Delegation (MUST STUDY!!!)

The registered nurse (RN) is teaching a newly hired nurse about delegating tasks to the healthcare team. When asked what the rights of delegation are, which right listed by the hired nurse indicates the need for further teaching? Select all that apply. 1 Right task Incorrect2 Right direction 3 Right person Correct4 Right drug name 5 Right circumstance

The 5 rights of delegation are right task, right circumstance, right person, right directions and communication, right supervision and evaluation.

During the delegation process, which healthcare professional acts as a liaison between the team leader and healthcare provider? Correct1 Charge nurse 2 Nurse manager 3 Nursing supervisor 4 Chief nursing officer

The charge nurse is responsible for acting as a liaison between the team leaders and healthcare providers. Nurse managers cannot act as a liaison between the team leader and other healthcare providers because they are often responsible for more than one unit and have other managerial responsibilities. The nursing supervisor will be delegated to supervise and ensure effective outcomes for the tasks delegated to the delegatees. The chief nursing officer is responsible for establishing the systems for assessment.

A registered nurse (RN) delegates a task to a licensed practical nurse (LPN). What should the RN do when the LPN executes the task improperly? Correct1 Provide constructive feedback. 2 Engage in a verbal attack on the delegate. 3 Express satisfaction with the LPN's execution of the task. 4 Ignore the task for now but stop considering the LPN for further delegation.

The delegator should provide constructive and positive, yet honest, feedback about the work of the delegatee. A verbal attack will destroy the relationship between the delegatee and delegator. The RN would lose credibility by conveying satisfaction with the delegatee's work, which is not satisfactory. Ignoring the task and not giving feedback will not promote a healthy relationship.

Which activity performed by the registered nurse (RN) indicates effective delegation? 1 Following one-way communication with the delegatee 2 Assigning a task to a new licensed practical nurse(LPN) 3 Providing feedback to the delegatee while performing the task Correct4 Supervising and monitoring the licensed practical nurse (LPN) about the different activities

The delegator should supervise and monitor the delegatee when the work is being assigned to the delegatee. The communication between delegatee and delegator should always be two-way to get the expected outcome. The delegator should evaluate the ability of the delegatee and should supervise the different tasks before assigning the work to the new delegatee. The delegator should always provide feedback at the end of the task.

An elderly client with periods of confusion underwent surgery and requires assistance for feeding. To which healthcare professional should the registered nurse delegate the task? 1 Charge nurse 2 Nurse manager Correct3 Licensed practical nurse Incorrect4 Unlicensed assistive personnel (UAP)

The registered nurse should delegate the task of feeding to the licensed practical nurse. The charge nurse may delegate the task in the absence of a registered nurse, but he/she is not likely to feed the client. The nurse manager is the designated individual to whom all nursing professionals should be answerable regarding a given task. The UAP performs all hygienic tasks. Feeding the client can be performed by the UAP but only for uncomplicated, low-risk clients.

A licensed practical nurse (LPN) was hired recently. Which strategy should be applied by the registered nurse (RN) to open lines of communication between them? 1 Telling 2 Selling Correct3 Asking 4 Offering

Asking is the first strategy and begins with questions that open lines of communication between the newly hired LPN and RN. Telling is helpful when the delegatee and delegator have a new relationship. Selling is the supervision by the delegator when the delegator and delegatee have a long relationship and have been working together for a while. Offering is also a strategy that can be followed after using the asking strategy by making a suggestion.

Which component of delegation is defined as the ability to perform duties in a specific role? Correct1 Authority 2 Supervision 3 Responsibility 4 Accountability

Authority is the ability to perform duties in a specific role. Supervision is the provision of guidance and oversight of a delegated task. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability involves determining whether the actions are appropriate and providing a detailed explanation of what has occurred.

When assigning a task, the delegator should understand the delegatee's personal values and align them with the organizational values. Which task can be achieved from this delegation? Correct1 Affirming 2 Managing Incorrect3 Renewing 4 Motivating

In the task of affirming values, sharing the personal values of the delegatee and aligning them with organizational values enables the delegatee to achieve an outcome. In managing, the delegator assists the delegatee with planning. In renewing, the outcome is achieved by enhancing the ability to care for the delegatee. In motivating, the delegatee is inspired to achieve the outcome.

Which activity performed by the licensed practical nurse (LPN) would be appropriate while caring for a client based on the principle of right task of delegation? 1 Willing to perform the task 2 Providing feedback to the delegator Correct3 Performing the task based on institutional policies 4 Following appropriate supervision while performing the task

The principle of right task of delegation indicates if the task is appropriate to delegate based on institutional policies and procedures. Assessing whether the delegatee is willing to perform the task indicates the principle of right person. Providing feedback to the delegator and following supervision of the delegator indicates right supervision of delegation.

A healthcare team is caring for a client with dental pain. Which task is most suitable to be delegated to unlicensed assistive personnel (UAP) to provide effective client care? 1 Administering analgesics 2 Administering intravenous antibiotics 3 Administering nerve block anesthesia Correct4 Administering mouth wash for oral hygiene

The UAP scope of practice includes administering mouth wash to the client. Instructing the UAP to administer medications such as antibiotics and anesthetics is inappropriate because the UAP is not eligible to do so and may not have the knowledge to administer medications. Administering nerve block anesthesia should be performed by the anesthesiologist.

The registered nurse is caring for an elderly client who is admitted with severe asthma. Which task delegated by the nurse is most suitable to be performed by the client attendant? Incorrect1 Assessing the vital signs 2 Monitoring respiratory rate 3 Administering inhalational medications Correct4 Assisting the client during nebulization

The client attendant is the unlicensed assistive personnel whose scope of practice is limited to providing basic care and comfort to the client. Assisting the client during nebulization is considered basic care and comfort and can be safely carried out by the client attendant. Assessing vital signs should be performed by the registered nurse. Monitoring respiratory rate can be delegated to the client attendant if the client condition is stable; however, since this client's condition is not stable, this task should not be delegated. Administering inhalational medications is not performed by unlicensed personnel such as a client attendant.

When does delegation become more challenging? Select all that apply. Incorrect1 When the client is stable Correct2 When the client is pregnant Incorrect3 When the geographic area is small 4 When the resources are abundant Correct5 When school children are receiving care

The delegation process becomes more challenging when vulnerable populations such as pregnant women and school children are receiving care. Delegation can be safely and successfully carried out in the stable client. Delegation can be accomplished successfully when the geographical area is small and resources are abundant.

A registered nurse (RN) is sent to a rehabilitation center because of chemical impairment issues. Which member of the healthcare team will be asked to provide feedback about the RN's progress? Correct1 Nurse manager 2 Healthcare provider 3 Patient care associate 4 Cross-trained technician

The nurse manager, who is the delegator for the healthcare team, will be asked to provide feedback about the progress of the RN in the rehabilitation center. The healthcare provider will not be asked to provide feedback about the RN's progress. The patient care associate and cross-trained technician also do not provide feedback about the RN because they do not supervise the RN.

The registered nurse (RN) delegated a task to a licensed practical nurse (LPN). The LPN completed the task effectively. Which statement made by the RN is appropriate feedback? 1 "Nice job." 2 "Well done." 3 "Your performance was good." Correct4 "You performed that procedure safely and professionally."

The statement, "You performed that procedure safely and professionally," clearly identifies what the LPN did well, so it can shape the future behavior positively. The RN should not include vague statements, such as, "Nice job," or, "Well done." The statement, "Your performance was good," could have a positive impact, but a specific behavior is not mentioned in the statement.

A client presents to the physician with a rash. The physician orders the application of a topical medication. Which healthcare team member will most likely carry out this order? 1 Nurse manager (NM) 2 Registered nurse (RN) Correct3 Licensed practical nurse (LPN) 4 Unlicensed assistive personnel (UAP)

The LPN administers oral and topical medications and monitors all vital signs. The NM is the designated individual to whom all nursing professionals are answerable regarding a given task. The RN is responsible for performing the administration of intravenous medications and the delegation of tasks to LPNs and UAPs. The UAP assistive personnel performs all hygiene tasks.

A client is hospitalized with pressure ulcers. Which task could be delegated to an unlicensed nursing professional (UNP)? Select all that apply. Correct1 Empty wound drainage containers. Correct2 Report changes in wound appearance. 3 Apply prescribed dressings and medications. 4 Assess and record data about wound appearance. 5 Choose dressings and therapies for wound treatment.

The UAP is eligible to empty wound drainage and report changes in wound appearance. The licensed practical nurse is eligible to apply prescribed dressings and medications to the client. A licensed practical nurse can collect and record data about the appearance of a wound. The registered nurse is eligible to choose dressings and therapies for wound treatment.

Which characteristics of the delegatee should be considered to determine that he or she is the "right person"? Select all that apply. Correct1 Experience 2 Supervision Correct3 Willingness Correct4 Competence 5 Communication

The delegatee should be assigned a task if he or she has experience that would allow the delegator to provide minimal guidance. The willingness of the delegatee is also important to consider before assigning the task. The competence of the delegatee must be assessed before assigning the task. The delegator should supervise the tasks performed by the delegatee. The delegatee's communication skills are assessed to ensure right direction and communication.

Which healthcare team member would the nurse expect can be delegated with the task of administering oral medication to a client per the functional model? Incorrect1 Registered nurse 2 Patient care associate Correct3 Licensed practical nurse 4 Unlicensed assistive personnel

The licensed practical nurse can give oral medication to a client. The registered nurse gives IV medication to a client. Patient care associates assist and monitor vital signs. Unlicensed assistive personnel perform all hygienic tasks.

The nurse is assessing the level of readiness before delegating tasks to unlicensed assistive personnel (UAP). According to Hersey's model of situational leadership, what specific factors reflect the level of readiness? Select all that apply. Correct1 Ability 2 Honesty Incorrect3 Reliability Correct4 Willingness Incorrect5 Conscientiousness

Ability and willingness are two factors that determine the level of readiness according to the Hersey's model. Honesty and reliability may not determine the readiness of the UAP to perform a delegated task. Conscientiousness is the desire to complete a task, which may not determine readiness if the UAP does not have sufficient knowledge to perform the task.

Which right of delegation would the nurse describe as most instrumental in shaping quality and safety outcomes according to Anthony and Vidal? 1 Right task 2 Right person 3 Right supervision Correct4 Right communication and direction

Right communication and direction is most instrumental in shaping quality and safety outcomes because timely and effective communication enhances the safety and quality of client care. Right task is important to prevent legal issues. Right person is important for ensuring the delegatee has the knowledge and experience to perform the specific task safely. Right supervision is important for monitoring and evaluating appropriately.

The registered nurse (RN) delegates the collection of respiratory rate data to a licensed practical nurse (LPN) for a client who is experiencing severe dehydration and whose condition is unstable. The LPN reports the data to the RN. The RN rechecks the data and finds that the report no longer reflects the patient's current condition. Which characteristic of communication has interfered with the delegation process? Correct1 Information decay 2 Information salience 3 Confidence in abilities 4 Synergy between team members

Information decay can occur in a rapidly changing situation when reported information is no longer relevant to a patient's condition. Information salience describes the different ways individuals from different backgrounds might assess the quality, meaning, and clarity of certain information. Trust is developed when there is confidence in the abilities and capabilities of the team members. Healthy relationships among members of the health care team promote synergy between the team members.

The primary healthcare provider prescribes a rectal suppository for a client with severe constipation. Which healthcare professional would be delegated the task of administering the suppository? 1 Patient care associate Correct2 Licensed practical nurse 3 Unlicensed assistive personnel 4 Unlicensed nursing personnel

Licensed practical nurses may be delegated the task of administering rectal suppositories to the client. Patient care associates, unlicensed assistive personnel, and unlicensed nursing personnel may do all hygiene tasks and basic care for clients. However, administering suppositories is not in their scope of practice.

While caring for a post-operative client, the delegator has assigned a task to a delegatee. Which statements made by the delegator indicates that the delegatee has the experience to perform the task? Select all that apply. Correct1 "I am available to you at any time for report." Correct2 "I am aware of your technical competencies." 3 "I will tell you what is necessary to perform the task." Incorrect4 "I will share my expectations about your performance." Incorrect5 "I will tell you what conditions are important to notify each other."

A delegatee with good experience may need little guidance. He or she knows what to do and when to report. As the delegatee has experience, he or she should just remember that the delegator is available at all times; the delegate can report at any time. The delegator should also make it known that the delegatee's competencies are known. The delegator tells a delegatee who is new to a task what is necessary to perform that task. The delegator will share expectations about the delegatee's performance when that delegatee can do the work and when he or she is new in assisting the registered nurse (RN). When the delegatee can do the work and is new in assisting the RN, the delegator tells the delegatee the appropriate conditions for notifying one another.

The nurse is caring for a pregnant client with hypertension. Which client care tasks are most suitable to be delegated to the patient care associate (PCA)? Correct1 Recording the vital signs 2 Monitoring the blood pressure 3 Administering intravenous fluids 4 Administering antihypertensive medications

A patient care associate (PCA) is an unlicensed assistive personnel whose scope of practice is very limited. A PCA can be delegated the task of recording the vital signs as communicated by the delegator even if the condition of the client is acute or unstable. In stable clients, the PCA may be instructed to monitor the blood pressure, but in this acute condition, only the registered nurse (RN) should monitor the blood pressure. Administration of intravenous fluids or medications is out of scope of practice of the PCA. A PCA is not suitable to be delegated the task of administering any medication to a client.

A patient care associate (PCA) is delegated a task that can be completed in 2 hours. The PCA has limited knowledge and willingness regarding that particular task. Which leadership style should be implemented by the delegator in this situation? 1 Selling Correct2 Telling Incorrect3 Monitoring 4 Participating

If the ability and willingness of the delegatee is low and the work assigned to the delegatee can be completed in 2 hours, it means the nature of relationship between delegator and delegatee is limited. In such situation, the leadership style of the delegator should be telling, because it provides a fair amount of guidance and also limits the time spent on the interactions. The selling style of leadership should be used when the relationship is ongoing; that is, individuals who usually work together continue to work together. The monitoring style should be used when the delegatee has the ability and willingness, and has an established relationship with the delegator. The participating style can be implemented when the delegatee is willing to perform the task.

The registered nurse (RN) delegates a task to the licensed practical nurse (LPN). If the LPN fails to perform the task within acceptable standards, what would happen? Select all that apply. Correct1 A potential for nursing malpractice emerges. Correct2 The institution remains legally responsible for the situation. Correct3 The accountability for care remains with the registered nurse (RN). 4 The licensure of the licensed practical nurse (LPN) would be revoked. Incorrect5 The accountability for care remains with the licensed practical nurse (LPN).

If the delegated task is not performed within acceptable standards, a potential for nursing malpractice emerges. Failure to delegate and supervise within acceptable standards may extend to direct corporate liability for the institution. Whenever care is provided by staff other than a registered nurse (RN), the accountability for care remains with the delegator who is an RN. The licensure of the licensed practical nurse (LPN) would not be cancelled because the LPN is not held accountable for the situation. When the work is assigned to the LPN, only responsibility of the task is transferred.

A client with postural hypotension requires nursing care. Which task can be safely delegated by the registered nurse to unlicensed nursing personnel (UNP)? Select all that apply. Incorrect1 Mobilizing the client 2 Assessing the pulse rate 3 Assessing the blood pressure Correct4 Managing foot care of the client Correct5 Maintaining oral hygiene of the client

In postural hypotension, any sudden change in posture will lower the blood pressure. Therefore, the client should be carefully evaluated before delegation. Managing foot care and maintaining oral hygiene can be done by the UNP because there is no foreseeable risk associated with the condition. Mobilizing the client and assessing vital signs such as pulse rate and blood pressure should be carefully monitored and performed by the registered nurse.

The legal authority wants a record of the tasks performed by the delegatees and asks the delegatees to maintain a record of completed tasks. Which task is marked by the licensed practical nurse (LPN)? Correct1 Task A 2 Task B 3 Task C 4 Task D

The LPN is a licensed nursing professional whose scope of practice includes tasks such as the administration of oral medications. Admission of the client to the ophthalmology department is under the scope of a registered nurse. Collection of the data that is used for the assessment of the client is a task that can be performed by an unlicensed nursing practitioner. Provision of basic hygiene care is the task that is to be performed by nursing assistive personnel.

Which condition may increase the potential for nursing malpractice? 1 When the client care is satisfactorily provided 2 When the delegatee is unable to perform the specified task 3 When the nursing assistant adapts to the changing situation Correct4 When the delegation task is not within acceptable standards

The delegator is personally responsible for prudent action. A potential for nursing malpractice emerges when the delegation task is not performed within acceptable standards. Satisfactory client care results from successful delegation. The expected outcome of a specified task may be affected when the delegatee is unable to perform the specified task. The nursing assistant usually adapts to the changing situation; if not, a gap in the delivery of client care will be generated.

