Leadership CH 6 - delegation and prioritizing of client care staffing

7. An experienced LPN is working under the supervision of the RN. The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LPN? (Select all)

- auscultate breath sounds; - administer medications via metered dose inhaler (MDI)

2. A nurse is caring for a patient who has a pulmonary embolus. The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give the NAP who will help the patient with activities of daily living? (select all):

- use a lift sheet when moving and positioning the patient in bed - use an electronic razor when shaving the patient each day - use a soft-bristled toothbrush or tooth sponge for oral care - be sure the patient's footwear has a non-slip sole when the patient ambulates

3. A nurse is caring for a patient who has COPD and is 2-days post op after a laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to NAP?

Assisting the patient to sit up at the side of the bed

5. A nurse is assigned to care for the following patients. Which patient should the nurse assess first? a. A 60 y/o patient on a ventilator for whom sterile sputum specimen must be sent to the lab b. A 55 y/o with COPD and a pulse oximetry reading from the previous shift of 90% saturation c. A 70 y/o with pneumonia who needs to be started on IV antibiotics d. A 50 y/o with asthma who complains of shortness of breath after using a bronchodilator

D

6. A respiratory therapist performs suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the NAP obtains vital signs. The nurse should communicate that the NAP needs to report which vital sign value(s) immediately? a. HR of 96 BPM b. RR of 24 breaths per minute c. Pulse oximetry of 95% d. Tympanic temperature of 101.4 F (38.6 C)

D

8. An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from a surgical unit to the medical unit? a. A 58 y/o on airborne precautions for TB b. A 68 y/o who just retuned from bronchoscopy and biopsy c. A 69 y/o with COPD who is ventilator dependent d. A 72 y/o who needs teaching about the use of incentive spirometry

D

The patient with COPD has a nursing diagnosis of ineffective breathing pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision?

Observe how well the patient performs pursed lip breathing

4. A nurse is caring for a patient who is diagnosed with coronary artery disease and sleep apnea. Which action should the nurse delegate to NAP?

Remind the patient to sleep on his side instead of his back

9. The nurse assistant tells a nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should the nurse suggest to improve the patient's comfort for this problem?

Suggest the patient's O2 be humidified

1. A nurse is helping a NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene?

The nurse assistant answers the phone while wearing gloves