N588 Exam 3
An organization's culture should promote:
-self-actualization: being the best that you can be -humanism: high regard for the intrinsic value of every person -affiliations: value of group cohesion and people working togetther -achievement: celebrates individual and group accomplishments without jealousy
What are strategies to decrease handoff errors?
-standardize (SBAR) -no distractions -read back
What is the delegate responsible for?
-their own actions -accepting only tasks or assignments that he or she is qualified to perform -providing feedback on tasks according to the guidelines specified by the delegator
Before delegating, what must you be sure of?
-there is RN supervision available -there's adequate staff -the person to whom the task is being delegated has the required skill set
What stage of change is this? Individuals and organizations recognize the need for change and begin to get ready to make that change; look at benefits and costs
Unfreeze
What are the 3 stages of change based on Lewin's Force-Field Model?
Unfreeze -> Change -> Refreeze
Insight is good, but it's limited by your ______________
attitude
Key concept of delegation: you've been given the right to perform the task based on your job description =
authority
As a management concept, delegation is discussed in what 3 terms? As a legal concept, delegation is defined in what 2 terms?
authority, responsibility and accountability authority and liability
People commit to __________, not plans
causes
What are the 4 C's for effective communication when delegating?
clear concise correct complete
Knowing and being with is grounded in our _____________
compassion
Enabling and doing for are grounded in our ____________
competence
What is the difference between a centralized and decentralized organization?
decentralized = decisions made close to patient care centralized = decisions made closer to the top
The individual staff person receiving the delegated task =
delegate
The nurse manager is responsible for ensuring that his/her staff is trained in ______________, not just making assignments
delegation
The individual making the delegation =
delegator
Prior to delegation, determine that the task meets the following criteria: -task performed _____________ in daily care of clients -involves little or no ___________ from one patient to another -task doesn't involve ongoing assessment, interpretation, or decision making -task has a _____________ outcome -task is performed according to a set sequence of steps -does not ____________ the patient's life or well-being -is allowed by agency policy/procedures
frequently modification predictable endanger
What is the central tenet of root cause analysis? What is the goal of RCA?
identifying underlying problems that increase the likelihood of errors while avoiding the trap of focusing on mistakes by individuals to identify active and latent errors
The only part of the nursing process that the RN can delegate is the ________________ part
implementation
Organization culture represents the _____________ organization
informal
When analyzing data for a RCA, what does the 5 why's mean?
it means you keep asking why until you uncover all issues to come up with a solution
A _________ culture recognizes that competent professionals make mistakes and acknowledges that event competent professionals will develop unhealthy norms (shortcuts), but has zero tolerance for reckless behavior
just
Which aspect of the Swanson Caring Model is this? -ignites consumerism in healthcare decision making -inspiring patient belief in a future -promotes brand loyalty
maintaining belief
Delegation is both a ______________ concept and a _____________ concept
management legal
What are 3 major influencing factors in delegation? Of the 3, which is the most significant?
most significant = accountability then, assignment and patient safety
"Crossing the quality chasm: A new health system for the 21st century" published by the IOM in 2001 introduced 6 aims for providing quality healthcare:
-safe -effective -patient-centered -timely -efficient -equitable
What are some influencing factors on delegation?
-possible repeal of the Affordable Care Act -new types of unlicensed personnel constantly emerging -limited to no use of LPNs in acute care settings -new roles for RNs making delegation difficult -continued call for increasing quality and patient safety -APRNs in acute care units -technology/telehealth -continued attention to the role of UAP in schools
What are some examples of the nurse-related measures that the National Quality Forum (NQF) collects?
-pressure ulcer prevalence -ventilator associated pneumonia -nurse turnover -nursing care hours per patient day (determines staffing)
_________________ errors are errors that occur at the point of contact (the how)
Active
Out of all the delegation definitions, the biggest similarity is that they all require: ______________, _______________, and ______________
-responsibility -accountability -authority
-Published by the Institute of Medicine in 2000 -increased awareness of patient safety issues -discovered that between 44,000-98,000 pts die each year due to errors -brought pt safety to the forefront nationally
"To Err is Human: Building a Safer Health System"
For effective delegation to occur, the following elements must be present. If any one of these elements is missing, effective and legally defensible delegation can't occur:
-Autonomy: the power to do the job (a job description) -Authority: the right to do the job (a license) -Competence: the skill to do the job
What is the delegator responsible for?
-assessment of the situation -ascertaining the competence of the delegate -follow-up supervision -management of results
What are advantages of a positive org culture?