A healthcare team is caring for a client with food poisoning. Which task is most suitable to be delegated to licensed practical nurse (LPN)? 1 Collecting vital signs 2 Performing a stomach wash Correct3 Administering oral antiemetic medication 4 Administering intravenous replacement fluids

The licensed practical nurse (LPN) can perform activities such as administering oral medication for the client. Monitoring vital signs can also be performed by the LPN but since the condition of the client is acute, it will be performed by the registered nurse. Performing a stomach wash and administering intravenous replacement fluids are performed by the registered nurse.

The registered nurse (RN) assigns a task to a licensed practical nurse (LPN) to take care of a client admitted with severe burns. Which tasks are being performed by the LPN in this situation? Select all that apply. Incorrect1 Performing hygiene tasks Correct2 Monitoring the heart rate 3 Evaluating the medical reports Correct4 Monitoring the blood pressure Correct5 Administering the oral medication

The licensed practical nurse monitors the heart rate, monitors blood pressure, and administers oral medications. Hygienic tasks are performed by the unlicensed assistive personnel. Evaluating medical reports is performed by the RN, not by the LPN.

While caring for a client with diabetes, the registered nurse delegates the task of administering oral medications to the licensed practitioner nurse (LPN), but the LPN is reluctant to take the assignment. What should be the most appropriate response of the registered nurse in this situation? Correct1 Evaluate the reason for the behavior. 2 Engage more actively in the delegated task. 3 Require the delegatee to complete the task. 4 Report the LPN's reluctance to higher authorities.

The registered nurse (RN) should first evaluate the reason for the behavior of the LPN and try to determine if the LPN has insufficient knowledge, a psychomotor deficit, or any other reason for the reluctance. If the LPN is unwilling to perform in a specific situation, the RN should engage more actively. Requiring the delegatee to complete the task despite reluctance may not be safe. Reporting the issue to higher authorities should not be the initial intervention.

The registered nurse (RN) is caring for a client with severe diarrhea. Which task of the client care plan can be safely delegated to the unlicensed assistive personnel (UAP) by the registered nurse? 1 Administration of oral antidiarrheal 2 Administration of intravenous antibiotics Correct3 Administration of oral replacement fluids 4 Administration of intravenous antiemetics

The scope of practice of the UAP is limited to perform basic care, feeding, and hygiene. Administering oral replacement fluids can be safely performed by the UAP, as it is a basic care that may also be included under feeding. Administering oral medications such as antidiarrheal drugs can be safely delegated to a licensed practical nurse (LPN) or a licensed vocational nurse (LVN) according to guidelines but not to the UAP. Administering intravenous medication such as antibiotics or antiemetics is the role of the registered nurse.

The registered nurse delegates a task to the unlicensed nursing personnel (UNP). Which client care is suitable for UNP? 1 Client A 2 Client B Correct3 Client C 4 Client D

The task of delivering care to client C is delegated to the UNP because the UNP can monitor the wound discharge in clients who have undergone surgery. Severe burns are an acute condition where the vitals are unstable. Therefore, the UNP is not authorized to provide care to client A with severe burns. UNP's scope of practice is limited for administration of intravenous fluids or medications, so the UNP is not authorized to provide care to client B, who has diabetes insipidus and requires intravenous administration of medications. Cardiogenic shock is an acute condition where the vitals are unstable, so the UNP is not qualified to provide care to client D with cardiogenic shock, and acute condition which may require continuous monitoring of vital signs.

The registered nurse is evaluating the statements of the student nurse after teaching about the span of control in a group of individuals working in a healthcare organization. Which statement made by the student nurse indicates a need for correction? Correct1 "The unit secretary in a healthcare organization has legal recognition." 2 "The nurse manager in a healthcare organization is a designated delegator." 3 "The licensed practical nurse working under a physician has a dependent status." 4 "The registered nurse is designated as being answerable to a designated delegator."

The unit secretary in healthcare organizations has no formal preparation and legal recognition. Therefore, the statement of the student nurse that the unit secretary in healthcare organization has legal recognition is incorrect. The nurse manager in a healthcare organization is a designated delegator. The licensed practical nurse has a dependent status and works under a physician. The registered nurse is designated as being answerable to a designated delegator.

The registered nurse is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for being delegated the task of administering vaccinations? 1 Nursing aide 2 Certified technician 3 Patient care associate Correct4 Licensed practical nurse

Tetanus vaccination is administered through the intramuscular route. The licensed practical nurse can administer oral, topical, and intramuscular medications, except for intravenous. The nursing aide, certified technician, and patient care associate are unlicensed assistive personnel whose scope of practice is limited for administering medications.

Which client's care is least likely to be delegated to unlicensed nursing personnel (UNP)? 1 Client A 2 Client B 3 Client C Correct4 Client D

UNP can safely care for clients in stable condition because these cases will not require critical nursing assessment and decision-making. In an emergency setting, the client with accidental poisoning should be kept under constant monitoring and any small detail of fluctuation should be noted. Therefore, client D cannot be safely delegated to UNP. Clients undergoing home care, extended care, or long-term care do not require exhaustive monitoring and do not have life-threatening conditions, so they can be safely delegated to UNP.

A client underwent extraction of a tooth due to an underlying tumor one day ago. Which healthcare professional is appropriately involved in caring for the postoperative oral hygiene needs of this client? Correct1 Registered nurse (RN) 2 Licensed practical nurse (LPN) 3 Licensed vocational nurse (LVN) Incorrect4 Unlicensed nursing practitioner (UNP)

If there is any anticipated risk in client care, the task should not be delegated but should be carried out by the RN. Because there is a risk of infection and oral bleeding, the RN should not delegate the task of postoperative oral hygiene to the LPN, LVN, or UNP.

Which task can be safely delegated by a registered nurse (RN) to unlicensed nursing personnel (UNP) for a client with thrombocytopenia? 1 Shaving the client Correct2 Positioning the client 3 Maintaining oral hygiene 4 Giving intravenous platelet infusions

Clients with thrombocytopenia are at risk of bleeding with slight bruising. Therefore tasks that do not risk bruising the client may be delegated to the UNP. The RN should shave the client and maintain oral hygiene. Intravenous infusions should not be administered by a UNP to any client.

Which action in the delegation process represents accountability? 1 Providing open and honest feedback to the delegatee 2 Assisting other registered nurses with delegation decisions Correct3 Monitoring the client care given and determining outcomes 4 Assessing the ability of the delegatee and educating him or her about the task

Monitoring client care and determining outcomes represents accountability of the task in case of conflicts. Providing open and honest feedback to the delegatee improves work performance and client care outcomes. The nurse can assist other registered nurses with delegation decisions when there are safety issues, an urgent need to intervene, or potential negative client outcomes. Assessing the ability of the delegatee and educating him or her about the task indicates responsibility.

The nurse is caring for four different clients with different health conditions. Which client care task delegated to the licensed vocational nurse (LVN) would be appropriate to develop a suitable care outcome? 1 Client 1 2 Client 2 3 Client 3 Correct4 Client 4

Providing oral medication to the client who has undergone hysterectomy can be done by the licensed vocational nurse (LVN). The LVN is not eligible to write a nursing care plan for the client with hysterectomy; this must be performed only by the registered nurse (RN). An LVN cannot provide intravenous fluids. Continuous peritoneal dialysis is not performed by an LVN; this procedure requires a more experienced practitioner such as an RN.

In a health care setting, there are a limited number of unlicensed nursing personnel. Who would take up the responsibility of delegation in place of the registered nurse? Correct1 Charge nurse 2 Chief nursing officer 3 Patient care associate 4 Licensed practical nurse

Charge nurses act as delegators as they also have knowledge and expertise in the clinical setting. In cases where there are a limited number of unlicensed nursing personnel, the registered nurse does not delegate tasks. In this instance the charge nurse usually becomes a delegator and delegates the tasks. The chief nursing officer is not the immediate person to delegate the tasks in such instances. Patient care associates and licensed practical nurses act as delegatees.

The registered nurse is delegating tasks for nursing assistants caring for a client who requires more attention. Which element should be considered when selecting the suitable nursing assistant for delegation of a task? 1 Time Incorrect2 Safety 3 Stability Correct4 Critical thinking

Critical thinking is of utmost importance for selecting a suitable nursing assistant for delegation of a task in a situation where a client requires more attention, as the delegatee should be able to perform the task effectively. Time, safety, and stability are also the elements for effective delegation, but these are suitable depending on the situation for assigning a task and delegation.

If the nurse is considering whether the right equipment and resources are available to complete a task, which delegation right is considered? 1 Task 2 Supervision Correct3 Circumstance 4 Communication

If the right equipment and resources are available to complete a task, it is considered the right circumstance. Task is the delegation right that involves asking if the task is appropriate to delegate based on institutional policies and procedures. Supervision is the delegation right involving the provision of clear feedback related to completion of an assigned task. Communication is the right that involves asking the delegator and delegate to understand a common work-related language.

Which nursing model includes a registered nurse (RN) paired with technical assistance? 1 Team nursing model Correct2 Co-primary nursing model 3 Patient-focused care model 4 Functional model of nursing

In the co-primary nursing model or practice partnership model, the registered nurse (RN) is paired with technical assistance. The team nursing model is a modification of the functional nursing model. The focused care model is the care delivered in patient-focused care. The functional model of nursing is a method of providing care by each licensed and unlicensed staff member who performs specific tasks for a large group of clients.

A registered nurse (RN) delegates the task of oral care of a client with stomatitis, to an unlicensed assistive personnel (UAP). Which instruction should be given by the RN to the UAP? 1 "Use a mouthwash containing alcohol with the client." 2 "Teach the client to rinse the mouth once every 4 to 5 hours." Incorrect3 "Avoid using toothpaste containing sodium lauryl sulfate with the client." Correct4 "Be certain to use mouthwash containing sodium bicarbonate with the client."

Since the RN is accountable for the work of the UAP, she or he is giving instructions to the UAP before delegating the task. Sodium bicarbonate is slightly alkaline in nature and is soothing to the client. Alcohol will cause burning and aggravate ulcers, and is therefore contraindicated in clients with stomatitis. The oral cavity should be rinsed with sodium bicarbonate solution once every 2 to 3 hours. Sodium lauryl sulfate should be avoided as it is associated with the risk of stomatitis.

Which factors does the registered nurse consider in the decision to delegate process? Select all that apply. 1 Evaluation Incorrect2 Nursing judgment Correct3 Predictability of outcomes Incorrect4 Pervasive functions of assessment Correct5 Complexity of the task to be performed

Two factors responsible for the decision to delegate process are predictability of outcomes and complexity of the task to be performed. Evaluation, nursing judgment, and pervasive functions are not factors in the decision to delegate process.

The registered nurse (RN) who delegates work to a newly hired licensed practical nurse (LPN) says, "Please tell me how you will go about performing this procedure, and I will share my expectations with you." Which behavior strategy of Hersey's model is being applied? 1 Telling 2 Selling Incorrect3 Delegating Correct4 Participating

When the LPN has the willingness and ability to perform a task, but the relationship is new, the RN will share his or her expectations and conditions with the LPN. This is a clinical example of participating. Participating is encouraging the delegatee to perform the task and taking an active part in problem solving, which may occur during the execution of a given task. If the LPN has limited knowledge and ability to perform a task, the RN will provide more guidance, which is an example of telling what is the task to be done and how it is to be performed. If the LPN is delegated a new task, it requires explanation from the RN. This is termed as selling in Hersey's model, which is the process of explaining and persuading; this happens if a situation involves a new task and the relationship is ongoing. If the LPN has an established relationship and experience, he or she requires a little guidance and this is called delegation.

Which characteristic of the nurse as a delegator is reflected in the statement, "Let me show you how this procedure is done; then you can do it yourself"? Correct1 Doing 2 Asking Incorrect3 Offering 4 Delegating

Doing occurs by demonstrating the specific task or behavior to improve client care. The statement, "Let me show you how this procedure is done; then you can do it yourself," indicates doing. Asking begins with questions related to the problem or issue regarding client care and can open lines of communication between the delegator and the delegatee. Offering involves making a suggestion to facilitate the achievement of a desirable outcome. Delegating refers to transferring responsibility for the performance of a task nurse or delegator to the delegatee while retaining the accountability for the outcome.

Which delegatee requires little guidance from the delegator? Correct1 Delegatee who is familiar with the task but not the client 2 Delegatee who has experience but is unfamiliar with the task 3 Delegatee who has little experience but has willingness to do the task 4 Delegatee who is very familiar with the client but has a lack of ability to do the task

A delegatee who has experience and is familiar with the task requires less guidance and support from the delegator as he or she has the ability to accomplish the task. A delegatee who has work experience may have ability but requires guidance as he or she is new to the delegated task. A delegatee who shows willingness to do the task but has little experience requires supervision. A delegatee who is familiar with the client but has a lack of ability to do the task requires supervision or guidance.

A nurse delegator assigns work to a delegatee who has the ability and willingness to do the work but the relationship between the delegator and delegatee is relatively new. How is the delegator's behavior described according to Hersey's Model? 1 Selling 2 Telling 3 Delegating Correct4 Participating

According to Hersey's Model, if the delegatee has the ability and willingness, but the relationship between the delegator and delegatee is relatively new, they need to establish mutual expectations and conditions of performance. Hersey's model describes this behavior of the leader as participating. If a situation involves a new task and the relationship is ongoing, Hersey's model describes this behavior of the leader as selling. If the delegatee has limited knowledge and ability to perform a task, the delegator needs to provide more guidance. Hersey's model describes this behavior of the leader as telling. If the delegatee has the ability and willingness, the expertise to accomplish the work, and an established relationship, Hersey's model describes this behavior of the leader as delegating.

While caring for a client with asthma, the delegator assigns the client to a registered nurse (RN) and to a licensed practical nurse (LPN). Which component of delegation is transferable to the RN? Select all that apply. Correct1 Authority Incorrect2 Supervision Correct3 Responsibility Correct4 Accountability 5 Communication

Authority, a component of delegation, is transferred to the registered nurse (RN) by the delegator. Responsibility is the component of delegation that is transferable to the RN. Accountability is also a component of delegation that is transferable to the RN. Supervision and communication are rights of delegation.

Which healthcare professional does the nurse know is authorized to delegate work to other healthcare members? Correct1 Registered nurse (RN) 2 Licensed practical nurse (LPN) 3 Unlicensed nursing personnel (UNP) 4 Unlicensed assistive personnel (UAP)

Delegating work is the most effective professional management strategy that an RN can implement in clinical practice to improve the safety and quality of client care. RNs can delegate work to LPNs, UNP, or UAP.

The registered nurse (RN) is caring for a client who underwent brain surgery. The registered nurse delegated the task of reinforcing ambulation to the licensed practical nurse (LPN). Who is accountable for the client' scare? 1 Charge nurse Correct2 Registered nurse 3 Licensed practical nurse 4 Primary healthcare provider

Delegation involves sharing the responsibility of client care while the delegator retains the accountability. In this scenario, the RN is the delegator who retains the accountability by transferring tasks to the LPN. A charge nurse is accountable in the absence of the RN or if the charge nurse is delegating the task. The LPN is under dependent status and is transferred the responsibility but the accountability is retained by the delegator. The primary healthcare provider may not be accountable for the client's care because the primary healthcare provider is not the delegator.

The behavior of four nurses in different situations is given below. Which nurse exhibits a behavior that can be characterized as delegation according to Hersey's model? 1 Nurse A Correct2 Nurse B 3 Nurse C 4 Nurse D

Hersey's model describes "delegation" as the leader's behavior of observing or monitoring if the delegatee has the ability, willingness, and expertise to accomplish the work and there is an established relationship, as with nurse B. Nurse A exhibits guiding or directing, described as "telling," in which the delegator simply tells the individual what is the task to be done and how to perform the task. This happens if the relationship is limited. "Selling" is exhibited by nurse C and is the process of explaining and persuading, which happens if a situation involves a new task and the relationship is ongoing. "Participating" is exhibited by nurse D and is the ability of encouraging the delegatee to perform the task and taking an active part in problem solving, which may occur during the execution of a given task.

A delegator, working in collaboration with a delegatee, allots responsibilities and explains the various procedures and techniques needed to accomplish the task. Which action is the delegator performing, according to the Hersey model? 1 Guiding and directing 2 Observing or monitoring Correct3 Explaining and persuading 4 Encouraging or problem solving

Hersey's model describes the leader's behavior as explaining or persuading, which is characterized as "selling." In this situation, the delegator is assigning the work to the delegatee and explaining the various procedures and techniques to accomplish the specified task. A leader's behavior described as guiding or directing is characterized as "telling," in which the delegate simply assigns the task to the delegatee. The leader's behavior of observing or monitoring is characterized as "delegating," in which the delegator is responsible and accountable for the entire task. A leader's behavior that is encouraging or problem solving is characterized as "participating," in which the delegator establishes a working environment in which to complete the task in the specified time.

