. Client requiring sterile dressing change to left wrist burn. 5. Client with total laryngectomy due for trach care this shift.

1, 2 and 4. CORRECT. An LPN can perform tasks on a stable client, as long as the task does not require any assessment of that client. The LPN can perform sterile pin care on stable clients with any form of long-term traction such as Gardner-Wells tongs. Obtaining a urine sample by straight-cathing a client is also within the LPN's scope of practice. Sterile dressing changes on burns can be performed by an LPN, though the RN should indicate any need to view or assess the wound before the LPN redresses the site. 3. INCORRECT. A client needing post-operative ambulation could indeed be accompanied by an LPN. However, despite the open cholecystectomy, the client could also be ambulated by a UAP so the LPN can be utilized for a more complex task. 5. INCORRECT. Tracheostomy care must be completed by an RN because of the potential for tracheal suctioning, as well as the need to assess lung sounds before and after the procedure.

An RN has delegated several tasks to be completed before end of shift. What delegation "right" was violated by the nurse? Select All That Apply 1. LPN asked to obtain stat vital signs on client reporting chest pain. 2. UAP asked to remove foley catheter prior to client discharge. 3. UAP assigned to empty and measure fluid in client urinal. 4. LPN instructed to check drainage in client's closed drainage unit (CDU) for amount. 5. UAP ordered to obtain finger-stick blood sugar on client at four pm.

1, 2, 4, and 5. CORRECT. The rights of delegation include the right task, right circumstances, right person and the right direction followed by the right supervision or evaluation. The RN has made several errors in utilizing correct delegation principles. A client reporting chest pain is considered unstable and should not be assigned to the LPN, even for vitals. Removal of invasive lines cannot be assigned to a UAP, which includes removal of a foley catheter. Chest tube drainage should be evaluated by an RN in order to assess color, consistency and amount during the shift. Blood glucose levels obtained by Accu-check, also referred to as finger stick, can not be performed by a UAP and reported to the LPN or RN. 3. INCORRECT. The UAP is qualified to empty a urinal or bedpan as part of assisting clients with ADL's and can also measure the amount of fluid at that time. Both task and individual meet the correct "rights" of delegation.

I am an ED nurse with 15 years of experience and I get pulled to the labor and delivery unit. Which client are you going to give me? 1. The client with an acute DVT 2. The client in active labor 3. The client who is eight hours postpartum 4. The client requiring fetal monitoring

1. This is the only option that does not require specialized care.

A client diagnosed with confusion and dehydration is admitted to the medical unit. The RN is working with an LPN and an unlicensed assistive personnel (UAP). Which tasks would be best for the RN to assign to the LPN? 1. Insert an indwelling urinary catheter 2. Reinforce the teaching plan with the client's family 3. Maintain fluids at bedside 4. Assess I & O for adequate fluid replacement 5. Obtain daily weights

1. & 2. Correct: The LPN can insert a indwelling urinary catheter since hourly urinary output measurements are needed, this is within the scope of practice. The LPN can reinforce an already prepared teaching plan, but cannot develop one. 3. Incorrect: This can best be accomplished by the UAP, it can be done by LPN but not best use of resources. 4. Incorrect: Assessment is a role of the RN. LPN can observe and data collect but not assess and evaluate on the NCLEX. 5. Incorrect: Weighing a client is a task that may be assigned to the UAP.

A nurse is hired to address quality improvement at a long-term care facility. The nurse quickly notes several legal issues requiring intervention and correction. What situation noted by the nurse represents the greatest legal or ethical risk in the facility? Choose One 1. A LPN regularly leaves pills in client's room for client to take after meals. 2. The UAP refills the water pitcher for a client on fluid restrictions. 3. Staff asks family members to assist in turning an obese client. 4. The UAP loosens trach ties at bath-time to apply cream on neck.