-better recruitment (get the cream of the crop) -increased retention -increased nurse satisfaction -decreased pt mortality -increased pt satisfaction
Self-determination is based on 3 core principles that ensure that people are able to decide for themselves:
-choice -latitude -personal accountability
Nurses should consider 6 cultural phenomena when delegating to culturally diverse staff: Wha are the 2 most crucial phenomena?
-communication style -space -social organization -time -environmental control -biological variation communication style and space
What are some emerging threats to patient safety?
-complexity of cases -complexity of care -budget constraints -antimicrobial resistance solution = integrated systems approach
The "Future of Nursing Report" in 2010 made recommendations to suggest new ways for nurses to practice and enhance access to care -these are centered on the pt -they rely on evidence-based practices -nurses and nursing leaders are central to the vision what are some of the recommendations?
-increase proportion of nurses w a baccalaureate degree to 80% -remove scope of practice barriers (for NPs) -implement nurse residency programs -double the number of nurses with a doctorate by 2020 -ensure that nurses engage in lifelong learning -prepare and enable nurses to lead change to advance health -build an infrastructure for the collection and analysis of interprofessional healthcare workforce data
What are some concerns with RCA?
-interpretation of results isn't standard -time consuming and labor intensive ($$$) -tainted by hindsight bias *but despite the concerns, the Joint Commission mandate requires use
What settings are acceptable for medications being delegated to unlicensed persons?
-long term care -assisted living -some school settings -correctional settings -day care settings -doctor's offices
What are examples of sentinel events?
-never events: means it never should have happened (like wrong site surgery) -serious adverse events (could be a med error or admission of care) -near misses
3 types of errors in Just Culture:
1. Human error: -unintentional, inadvertent, slips, honest mistakes -not reportable -this is what happens most of the time example: single med error 2. At risk behavior: -going outside the rules -risk may not be recognized example: exceeding scope of practice, pre-documentation 3. Reckless behavior: -nurse makes choice to consciously disregard an unjustifiable risk -the action or inaction is intentional or purposeful examples: -nurse leaves work without completing care, and doesn't report to another nurse in order to get to dinner on time -nurse observes patient climbing over bedrails, but doesn't intervene bc the pt isn't assigned to them
What are the 2 types of change?
1. Nonlinear (complex): unplanned change - disconcerting, unanticipated, and adaptvie 2. Linear (planned): deliberate and organized, with the goal of improvement
What are 5 steps to safer health care included in the AHRQ Initiatives?
1. ask questions if you have doubts or concerns 2. keep and bring a list of ALL meds you take 3. get the results of any test or procedure 4. talk to your dr about which hospital is best for your health needs 5. make sure you understand what will happen if you need surgery
What can you do to encourage Just Culture?
1. be engaged: join committees 2. review policies and procedures 3. management, staff, various departments
What is the RCA process?
1. data collection/event reconstruction 2. analysis of sequence of events by a multi-disciplinary team 3. identification of active and latent errors 4. recommendations and implementation
What is Kotter's 8 Stage Process of Creating Major Change (1996)?
1. establish a sense of urgency (the need for change) 2. create the guiding coalition (empower a team) 3. develop a vision & strategy (gives direction to the efforts) 4. communicate the change vision 5. empower a broad-based action 6. generate short-term wins (positive reinforcement) 7. consolidate gains and produce more change 8. actor new approaches in the culture
What aspect of the Swanson Caring Theory is this? being emotionally present with another
Being With
•In the care of a patient with neutropenia, what tasks can be delegated to a UAP? (Select all that apply.) •A. Take VS Q 4 hr •B. Report temperature of more than 100.4F (38 C) •C. Assess for sore throat, cough, or burning with urination •D. Gather the supplies to prepare the room for protective isolation •E. Report superinfections, such as candidiasis •F. Practice good handwashing technique
A, B, D, F
•You are preparing to care for a 6-year-old who has just undergone allogenic stem cell transplantation and will need protective environmental isolation. Which nursing tasks will you delegate to a UAP? (Select all that apply.) •A. Stocking the patient's room with the needed PPE •B. Teaching the patient to perform thorough hand washing after using the bathroom •C. Reminding visitors to wear a respirator mask, gloves, and gown •D. Posting the precautions for protective isolation on the door of the patient's room •E. Talking to the family about the reasons for the isolation
A, C, D
•Which of following patients are appropriate for the RN to assign to a LPN? Select all that apply. •A. A patient who needs to ambulate for the first time after a thoracotomy. •B. A patient who needs pre-op teaching before a skin graft. •C. A new patient who needs an admission assessment. •D. A patient who has a unit of whole blood that has been infusing for 1 hour. •E. A patient who has a repeat bone marrow biopsy scheduled for tomorrow
A, D, E
•The nurse should use which guideline(s) to plan delegation and assignment-making activities? (Select all that apply.) •A. Ensuring patient safety •B. Requests from the staff •C. The clustering of rooms on the unit •D. The number of anticipated discharges •E. Patient needs and workers' needs and abilities
A, E
Which client should the charge nurse in the ICU assign to the most experienced nurse? A. the client previously diagnosed with thyroid storm who is 1 hr post-op thyroidectomy B. the client diagnosed with end stage renal failure who had 15 ml of urine output on the last shift and has CHF C. the client diagnosed with diabetic ketoacidosis whose last serum glucose was 250 D. the client diagnosed with pheochromocytoma whose BP is 146/92
A. the client previously diagnosed with thyroid storm who is 1 hr post-op thyroidectomy
Patient-targeted initiative that encourages patients to ask questions about their care, and gives them a voice =
AHRQ Initiatives
The actual handing over of the wrong medication from the nurse to the patient is an example of what type of error?