The registered nurse is teaching a newly hired nurse about active delegation. Which statement made by the newly hired nurse indicates the need for further teaching? 1 "I will evaluate the client's pain status." 2 "I will assess the client's laboratory findings." 3 "I will instruct the unlicensed assistive personnel (UAP) to wash the client." Correct4 "I will instruct the licensed vocational nurse (LVN) to administer intravenous (IV) medications."

In active delegation, the registered nurse (RN) assesses the client's situation, determines what is appropriate for client care, directs assistive personnel to perform certain tasks, and holds the individuals accountable. Instructing the LVN to administer intravenous (IV) medications is beyond the practice scope for an LVN. Evaluating the client's pain status is a part of active delegation. Assessing the client's laboratory findings is active delegation. Instructing the UAP to wash the client is an active delegation as the RN is directing a task that is to be performed by the UAP for the client.

The newly hired nurse is delegated the task of preparing the client care plan for a diabetic client who underwent amputation. Which task in the care plan is inappropriate according to guidelines? 1 The registered nurse (RN) administering antidiabetic medications Correct2 Instructing the licensed practical nurse (LPN) to monitor vital signs 3 The RN assessing the client's blood glucose levels at regular intervals Incorrect4 Instructing the licensed practical nurse (LPN) to change the dressing at the amputation site

The LPN's scope of practice includes monitoring vital signs in clients with a stable condition. Instructing the LPN to monitor the vital signs of a client in an acute condition is inappropriate according to the guidelines. Administering antidiabetic medications to a diabetic client who underwent amputation should be done by the RN because the condition of the client is acute. The RN is responsible for assessing the blood glucose levels of the client who underwent amputation. The LPN is instructed to change the dressing at the amputation site.

The nurse is caring for a client who underwent a hysterectomy and who is admitted to a general medical-surgical unit. Which tasks can be delegated to the unlicensed assistive personnel (UAP)? Select all that apply. Correct1 Oral hygiene Correct2 Assistance with bathing 3 Oral medication administration 4 Intravenous fluid administration 5 Providing treatments with supervision

The UAP is eligible to carry out hygiene tasks such as providing oral hygiene and assisting with bathing. The licensed practical nurse and licensed vocational nurse may provide oral medications and treatments under the supervision of an RN. While treating clients, tasks such as intravenous administration of fluids should be carried out by the RN, as they are associated with potential risk if improperly infused.

Which healthcare team member would the nurse expect can be delegated with the task of administering oral medication to a client per the functional model? 1 Registered nurse 2 Patient care associate Correct3 Licensed practical nurse 4 Unlicensed assistive personnel

The licensed practical nurse can give oral medication to a client. The registered nurse gives IV medication to a client. Patient care associates assist and monitor vital signs. Unlicensed assistive personnel perform all hygienic tasks.

What are the three strategies that the nurse can perform while assisting other nurses in making delegation decisions? Select all that apply. Correct1 Doing 2 Telling Correct3 Asking Correct4 Offering 5 Participating

The nurse can assist other registered nurses with delegation decisions by using three strategies: asking, offering, and doing. Telling and participating are the strategies used by the nurse to communicate with the delegatee.

The client with methicillin-resistant staphylococcus aureus (MRSA) is admitted to the medical unit. Which of the following tasks should be performed by the registered nurse? 1 Feeding 2 Administrating oral medication Correct3 Initiating intravenous (IV) antibiotic therapy 4 Changing the dressing of a postoperative wound

The registered nurse performs the task of administering the IV medication. Feeding the hospitalized client is done by the unlicensed nursing professional. Oral administration of medicine is done by the licensed practical nurse. Changing the dressing of a postoperative wound is done by the unlicensed nursing professional.

The nursing team is involved in effective pain management. Which task would be performed by a registered nurse (RN) in this case? 1 Performing hygiene tasks 2 Taking and reporting vital signs 3 Administering oral pain medications Correct4 Developing a treatment plan for client's pain

The role of the RN is to develop a treatment plan for the client's pain. All hygienic tasks are performed by unlicensed nursing personnel. Administering oral pain medications is done by the licensed practical nurse. Taking and reporting vital signs is done by the licensed practical nurse.

The registered nurse (RN) is teaching a newly hired nurse how to communicate with a delegatee while delegating a task. Which statements made by the newly hired nurse indicate effective learning? Select all that apply. Correct1 "I will keep the information simple." 2 "I will share more information than required." Correct3 "I will share the information using electronic media." Correct4 "I will provide an opportunity to clarify the information." Incorrect5 "I will repeat the information in the same way until the new nurse understands it."

While communicating with the delegatee, the information should be simple to enable better understanding. Electronic media is used as a primary communication mechanism to share information. Providing an opportunity to clarify the information helps evaluate the ability of the delegatee. Giving more information than required may lead to confusion. The information should be repeated in different ways if necessary, to ensure better understanding.

A registered nurse is teaching a group of newly hired licensed registered nurses, licensed practical nurses, and unlicensed nursing professionals. Which teaching strategies would be appropriate to develop competencies? Select all that apply. Correct1 Case studies Correct2 Online learning 3 Teaching experience Correct4 Clinical nursing practice Incorrect5 Demographics of learning group

Competencies can be developed through different teaching strategies such as case studies, online learning, and clinical nursing practice. These strategies can help in improving the learning ability of the student nurses, licensed practical nurses, and unlicensed nursing professionals. Teaching experience and demographics may not be required to develop competencies.

A registered nurse is providing feedback to a delegatee after monitoring the work. Which feedback is the best for shaping the future behavior of the delegatee? 1 "Nice job." Incorrect2 "You could have done it better." 3 "That was better than what I expected." Correct4 "You performed that procedure safely and professionally."

Giving feedback that the performance was safe and professional clearly describes the work performance and helps in shaping the future behavior of the delegatee. Giving feedback that the work was nice is vague and not specific to a behavior. Giving feedback that the work was better than expected is insulting and is not constructive feedback. Giving feedback that the work done was better than expected is vague and does not clearly explain the work performance.

During the process of delegation, the delegator's behavior is noted to be observing and monitoring. How is the relationship between the delegator and delagatee in this situation? 1 Limited Correct2 Established 3 New or developing Incorrect4 Developing or ongoing

Observing and monitoring behavior of the delegator indicates delegating, which is done when the relationship between the delegator and delegatee is established. The delegator's behavior is guiding or directing when the relationship between the delegator and delegatee is limited. The delegator's behavior is encouraging or problem solving when the relationship between the delegator and delegatee is new or developing. The delegator's behavior is explaining or persuading when the relationship between the delegator and delegatee is developing or ongoing.

The delegator explains the procedure of the task to the delegatee and asks to provide regular feedback on the events. Which delegation right is the delegator referring to in this situation? 1 The right person Correct2 The right supervision 3 The right circumstances 4 The right communication

The delegator is supervising the task by asking the delegatee to provide regular feedback on the events of the specific assigned task. The delegator has to understand and assess the abilities and skills of the delegatee to determine that the right person is selected to perform the specified task. The right circumstance may be assessed by checking the environment, equipment, and resources to perform the task. The delegator has to develop and maintain open lines of communication to promote a positive work environment.

After assigning a task, the delegator makes sure that the instructions are clear to provide feedback related to the task. Which delegation right is referred in this situation? 1 Task 2 Person 3 Direction Correct4 Supervision

Ensuring that the delegatee is clear to provide feedback related to the task refers to the right supervision. Knowing whether the task is appropriate to delegatee based on institutional policies and procedures refers to the right task. Knowing whether the delegatee has the knowledge and experience to perform the specific task safely refers to the right person. Knowing whether the delegatee understands the assignment and directions of the task refers to the delegation right direction.

While working with a delegatee, the registered nurse says to the delegate, "It's easy; you can do the procedure tomorrow after watching me do it today. Just follow the steps I have demonstrated." What is the behavior of the registered nurse in this situation? 1 Telling Correct2 Selling 3 Delegating 4 Participating

Telling the delegatee that the procedure is easy and he or she can do it by following the demonstrated steps utilizes persuasion. According to Hersey's model, persuading statements of a delegator indicates selling behavior. According to Hersey's model, directing statements indicate telling behavior. According to Hersey's model, monitoring statements indicate delegating behavior. According to Hersey's model, problem-solving statements indicate participating behavior.

The charge nurse is teaching the newly-hired registered nurse (RN) about delegating tasks to unlicensed nursing personnel (UNPs). Which statement made by the newly hired RN indicates the need for further teaching? 1 "I should assist the staff in interpreting." Incorrect2 "I should assist the staff in decision-making." 3 "I should assist the staff in achieving optimal functioning." Correct4 "I should assist the staff in sorting out and articulating values."

The RN does not assist the staff in sorting out and articulating the values, the healthcare provider or the physicians do. The RN should assist the staff in interpreting to achieve better outcomes. As a delegator, it is the duty of the RN to help the staff in decision-making. The RN should assist the staff in achieving optimal functioning because the allotted task can have a better outcome only under the supervision of the RN.

When delegating a task, the delegator says, "Please tell me how you are going to perform this procedure, and I will share my expectations regarding how we need to communicate with each other." What can be inferred about the delegatee? 1 The delegatee has expertise and an established relationship with the delegator. 2 The delegatee has limited knowledge and ability to perform the task. Correct3 The delegatee has willingness and ability, but the relationship is new. 4 The delegatee has an established relationship with the delegator, but a new task has been delegated.

When the delegatee has the willingness and ability to perform the task but the relationship is new, the delegator tries to establish mutual expectations and conditions for performing the task. The delegator must open the lines of communication with the delegatee. When the delegatee has expertise and an established relationship with the delegator, the delegator asks the delegatee to communicate if any issue or concern arises. When the delegatee has limited knowledge and ability to perform the task, the delegator would provide more guidance to the delegatee by giving detailed instructions. If the delegatee has an established relationship with the delegator but a new task has been delegated, the delegator will need to provide explanation of what is needed to accomplish the task.

The registered nurse (RN) who delegates work to a newly hired licensed practical nurse (LPN) says, "Please tell me how you will go about performing this procedure, and I will share my expectations with you." Which behavior strategy of Hersey's model is being applied? 1 Telling 2 Selling 3 Delegating Correct4 Participating

When the LPN has the willingness and ability to perform a task, but the relationship is new, the RN will share his or her expectations and conditions with the LPN. This is a clinical example of participating. Participating is encouraging the delegatee to perform the task and taking an active part in problem solving, which may occur during the execution of a given task. If the LPN has limited knowledge and ability to perform a task, the RN will provide more guidance, which is an example of telling what is the task to be done and how it is to be performed. If the LPN is delegated a new task, it requires explanation from the RN. This is termed as selling in Hersey's model, which is the process of explaining and persuading; this happens if a situation involves a new task and the relationship is ongoing. If the LPN has an established relationship and experience, he or she requires a little guidance and this is called delegation.

A delegator is providing feedback to four delegatees. Which feedback is constructive feedback that can help the delegatee to improve quality of care? 1 A 2 B 3 C Correct 4 D

Providing feedback to delegatee D that the procedure properly performed followed by demonstrating a more effective way to perform the task improves quality of client care. Therefore, the feedback given to delegatee D is constructive feedback. Saying to delegatee A that the work was nice is vague feedback, which does not specify the behavior of the delegatee and is not constructive feedback. Providing feedback to delegatee B asking what had gone wrong with him or her today is a verbal attack that does not produce effective change and potentially may undermine a long-term working relationship. Asking delegatee C how the client responded after the task was done is an open-ended question that allows the delegator to gain pertinent information from the delegatee.

A healthcare team is caring for a postsurgical client who underwent knee surgery. Which task is most suitable to be delegated to a licensed practical nurse (LPN) to provide effective client care? Select all that apply. Correct1 Changing the dressing 2 Ambulating the client Correct3 Administration of oral analgesics Correct4 Reinforcing leg exercise instructions 5 Administering intravenous antibiotics

The LPN scope of practice includes changing the dressing of the surgical site and administration of oral analgesics. Reinforcing leg exercise instructions may also be performed by the LPN. Ambulating the client who underwent knee surgery is usually performed by a physical therapist. Instructing the LPN to administer intravenous medication may not be appropriate according to guidelines.

What does "information salience," a characteristic of communication, refer to according to Anthony and Vidal? Incorrect1 Decay of information Correct2 Clarity of information 3 Change in client's health status 4 Change in client's health information

According to Anthony and Vidal, "information salience" is a characteristic of communication that refers to the clarity of information shared between the delegator and the delegate. Decay of information, change in client's health status, and change in client's health information are described by the term "information decay."

The registered nurse is assigning work to four delegatees. Which delegatee most likely has a limited relationship with the delegator? Incorrect1 Delegatee A Correct2 Delegatee B 3 Delegatee C 4 Delegatee D

According to Hersey's model, if the relationship between the delegator and delegatee is limited, the behavior of the delegator is "telling." The delegator is telling Delegatee B to check the client's blood pressure every morning, which indicates a limited relationship between them. Participating in the delegatee's work by helping to complete the task early indicates a new relationship, which may be ongoing. Monitoring the delegatee by saying he or she is right indicates an established relationship between the delegator and delegatee. Recommending that the delegatee use a digital sphygmomanometer for ease and accuracy indicates selling behavior; this is done when the relationship between the delegator and delegatee is ongoing.

Which work is automatically increased for the delegator when there is a decrease in direct client care? 1 Leadership Correct2 Supervision 3 Delegation 4 Assignment

After delegating tasks to other members of the health care team, the delegator's care towards the client in a direct way decreases, and the supervisory work of the delegator increases. Leadership work does not necessarily increase when there is a decrease in direct client care. Delegation and assignment of work does not increase, because the work has already been delegated to another health care team member.

Which among the Five Rights of Delegation is the cornerstone of delegation? 1 "Right person" 2 "Right supervision" 3 "Right circumstance" Correct4 "Right communication and direction"

Among the Five Rights of Delegation, "right communication and direction" is the most important right of delegation. It is the most useful in maintaining the quality and safety outcomes, as it involves communication and direction. "Right person" is useful for understanding which person has the appropriate skills to perform the task. "Right supervision" involves monitoring the tasks that are performed with the goal of improving outcomes. "Right circumstance" seeks to ensure that the appropriate equipment and resources are available for the delegatee.

The registered nurse is assigning tasks to a healthcare team to provide care for a group of clients in hospice care. How should the registered nurse help the healthcare team attain an effective outcome in the hospice care? Correct1 Assisting the healthcare team in planning 2 Assisting the healthcare team in interpreting 3 Assisting the healthcare team to enhance the ability Incorrect4 Assisting the healthcare team to achieve optimal functioning

Assisting the healthcare team in planning a task by the registered nurse can be beneficial in managing the effective outcome of the hospice care. Assisting in interpreting is beneficial in affirming of the outcome. Assisting to enhance ability will help in renewing the outcome. Assisting to achieve optimal functioning will be beneficial in achieving workable unity.

Which component of delegation is suitable to all the members on the healthcare team? Correct1 Authority 2 Supervision 3 Accountability 4 Communication

Authority is the component of delegation that is suitable for all the members on the healthcare team. Supervision is a right of delegation in which the delegator supervises the other assistive personnel to perform the task. Accountability is the component of delegation that is suitable for delegators such as registered nurses (RNs). Communication is the right of delegation in which the delegator gives the directions to perform the task.

Which client care can be safely delegated to the unlicensed nursing personnel (UNP) to provide oral hygiene? Correct1 Client A 2 Client B 3 Client C Incorrect4 Client D

Client A with dental caries is least likely to have any complications during oral hygiene. Oral care in clients with oral cancer has associated risks; therefore, it should be performed by a registered nurse (RN). Since client C with a jaw fracture has limited ability to open the mouth, care cannot be safely delegated to the UNP. In client D with thrombocytopenia, small bruises that could occur during oral care may result in persistent bleeding. This complication prevents delegation of oral hygiene for client D to UNPs.

What are some challenges faced in the process of delegation? Select all that apply. Correct1 Limited resources Correct2 Large geographic area 3 Time-saving considerations Correct4 Vulnerable populations receiving care 5 Provision of assistance with activities of daily living

Delegation is a complex process. Delegating a task when resources are limited is a great challenge. Delegation is also more challenging the larger the geographic area is where the task should be performed. The process of delegation also becomes more challenging when care is being delivered to vulnerable populations. Time conservation is a benefit of the delegation process even if the decision to delegate may not be based on time-saving considerations. Providing assistance with the client's activities of daily living is a benefit rather than a challenge of delegation.