1. CORRECT. All the situations have the potential to become problematic. However, leaving medications unattended in a client's room violates multiple protocols as well as legal issues. The nurse must witness the client actually ingesting medication to legally sign off the drug as 'given'. Also the nurse should observe the client in case of accidental choking. Unattended pills could easily be ingested by someone other than the designated individual, or the client may simply throw the medication away. 2. INCORRECT. All staff should have been clearly instructed regarding the client's fluid restrictions. However, filling the pitcher does not necessarily mean the client drank the extra fluid. The nurse is responsible to instruct staff on any type of client restrictions. A sign noting fluid restrictions could be placed above the bed without violating HIPAA regulations as long as no name appears on the sign. 3. INCORRECT. Regardless of whether a client is obese, family should never be asked to assist staff in moving or positioning an individual. Family is neither properly trained nor covered by facility insurance for personal injury. Even if family offers to assist, the staff should utilize only other staff members. 4. INCORRECT. The UAP is never permitted to untie or loosen trach ties for any reason. If the client needs, or requests, cream to the neck area, the RN can do so during trach care. If the back of the client's neck is irritated, the RN can also address that issue with proper interventions.

When giving report to the on-coming staff, the night nurse reports a chaotic shift with short-staffing. Later, the day nurse finds multiple uncompleted tasks. What task is most concerning to the charge nurse? Choose One 1. A dose of narcotic medication not signed off. 2. A prescribed wound specimen not collected. 3. Primary healthcare provider not notified of abnormal lab results. 4. A finger stick blood sugar not obtained.

1. CORRECT. There are multiple concerns when any medication is not properly recorded, and particularly a narcotic medication. Because of the legalities involved with Schedule II or III drugs, narcotics are tracked and accounted for by two nurses. In this instance, the drug was not acknowledged, making it difficult to determine when, or even if, the client received the medication. 2. INCORRECT. Not obtaining or sending a prescribed wound specimen may delay possible treatment by an extra day, based on how soon the nurse completes this task. However, it is possible the primary healthcare provider may compensate for this issue by ultimately changing the medication or dose ordered when lab results arrive. 3. INCORRECT. While this has the potential to be serious, there is not enough data provided. Abnormal results could be life-threatening or minimal enough to require no intervention. No determination can be made. 4. INCORRECT. The primary healthcare provider will be notified of the missed blood glucose level. The action determined will depend on whether a glucose level has been obtained since the missed level, or if the primary healthcare provider prescribes a stat level now. However, there is a more serious issue.

A facility housekeeper approaches the nurse, reporting their sibling with no advanced directive has been admitted in a coma following a massive stroke. As the client's only family member, the housekeeper requests information on the client's condition and prognosis. What actions by the nurse are most appropriate? Select All That Apply 1. Offer to contact a spiritual leader to provide comfort. 2. Inform housekeeper that you are not the client's nurse. 3. Check the chart data and provide brief update on client. 4. Ask Social Services to help housekeeper with legal issues. 5. Offer to call primary healthcare provider for housekeeper.

1.,4., and 5. CORRECT. There are obvious legal issues which complicate this situation. Though the housekeeper claims to be the only living relative, unless this claim can be legally proven, the nurse cannot verify this information. However, the nurse can still assist the housekeeper or any family member with other needs. Contacting a spiritual leader of choice can be easily accomplished. Even more important is that Social Services, as part of an interdisciplinary team, can assist the housekeeper with multiple needs, including legal requirements to obtain guardianship or power of attorney. It would also be helpful to advise the primary healthcare provider that the housekeeper is the sole relative, and allow that physician to make a determination what to reveal under such dire circumstances. 2. INCORRECT. The nurse's statement may be correct but does not provide the housekeeper with usable information or alternatives to achieve the goal regarding sibling's condition. 3. INCORRECT. HIPAA prohibits accessing charts of client's unless directly involved with the care for that individual. Even if the nurse was assigned to the sibling, it is a violation to share information, even under the unique circumstances described in the scenario.

A 17-year-old client has been declared brain dead following a motorcycle accident. The nurse informed the family that an organ donor card was found in the client's belongings, but the family is resistant. The nurse is aware what guidelines apply to organ donation in this situation? 1. The clients donor card guarantees that organs or tissues can be harvested. 2. The parents can refuse organ donation even though the client signed the card. 3. The hospital must make the final determination since the client cannot speak. 4. No one can refuse the client's wishes because a donor card is legally binding.

2

A new nurse is assigned to address quality improvement on a medical-surgical unit. The nurse is aware what tasks could not be safely completed by a UAP? Select All That Apply 1. Obtain vitals on a client following a colonoscopy. 2. Reinforce teaching for a client awaiting discharge. 3. Feed pureed food to client with left-sided paralysis. 4. Get finger stick on confused client with diaphoresis. 5. Provide ice packs to client with a new long leg cast.