Active
•Which action should you delegate to the UAP for the patient with DKA? (Select all that apply) •A. Check and interpret fingerstick glucose results Q 1 hour •B. Record intake and output every hour •C. Measure VS Q 15 min •D. Assess for indicators of fluid imbalance
B, C
What stage of change is this? Planned interventions and strategies are executed to support the implementation of the change
Change
What are the CUS words?
Concerned Uncomfortable Safety (this is a patient safety issue) -patient safety is the highest line of concern
Constructive or non-constructive culture? -whole is more important than the parts (systems approach) -everyone is working towards a common goal, not just working for themselves -members consider how their actions affect those in other departments -allows coordinated action and continuous learning -boundaries bt departments are minimized -equality and trust are primary values -allows learning from mistakes (just culture) -encourages risk-taking, change, and improvement -it's okay to question the status quo
Constructive
T/F: LPNs can develop a plan of care in acute care settings
False - LPNs or unlicensed personnel cannot develop a plan of care or establish goals
The nurse employed in a long term care facility is planning assignments for the clients on a unit. The nurse needs to assign 4 clients and has a LPN and 3 unlicensed assistive personnel on a team. Which client would the nurse most appropriately assign to the LPN? A. a client who requires a bed bath B. an older client with pneumonia expectorating green sputum who is febrile C. a client who requires 2 hr VS measurements D. a client requiring abdominal wound dressing changes with a saline wash every 3 hrs
D. a client requiring abdominal wound dressing changes with a saline wash every 3 hrs
Transferring to a competent individual the authority to perform a selected nursing activity in a selected situation =
Delegation
•You are caring for a patient with esophageal cancer. Which task could be delegated to a nursing assistant? •A. Assist the patient with oral hygiene. •B. Observe the patient's response to feedings. •C. Facilitate expression of grief or anxiety •D. Initiate daily weighings
•A. Assist the patient with oral hygiene.
What aspect of the Swanson Caring Theory is this? doing for others what they would do for themselves if it were at all possible
Doing For
_____________ is simply telling the person to do tasks with no consideration of the many variables that may impact this
Dumping
What aspect of the Swanson Caring Theory is this? facilitating the capacity of others to care for themselves
Enabling
T/F: A decentralized organizational structure is one in which decisions are made far away from patient care.
False
T/F: An example of a constructive organizational culture is one in which departments are isolated.
False
T/F: In systems theory, what happens in one department has no effect on what happens in another department.
False
T/F: LPNs can do initial/admission assessments in acute care
False
T/F: Organizational culture includes only the values and beliefs of the people who work in the organization.
False
What are 3 characteristics that make up organization structures?
Formalization: amt of rules and regulations Complexity: how complex is the org? Centralization: decentralized or centralized?
__________ activities are critical events in the delegation process to ensure continuity of oversight
Hand-off
•The charge nurse assigned the care of a patient with acute renal failure and hypernatremia to you, a new grad nurse. Which actions should you delegate to the UAP? •A. Provide oral care every 3-4 hours •B. Monitor for indications of dehydration •C. Administer 0.45% NS via IV •D. Assess daily weights for trends
•A. Provide oral care every 3-4 hours
-The not-for-profit organization that accredits healthcare organizations -Has "deemed" status from the Centers for Medicare and Medicaid Services (CMS) -An organization that meets their standards is deemed to have met the CMS sets
Joint Commission
In 1997, the ___________ ___________ mandated the use of RCA in the investigation of sentinel events in accredited hospitals
Joint Commission
__________ culture focuses on evaluation of behavior and choices that led to the behavior, not the outcome
Just
What aspect of the Swanson Caring Theory is this? striving to understand events as they have meaning in the lives of others
Knowing
A medication error that occurs because two similar sounding drugs are beside each other in the pyxis is an example of what type of error?