The unlicensed nursing personnel (UNP) is delegated tasks related to client care. What is the correct order of steps the registered nurse (RN) should follow when deciding to delegate the work to the UNP? Incorrect 1. Determining the knowledge and skills of the UNP Incorrect 2. Assigning the client-specific tasks to the UNP Incorrect 3. Monitoring the assignments allotted to the UNP Incorrect 4. Assessing the client's health status Correct 5. Reporting deviations in the client's response Correct 6. Providing feedback about the UNP performance

Delegation is a process of the RN assigning work to other health care personnel who are capable. First, the RN should assess the client's health needs and the knowledge and skills of the UNP for performing the care. Assignment of tasks to the UNP is based on the client's health needs after assessing the skills of UNP. The RN then monitors the client's responses to the care provided by the UNP, which is also useful to assess the performance of UNP. Any deviated client responses or any other client-specific issues are reported in order to evaluate the client's response to the care. Finally, the RN provides feedback to the UNP to help the UNP improve care.

The registered nurse assigns a task to a licensed practical nurse (LPN) to check the blood pressure and temperature of a client. Which factor is transferred to the LPN for the performance of the task? 1 Liability 2 Authority Correct3 Responsibility 4 Accountability

Delegation is the transfer of responsibility for the performance of the task. So, the LPN is responsible until the task is completed. Liability is the person's responsibility and accountability for individual actions. Authority is the ability to perform duties in a specific role. Accountability is transferred when the work of one individual is performed by the other.

What does appropriate delegation do to a healthcare organization? Select all that apply. Correct1 Reduces stress 2 Decreases trust 3 Reduces client care Incorrect4 Decrease time efficiency Correct5 Improves treatment outcomes

Delegation requires empowerment of the delegatee to accomplish the task and, therefore, sharing functions reduces stress. As functions are distributed, it improves treatment outcomes. Appropriate delegation increases trust between the delegator and the delegates, increases client care, and increases time efficiency.

A registered nurse delegated a task to the unlicensed nursing personnel (UNP) and is supervising the UNP. Which statements made by the nurse after the UNP completes the task can yield a positive outcome from the UNP? Select all that apply. Correct1 "Nice job." 2 "What is wrong with you?" Correct3 "You performed that task safely and professionally." 4 "Did the client respond positively to the nursing care?" Correct5 "The task was well done, but there is room for improvement."

Feedback, when given clearly and honestly, will yield a positive outcome from the UNP. When the nurse says, "You performed that task safely and professionally," or "The task was well done, but there is room for improvement," it shows that the UNP's work is recognized. Statements such as, "Nice job," are vague and ineffective. Statements such as, "What is wrong with you?" will be perceived as a verbal attack and will not have any positive effect. Questions should be open-ended, in order to encourage the UNP to share experiences with the RN. "Did the client respond positively to the nursing care?" is a closed-ended question that cannot be described further.

The registered nurse (RN) is caring for a client who has severe abdominal pain. The RN plans to work with the assistance of an unlicensed nursing personnel (UNP). The RN starts the client care. What should the RN consider during the process of active delegation? Select all that apply. Correct1 Assessing the level of the client's abdominal pain Correct2 Directing the UNP to assist the client while toileting 3 Advising the client to take pain medication when needed Correct4 Ensuring that the UNP is accountable for successful completion of the task 5 Explaining to the client about the reason and cause of abdominal pain

In active delegation the RN assesses the client's situation to ensure the client is stable enough to be handed over to the UNP. The RN can then delegate specific basic tasks to the UNP such as oral care and toileting. The RN then holds the UNP accountable for successful completion of the task. It is within the scope of practice of the RN to advise the client to take pain medication in accordance with the primary health care provider's prescription. Likewise, the RN can explain the reason and cause of the condition diagnosed by the primary health care provider. These tasks are considered passive delegation.

The registered nurse (RN) has delegated a task to an unlicensed nursing personnel (UNP). After performing the task, the UNP reports to the RN for appraisal. Which statement by the UNP is related to individual accountability? Select all that apply. Correct1 "I take full responsibility for the action performed." Correct2 "I have ensured that the action has achieved the desired outcome." 3 "I have ensured that there is a ventilator placed in every intensive care unit." 4 "I have established systems for assessing and monitoring the tasks assigned." Incorrect5 "I have evaluated whether the work environment is conducive to work or not."

Individual accountability is a component of delegation. It refers to the individual's ability to take responsibility for the actions performed and outcomes related to the task, which are obtained after the action. Ensuring that there is a ventilator placed in the intensive care unit, establishing systems for assessing and monitoring the competencies, and evaluation of the work environment are all related to organizational accountability, not individual accountability.

The registered nurse (RN) delegates obtaining and recording a client's pulse every 30 minutes. During the last hour, the licensed practical nurse (LPN) fails to report the client's elevated heart rate to the RN. Which factor best explains the situation? 1 Limited delegation 2 Information salience Correct3 Decayed information 4 Ineffective supervision

Information decay is the characteristic feature of communication that occurs when the client's health status changes rapidly; this might include a change in the client's vital signs such as the heartbeat. Nursing when performed with limited delegation leads to misusing valuable resources. Information salience is a characteristic feature of communication in which the information provided by the delegator is monitored and evaluated. Supervision is mainly provided to the new delegatees.

Which task can be delegated to the licensed vocational nurse (LVN)? Select all that apply. 1 Analyzing vital signs 2 Maintaining oral hygiene 3 Administering intravenous drugs Correct4 Administering oral hypoglycemic agents Correct5 Administering intramuscular medications

Licensed vocational nurses and licensed practical nurses are authorized to administer drugs through oral and intramuscular routes. Analyzing vital signs should be performed by the registered nurse. Hygiene maintenance can be delegated to unlicensed nursing practitioners (UNP). Administering intravenous drugs should be done by the registered nurse.

A nursing assistant is working with a delegator. Which action of the nursing assistant may negatively affect client care management? 1 Addressing challenges together Correct2 Performing the same tasks as the delegator 3 Initiating conversation about the new roles and functions Incorrect4 Communicating the cultural perspectives with the delegator

Nursing assistants who have similar strengths as the delegator should adapt to changing situations. A nursing assistant performing the same tasks as the delegator may create a gap in the delivery of client care. Building on the strengths and minimizing the challenges of the team proves to be an effective strategy. Initiating a conversation about the new roles and functions in the organization can open lines of communication to explain why supervision is necessary. It also helps to eliminate or diminish any negative feelings about being supervised. The lines of communication between the delegator and the nursing client can be improved by appreciating and valuing cultural perspectives.

Which statement is true regarding delegation? Select all that apply. 1 The delegatees are accountable for effective client care. Correct2 Open lines of communication must occur between delegator and delegatee. Correct3 Delegation occurs only when at least two people are involved in a mutual work situation. Incorrect4 The delegation potentials are significantly lower when caregivers such as UNPs are partnered. Correct5 Delegation involves sharing activities with other appropriate authority to accomplish the work.

Open lines of communication between delegator and delegatee helps to eliminate any misunderstanding regarding delegated tasks. Delegation occurs only when at least two people are involved in a mutual work situation; one who has the authority to perform specific tasks and other who holds accountability for the task being performed. Delegation involves sharing activities with other appropriate authority to accomplish the work. When delegating a task to delegatee, the delegator retains accountability for effective client care by ensuring that the task is completed by the right person and that the person is supervised appropriately. The delegation potentials are significantly higher when caregivers such as UNPs are partnered.

Who is most accountable for an initial assessment and the ongoing evaluation of client care? 1 Client Correct2 Registered nurse 3 Licensed practical nurse 4 Unlicensed nursing personnel

Registered nurses are accountable for initial assessment and the ongoing evaluation of client care. The client is not responsible for assessment and evaluation. The licensed practical nurse has a responsibility to assess and report client care. Unlicensed nursing personnel perform tasks as delegated by the registered nurse.

What happens when a registered nurse does not trust other individuals in the healthcare organization? Select all that apply. Correct1 Altered client care 2 Appropriate delegation Correct3 Compromised healthcare Correct4 Limited career opportunity 5 Efficient time management

Registered nurses who do not trust other individuals in a healthcare organization may choose to perform the tasks themselves and this leads to altered client care. Consistently choosing to perform tasks themselves may lead to compromised healthcare and limit career opportunities. Registered nurses who do not trust other individuals in a healthcare organization are unable to delegate appropriately because they choose to perform the tasks themselves. Doing the work themselves increases the time to complete client care and affects time management.

Which hospital care setting is most appropriate for a case manager to perform tasks as a delegatee? 1 Hospice care 2 Extended care Incorrect3 Long-term care Correct4 Rehabilitative care

Rehabilitative care settings are the most suitable for a case manager to perform tasks as a delegatee. Hospice care settings are generally delegated to the registered nurse (RN). In extended care and long-term care settings, tasks are delegated to unlicensed assistive personnel (UAP).

Which component of delegation is considered a "two way process"? 1 Authority 2 Supervision Correct3 Responsibility 4 Accountability

Responsibility is a two way process. Authority is the ability to perform duties in a specific role. Supervision is defined as the "provision of guidance and oversight of a delegated nursing task." Accountability may not be a two-way process. It determines if the actions were appropriate and provides a detailed explanation of what occurred.

The licensed practical nurse (LPN) has been asked to monitor the blood pressure of a client with hypertension. The LPN reports to the registered nurse (RN) that the blood pressure monitor is malfunctioning. Which component of the duty is the LPN practicing? 1 Authority 2 Supervision Correct3 Responsibility 4 Accountability

Responsibility refers to the reliability, dependability, and obligation to accomplish a task; it is allocated by the delegator and accepted by the delegatee. Authority is the ability of an individual to perform duties in a specific role, it also involves the responsibility of the delagatee to inform the delegator about limitations that may impede completion of a task, such as malfunctioning equipment. Supervision involves the delegator providing guidance and oversight. Accountability involves the delegator determining whether the appropriate actions are being performed and the delegatee providing a detailed explanation of what is happening in the ongoing process.

The nurse is delegating someone to care for a client with diabetes mellitus. Which instruction given by the nurse better explains the selling relationship with the delegatee? 1 "Record the client's blood glucose level each morning." 2 "You may approach me for further assistance and questions. Thank you." 3 "I will guide and assist you while you learn how to check the client's blood glucose." Correct4 "You will take complete care of the client with diabetes and make sure to record the blood glucose level."

Selling includes ongoing relationships with an explanation of the delegated new task. This is better explained in the statement, "You have to take complete care of the client with diabetes and make sure that you record the blood glucose level." Telling is ordering the delegate to record the client's blood glucose level each morning. Delegation, involving established relationships and expertise, is better explained by, "You may approach me for further assistance and questions. Thank you." Participation is mutual involvement to accomplish the task. It is better explained by the statement, "I will guide and assist you while you learn how to check the client's blood glucose."

The registered nurse oversees five unlicensed nursing personnel (UNP), and each UNP cares for five clients, so the registered nurse in effect has responsibility for five UNPs and 25 clients. What do these numbers of subordinate and clients indicate? Incorrect1 Supervision Correct2 Span of control 3 Passive delegation 4 Appropriate authority

Span of control is the number of individuals the supervisor or delegator is responsible for. In this instance, the RN is responsible for the delegatees as well as the clients they are caring for. Supervision involves ensuring that the appropriate oversight and guidance is provided for a delegated task. Passive delegation occurs when licensed members of an organization perform tasks that are essential to their normal practice. Appropriate authority is the specific ability to perform the work or task.

The registered nurse suggested that a newly hired registered nurse delegate tasks to nursing assistants. Which is an element that fosters effective delegation decisions by the newly hired registered nurse? 1 Skills Correct2 Stability 3 Practice 4 Environment

Stability along with safety, critical thinking, and time for decision-making creates an integrative process, which fosters effective delegation decisions. Skills are important for making decisions based on critical thinking. Practice accomplishes safety in delegation. Environment with feedback about performance is the best strategy for shaping the future behavior of individuals.

A nursing supervisor sends an unlicensed healthcare worker to help relieve the burden of care on a short-staffed medical-surgical unit. Which tasks can be delegated to the health care worker? Select all that apply. Correct1 Taking routine vital signs 2 Applying a sterile dressing Correct3 Answering clients' call lights 4 Administering saline infusions Correct5 Changing linens on an occupied bed 6 Assessing client responses to ambulation

Taking routine vital signs is a universal activity that all healthcare workers are taught to perform regardless of the setting; it is within the job description for unlicensed health care workers. Answering call lights is a universal activity that all unlicensed healthcare workers are taught to perform regardless of the setting; it is within the job description for unlicensed healthcare workers. Making an occupied bed is a universal activity that all unlicensed healthcare workers are taught to perform regardless of the setting; it is within the job description for unlicensed healthcare workers. Unlicensed health care workers do not have the expertise or credentials to apply sterile dressings. Unlicensed healthcare workers do not have the expertise or credentials to administer intravenous solutions. Registered nurses are not permitted to delegate assessment.

When evaluating a task performed by a delegatee, the registered nurse finds that the delegatee fails to provide appropriate feedback. Which right of delegation is compromised in this situation? 1 Right task 2 Right person Correct3 Right supervision Incorrect4 Right communication

The "right supervision" includes assessing whether the delegatee can provide feedback related to the task when appropriate. "Right task" involves providing tasks to the delegatee in accordance with legal and institutional policies. "Right person" involves delegating tasks to team members who are competent and show willingness towards the task. "Right communication" involves the delegator providing clear, concise instructions and the delegate understanding those instructions.

A client underwent angioplasty and is hospitalized for several days for observation. Which task can be delegated by the registered nurse (RN) to a licensed practical nurse (LPN)? Incorrect1 Assisting 2 Assessing 3 Evaluating Correct4 Monitoring

The LPN is eligible to monitor the client who underwent angioplasty. Any change in the condition of the client should be reported to the RN in an emergency. Assistance can be given by unlicensed nursing professional (UPN). Assessment of the client's reports is done by the RN. The LPN and UNP are not eligible for assessing reports. Evaluation of the client's reports can be done only by the physician.

A healthcare team is caring for a 68-year-old client with diabetes insipidus. Which task is most suitable to be delegated to licensed practical nurse (LPN) to provide effective client care? Select all that apply. Incorrect1 Emptying the urinary drainage bag Correct2 Monitoring urine output 3 Feeding the client with food 4 Administration of intravenous fluids Correct5 Administering oral rehydration medication

The LPN scope of practice includes monitoring urine output. Administration of any type of oral medication can also be performed by the LPN. Activities related to a client's hygiene such as emptying the drainage is usually performed by unlicensed assistive personnel (UAP). Feeding the client is usually performed by a UAP. Administration of intravenous fluids is the responsibility of the registered nurse.

A healthcare team is caring for a client who is hospitalized with severe diarrhea. According to the principle of right of supervision of delegation, what does the RN do in this situation? 1 Feed the client every 2 hours. Correct2 Monitor the hemodynamic status. 3 Assess the resources required in the client's care. 4 Follow the institutional procedures for administering fluids.

The RN should monitor the hemodynamic status of the client according to the right of supervision of delegation. It is the responsibility of the RN to supervise the delegated task. Feeding the client is usually performed by a licensed practical nurse, unlicensed nursing professional, or any member of the healthcare team. Assessment of resources is monitored before assigning tasks to the healthcare team. Following institutional procedures for administration of fluids is actually done by the RN, so it is not supervised by the RN.

A registered nurse (RN) diagnosed with chemical impairment issues is transferred to work at a rehabilitation center as a part of treatment. Which actions performed by the nurse manager at the new work place result in effective outcome of treatment for chemical impairment? Select all that apply. Correct1 Restricting the RN from working near the abused chemical 2 Delegating other staff to assist the RN in providing client care Correct3 Restricting the RN from administering any controlled substances 4 Requiring the RN to share what he or she is doing to control the problem Incorrect5 Permitting the RN to share the problem with other members of the healthcare team

The RN's job has been moved to a rehabilitation center because of chemical impairment issues and the RN is restricted from working at a facility where the drug is used, which helps the RN in his or her recovery. Controlled substances may be abused, so restricting the RN from administering such substances may result in effective outcome of therapy. Delegating the other staff the task of assisting the RN in providing client care may be a positive experience for the staff, but this intervention may not result in positive outcome of the treatment. Requiring the RN to share what he or she is doing to control the problem or allowing the RN to share his or her problem with other staff of the healthcare team may not result in positive outcome of the treatment.

Which statements are true regarding the primary nursing care developed by Marie Manthey as a method for organizing client care? Select all that apply. Correct1 The associate nurse provides input into the client's plan of care. 2 The charge nurse will be accountable for the care from admission to discharge. Correct3 If the client develops complications, the associate nurse should notify the primary nurse. Incorrect4 According to the associate nurse's care specifications, the primary nurse should provide care. Correct5 The registered nurse functions autonomously as the primary nurse throughout the client's hospital stay.

The associate nurse cares for the client according to the care specifications provided by the primary nurse in the care plan. The associate nurse provides input to the client's plan care if the associate nurse notices any complications and also notifies the primary nurse for alterations in the care plan. The registered nurse functions autonomously as the client's primary nurse by taking the responsibility and accountability of the client care from admission through discharge. It is the primary nurse, rather than the charge nurse, who will be accountable for the care of the client from the admission through discharge. According to the primary nurse's care specifications, the associate nurse should provide care.