2, 3, and 4. CORRECT. Unlicensed assistive personnel, often referred to as a 'nursing assistant', should be assigned repetitive, uncomplicated tasks on stable clients. These tasks include activities of daily living, routine vital signs and ambulation. The UAP is not able to reinforce teaching because this requires an evaluation of client learning. The client with left-sided paralysis is at risk for aspiration and requires specific knowledge about position during feeding. An LPN or RN should be assigned to feed this client. Getting a blood sugar by finger-stick is not within the abilities of a UAP across the country. Some states allow FSBS by UAPs that have been trained, but this is not from coast to coast. 1. INCORRECT. Obtaining vitals on a post-procedure client is based on the type of test and potential for complications. A colonoscopy is generally an uncomplicated procedure and the UAP would certainly be able to do vitals on this client. 5. INCORRECT. Filling and providing ice packs to a client with a cast is within the scope of activities for unlicensed assistive personnel. The nurse would need to provide instruction about placing ice packs to the side of the cast, rather than on top, but this activity can definitely be assigned to the UAP.

The charge nurse is assigning several immediate tasks to on-coming shift personnel. What task should the nurse assign to a licensed nurse only? Choose One 1. Reposition a client with a long term Peg tube. 2. Obtain scheduled vital signs during blood transfusion. 3. Assist diabetic client with neuropathy to walk to bathroom. 4. Ambulate client following laparoscopic appendectomy.

2. CORRECT. Blood transfusions present a potential for complications the entire time the blood is transfusing, even though any problems which might occur generally happen in the first 15 minutes. But data collection regarding client response, including skin color, respiratory status and IV site should be assessed during vitals sign monitoring. 1. INCORRECT. Repositioning a client with a Peg tube can be safely accomplished by unlicensed assistive personnel. A Peg tube is secured inside the stomach wall and simply repositioning a client would not create an issue requiring a nurse. 3. INCORRECT. Ambulating a diabetic client requires the same precautions as walking with any individual. Neuropathy may cause pain or numbness to the soles of the client's feet, but the UAP is still capable of ambulating this client safely. A licensed nurse is not required at this time. 4. INCORRECT. A laparoscopy is the process of performing a surgical procedure without cutting open the body. Three or four small holes are created through which instruments are passed, including a camera, allowing the surgery to be completed. Ambulating this client is no different from any other post-operative walk, and therefore can easily be accomplished by the UAP.

When working in a new facility, the nurse identifies several violations of client privacy and confidentiality. What situation should the nurse report immediately to the supervisor? Choose One 1. Primary healthcare provider left client chart opened on the desk while completing rounds. 2. Students in teaching hospital observe client care without permission. 3. Staff personnel in an elevator laughing about "crazy guy" on 4th floor. 4. Secretary copying client charts leaves several pages in office copier.

2. CORRECT. Client confidentiality and privacy are guaranteed by both federal and state regulations as well as those principles outlined in the nurse's code of ethics. As a client advocate, the nurse has the responsibility to protect those rights by reporting infractions to the appropriate personnel. An actual violation has occurred when students enter a client's room to observe a procedure without first asking the client's permission. Even though the client is in a teaching hospital, this does not eliminate the client's right to privacy or to refuse to have students present. 1. INCORRECT. Opened and unattended charts represent the potential for confidential information to be viewed by others, including non-medical persons. The potential exists for client information to be seen or used by those not entitled to view such information. Charts should remain closed when not in use. 3. INCORRECT. Such a breach of ethics violates multiple healthcare principles. However, though unprofessional and rude, the staff did not mention a client name or room number. That does not mean there will be no disciplinary action, but actual client details were not revealed. 4. INCORRECT. Leaving client data in a copier violates client privacy and a potential breach of confidentiality. The copy machine is in facility office, not a public location; however, there are individuals within an office which should not have access to those client records.

The charge nurse in a psychiatric facility is assigning morning tasks to an unlicensed assistive personnel (UAP). What task should the nurse instruct the UAP to complete first? 1. Accompany client off unit to smoking area. 2. Obtain a morning weight on anorexic client. 3. Assist a client who is depressed to get out of bed. 4. Prepare the day room for group breakfast.