Latent
_________________ errors are errors that occur due to hidden problems within the system that contribute to adverse events (the why)
Latent
What aspect of the Swanson Caring Theory is this? sustaining faith in the capacity of others to get through an event and face a future with meaning
Maintaining Belief
Membership-based organization designed to develop and implement a national strategy for healthcare quality management and reporting = (collects nurse-related measures)
National Quality Forum (NQF)
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge =
Quality
Any delegation question with the words "initial" or "initiate" will always be done by the ______
RN
Latent errors are highlighted by the ___________ model
Reason's
What stage of change is this? Focuses on sustaining the change over a long period of time; reinforce the new, desired behaviors and processes by praising, rewarding, and providing feedback. Careful about slipping back into routines and more comfortable patterns
Refreeze
•In the care of patients with pain and discomfort, which task is most appropriate to delegate to the UAP? •A. Assisting the patient with the preparation of a sitzbath •B. Monitoring the patient for signs of discomfort while ambulating •C. Coaching the patient to deep breathe during painful procedures •D. Evaluating relief after applying a cold compress
•A. Assisting the patient with the preparation of a sitzbath
What strategies are used to improve communication?
SBAR and CUS
Minimized risk of harm to patients and providers through both system effectiveness and individual performance =
Safety
________ ______________ is the sharing that occurs bt nursing management and patient care nurses so that nurses are accountable for all nursing care decisions -it provides the opportunity for individuals to be fully empowered in the deliberations, decisions, and actions undertaken by the profession -focuses on nurses controlling their practice -empowers bedside nurses to actively participate in policy-making for the org -decisions include personnel issues, salaries and benefits, staffing, scheduling, supplies and budgets, quality initiatives
Shared governance
Constructive or non-constructive culture? -individual departments are isolated -there's a set culture, things don't change bc "this is how we've always done it" -fails to adapt to changes in the external environment -takes for granted that what has worked will continue to work -rigidity and stability are encouraged -managers are more concerned for themselves and their agendas -risk-taking and changes are discouraged -comfortable with the status quo
non-constructive
When individuals fail to delegate for a variety of reasons =
underdelegation
T/F: When a medication is being given by an unlicensed person in rare instances, dosages must already be prepared (no calculations allowed)
True
T/F: With outsight, you have a much better chance of seeing opportunities for change and new ways of doing things
True
T/F: You can have safety without quality, but in the perfect world you'd want to have both
True
T/F: Anything ongoing that has already been started can be delegated to the LPN
True
T/F: Assessment, evaluation, and nursing judgment cannot be delegated
True
T/F: Change can be initiated by an individual or at an organizational level
True
T/F: Change is a natural social process
True
T/F: Changes in organizational structure and relationships call for full engagement of all stakeholders in the elements of design, partnership, accountability, and ownership of effort and outcome.
True
T/F: Culture affects outcomes and quality of care
True
T/F: Emotions make things memorable, if you want to generate excitement among the members of your group, you need to communicate your emotions, both verbally and nonverbally
True
T/F: Errors during transitions in care as patients move throughout the healthcare system are among the most common errors
True
T/F: If the delegate refuses an assignment, it's important to determine the reason for refusal to accept the assignment
True
T/F: In limited instances and careful consideration of laws, rules, standards, policies, and procedures, the UAP can administer intradermal, subQ, and intramuscular with appropriate education and competency
True
T/F: In most places, level of experience also helps define your assignment
True
T/F: In some instances, medications can be delegated to unlicensed persons (school aides, Certified Medication Aides)
True
T/F: In value-driven health care, the nurse leader will be at the center of coordination, integration, and facilitation of care.
True
T/F: LPNs can reinforce teaching
True
T/F: LPNs cannot give IV push meds in acute care
True
T/F: Outcomes and processes in health care organizations are affected by the structure of the organization.
True
T/F: Oversupervision is confining and restricts the creativity and problem-solving potential that longs to come out of most people
True
T/F: Patient safety should always be at the forefront of delegation decisions
True
T/F: Shared governance is a type of organizational structure that is focused on nurses controlling their practice.