Which action by the nurse constitutes constructive feedback for the delegatee? 1 Providing verbal attacks on feedback Incorrect2 Providing feedback to individual delegatee 3 Providing nonspecific feedback about the behavior Correct4 Providing open feedback about specific strategies for change

The best strategy is to provide open, honest, and constructive feedback. The feedback should be about work-related performance and specific strategies for change in the quality of performance. A verbal attack on a delegatee does not produce effective change and could undermine any long-term working relationship. Providing feedback to an individual delegatee as satisfactory may diminish the credibility of the nurse. Creating a work environment in which specific feedback about performance is provided is the best strategy for shaping the future behavior of the delegatee.

The delegatee is performing a task and in the process loses confidence in what he or she is doing. Which delegator's action may have contributed to the delegatee's loss of confidence? Correct1 Intervening when the delegatee is performing the task 2 Providing feedback about the work performed Incorrect3 Communicating with the delegatee about the work being performed 4 Stating that the task should be completed by a specified time

The delegatee may lose confidence and get frustrated if the delegator intervenes. Therefore intervening in tasks is not encouraged. The delegator can instead provide feedback about the task being performed to help improve the effectiveness of the delegation. Communication generally opens lines between the delegator and delegatee and will be helpful in effective delegation. The delegator should brief the delegatee about the specified time the task should be completed; this would not make the delegatee lose confidence.

What order should the nurse follow during the delegation decision-making process when delegating client care? 1.Assessing the health needs exhibited by the client 2.Assessing the abilities demonstrated by unlicensed personnel 3.Seeking client care issues 4.Ensuring the stability of the client 5. Monitoring the task 6.Providing feedback to unlicensed personnel

The delegation process starts with assessing the health needs of the client and the skills of unlicensed personnel (UNP). The key component of delegation decision-making is assessing the UNP's ability to perform the work, including, safety, critical thinking, stability, and time. It is also vital to make client care decisions at the same time. The nurse has to make sure that the client is stable and steady to ensure the best care. The greater the stability of a client, the more likely the UNP can provide safe client care. The nurse should then monitor the task being performed by the UNP. The nurse should also maintain an open line of communication with the UNP to seek client care updates and limitations. The nurse should always provide direct feedback to the UNP for professional growth and development to improve client care outcomes.

The registered nurse delegates a task to the unlicensed assistive personnel (UAP). After the UAP starts the task, the registered nurse (RN) asks for feedback related to the task. Which right of delegation is the RN following? 1 Task Correct2 Supervision 3 Circumstance Incorrect4 Communication

The delegation right of supervision refers to obtaining feedback, monitoring, and evaluating the delegatee appropriately. Right task refers to the delegation of an appropriate task based on institutional policies and procedures. Right circumstance refers to evaluation of the working environment and ensuring adequate supervision of delegatees. To ensure right communication, the RN should communicate properly and accurately to the delegatee and provide clear and concise directions for the task.

A registered nurse delegates the task of administering oral antibiotics for a client with diabetes. Which statements are true in this scenario? Select all that apply. Correct1 The registered nurse (RN) is accountable for the delegatee's work. Correct2 The licensed practical nurse (LPN) should report to the RN once the task is completed. 3 The unlicensed nursing practitioner (UNP) can also be delegated the task of administering oral antibiotics. Correct4 The licensed practical nurse (LPN) can be held responsible for any failure in administration of oral medication. 5 The licensed practical nurse (LPN) can change the medication dosage according to the client's physiological needs in the absence of the RN.

The delegator (RN in this case) is accountable for the tasks of the delegatee. The LPN should report the completion of tasks to the RN. The LPN is responsible for tasks delegated by the RN. UNPs are not authorized to administer oral antibiotics to clients, since their role is limited only to hygiene maintenance and assessing vital signs under the supervision of the RN. The duty of the LPN is only to administer the prescribed drug dosage.

The registered nurse (RN) is delegating tasks to several health care team members caring for a client with a bacterial infection and high fever. Which statements by the registered nurse would be most appropriate for the licensed practical nurse (LPN)? Select all that apply. Correct1 "You should administer an antipyretic after the meal." 2 "You should assess the client's condition." 3 "You should change the bed sheets and dress the client every day." Correct4 "You should administer prescribed antibiotics to the client twice a day." Correct5 "You should collect data that can be used in the assessment of client's condition."

The delegator can delegate tasks such as administration of antipyretic for the client who has fever. This particular task should be delegated only to the licensed nursing personnel, such as LPN. The delegator can delegate the task such as administration of antiallergic medication to the licensed professional, such as LPN. The RN is responsible for all the assessments performed, but the UAP or LPN can collect the data that can be used for the assessment. The RN is responsible for assessing the client's condition. The RN should delegate basic tasks such as changing the bed sheets and dressing the client to unlicensed nursing personnel.

A registered nurse teaches a student nurse about delegation. Which statement made by the student nurse indicates appropriate learning? 1 "Licensed practical nurses are accountable for the tasks they perform." 2 "Complete client care can be delegated to the licensed practical nurse." Incorrect3 "Professional aspects of care can be carefully delegated to the licensed practical nurse." Correct4 "Licensed practical nurses can be expected to perform tasks with which they have experience."

The delegator can safely delegate the task to the LPN if the task is within the scope of function or if the LPN is very experienced in performing the task. The LPN, being a delegatee, is not held accountable for the delegated work; the LPN is held responsible for the delegated task. The delegator is held accountable for the LPN's work. The delegator can never delegate complete client care to the LPN, but can only transfer functions and tasks. Basic skills such as activities of daily living and personal hygiene can be delegated by the delegator, but professional aspects of care should not be delegated.

The registered nurse is teaching a newly hired nurse about communicating with delegatees during delegation. Which statement made by the newly hired nurse indicates the need for further learning? 1 "I should identify priorities." Incorrect2 "I should specify deviations." Correct3 "I should provide examples of each delegation." 4 "I should specify any performance limitations to the delegatee."

The delegator should ask the delegatee to provide examples of each delegation in order to understand his or her knowledge level. The delegator should identify priorities before delegating the task to the delegatee. The delegator should specify deviations, such as when the delegatee must take an immediate action while performing the task. The delegator should specify the performance limitations to the delegatee, which can help in performing the task effectively.

Which of these clients can be provided care safely by unlicensed nursing personnel? Select all that apply. 1 A client with pain 2 A client who is upset Correct3 A client who is stable Correct4 A client who is recovering 5 A client with suicidal intention

The greater the stability of a client, the more likely it is that unlicensed nursing personnel (UNP) can provide safe client care. It is also easy for a UNP to care for a client who is recovering. A client with pain is anxious and agitated, and it will take the UNP time to calm the client. Client care may be affected when the client is psychologically upset and has suicidal intentions.

The registered nurse considers the qualification of the unlicensed nursing personnel (UNP) before delegating a task. Which right of delegation is followed by the nurse? 1 Task Correct2 Person 3 Direction 4 Supervision

The knowledge and experience to perform the specific task safely by the delegatee is assessed by the qualification of the delegatee, which determines whether he or she is the right person. The right task involves assessing whether the task is legally appropriate to delegate or whether it is appropriate under institutional policies. The right direction involves the delegator providing clear and concise directions to perform the task. The right supervision is determined by whether the delegator is able to monitor and evaluate the client appropriately.

A healthcare team is caring for clients after a fire. The charge nurse delegates different tasks to the healthcare team according to the functional model of nursing. Which team member is eligible and accessible to provide oral medications to any clients? 1 Nursing manager 2 Chief nursing officer Correct3 Licensed practical nurse 4 Unlicensed nursing professional

The licensed practical nurse is eligible and accessible to provide oral medications to clients. The nursing manager is responsible for more than one unit and has other managerial responsibilities and may not be available for providing oral medications to the clients. The chief nursing officer is busy assessing, monitoring, and verifying requirements. The unlicensed nursing professional is not eligible to provide oral medications; they can only monitor and assist the clients.

The registered nurse (RN) delegates a task to a licensed practical nurse (LPN) to take care of the client who underwent a tracheostomy. Which task should be performed by the LPN in this situation? 1 Developing a plan to avoid aspiration 2 Assessing the client's condition after tracheostomy Correct3 Providing tracheostomy care using sterile techniques 4 Teaching a client and caregiver about home tracheostomy care

The licensed practical nurse provides tracheostomy care using sterile techniques. Developing a plan to avoid aspiration in a client with tracheostomy is done by the registered nurse. Assessing the client's condition after tracheostomy is done by the registered nurse. Teaching a client and caregiver about home tracheostomy care is done by the registered nurse.

The nurse is teaching breathing exercises to a client who underwent surgery. Which member of the healthcare team is most suitable for reinforcement of teaching in the client? 1 Certified technician 2 Case manager 3 Cross-trained technician Correct4 Licensed vocational nurse (LVN)

The licensed practical nurses (LPN) are most suitable to be delegated the task of reinforcement teaching. A certified technician is an unlicensed member who can only record the vital signs or provide basic hygiene to the client. A case manager can provide primary education to the client. These personnel can delegate the task of reinforcement teaching to the assistive nursing personnel. Cross-trained technicians may perform respiratory therapy, draw blood samples, and monitor electrocardiography.

Which assets of the nurse as a licensed health care professional help in planning effective nursing care? Select all that apply. Correct1 Critical thinking Correct2 Diagnostic reasoning Correct3 Ability to synthesize information Incorrect4 Establishment of assessment system for the organization Incorrect5 Communication of competency requirements

The nurse uses critical-thinking skills to analyze the process of delegation. Diagnostic reasoning and the ability to synthesize information from various sources are also skills that allow the nurse to deliver an effective nursing care plan that is beneficial for the client. Establishing systems for assessment and the communication of competency requirements are the responsibilities of a chief nursing officer.

A healthcare team is caring for a population according to the functional model of nursing. Which healthcare team member is most appropriate for the delegation of hygiene care? 1 Unit secretary 2 Registered nurse Correct3 Nursing assistant 4 Licensed practical nurse

The nursing assistant is eligible for performing activities such as providing hygiene care and determining vital signs. Unit secretaries are not delegated to provide hygienic care because they do not have formal preparation and legal recognition. The registered nurse performs other activities such as treatment, admissions, and administering intravenous medications. The licensed practical nurse performs activities such as providing oral medications.

What is the status of the primary healthcare provider as a member of the healthcare team that is in the span of control of a registered nurse (RN)? Incorrect1 Devoid of legal authority 2 Devoid of delegation authority Correct3 Answerable to the nurse manager 4 Answerable to the registered nurse

The primary healthcare provider as a team member is designated to be answerable to a delegator such as the nurse manager. The unit secretary is devoid of legal authority or formal preparation. The primary healthcare provider may delegate tasks to the members of the healthcare team who have dependent status, such as unlicensed assistive personnel (UAP), licensed practical nurses (LPN), or licensed vocational nurses (LVN). Generally, those with dependent status are answerable to the RN.

Which question does the registered nurse recognize as related to the right of circumstance when delegating? Correct1 "Is the delegation appropriate to the situation?" 2 "Is the task within the delegatee's scope of practice?" 3 "Is the prospective delegate a willing and able employee?" Incorrect4 "Is the delegator able to monitor and evaluate the client appropriately?"

The question, "Is the delegation appropriate to the situation?" is related to right circumstance. The question, "Is the task within the delegatee's scope of practice?" is related to right task. The question, "Is the prospective delegate a willing and able employee?" is related to right person. The question, "Is the delegator able to monitor and evaluate the client appropriately?" is related to right supervision.

The client is admitted to the medical unit with a diagnosis of pulmonary edema. The client care is assigned to the registered nurse (RN) by the charge nurse. The RN admits and provides a written plan and assigns the client to a licensed practical nurse. Which healthcare personnel is accountable and responsible for the client if there is development of any complications in the client? 1 Charge nurse 2 Associate nurse Correct3 Registered nurse 4 Licensed practical nurse

The registered nurse is responsible and accountable for the client if complications develop. The registered nurse is responsible for the client because he or she delegated client care and wrote the care plan. The charge nurse may be accountable but may not be responsible since the charge nurse gets the task in the absence of the RN. The associate nurse is responsible for the client's condition if the primary nurse's written plan is implemented by the associate nurse. The licensed practical nurse (LPN) is not responsible because the LPN follows the written plan given by the RN.

The registered nurse finds that the delegatee is only working for half a day in the healthcare unit. Which is the most appropriate leadership style in this situation? 1 Selling Correct2 Telling 3 Delegating 4 Participating

The relationship between the delegator and the delegatee is limited if the delegatee is only working for a half day in the healthcare unit. Therefore, the most appropriate leadership style in this situation is telling because it provides a fair amount of guidance but limits the time spent on the interactions. The leadership style of selling requires more time because the delegator needs to understand the delegatee's motivation related to the situation. Delegating is the leadership style when the relationship between the delegator and delegatee is well established and the delegatee spends more time in the healthcare organization. Participating is the leadership style of sharing and exchanging views, which requires more time and an ongoing relationship between the delegator and the delegatee.

The registered nurse (RN) is caring for a client who underwent a hysterectomy. Which tasks can be delegated to the unlicensed assistive personnel (UAP) to provide quality care to the client? Select all that apply. Correct1 Recording vital signs Correct2 Assisting the client with bathing 3 Administering oral medications 4 Preparing the care plan for the client 5 Administering intravenous antibiotics

The tasks within the scope of unlicensed assistive personnel (UAP) include recording vital signs and providing basic hygiene, such as assisting the client with activities of daily life such as bathing. Administering oral medications is under the scope of licensed practical nurse (LPN) or licensed vocational nurse (LVN), but not the UAP. Depending on the state, administering intravenous antibiotics can be performed by either the RN or an LPN/LVN. Preparing the care plan for the client should be performed by the registered nurse only.

Which questions related to decision making for delegation are appropriate according to the delegation right of "right circumstance"? Select all that apply. 1 Is the task legally appropriate to delegate? 2 Is the prospective delegatee a willing and able employee? Correct3 Are the equipment and resources available to complete the task? Correct4 Does the delegatee have appropriate supervision to complete the task? Incorrect5 Is the task appropriate to delegate based on the institutional policies and procedures?

There are Five Rights of Delegation. Questions related to the equipment and resources available for carrying out the task allotted are appropriate for the delegation right "right circumstance." Asking about the required supervision needed for the delegatee to complete the task is appropriate for the delegation right "right circumstance." Questioning whether the task allotted is legal is appropriate for delegation right "right task." Checking whether the delegatee is an able person to perform the task would come under delegation right "right person." Checking whether the task is based on the policies and procedures of the institution comes under the delegation right "right task."

After assessing the delegatee's inability to perform an assigned task, the delegator explains the procedure and demonstrates the task to the delegatee. What can be inferred about the delegatee? 1 The delegatee may have limited knowledge and ability to perform the task. 2 The delegatee has an established relationship with the delegator and expertise. Incorrect3 The delegatee has the willingness and ability, but the relationship with the delegator is new. Correct4 The delegatee may have an ongoing relationship with the delegator, but a new task is assigned.

When the delegatee has an ongoing relationship with the delegator, but a new task is assigned, the delegator should explain and demonstrate the procedure. When the delegatee has limited knowledge and ability to perform the task, the delegator should provide more guidance. When the delegatee has an established relationship with the delegator and the expertise, little guidance is needed from the delegator to perform the task. When the delegatee has the willingness and ability to perform a task, but the relationship is new, it requires both individuals to create mutual expectations and the conditions for performance.

Which factors should be assessed to determine the level of followers' readiness according to Hersey's model? Select all that apply. Correct1 Ability Correct2 Willingness 3 Family history Incorrect4 Work experience Incorrect5 Educational qualifications

According to Hersey's model, the delegator should check the ability and willingness of the delegatee before delegating any task. Information about family history may not be required for delegating a task. According to Hersey's model, work experience and educational qualifications are not considered as factors required to determine followers' readiness.

Which client's care can the registered nurse (RN) safely delegate to unlicensed nursing personnel (UNP) based on the given data? Correct1 Client A, with chronic hypertension and stable vitals 2 Client B, with drainage from diabetic foot 3 Client C, with myocardial infarction due to atherosclerosis 4 Client D, with foot ulcers from peripheral vascular disease

Care of client A can be safely delegated because the chronic hypertension with stable vitals is not generally associated with any complications. Client B with drainage from diabetic foot is at a risk of aggravating foot issues, so this client's care cannot be safely delegated. Client C with myocardial infarction due to atherosclerosis is at a risk of cardiovascular instability and care should not be delegated. Client D has a risk of foot ulcers due to peripheral heart disease so this client's care also cannot be safely delegated to the UNP.

Which health care professional is accountable for establishing systems to assess and communicate competency requirements related to delegation? Incorrect1 Registered nurses Correct2 Chief nursing officers 3 Licensed practical nurses 4 Unlicensed nursing personnel

Chief nursing officers are expected to establish the systems to assess and communicate the competencies required for delegation. Registered nurses are accountable for client care. The licensed practical nurse and unlicensed nursing personnel act as delegatees for various tasks.