2. Correct: An accurate daily weight is obtained each morning at the same time, on the same scale, in the same clothing. The accuracy of this procedure is particularly critical for the anorexic client and should be performed prior to breakfast. The nurse will also remind the UAP to be particularly vigilant of the client attempting to alter the scale reading, perhaps by hiding an object in a bathrobe pocket. 1. Incorrect: Clients who smoke often request an early morning cigarette, prior to breakfast, and must be accompanied by a member of the staff during that time. Although many facilities are non-smoking, older clients who do smoke are provided with a specific location to do so, but this is not a priority at this time. 3. Incorrect: It is important to help clients who are depressed to participate in daily routines, such as eating breakfast in a group setting. Based on the degree of depression, many clients may also require assistance to even get out of bed and dress. The UAP will need to complete this task before breakfast but it is not the first priority of the morning. 4. Incorrect: It will be important to get the day room ready for group breakfast. However, preparing the dayroom will likely take quite a bit of time and there is a more important task that needs to be completed prior to breakfast preparations.

A nurse is posting to a blog titled, "A day in the life of a nurse." Which post would be acceptable for the nurse to make? Select all that apply. 1. "Today is a sad day for me. One of my clients was rude to me. All I was trying to do was help." 2. "There was a serious accident on the freeway today. Several came to our emergency department. We have the best trauma unit. All our victims survived." 3. "I save lives! This is the reason I became a nurse. To make a difference in people's lives." 4. "A major role I have as a nurse is education. Today I want to share how you can decrease your risk of developing type 2 diabetes." 5. "Today was a very frustrating day at work. I expect my coworkers to be as competent as I am. Mistakes should not occur." 6. "This is what can happen to clients who become bedridden. My client told me I could share this photograph."

3, 4

An confused elderly client is admitted with a diagnosis of malnutrition following a 30-pound (13.6 kg) weight loss in a month. The family requests insertion of Peg tube for enteral feedings, despite the client's advanced directives indicating "no life-prolonging measures". What is the most appropriate comment by the nurse to the family? Choose One 1. "Perhaps you could convince your parent to allow a Peg tube insertion." 2. "Maybe the client just needs family to prepare meals and help feed the client." 3. "The client completed an advanced directive form specifying what we may do." 4. "It is the client's right to refuse procedures not wanted."

3. CORRECT. This statement by the nurse provides an explanation of advanced directives as well as the fact the client has completed such a form. The focus is placed on the purpose of advanced directives and how medical personnel must abide by the client's wishes. The nurse has given the family a response which includes accurate knowledge as well as advocating for the client. 1. INCORRECT. Such a statement does not focus on the client's right to refuse life-extending procedures as noted in the advanced directives. The family is given false hope rather than a correct explanation regarding advanced directives and client rights. 2. INCORRECT. The nurse is attempting to refocus the family on the client's weight loss rather than the client's choices. The issue at this time is not the cause of the weight loss, but rather the client's right to refuse life-extending procedures as detailed in the advanced directives. 4. INCORRECT. Though this statement is accurate, it is abrupt and closed-ended. When addressing family, the nurse needs to remember that stress, fear and frustration can overwhelm judgment. The family may fear losing the client and the nurse's statement would not address those fears or the advanced directives.

A client asks, "I would like to view my medical records." Which response made by the nurse is most appropriate? You answered this question Incorrectly 1. You will first need to contact your primary healthcare provider. 2. You may view your electronic health records on a weekly basis. 3. You have the right to view the medical records that pertain to your care. 4. You want to view your medical records?

3. Correct: According to the Client's Bill of Rights, the client has the right to view medical records pertaining to the client's care and to have those records explained if necessary. 1. Incorrect: The client may contact medical records and does not need to first contact the primary healthcare provider. 2. Incorrect: The electronic health record can be made available to the client when requested. 4. Incorrect: This is an open ended question, but the client may view this as challenging their desire to view the medical records.

What task would be most appropriate to assign to the UAP when caring for a client with ulcerative colitis? 1. Sharing successful anxiety reduction measures. 2. Encouraging the client to express concerns about an ileostomy. 3. Reminding the client to avoid cold foods and smoking. 4. Explaining the rationale for needing a low residue diet.

3. Correct: Reminding clients to follow through on teaching performed by the RN such as to avoid cold foods and smoking would be an appropriate task for the UAP. 1. Incorrect: Sharing successful anxiety reduction measures is teaching. This is the role of the RN and would not be appropriate to delegate to the UAP. 2. Incorrect: Although encouraging a client to express concerns about the possibility of having an ileostomy sounds like something that could be assigned to the UAP, this would require assessment of the client's concerns and should be performed by the RN. 4. Incorrect: Explaining the rationale for needing a low residue diet is teaching. This is outside the scope of practice for the UAP. The RN should retain all tasks related to teaching.