True
T/F: The U.S. health care system is changing much later than many other global health care systems. It is moving from and illness-driven system to a health-driven system.
True
T/F: The framework for clinical excellence begins with a structure that supports work processes that are fluid, flexible, and supportive of practice excellence in the organization.
True
T/F: The nurse manager needs to be aware of under-delegation as well as over-delegation
True
T/F: The terms "initial," "admission" or "event focused" are defined by agency policy, not by nursing laws and rules
True
T/F: To become a leader you must be able to envision the future - people want to follow only those who can see beyond today's problems and visualize a brighter tomorrow
True
Maintaining belief is what helps maintain our patient's _____________
wellbeing
Key concept of delegation: acknowledgment and assumption of responsibility for actions, decision, and policies within the scope of the role or employment position and encompassing the obligation to report, explain, and be answerable for resulting consequences means you (the RN) will be held liable if something happens legally =
accountability
The RN retains ____________ when delegating
accountability
Key concept of delegation: doing the task as prescribed by the job description is designating responsibility for implementation of a specific activity or set of activities to a person licensed and competent to perform such activities =
assignment -the RN assigns to RNs and LPNs -the LPN assigns to LPNs
The concept of change is founded on the belief that individuals and organizations are ________ systems that can be influenced by internal and external variables
open
What types of meds are acceptable for medications being delegated to unlicensed persons?
oral liquids scored tablets G tube feeds inhalants nasal ophthalmic topicals vaginal
The reflection of the norms or traditions of the organization as exemplified through behaviors that illustrate the values and beliefs of the organization = (the unwritten, feeling part of the org, there's no policy written about it)
organization culture
Providing sufficient resources, staffing, and an appropriate staff mix; implementing policies and role descriptions; providing opportunities for continuing staff development; and creating an environment conducive to teamwork, collaboration, and client centered care =
organizational accountability
A framework that divides work within an organization and designates points of authority, responsibility, accountability, and non decision-making support =
organizational structure
The process of looking outside yourself and outside your familiar world for inspiration is what we call exercising ________________ -the capacity to perceive external things
outsight
When workload is beyond what the delegate can reasonably accomplish in the assigned time =
over delegation
The health care discipline that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery =
patient safety
The delegator is accountable for the ______________, and the delegate is responsible for the ____________
process work
Organizational structure affects _____________, which affects outcomes, which affects _____________
processes money
Key concept of delegation: you have some obligation to complete the task =
responsibility
Which of the 5 rights of delegation does this describe? the expectations are clear, concise, an include both limits and expectations
right directions
Which of the 5 rights of delegation does this describe? the delegate is competent for this situation
right person
Which of the 5 rights of delegation does this describe? appropriate monitoring, evaluation, intervention as needed, and feedback are provided
right supervision
Which of the 5 rights of delegation does this describe? appropriate to the situation
right task
What are the 5 rights of delegation?
right task right person right direction/communication right supervision/evaluation right circumstances
Which of the 5 rights of delegation does this describe? the circumstances are appropriate and resources are available
right time
A structured method to analyze serious adverse events =
root cause analysis
Leaders understand how important it is that others feel strong, capable, and useful - this is the idea of _____ ____________
self-determination
An unexpected occurrence involving death or serious physical or psychological injury or the risk thereof. The phrase "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome =
sentinel event
The person that you have delegated to has the right for ________________
supervision
What is the Open Systems Theory?
the healthcare system is an open system the environment (state and federal funding, policy changes, health of population) affects the rest of the system environment -> hospital -> unit -> patients
What are things that make up an organization's culture?
thoughts, speech, actions, beliefs, social norms, traits, morals
Why are there multiple investigators when doing a RCA?