The registered nurse (RN) delegates a task to a licensed practical nurse (LPN). Which client task can be assigned to the LPN? 1 Client A Correct2 Client B 3 Client C 4 Client D

Client B is delegated to the LPN to perform sterile dressing changes on acute and chronic wounds. Assessments such as evaluating fluid electrolyte needs in client A with dehydration are performed by the RN. In client C, notifying the registered nurse if the client reports pain is done by unlicensed nursing professional (UAP). In client D with presbycusis, helping the client with hearing aid replacement is performed by the UAP.

What would the nurse describe as the challenges of delegation? Select all that apply. Correct1 Limited resources 2 More staff availability Correct3 Larger geographic area Correct4 Care for vulnerable populations 5 Deciding if delegating is time-saving

Delegation can be more challenging when the resources are limited, when the geographic area is greater, and when care is given for vulnerable populations. Availability of more staff is a benefit of delegation. Decisions for delegation should not be solely based on time-saving considerations; they should also be based on the abilities of the nursing staff to complete the tasks effectively and safely.

After assigning a specific task, the registered nurse observes that the delegatee is unable to perform the task accurately. What will be the appropriate statement of the registered nurse in this situation? 1 "It's better if I do the work myself." 2 "We will do the task some other time." 3 "You can't do even this work properly." Correct4 "Just follow my steps and you can do it."

Delegation is a complex process of sharing activities among team members. If a team member is not competent to perform a given task, the registered nurse lowers expectations and helps the delegatee accomplish the task. Therefore the appropriate statement of the registered nurse in this situation is to follow his or her example to do the work, because this provides encouragement. If the registered nurse says that it is better for him or her to do the work, it increases time and affects the process of delegation. If the registered nurse says to accomplish the task some other time, it affects the quality of client care. If the registered nurse says to the delegate that he or she cannot do the work properly, it is a verbal attack, which may undermine their relationship.

Which client is most appropriate to be delegated to unlicensed assistive personnel (UAP) based on the given data? 1 Client A 2 Client B 3 Client C Correct4 Client D

The unlicensed assistive personnel (UAP) is delegated to work in long-term care settings and extended-care settings as the clients are more stable. The UAP may not be delegated to work in acute care, emergency care, and intensive care settings. In dementia, the client experiences confusion, so long-term care is essential for this client. Since UAPs generally work in long-term care, client D is most appropriate to be delegated to a UAP. As severe diarrhea needs acute care, client A may not be delegated to a UAP. Though a hand fracture may require extended care, the client can do work on his or her own when compared to the client with dementia. Therefore, client B may not be delegated to a UAP. Clients with bronchitis need acute care as they may experience breathing difficulties. Therefore, client C is not delegated to a UAP.

A client is brought to the emergency department following ingestion of pesticides. The primary health care provider orders gastric suction. Which task can be delegated to the unlicensed assistive personnel (UAP) in this situation? 1 Monitoring the vital signs 2 Evaluating the client response 3 Gastric suctioning through vented tube Correct4 Emptying and measuring the gastric drainage

Unlicensed assistive personnel (UAP) scope of practice is limited to providing basic care, comfort, and hygiene. The UAP can measure the drainage and report the finding before emptying it. Unlicensed assistive personnel (UAP) can monitor vital signs only for clients in a stable condition. This client has an acute condition, so monitoring the vital signs is the role of registered nurse. Evaluating the client response is the role of registered nurse. UAP may perform all hygiene tasks; however, gastric suctioning through a vented tube is not within the scope of practice of the UAP.

Which delegation actions may be performed by unlicensed nursing personnel while caring for a client? Select all that apply. 1 Teaching the care plan to the client 2 Infusing intravenous fluids into the client Correct3 Asking the client to wash the hands before meals 4 Instructing the client to take specific medications Correct5 Instructing the client to wear footwear while walking

Unlicensed nursing personnel (UNP) can delegate simple and straightforward client teaching, such as asking the client to wash his or her hands before meals and wear footwear while walking. Complex and multifaceted teaching, such as detailing the care plan to the client, cannot be delegated to a UNP. The UNP has less knowledge and professional skills with which to perform complex procedures such as infusing intravenous fluids into the client and does not have a complete knowledge of medications with which to coach the client about medications.

A client is admitted to the hospital with severe backache and chest discomfort. After reviewing the client's condition, there is a need for 24-hour client care by the registered nurse (RN). Which healthcare professional is responsible for assigning the task to a registered nurse when 24-hour client care is needed? Correct1 Nurse manager 2 Nursing supervisor 3 Chief nursing officer 4 Primary healthcare provider

When the client requires 24-hour care, the nurse manager is responsible for deciding oversight of RN supervised care to the client. The nursing supervisor is responsible for supervising tasks being performed by team members. The chief nursing officer is responsible for establishing systems to provide competent and effective care. The primary healthcare provider cares for the client by diagnosing and prescribing; assigning work to the registered nurse is the responsibility of the nurse manager.

The nurse is managing a client who underwent cardiac bypass surgery. Which healthcare member can be safely delegated the task of monitoring electrocardiography? 1 Nurse aide 2 Certified technician Correct3 Cross-trained technician Incorrect4 Licensed vocational nurse (LVN)

A cross-trained technician is suitable for monitoring electrocardiography in a client who underwent bypass surgery. A nurse aide is an unlicensed individual who can assist the client with basic hygiene; this aide cannot monitor electrocardiography. A certified technician is also an unlicensed member who can only record the vital signs or provide basic hygiene to the client. A licensed vocational nurse (LVN) can administer oral and intramuscular medications and record the vital signs.

Which of these clients is most appropriate for delegation to a cross-trained technician? Correct1 Client A 2 Client B Incorrect3 Client C 4 Client D

A cross-trained technician, when paired with a registered nurse (RN), may perform respiratory therapy, phlebotomy, and electrocardiography. Care of client A can be safely delegated to a cross-trained technician. Though the cross-trained technician can record the ECG, he or she may not monitor the continuous ECG. Monitoring of vital signs is also the role of the RN. Leg exercises may be taught by the RN or by a physician. The other licensed assistive personnel may be delegated the task of reinforcing the teaching, but this is not an appropriate role for the cross-trained technician.

The registered nurse (RN) is caring for a client who is currently hospitalized for a stroke. What is the most effective professional management strategy for the RN to improve the safety and quality of client care? Correct1 Delegation 2 Leadership 3 Supervision 4 Assignment

Delegation is the most effective professional management strategy to implement in clinical practice to improve the safety and quality of client care by the registered nurse. Leadership is the action of leading a group, which is not suitable in this situation. Supervision is the active process of directing, guiding, and influencing the outcomes. Assignment is the transfer of both accountability and the responsibility from one person to another.

The registered nurse is teaching the student nurse about the concepts of delegation. Which response given by the student nurse indicates the need for further teaching? 1 Delegation always involves two individuals. Correct2 Delegation is the transfer of accountability while retaining responsibility. 3 Delegation is an important strategy for client safety and quality of client care. 4 Delegation has five rights that should be followed in the process of delegation.

Delegation is the transfer of the responsibility for the task, while the final accountability is always retained with the delegator. Delegation involves the delegator and the delegatee. Delegation is an important strategy for ensuring client safety and quality of client care. Delegation has five rights that are to be followed throughout the delegation process: right task, right person, right circumstance, right direction/communication, and right supervision.

A delegator working in a rural setting has to handle a task of managing care for clients in that area. Which crucial step should the delegator take to develop a productive strategy in delegating tasks to a delegatee? 1 Assigning the task to the delegatee 2 Providing feedback to the delegatee 3 Supervising the task at regular intervals Correct4 Understanding the capabilities of the delegatee

A delegator, before handling a task, should understand the specific capabilities and skill set of the delegatee. Selecting a delegatee who has the specific skill set for the particular task is a more productive strategy than just selecting a competent individual. The delegator has to assess the delegatee and then assign the task on the basis of the competitive skills. Providing feedback during and after the task may enhance the working capabilities of the delegatee. Supervising a task is an ultimate essential element for the delegator, because the delegator is responsible for the accountability of completing the task.

A nurse manager delegates the task of phlebotomy to the members of a healthcare team who are caring for a client with diabetes. Which individual on the team can be delegated to perform the task of phlebotomy? Incorrect1 Registered nurse Correct2 Cross-trained technician 3 Licensed vocational nurse 4 Unlicensed assistive personnel

A cross-trained technician can safely perform the task of phlebotomy when paired with a registered nurse (RN). The RN delegates tasks to other assistive personnel. A licensed vocational nurse is assigned to administer oral and intramuscular medications to clients. Unlicensed assistive personnel are delegated to perform basic hygiene for clients.

The registered nurse is delegating work to four delegatees. Which delegatee has an established relationship with the delegator? 1 Delegatee A Correct2 Delegatee B 3 Delegatee C Incorrect4 Delegatee D

According to Hersey's model, if the relationship between the delegator and delegatee is established, the behavior of the delegator is "observing or monitoring." Telling delegate B that his or her method is correct and to continue doing it in the same way indicates that the delegator is monitoring the delegatee's actions, which indicates an established relationship. Recommending delegatee A do the procedure because it can easily be done indicates a persuading behavior, which is done when the relationship between the delegator and delegate is developing. According to Hersey's model, if the relationship between the delegator and delegate is limited, the behavior of the delegator is "telling." The delegator is simply telling delegatee C to check the client's blood sugar level every morning for 5 days, which indicates a limited relationship between them. Participating in the work of delegatee D by demonstration indicates a new relationship.

The nurse manager is teaching newly assigned delegators about the limitations of delegation. Which statements made by the delegators indicate effective teaching? Select all that apply. Correct1 "Personal hygiene activities can be delegated to unlicensed assistive personnel (UAP)." Correct2 "Administration of oral medication can be delegated to the licensed practical nurse (LPN)." 3 "Administration of intravenous medication can be delegated to the licensed practical nurse (LPN)." 4 "Tasks related to caring for diabetic clients can be delegated to unlicensed assistive personnel (UAP)." Correct5 "Tasks related to caring for clients in a hospice care setting can be delegated to licensed vocational nurses (LVNs)."

Activities related to client hygiene can be delegated to unlicensed assistive personnel (UAP). Administration of oral medication can be done by the licensed practical nurse (LPN). Licensed vocational nurses (LVNs) can care for the clients in a hospice care setting. Administration of intravenous medication cannot be done by LPNs as they are not eligible. Diabetic clients cannot be cared by UAP as this group does not have sufficient knowledge about how to care for clients with diabetes.

What does the nurse say is the advantage of an appropriate delegation? 1 Assistance 2 Accountability Incorrect3 Empowerment Correct4 Reduced stress

Appropriate delegation reduces stress and increases time efficiency by providing timely care to the client. Assistance or direction is asked by the delegatee to complete the task if the nurse provides limited information on an assigned task. The nurse is accountable and responsible for the task assigned to the delegatee if the delegation does not work properly. Delegation requires empowerment of the delegatee to accomplish a task.

Which statement is correct regarding delegation? Select all that apply. Correct1 It involves transfer of authority. Correct2 The delegator retains accountability for the outcome. Incorrect3 The delegatee retains accountability for the outcome. 4 It is the transfer of both responsibility and accountability. Correct5 Principles of delegation outline what nurses need to know about the task.

Delegation involves two people—delegator and delegatee—with the transfer of authority to perform the task. The delegator retains accountability for the outcome of the task delegated. The delegatee holds responsibility but not accountability for the task. Assignment involves the transfer of both responsibility and accountability of the work to the delegatee. Principles of delegation outline what nurses need to know and do in relation to completing the task.

Before assigning a task, the registered nurse makes sure that the prospective delegatee is willing to complete the task. Which delegation right does this situation reference? Correct1 Person 2 Supervision 3 Circumstance Incorrect4 Communication

Ensuring that the prospective delegatee is willing to complete the task refers to the delegation right person. Knowing whether the delegator is able to monitor and evaluate the client appropriately refers to the delegation right supervision. Ensuring whether the equipment and resources are available to complete the delegation process refers to circumstance. Ensuring whether the delegator and delegatee understand a common work-related language refers to the delegation right communication.

Which care settings are more suitable for unlicensed nursing personnel (UNP)? Select all that apply. 1 Acute care 2 Surgical care Correct3 Extended care Correct4 Long-term care 5 Emergency care

Extended care and long-term care settings are more suitable for unlicensed nursing personnel (UNP). Acute care, surgical care, and emergency care settings require highly qualified and licensed nursing professionals. Acute care, surgical care, and emergency care are not suitable for UNPs because the clients are less stable compared to those in extended care and long-term care. Since acute care, surgical care, and emergency care settings require highly qualified and licensed nursing professionals, the UNP's role is very limited.

The registered nurse (RN) assigned the task of providing client care to four clients to a licensed practical nurse (LPN). In which order of priority should the LPN provide care to the clients? Correct 1. Client C Correct 2. Client A Incorrect 3. Client B Incorrect 4. Client D

The LPN should prioritize care to client C who underwent surgery for a heart attack and was hospitalized for 2 days to monitor the conditions post-surgery. Client A should be the next priority, so the LPN should assign a UNP to monitor the client for any changes. Third, the LPN should provide care for client D who has severe diarrhea and who has been hospitalized for 2 days. Finally, the LPN should monitor client B.

A registered nurse (RN) delegates the task of foot care for a client to an unlicensed nursing personnel (UNP). The UNP is skillful and willing to perform the given task, but was recently hired and is unfamiliar with the client's condition. What should the RN do in this situation? 1 Provide guidance to the UNP. 2 Observe and motivate the UNP. Correct3 Establish mutual expectations and conditions. Incorrect4 Explain what to do and how to perform the task.

If the delegatee is new to the workplace, but has the ability and willingness to perform a task, the RN should establish mutual expectations and conditions of performance to establish a good relationship. If the delegatee has limited knowledge and ability to perform a task, the delegator is expected to guide the UNP. The RN is expected to observe and monitor the task performed by the delegate to ensure the delegatee has the ability and willingness to establish a relationship and accomplish the work. The RN can also explain the task and how to execute it if the situation involves a new task and relationship is ongoing.

The registered nurse is caring for a client admitted with sudden paralysis in the legs and an inability to walk. Which interventions made by the registered nurse (RN) indicates correct active delegation? Select all that apply. 1 The RN assessing the client's diagnostic and laboratory findings 2 The RN administering an intravenous (IV) calcium gluconate injection Correct3 Instructing the licensed practical nurse (LPN) to report client's vital signs Correct4 Instructing the licensed practical nurse (LPN) to administer vitamin B12 injection 5 Instructing the unlicensed nursing personnel (UNP) to administer oral vitamin D3

In active delegation, the RN assesses the situation, determines what is appropriate for client care, directs assistive personnel to perform certain tasks, and holds the individual accountable. Instructing the LPN to report the client's vital signs is an active delegation that includes directing the assistive personnel to perform the task. Instructing the unlicensed nursing personnel to administer oral vitamin D3 is beyond their scope of practice. The RN assessing the client's diagnostic and laboratory findings does not involve delegation. The RN administering an intravenous calcium gluconate injection does not involve delegation. Instructing the LPN to administer a vitamin B12 injection is within the scope of practice for the LPN.

Which element of the healthcare system is the registered nurse (RN) practicing when the delegator shares accountability with the RN? Correct1 Delegation 2 Leadership 3 Supervision 4 Assignment

In delegation, the delegator and delegatee share accountability for certain tasks. In leadership, the delegator, as leader, manages the healthcare team and delegates tasks to members of the team. In supervision, the delegator supervises the delegatee as he or she completes a task. In assignment, both accountability and responsibility are transferred from one person to another on the healthcare team.

The registered nurse (RN) delegates the task of caring for a client with a leg fracture to a licensed practical nurse (LPN) and asks the LPN to alert her if any issues arise. What approach is the RN taking as delegator in this instance? 1 Providing supervision Incorrect2 Providing explanation Correct3 Providing little guidance 4 Establishing mutual expectations

The RN as delegator asks the LPN as delegatee to contact her if any issues arise while caring for the client; this approach involves the RN providing little guidance to the LPN. Supervision involves more than simply requesting that the delegatee alert the delegator if any issues arise. The delegator provides explanation when a new task is being delegated to a delegatee who has an established relationship with the delegator. The delegator and delegatee must establish mutual expectations when the delegatee has willingness and ability but the relationship is new.