The nurse has received morning report on several new pediatric clients. What client would be the nurse's priority? 1. A child with exacerbation of cystic fibrosis and PaO2 of 93%. 2. A child with rheumatic fever and an oral temperature of 100°F. 3. A child with a sickle cell crisis reporting pain of 4 out of 10. 4. A child with a closed head injury and a urine specific gravity of 1.004.

4

A client is awake in the recovery room following a cardiac catheterization performed through the left radial artery. During the assessment, the nurse notes severe swelling of the left upper arm with a diminished left radial pulse, indicating an internal arterial hemorrhage. The cardiologist states the client will require immediate surgery to repair the leaking artery. The nurse understands what fact about the current consent form? 1. Can be assumed since it's an emergent situation. 2. Should be signed by client who is currently awake. 3. Is not needed since client consented to catheterization. 4. Must be approved by family or a spouse.

4. Correct: An additional procedure requires a new consent form which describes specifically what the cardiologist plans to do. Even though the client is awake, residual sedation from the catheterization makes it necessary for a family member or spouse to sign the consent form. 1. Incorrect: Emergent situations are those in which the client's life or limb is threatened. That type of consent is called "implied" consent; however, despite the seriousness of the situation, implied consent is not valid in this case. 2. Incorrect: Though awake following the catheterization, the client is considered impaired because of the sedation used during the catheterization. Even if the client understands what is occurring, a signature by the client is not considered legal at this time. 3. Incorrect: Once the surgery and potential risks are explained to the client, a consent form is completed specifically describing the procedure to be performed by the cardiologist. That form does not cover any additional procedures, even if directly connected to the original surgery.

An injured client brought to the emergency room by ambulance insists on leaving before being seen by the primary healthcare provider. What is the nurse's priority action? 1. Explain potential risks of leaving without proper care. 2. Insist the client sign "Against Medical Advice" form. 3. Calmly convince client to wait for needed treatment. 4. Notify primary healthcare provider immediately.

4. Correct: The nurse must notify the primary healthcare provider immediately about the client's desire to leave without care. The client cannot be physically prevented from leaving, or threatened with possible dire consequences by the nurse. The primary healthcare provider can explain potential risks of non-treatment and obtain a signature on the AMA form. 1. Incorrect: The client must be informed about the potential risks of leaving without medical treatment and that information is best explained by either the emergency room healthcare provider or primary healthcare provider based on knowledge of the client's potential injuries. 2. Incorrect: An "Against Medical Advise" (AMA) form is designed to protect staff and facility from potential litigation filed by clients leaving without treatment. However, a client cannot be forced to sign the form and this is not the nurse's priority action. 3. Incorrect: The nurse can use therapeutic techniques to discuss the situation and try to discover why the client wants to leave. However, there is another priority more important for the nurse.

Can an unlicensed assistive personnel take vital signs on a client receiving IV dopamine? What about on a client receiving a blood transfusion? Nitroglycerin?

No

Can the LPN evaluate the client to determine if a goal has been met?

No The LPN cannot do any form of evaluation because evaluation involves assessment.

Can an LPN devise a teaching plan for a newly diagnosed diabetic?

No This will be done by the RN.

The _____ must do the admission history.

RN

Can the LPN perform any tasks in an unstable situation?

Yes Like in a CODE, they can take the client's blood pressure or grab the crash cart

Can the UAP... Provide a total bed bath and dress the client? Serve meals and assist with eating? Obtain a urine specimen from a catheter? Turn client every two hours and provide skin care? Assist to the bathroom with a walker? Perform a fleet enema? Answer the client's call light? Clean and sanitize the client room? Change linen on a totally bedridden client? provide mouth care and denture cleansing?

Yes to everything except obtain a urine specimen from a catheter and performing a fleet enema. UAPs cannot do sterile procedures. A UAP can do some enemas, but a fleet enema is medicated.

Can the LPN... Collect data, monitor, and observe? Reinforce teaching from a plan of care? Administer IV piggyback medication? Administer IV push pain medications? Initiate transfusion of blood products? Monitor transfusion of blood products? Administer meds and nutrition via NG tube, G tube or button, J-tube? Insert, maintain and remove urinary catheters? Maintain and remove peripheral IV catheters? Calculate and monitor IV flow rate?