to help corroborate findings
T/F: In most states, a LPN may delegate tasks to a trained, unlicensed person if authorized by the RN to delegate and if the task is within the LPN's scope of practice
true
T/F: The multi-disciplinary team doing a RCA should be trained on methods for RCA to help eliminate bias
true
•When planning care for a group of patients with alterations related to GI cancer, which would be the most appropriate to assign to a LPN? •A. A patient with severe anemia secondary to GI bleeding •B. A patient who needs enemas and antibiotics to control GI bacteria •C. A patient who needs preoperative teaching for bowel resection surgery •D. A patient who needs central line insertion for chemotherapy
•B. A patient who needs enemas and antibiotics to control GI bacteria
The RN is planning the care for his group of patients for the day. Which is the most appropriate assignment for an unlicensed assistive personnel (UAP)? •A. A patient requiring a colostomy irrigation •B. A patient receiving continuous tube feedings •C. A patient who requires urine specimen collections •D. A patient with difficulty swallowing food and fluids
•C. A patient who requires urine specimen collections
•A nurse is delegating patient care assignments for the shift. Which is appropriate for the RN to delegate to the UAP? •A. Providing a dressing change •B. Evaluating pain relief after administering pain medication •C. Collecting I & O •D. Selecting a menu for a low-sodium diet
•C. Collecting I & O
•A patient with VRE (vancomycin-resistant enterococcus) infection is admitted to the medical unit. Which action can be delegated to the UAP? •A. Teach the patient and family about means to prevent transmission of VRE •B. Communicate with other depts when the patient is transported for ordered tests •C. Implement contact precautions when caring for the patient •D. Monitor the results of lab culture and sensitivity tests
•C. Implement contact precautions when caring for the patient
•A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the UAP? •A. Discuss weight-loss strategies such as diet and exercise with the patient •B. Teach the patient how to set up the BiPAP machine •C. Remind the patient to sleep on his side instead of his back •D. Administer Provigil to promote daytime wakefulness
•C. Remind the patient to sleep on his side instead of his back
•For a patient who is experiencing side effects from radiation therapy, which task would be the most appropriate to delegate to a UAP? •A. Help the patient to identify patterns of fatigue •B. Recommend participation in a walking program •C. Report the amount and type of food consumed from the tray •D. Check the skin for redness and irritation after the treatment
•C. Report the amount and type of food consumed from the tray
•The RN is preparing assignments for the day shift. Which of the following patients should the nurse assign to the LPN? •A. A patient with chronic renal failure who is being admitted to undergo peritoneal dialysis. •B. A patient with angina whose laboratory findings for cardiac enzymes are pending. •C. A patient who has a pleural effusion and bilateral chest tubes. •D. A patient who is two days postop following a hip replacement.
•D. A patient who is two days postop following a hip replacement.
•The nurse employed in a long-term care facility is planning assignments for the patients on a nursing unit. The nurse needs to assign four patients and has a LPN and three UAP's on a nursing team. Which patient would the nurse most appropriately assign to the LPN? •A. A patient who requires a bed bath •B. An older patient requiring frequent ambulation •C. A patient who requires hourly vital sign measurements •D. A patient who requires abdominal wound irrigations and dressing changes every 3 hours
•D. A patient who requires abdominal wound irrigations and dressing changes every 3 hours
•The RN is giving a bed bath to an assigned patient when an UAP enters the patient's room and tells the nurse that another assigned patient needs something for pain. What is the most appropriate nursing action? •A. Finish the bed bath and then administer the pain med. •B. Ask the UAP to find out when the last pain med was given to the patient. •C. Ask the UAP to tell the patient in pain that a pain med will be given as soon as the bath is completed. •D. Cover the patient, raise the side rails, tell the patient that you will return shortly, then administer the pain med to the other patient.
•D. Cover the patient, raise the side rails, tell the patient that you will return shortly, then administer the pain med to the other patient.
•A nurse is working with a UAP on the pediatric floor. Which task should the nurse have the UAP perform first? •A. Collect a stool sample for ova and parasites from a 2-year old child •B. Ambulate a post-op 5-year-old child to the playroom •C. Assist the nurse in bathing a 14-year-old child who has a handicap •D. Feed a 9-year-old child with bilaterally burned upper extremities
•D. Feed a 9-year-old child with bilaterally burned upper extremities
•An 8-year-old has stomatitis secondary to chemotherapy. What task would be most appropriate to delegate to a UAP? •A. Report evidence of severe mucosal ulceration •B. Assist the child in swishing and spitting anesthetic mouthwash •C. Assess the child's ability and willingness to drink through a straw •D. Help the patient to eat a bland, moist, soft diet
•D. Help the patient to eat a bland, moist, soft diet
•A patient has severe pain and bladder distention related to urinary retention and possible obstruction. An experienced nursing assistant states that she received training in Foley catheter insertion at a previous job. What task can be delegated to this UAP? •A. Assess the bladder distention and the pain associated with urinary retention •B. Insert the Foley, once you ascertain that she knows sterile technique •C. Evaluate the relief of pain and bladder distention after the catheter is inserted •D. Measure the urine output after the catheter is inserted and obtain a urine specimen
•D. Measure the urine output after the catheter is inserted and obtain a urine specimen