The registered nurse (RN) is caring for a client with epilepsy. Which tasks delegated by the registered nurse (RN) to the assistive personnel indicates active delegation? Select all that apply. 1 Instructing the licensed practical nurse (LPN) to administer diazepam Correct2 Instructing the licensed practical nurse (LPN) to monitor the vital signs 3 Instructing the licensed vocational nurse (LVN) to administer sedatives Correct4 Instructing the unlicensed assistive personnel (UAP) to reposition the client Correct5 Instructing the unlicensed assistive personnel (UAP) to place the oxygen mask

Passive delegation includes performing the tasks based on the position description such as physician or pharmacist. The individual functioning in this role performs these tasks through passive delegation. Instructing the LPN to administer diazepam, medication that was already prescribed by the primary healthcare provider, is passive delegation. Instructing the LVN to administer sedatives that were already prescribed by the primary healthcare provider is passive delegation. Instructing the LPN to monitor vital signs is active delegation as the RN directs assistive personnel to perform certain tasks and holds the individual accountable. Instructing the UAP to reposition the client is also an active delegation as the UAP is carrying out certain tasks that are directed by the RN. Instructing the UAP to place the oxygen mask is an active delegation as the RN directs assistive personnel to perform certain tasks.

The registered nurse (RN) is planning to provide feedback to the licensed practical nurse(LPN). Which questions asked by the RN help in eliciting the LPN's work quality? Select all that apply. 1 "Are you feeling well today?" Correct2 "How did the patient respond?" 3 "Has the task been completed?" 4 "Are you willing to perform the task?" Correct5 "What changes were observed in the client?"

Providing feedback is the best strategy for shaping the future behavior of the individual. To elicit feedback, a series of open-ended questions should be asked by the registered nurse (RN). This will help collect pertinent information from the individuals delegated a portion of client care, such as client's response and the task to be completed. Asking personal questions about the delegatee does not help in eliciting the work quality of the delegatee. Asking whether the task has been completed is not an open-ended question. Willingness to perform the task directly implies the work interest of the delegate, but not the quality of the delegatee's work.

Which activity of the registered nurse is included in supervision? 1 Performing the given task 2 Allocating a portion of the work 3 Providing information to the delegator Correct4 Providing guidance and oversight in delegating a task

Supervision is defined as "provision of guidance and oversight of a delegated nursing task." It includes open lines of communication between the delegator and the delegatee to provide guidance. Responsibility is the activity of performing a given task. Delegation is the activity of allocating a portion of work. Authority is the activity of providing information to the delegator.

Which quality of the nursing assistant should be known by the delegator when assigning a task? Correct1 Ability 2 Willingness 3 Interaction 4 Relationship

The ability of the nursing assistant to perform a task should be known by the delegator before assigning a task. The willingness of the delegatee to work on a task can be understood by the delegator while communicating with the delegatee. Interaction is the quality of a delegatee, which can determine the effectiveness of the delegatee to perform a task. Relationship between the delegator and delegatee is not an aspect that should be known by the delegator before assigning a task.

The registered nurse is delegating tasks for the care of a vulnerable population. Which healthcare team would be appropriate for the delegation of tasks? 1 Charge nurse (CN), chief nursing officer (CNO), and registered nurse (RN) 2 Licensed practical nurse (LPN), unlicensed nursing professional (UNP), and charge nurse (CN) 3 Chief nursing officer (CNO), Registered nurse (RN), and unlicensed nursing professional (UNP) Correct4 Registered nurse (RN), licensed practical nurse (LPN), and unlicensed nursing professional (UNP)

The appropriate healthcare team for delegation of tasks for the care of vulnerable populations consists of the RN, LPN, and UNP. Proper care and assistance can be provided by this team. The CN, CNO, and RN are all licensed health professionals and there are team members to provide assistance on this team. In the team consisting of the LPN, UNP, and CN, there is no person who can take responsibility and accountability of the client care. In the CNO, RN and UNP team, the UNP may not be eligible to carry all the activities and the CNO and RN are responsible for carrying out delegation.

Who functions as a liaison between team leaders and other healthcare providers? Correct1 Charge nurse 2 Registered nurse 3 Nursing manager 4 Chief nursing officer

The charge nurse functions as a liaison between team leaders and other healthcare providers. Registered nurses function as accountable and responsible people for delegated tasks. Nursing managers are responsible for more than one unit and have other managerial responsibilities. Chief nursing officers are accountable for establishing systems to assess, monitor, verify, and communicate competency requirements related to delegation.

Which intervention should the charge nurse perform to manage a task when the unlicensed nursing personal (UNP) is lacking competence? 1 Provide constructive feedback and assign another task. 2 Provide open vocal feedback and withdraw the UNP from task. Correct3 Provide additional support and temporarily lower expectations. Incorrect4 Provide accountability to the organization and undergo training again.

The charge nurse should manage a task by temporarily lowering expectations and providing additional support to an unlicensed nursing personal (UNP) who is lacking competence. This strategy allows the UNP to build on strengths, minimize weaknesses, and gain confidence. Providing constructive feedback and assigning another task may not improve the strategy of the UNP and may affect the productivity of the new task. Withdrawing the UNP from the task and providing open vocal feedback may weaken the working relationship and the UNP may lose confidence or become frustrated. The charge nurse should be aware of accountability to the organization in case of a failure of the delegation, but assigning the UNP for further training may lead to high risk for legal liability.

Which questions should the delegator assess to determine the right task? Select all that apply. Correct1 "Is the task legally appropriate to delegate?" 2 "Is the environment conducive to completing the task safely?" 3 "Does the delegator provide clear and concise directions for the task?" Correct4 "Is the task appropriate to delegate based on institutional policies and procedures?" 5 "Does the delegatee have the knowledge and experience to perform the specific task safely?"

The delegator has to determine right task by assessing whether the task is legally appropriate to delegate. The delegator must also check that the task is appropriate to delegate based on institutional policies and procedures. The right circumstance can be assessed by asking, "Is the environment conducive to completing the task safely?" The right direction and communication is assessed by asking, "Does the delegator provide clear and concise directions for the task?" The right person eligible to accomplish the task is assessed by asking, "Does the delegatee have the knowledge and experience to perform the specific task safely?"

What should the delegator do when he or she finds that a delegatee is unable to perform the given task? 1 Assign another task to the delegatee 2 Remove the delegatee form the task Incorrect3 Make an effort to complete the task on his or her own Correct4 Make sure to educate and provide feedback to the delegatee

The delegator should educate and guide the delegatee on finding that the delegatee is not competent to perform the task. The delegator should also provide feedback to the delegatee during and after the task to enhance working performance. Assigning the delegatee to another task may lead to poor performance and low quality of output. Removing the delegatee from the task may weaken the working relationship. The delegator has to make an effort to have the task completed by assigning, guiding, and monitoring the delegatee at regular basis.

Which right does the question, "Do staffing ratios demand the use of high-level delegation strategies?" indicate? 1 The right task 2 The right person Incorrect3 The right supervision Correct4 The right circumstance

The right circumstance can be assessed by asking, "Do staffing ratios demand the use of high-level delegation strategies?" The right task is assessed by the legally appropriate delegate, using institutional policies and procedures. The right person is selected when the delegatee has the knowledge and experience to perform the specific task safely. Providing feedback related to the task and monitoring the client promote right supervision.

After delegating the task of administering oral medications to a licensed practical nurse (LPN), the registered nurse (RN) ensures that the LPN is supervised until the task is accomplished. Which right of delegation does the scenario reflect? 1 The right task 2 The right person Incorrect3 The right direction Correct4 The right circumstance

The right circumstance is indicated by the appropriate supervision, availability of equipment and resources, and appropriateness of the given situation. If the task is appropriate to the delegate based on institutional policies and is legal then it represents the right task of delegation. If the delegatee has adequate knowledge and experience to perform a task safely and effectively, it represents the right person of delegation. The right direction is indicated by the clear and concise directions provided for the task.

The registered nurse is caring for a client undergoing chemotherapy. Which statement made by the client shows a need for the registered nurse (RN) to delegate unlicensed assistive personnel (UAP) to help the client with activities of daily living (ADL)? Select all that apply. 1 "I have severe nausea." 2 "I developed rashes after therapy." 3 "I am unable to bear the pain of chemotherapy." Correct4 "I am unable to eat by myself due to the intravenous (IV) catheter." Correct5 "I am unable to get out of bed because I am so weak from the therapy."

Unlicensed assistive personnel are members of the healthcare team whose scope of practice is limited to feeding, providing basic care, hygiene, and comfort. The client reporting an inability to eat due to the intravenous catheter and an inability to get out of bed due to weakness indicates that he or she can be assisted by the UAP. The RN will be required to report the client's severe nausea to the primary healthcare provider. The RN will be required to report the pain experienced by the client undergoing chemotherapy. The client who developed rashes after therapy will require the RN to report the side effects of the medication to the primary healthcare provider.

The healthcare team is caring for a client with neutropenia. Which task is delegated to unlicensed assistive personnel? 1 Administering antibiotics Correct2 Assisting with personal hygiene Incorrect3 Monitoring for signs and symptoms of infection 4 Teaching the client and caregivers about how to avoid infection

Unlicensed assistive personnel assisting with the client's personal hygiene. The licensed practical nurse administers antibiotics. Monitoring for signs and symptoms is performed by the licensed practical nurse. The registered nurse teaches the client and caregivers how to avoid infection.

While assigning a task, the registered nurse finds that one of the delegatees is not competent to hold the current position. Which strategy does the nurse follow for managing this issue during delegation? 1 Attacking the delegate verbally 2 Doing the task himself or herself Incorrect3 Adjusting the quality of client care Correct4 Lowering the expectations temporarily

When the delegatee is not competent to hold the current position, the registered nurse temporarily lowers expectations. Temporarily lowering the expectations helps the delegatee to build strengths, minimize weaknesses, and gain confidence. Verbal attacking does not help in the situation but will only undermine the relationship between the delegatee and the registered nurse. If the registered nurse does the task herself or himself, the delegatee will not improve. Delegation is a process meant to improve the quality of client care but it is not a strategy to overcome the situation.

Which right is applicable when the delegator and delegatee understand a common work-related language? Incorrect1 Right of person 2 Right of supervision 3 Righty of circumstance Correct4 Right of communication

When the delegator and delegatee understand a common work-related language, then right communication is applicable. Right person is applicable when the delegatee has appropriate knowledge and experience to perform a task. Right supervision is applicable when the delegator is able to monitor and evaluate the client appropriately. Right circumstance is applicable when the delegation process is applicable for the situation.

The registered nurse (RN) who was caring for a postsurgical client went out for a break. The RN assigns the work to a healthcare professional who is also an RN. Which is the correct statement regarding this situation? 1 The situation describes delegation. Correct2 The situation describes assignment. 3 The second nurse holds accountability rather than responsibility for the client. Incorrect4 The second nurse holds responsibility rather than accountability for the client.

When the work is assigned to another registered nurse (RN), it indicates assignment. The RN holds responsibility and also accountability of the assigned task. When the work is assigned to other practitioners, it indicates only responsibility is transferred.

The registered nurse is evaluating the statements made by a student nurse after teaching Hersey's situational leadership model regarding core competencies of a situational leader. Which statement made by the student nurse indicates a need for correction? 1 "A situational leader partners for performance." Correct2 "A situational leader is inflexible towards the work." 3 "A situational leader is able to identify the commitment of delegatee." 4 "A situational leader is able to diagnose the performance of a delegatee."

According to Hersey's situational leadership model, a situational leader is flexible towards work and adapts to the given situation. A situational leader collaborates with others to achieve the goals. A situational leader is able to identify the commitment of a delegatee. A situational leader is able to diagnose the performance of a delegate.

The registered nurse (RN) is caring for a client with renal calculi. Which healthcare professional is most suitable to be delegated the task of administering urinary alkalinizer by mouth to the client? 1 Certified technician 2 Patient care associate Correct3 Licensed practical nurse 4 Unlicensed assistive personnel

Administering oral medications such as urinary alkalinizer can be safely delegated to a licensed practical nurse (LPN) or licensed vocational nurse (LVN) as per guidelines. Certified technician is a licensed assistive personnel whose scope of practice is limited for administering medications. The scope of practice of the patient care associate and unlicensed assistive personnel is limited to performing basic care, feeding, and hygiene.

Total client care is delegated to a registered nurse. Which member of the healthcare team is responsible for consulting other healthcare professionals in planning and delivering client care? Incorrect1 Charge nurse Correct2 Primary nurse 3 Associate nurse 4 Nurse navigator

The primary nurse is responsible for consulting other healthcare professionals in planning and delivering client care. The charge nurse delegates work to other healthcare team members in the absence of the delegator. The associate nurse is delegated to provide care to the client according to the primary nurse's specifications. The nurse navigator works through the healthcare system to help clients obtain high-quality care.

The registered nurse is delegating work to four delegatees. Which delegatee has an established relationship with the delegator? 1 Delegatee A Correct2 Delegatee B 3 Delegatee C 4 Delegatee D

According to Hersey's model, if the relationship between the delegator and delegatee is established, the behavior of the delegator is "observing or monitoring." Telling delegate B that his or her method is correct and to continue doing it in the same way indicates that the delegator is monitoring the delegatee's actions, which indicates an established relationship.

Which behavior does the delegator adopt when communicating with the delegatee if the relationship between them is new, the delegatee has limited knowledge, and the delegator does not expect the relationship to be ongoing? Correct1 Telling 2 Selling 3 Delegating 4 Participating

According to Hersey's Situational Leadership Model, if the relationship between a delegator and a delegatee with limited knowledge is new and is not going to be ongoing, the delegator's behavior is characterized as "telling." Delegator's behavior is characterized as "selling" if the delegatee and delegator have an ongoing relationship and a new task is being delegated. The delegator's behavior is characterized as "delegating" when the delegatee has expertise and an established relationship with the delegator. If the delegatee has willingness and ability, but the relationship with the delegator is new, then the delegator's behavior is characterized as "participating."

The registered nurse (RN) is teaching a novice RN about delegating tasks to licensed practical nurses (LPN) and unlicensed assistive personnel (UAP). Which statement made by the novice RN indicates a need for further teaching? 1 "I will delegate the task of reinforcing client teaching to the LPN." Correct2 "I will delegate the task of assisting the client with bathing to the LPN." 3 "I will delegate the task of recording vital signs of the client to the UAP." Incorrect4 "I will delegate the task of administering intramuscular injections to the LPN."

Assisting the client with bathing is related to providing basic care, comfort, and hygiene and is a task better suited to unlicensed assistive personnel. The scope of practice of an LPN includes reinforcing the client teaching. Recording vital signs is within the scope of practice of UAP. Administering intramuscular injections is within the scope of practice of an LPN, not UAP.

The registered nurse is evaluating the statements of the student nurse after teaching about delegation. Which statement made by the student nurse indicates a need for correction? 1 "Delegation is merely sharing a set of functions." 2 "Delegation ensures quality client care outcomes." Correct3 "Professional aspects of care can also be delegated." 4 "The final accountability of a task remains with the delegator."

Basic activities of daily living and personal hygiene can be delegated but professional aspects of care cannot be delegated and should be performed by the registered nurse only. Delegation is a process of merely sharing a set of functions in which the delegator shares functions with the delegatee. Because delegation involves sharing of functions, it ensures quality client-care outcomes. Though the delegator assigns work, the final accountability of a task remains with the delegator.

A healthcare team is delegated the task of assisting a client with bathing. Which member of the healthcare team is responsible and accountable for this aspect of client care? Incorrect1 Nursing aide Correct2 Registered nurse (RN) 3 Patient care associate (PCA) 4 Licensed vocational nurse (LVN)

Bathing is often delegated to a patient care associate (PCA) on the healthcare team. The registered nurse (RN) is accountable for the client care, but is not delegated the task of basic hygiene care such as bathing. Though the nursing aide is responsible for client care, he or she is not accountable for the client care. Similarly, a PCA may be responsible but not accountable for client care. As bathing is not generally delegated to a licensed vocational nurse (LVN), the LVN is neither responsible nor accountable for client care.

The registered nurse (RN) is caring for a pregnant client with malnutrition due to morning sickness. Which task can be safely performed by the licensed practical nurse (LPN) in this condition? 1 Assessing hemoglobin levels 2 Evaluating nutritional status Correct3 Administering oral antiemetics 4 Administering intravenous fluids

Administering oral antiemetics is a task that can be safely performed by the licensed practical nurse (LPN). Assessing the hemoglobin levels is the role of the RN; this task may not be delegated to the LPN. Evaluating the nutritional status is also the role of the RN. Intravenous fluids are only administered by a registered nurse (RN).

A critically injured client was brought to the hospital following a car accident and the client should be immediately triaged for determining the nature and acuity of the injuries. Who is delegated to perform the task? 1 Nurse manager Correct2 Registered nurse 3 Licensed practical nurse Incorrect4 Primary healthcare provider

When the client arrives at the hospital after a trauma, it is the responsibility of the registered nurse to determine the nature and acuity of injuries. The nurse manager should usually be the delegator for the registered nurses and healthcare providers. Licensed practical nurses' scope of practice does not include caring for critically ill emergency clients. A primary healthcare provider should treat the client by providing required medications and diagnoses.