Yes, except for administering IV push pain medications and initiating transfusion of blood products.

The RN never delegates or assigns tasks that involve _______.

assessment

This is the routine care, activities, and procedures that are within the authorized scope of practice of the RN, the LPN, or part of the routine functions of the UAP. It is the sharing of routine work that each staff member is responsible for during a given shift or work period. The tasks should be part of the coursework taught in the basic educational program of the staff member.

assignment

The LPN can assist the RN in ______ collection, but that is not assessment in the NCLEX world. After the initial assessment made by the RN, the LPN updates client data throughout the shift but the decision-making or judgment will always be the RN's responsibility.

data

This is allowing a specific task to be performed that is not routinely performed and is beyond the traditional role of the individual to which the nursing activity, skill, or procedure is delegated. The key is that the staff member who is delegated the task has received additional training or education and has validated competency to perform the task.

delegation

If you are unsure if the UAP can perform a procedure, what should you do?

go with them and make sure no harm is done

Routine task assignments can change based on the circumstance. The same activity may differ in each situation. We know that feeding a healthy client who has two broken arms is different than feeding a client who has dysphagia. Also, bathing a weak client is not the same as bathing a client who is severely burned. So if there is ever a degree of potential _______, the RN must retain the task, no matter how routine it is.

harm

What type of clients can the RN delegate to the unlicensed assistive personnel? UAPs can perform tasks on _______ clients in uncomplicated situations. Tasks such as routine, simple, repetitive, common activities that do not require nursing judgment. What are some examples?

stable Hygiene, feeding, intake and output, routine vital signs, and ambulation - everyday things.

Advance directives include...

living will, healthcare proxies, and durable powers of attorney for healthcare

Organ donation decisions made by a _____ can be refused by the family, regardless of presence of documentation of organ donation wishes by the client.

minor Laws impacting the rights of the family to overturn documented wishes for organ donation in non-minors can vary from state to state.

When staff members are pulled to a new floor, you should...

pretend like they are a brand new nurse (do not give this nurse any clients requiring any specialized care)

We need to ask these three questions after a delegated task is completed: Was the task done _____ and in a safe manner? Was the task done in the proper timeframe? Were the client's needs met?

properly

RN to RN transfer is called a handoff and transfers both ______ and ______.

responsibility accountability

You can delegate the ______ of the task, but you cannot delegate the ultimate ______.

responsibility accountability

The LPN only provides nursing care to _______ clients.

stable An unstable client is medically fragile and requires an increased level of care. Examples include low blood sugar, changes in neurological status, a new admit, or a patient returning postop.

Do advanced directives guide care when the client is still competent? No. If the client is still competent and has the ability to make healthcare decisions, the client holds the authority to make these decisions and is the final word, not the family. If competency is in debate, report the differences in opinion to the _______. The legal system may need to be consulted. Check state laws to see if a state will honor an advanced directive that was generated in another state.

supervisor

The RN is accountable for all aspects of nursing care that are being provided. And that includes the choices you make about who is considered competent to perform the task. If we are safely delegating, that means that the right task is being assigned to the right ______ under the right ______. Along with this, the RN provides the right ______ and ______, the right ______, and finally, the right ______.

task; person; circumstance; direction; communication; supervision; evaluation

When a task is performed and you identify a weakness you are supposed to...

teach, teach, teach!

The RN is responsible for providing clear, concise, correct, and complete communication to nursing staff at the time of delegation, as well as providing continued direction on an ongoing basis. You must communicate a _______ frame and the priority of the task. Tell what you want done first, and what you want done in a particular time frame. Provide specific directions and expectations of how you want the task to be performed and describe the findings you want to be reported. You must guide, supervise, and evaluate the carrying out of any delegated task. You must ________ to see that the nursing tasks that you delegated are done properly.

time follow up

A client can be complex and stable at the same time. Don't let a complex, chronic diagnosis make you think the client is unstable and has to be seen only by the RN. Always consider a new admit _______. The RN should stop what he or she is doing and assess this patient first. The new admission is the responsibility or priority.

unstable

If someone else, such as an LPN, collects the admission data for you, never sign off on the form until you have _______ the data.

validated