The nurse manager has delegated tasks to a registered nurse (RN) and unlicensed assistive personnel (UAP) who are paired to provide care for a client with substance abuse. Which hospital care setting uses this model to deliver care to the clients? 1 Hospice care 2 Extended care 3 Long term care Correct4 Rehabilitative care

Clients with substance abuse require rehabilitative care. Rehabilitative care uses the partnership model to deliver care to the clients. In this model, the RN and UAP are paired to deliver the care. Hospice care is indicated for end-of-life care in clients. Extended care is provided for older clients. Long-term care is provided for clients with chronic diseases. Hospice care, extended care, and long-term care setting may not require the partnership model to deliver the care to the clients.

The registered nurse (RN) is getting ready to leave the client care unit for a lunch break. The RN asks the LPN to take care of a client during the lunch break. Which concept is emphasized in this situation? 1 Leadership Correct2 Delegation 3 Supervision 4 Assignment

Delegation is the concept of a transfer of authority between two people to perform some type of task, e.g., between an RN and licensed staff. Leadership is the action of leading a group or an organization. Supervision is defined as the active process of directing, guiding, and influencing the outcome of an individual's performance. Assignment is the transfer of both accountability and responsibility.

How can registered nurses develop delegation and supervisory strategies to adapt to their changing roles? Select all that apply. Correct1 Engage a nurse mentor for guidance. 2 Practice the nursing care process in various clinical settings. Correct3 Reinforce delegation knowledge through continuing education. 4 Become familiar with the hierarchy of authority in the health care organization. Correct5 Seek high-quality clinical delegation experience early in their career.

Engaging a nurse mentor helps provide guidance and facilitate problem-solving related to delegation and supervision. Reinforcing delegation knowledge through continuing education helps nurses become familiar with the changing trends in health care delivery in context of delegation. Seeking high-quality clinical delegation experience early in a nurse's career helps nurses gain confidence in delegation skills. Practicing the nursing care process in various clinical settings helps the nurses to improve patient outcomes, but would not specifically help develop delegation and supervisory strategies. Becoming familiar with the hierarchy of authority in the health care organization may help nurses understand management-related issues. However, this knowledge would not directly help nurses develop delegation and supervisory strategies.

Which element creates an integrative process that fosters effective delegation decisions by the registered nurse? 1 Ability 2 Liability Correct3 Stability 4 Ethnicity

Stability is the element that creates an integrative process that fosters effective delegation decisions. Ability is the factor that needs to be assessed to determine the level the leaders determine. Liability is the person's responsibility and accountability for individual actions. Ethnicity does not play a role in the process of delegation.

The registered nurse is assisting a client who is hospitalized with high fever. Which task delegated to the unlicensed assistive personnel (UAP) would be appropriate? Select all that apply. 1 Assessing the vital signs Correct2 Performing all hygiene tasks 3 Administering oral medications Correct4 Helping the client in changing clothes 5 Administering intravenous medications

The UAP does all the hygiene tasks and also helps in changing the clothes. Assessing the vital signs may not be performed by the UAP. Administering the intravenous medications is performed by the registered nurse. Oral administrating of medication is performed by the licensed practical nurse.

Which questions should the nurse consider to assess and ensure delegation to the right person? Select all that apply. Correct1 Is the prospective delegatee a willing and able employee? 2 Does the delegatee understand the directions and expected results of the task? 3 Does the delegatee understand how, what, and when to report to the delegator? 4 Is it clear that the delegatee will provide feedback related to the task when appropriate? Correct5 Does the delegatee have the knowledge and experience to perform the specific task safely?

The right delegatee is chosen on the basis of the person's willingness and ability. The nurse should assess the knowledge and experience of the prospective delegatee to perform the specific task safely and fulfill the expected outcomes. Right direction and documentation are assessed by the delegatee's ability to understand the directions and expected results of the task. It can also be assessed on the basis of the delegatee's understanding of how, what, and when to report to the delegator. The right supervision is providing feedback to the delegatee, related to the task, when appropriate.

Which conditions make a delegation more challenging for the registered nurses, delegatees, and clients? Select all that apply. Correct1 Limited resources 2 More staff availability 3 More client care time Correct4 Greater geographical area Correct5 Vulnerable populations receiving care

Delegation is a multifaceted decision-making process which involves a nurse directing another person to perform nursing tasks and activities. Delegation is more challenging when other resources are limited because it is difficult to care for all clients when resources are limited. Delegation is more challenging when the geographic area is greater because of more population. Delegation is more challenging when vulnerable populations are receiving care because they are economically uninsured. Delegation is better when more staff is available and when more time is allotted to care for clients.

Which behavior of the delegator with respect to the work delegated to a delegatee is characterized as "selling" according to the Hershey's Model? 1 Guiding or directing Correct2 Explaining or persuading 3 Observing or monitoring 4 Encouraging or problem solving

The delegator's behavior when explaining or persuading the delegatee is characterized as "selling" according to Hershey's Model. The delegator's behavior when guiding or directing the delegatee is characterized as "telling." The delegator's behavior when observing or monitoring the delegatee is characterized as "delegating." The delegator's behavior when encouraging or problem solving is characterized as "participating."

The legal authority has delegated the tasks according to the model of analysis type of care. Which statements are true regarding the model analysis? Select all that apply. Correct1 Model analysis improves client satisfaction. Correct2 Model analysis is a cost-effective idea for client care. 3 Quality control is better in the model analysis type of care. Correct4 Model analysis promotes organizational decision-making at lower levels. 5 Model analysis promotes adequate communication among the staff members.

Model analysis is a type of care that benefits clients in terms of satisfaction of care being provided. In model analysis, the team nursing method is followed. It is a cost-effective system because it works with an expected ratio of unlicensed to licensed personnel. Organizational decision making occurs at lower levels in model analysis. Control of quality is lower in model analysis. There may be inadequate communication among staff members due to the higher potential for fragmentation of care.

In a long-term care facility, the care tasks for a client who is suffering with liver disease are being delegated. Which statement made by the delegator indicates the responsibility for the tasks is with the registered nurse? Select all that apply. 1 "You will be responsible for the whole nursing unit." 2 "You will provide the treatment that is prescribed." Correct3 "You will assess alleviation of the client's symptoms." Correct4 "You will be monitoring the client care on an hourly basis." Correct5 "You will admit the client to the intensive care unit (ICU) if her condition deteriorates."

In a long-term care facility, the registered nurse will be responsible for supervising the licensed nursing professionals who will be the performing the delegated tasks. The registered nurse takes the responsibility of assessing alleviation of symptoms and monitoring the client on an hourly basis. Admission of the client to the ICU is the responsibility of the registered nurse. The licensed practical nurse (LPN) or the licensed vocational nurse (LVN) is responsible for taking the responsibility for the whole nursing unit. The LPN or LVN will be delegated the task of providing the treatments that are prescribed by the primary healthcare provider.

The registered nurse finds information decay during the process of delegation. What possible causes may have contributed to this? Select all that apply. Correct1 Frequent changes in the heart rate of the client Correct2 Rapid change in the blood pressure of the client Correct3 Frequent changes in the client's perception of pain Incorrect4 Diverse cultural background of the delegator and delegatee Incorrect5 Different educational background of the delegator and delegatee

Information decay is a characteristic of communication that occurs when the client's health status changes rapidly and specific information loses its value or becomes irrelevant to the client's condition. Rapid change in the blood pressure, frequent changes in the heart rate, and frequent changes in the client's perception to pain can all cause rapid changes in information and lead to information decay. Diverse cultural backgrounds of the delegator and delegatee refer to another characteristic of communication, "information salience." Different educational backgrounds of the delegator and delegatee refer to another characteristic of communication, "information salience."

The direct care nurse is delegated the task of reviewing the informed consent form after being completed by the client. Who should the direct care nurse consult regarding queries related to client rights? Incorrect1 Charge nurse Correct2 Nurse manager 3 Licensed practical nurse 4 Primary healthcare provider

Informed consent is the authorization by the client or client's representative to perform some therapeutic intervention. Informed consent is an important concept for nurse managers, and the nurse manager is the person who can clarify queries regarding informed consent. The charge nurse is the registered nurse who has the responsibility of coordinating and assigning client care and supervises the delegatees. A licensed practical nurse is a licensed nursing professional whose scope of practice is limited. It is not the responsibility of the primary healthcare provider to explain the concepts of informed consent of the client to the direct care nurses.

While caring for a client, the registered nurse (RN) needs the assistance of a licensed practical nurse (LPN). The RN feels that the LPN requires supervision as the LPN has previously only worked in a physician's office. Which action by the RN would help diminish any negative feelings the LPN might have about being supervised? 1 Initiating a conversation about the limited skills of the LPN Incorrect2 Appreciating the performance of the LPN when providing feedback 3 Explaining the policies and procedures of the organization Correct4 Initiating a conversation about the new role and functions of the LPN

Initiating a conversation related to new role and functions of the LPN opens up the lines of communication and provides an opportunity to explain why the supervision is necessary. It also helps eliminate or diminish the negative feelings of the LPN regarding the supervision. The RN can open up the line of communication by briefing the drawbacks of the LPN, but this may not help in diminishing the negative feelings about supervision. Appreciating the LPN's work may be welcome and appropriate, but would not necessarily address the LPN's negative feelings about being supervised. Likewise, an explanation of the organization's policies and procedures is important for a LPN who is new to the organization, but this would not necessarily diminish the LPN's negative feelings about supervision.

How should a student nurse be trained for implementing delegation in practice? 1 By reinforcing delegation to the student nurse only during academics Correct2 By interacting with highly qualified, clinically experienced nursing mentors 3 By improving didactic content by theoretically educating the student nurse Incorrect4 By considering the student nurse's opinions for the master delegation decisions

Interaction with highly qualified, clinically experienced nursing mentors fosters professional self-confidence in the student nurse. These experiences allow student nurses to build up their ability to be successful delegators. Delegation knowledge should also be reinforced in nursing continuing education programs. Didactic content about delegacy can be improved by pairing the education and the clinical experience from the healthcare practice site. The student nurse does not have enough knowledge to make master delegation decisions without adequate training.

The registered nurse is caring for a client suffering from skin infections. The nurse delegates the client care tasks to the health care team. Which task delegated is correct as per guidelines? 1 Daily changing of wet dressings by the unlicensed assistive personnel (UAP) Correct2 Topical administration of medication by the licensed practical nurse (LPN) 3 Administering intravenous antibiotics by the licensed practical nurse (LPN) 4 Teaching the client to minimize sun exposure by the unlicensed assistive personnel (UAP)

LPN scope of practice is limited to administering oral, topical, and parenteral medications except intravenous. The LPN can be delegated the task of administering topical medication to the client. The scope of practice for an unlicensed assistive personnel involves maintaining the client's hygiene and daily changing of wet dressings is delegated to a certified technician. Administering intravenous antibiotics to a client with infection is an inappropriate task to be delegated to an LPN. Teaching the client to minimize sun exposure cannot be delegated to the UAP. UAP can only reinforce the teaching provided by the registered nurse.

Which actions in the delegation process represent accountability? Select all that apply. Correct1 Monitoring client care Correct2 Seeking the outcome report 3 Assessing the ability of the delegatee 4 Providing honest feedback to the delegatee Incorrect5 Assisting registered nurses with delegation decisions

Monitoring client care and seeking the outcome report represents accountability of the task in case of conflicts. Assessing the ability of the delegatee and educating about the task indicates responsibility. Providing open and honest feedback to the delegatee improves work performance and client care outcomes. The nurse can assist other registered nurses with delegation decisions regarding safety issues, urgency to intervene, or potential negative client outcomes.

A nurse is assisting another registered nurse in the intensive care unit who is caring for a client with uncontrolled blood pressure. Which action on the part of the nurse indicates "offering" during delegation decisions? 1 "Did you check the client's blood pressure this morning?" Correct2 "You can use this stethoscope and sphygmomanometer to take the blood pressure." 3 "Would you fetch me the client's laboratory reports? I'll record the blood pressure." 4 "How is the client doing this morning? Let me look at yesterday's blood pressure report."

Offering involves making a suggestion to facilitate the achievement of a desirable client care outcome. The statement, "You can use this stethoscope and sphygmomanometer to take the blood pressure," is an example of offering. Asking begins with questions related to the problem or issue regarding client care. "Did you check the client's blood pressure this morning?" is an example of asking. Doing involves demonstrating the specific task or behavior needed to improve client care. "Would you fetch me the client's laboratory reports? I'll record the blood pressure," is an example of doing. "How is the client doing this morning? Let me look at yesterday's blood pressure report," is an example of supervision.

What does the decision strategy of "offering" include in delegation? Incorrect1 Allowing the delegator to examine the situation differently 2 Demonstrating the specific task or behavior to improve client care 3 Asking questions related to the problem or issue regarding client care Correct4 Making a suggestion to facilitate the achievement of a desirable client care outcome

The decision strategy of offering involves making a suggestion to facilitate the achievement of a desirable client care outcome. The decision strategy of asking allows the delegator to examine the situation differently. The decision strategy of doing includes demonstrating the specific task or behavior to improve client care. The decision strategy of asking includes questioning issues related to the problem regarding client care.

Which statements are true regarding the primary nursing care developed by Marie Manthey as a method for organizing client care? Select all that apply. Correct1 The associate nurse provides input into the client's plan of care. 2 The charge nurse will be accountable for the care from admission to discharge. Correct3 If the client develops complications, the associate nurse should notify the primary nurse. 4 According to the associate nurse's care specifications, the primary nurse should provide care. Correct5 The registered nurse functions autonomously as the primary nurse throughout the client's hospital stay.

The associate nurse cares for the client according to the care specifications provided by the primary nurse in the care plan. The associate nurse provides input to the client's plan care if the associate nurse notices any complications and also notifies the primary nurse for alterations in the care plan. The registered nurse functions autonomously as the client's primary nurse by taking the responsibility and accountability of the client care from admission through discharge. It is the primary nurse, rather than the charge nurse, who will be accountable for the care of the client from the admission through discharge. According to the primary nurse's care specifications, the associate nurse should provide care.

Which condition may lead to delegation failure due to malpractice? 1 Adapting to changing situations by the nursing assistant 2 Educating and monitoring the nursing staff incompetent to perform a task Correct3 Employing more unlicensed nursing personal (UNP) in the emergency department Incorrect4 Assigning the more unlicensed nursing personal (UNP) for long-term care facilities

The greater the stability of a client, the more likely an unlicensed nursing personal (UNP) can provide safe client care. It is not ideal to increase the numbers of UNPs in the emergency department due to client instability. The nursing assistant has to adapt to changing situations to deliver proper client care. The delegator must train and monitor the performance of the nursing staff, who are responsible for completing tasks in a specified time. This helps in improving the performance of any incompetent nursing staff. The intensity and length of the interactions with the client are also significant factors to consider in planning client care. The UNP can provide efficient client care in long-term care facilities because the clients are stable.

The nurse is assisting the registered nurse with delegation decisions regarding management of a client with shortness of breath. Which action by the nurse indicates a need for correction? 1 Asking questions about the client's respiratory rate 2 Asking the client to perform breathing exercises regularly 3 Administering oxygen to the client with shortness of breath Correct4 Providing constructive feedback about client care management

The nurse may not provide constructive feedback about the client care management during delegation decisions. The nurse may, however, provide constructive feedback to the delegatee to maximize the efficiency of the client care.

The registered nurse delegates the task of feeding a 90-year-old client suffering from dysphagia to the unlicensed assistive personnel (UAP) who has previously performed this task. The client died of choking and aspiration after being fed by the UAP. Which right of delegation was violated for this client? 1 Task 2 Person Correct3 Circumstance 4 Communication

The right circumstance includes whether the delegation process is appropriate to the situation or not. For this client, the nurse is responsible for supervising during feeding or providing feeding as the client is suffering from dysphagia. In accordance with right task, the UAP can be delegated the task of feeding. As the UAP is caring for this client and has performed this task previously, he or she has experience of performing this task. Therefore he or she is the right person to delegate the task of feeding as per the UAP ability and willingness. The right of direction and communication includes the delegator providing clear instructions to the delegatee; there is no indication that this right was violated.

While caring for a client with severe fever, the registered nurse (RN) delegated the task to a new delegatee to assist the RN in recording the temperature. Which instruction given by the RN indicates that the delegatee is new to working with that RN? 1 "Note the temperature every hour." Correct2 "Tell me how you record the temperature." 3 "You can approach me at any time to report any of the client's issues." 4 "Let me show you what is necessary while recording the temperature."

When the work relationship is new, the registered nurse (RN) should ask the delegate to explain how he or she would perform a particular task. So, learning how the delegatee will record the temperature will help to create mutual expectations and conditions for performance. Recording the temperature every hour is the instruction given to the delegatee who has limited knowledge and limited ability to perform the task. Telling the delegatee what is necessary while recording the temperature is important to a delegatee who is new to the assigned task. A delegatee with good knowledge needs minimal guidance, but he or she should remember to report any client issues to the available RN at any time.