Theory Collaboration
Which healthcare team member is responsible for the coordination and assignments of client care? Charge nurse Nurse manager Chief nursing officer Patient care associate
A charge nurse coordinates care and assignments and will ultimately be the only person who is familiar with all the needs of any individual client. A nurse manager is responsible for managing the staffing and delegation aspects of the healthcare team. The chief nursing officer is responsible for establishing the systems for assessment and checking the requirements for competent work of the team members. A patient care associate is responsible for providing basic care to the client.
Which of these clients can be provided care safely by unlicensed nursing personnel? Select all that apply. A client with pain A client who is upset A client who is stable A client who is recovering A client with suicidal intention
A client who is stable A client who is recovering 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.
What does the nurse understand is the collaborative definition of delegation according to the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN)? "Delegation is the process of directing and guiding the outcomes of an activity." "Delegation is the process for the nurse to direct another person to perform nursing tasks." "Delegation is the transfer of accountability and responsibility from one person to another." "Delegation is the act of transferring the authority to perform a nursing task in a selected situation."
According to the ANA and the NCSBN, delegation is the process for the nurse to direct another person to perform nursing tasks and activities. The process of guiding, directing, and influencing the outcome of an individual's performance of an activity is defined as supervision. The transfer of accountability and responsibility indicates assignment. According to the NCSBN, delegation is defined as the act of transferring the authority to perform a selected nursing task in a selected situation to a competent individual.
Which description by the nurse is a correct explanation of delegation? The transfer of responsibility for the performance of an activity The person's responsibility and accountability for individual actions or omissions The active process of directing, guiding, and influencing the outcome of an individual The transfer of both the accountability and responsibility from one person to another
Delegation is the transfer of responsibility for the performance of an activity. Personal liability defines each person's responsibility and accountability for individual actions or omissions. Supervision is defined as the active process of directing, guiding, and influencing the outcome of an individual. Assignment is the transfer of both the accountability and the responsibility from one person to another.
Which generation of nursing professionals, being exposed to both terrorism and natural disasters, should be key members for disaster planning initiatives? Veteran Generation X Generation Y Baby Boomer
Generation Y nurses are the future of the profession and have grown up with massive amounts of information and technology. They have experienced terrorism and natural disasters. This generation of nurses should be key members for disaster planning initiatives. While contributions from nurses from the Veteran, Generation X, and Baby Boomer generations are important, these individuals do not have the experience with these topics that the Generation Y possesses.
A nurse is working with an unlicensed assistive personnel (UAP) in caring for a group of clients. Which statement by the UAP indicates a correct understanding of the UAP's role? "I will turn off clients' IVs that have infiltrated." "I will take clients' vital signs after their procedures are over." "I will use unit written materials to teach clients before surgery." "I will help by giving medications to clients who are slow in taking pills."
Monitoring vital signs after procedures is within the scope of a UAP's role. Registered professional nurses or licensed practical nurses, not UAPs, should perform turning off clients' intravenous (IV) infusions that have infiltrated. Using unit written materials to teach clients before surgery should be performed by registered professional nurses or licensed practical nurses, not UAPs. Helping by giving medications to clients who are slow in taking pills should be performed by registered professional nurses or licensed practical nurses, not UAPs.
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. Oral hygiene Assistance with bathing Oral medication administration Intravenous fluid administration 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 interventions are in the scope of a licensed practical nurse (LPN)? Select all that apply. Client teaching Ambulating the client Interpreting lab data Assisting the client with bathing Administering intramuscular medications
Ambulating the client and assisting with bathing are within the scope of UAPs, RNs, and LPNs. The LPN may administer intramuscular injections per their scope of practice as well. Though each state has its own nurse practice acts, the RN is always ultimately responsible for assessment, interpretation of data, and client teaching.
Which component is the ability to perform duties in a specific role? Authority Responsibility Accountability Legal authority
Authority is the ability to perform duties in a specific role. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability determines whether a person's actions were appropriate and provides a detailed explanation of what occurred. Legal authority is the ability to transfer selected nursing activities in a given situation to a competent individual.
Who would the registered nurse state is accountable for establishing systems to communicate competency requirements related to delegation? Registered nurse (RN) Chief nursing officer (CNO) Licensed practical nurse (LPN) Unlicensed assistive personnel (UAP)
CNOs are accountable for establishing systems to communicate competency related to delegation. The registered nurse delegates the task to LPN and UAP. In delegation, the RN implements in clinical practice to improve the safety and quality of client care. LPNs provide direct care to the client. UAP provide direct care to the client under the supervision of the registered nurse who retains accountability for client care outcomes.
Which process involves transferring responsibility to multiple players, usually with varying degrees of education and experience, while retaining the ultimate accountability for providing the client care? Leadership Delegation Supervision Assignment
Delegation is a process of sharing the responsibility of client care. It involves the transfer of responsibility for the performance of an activity from one individual to another, with the delegator retaining accountability for the outcome. Leadership is the use of individual traits and abilities in relationship with others, the ability to interpret the context where a situation is emerging, and entering that situation in the absence of a script or defined plan that could have been projected. Supervision is defined as the active process of directing, guiding, and influencing the outcome of an individual's performance of an activity. Assignment is the transfer of both the accountability and the responsibility from one person to another.
The nursing manager is preparing a schedule for delegating appropriate tasks to different health care team members. Which health care team member can be delegated the task of administering oral medications? Select all that apply. Certified technician Patient care associate Licensed practical nurse Licensed vocational nurse Unlicensed nursing personnel
Delegation of tasks is different for different health care team members, based on their position, skills, and capabilities. Provision of prescribed treatments, such as administering oral medications, are tasks delegated to licensed professionals, such as licensed practical nurses and licensed vocational nurses. A certified technician is an unlicensed nursing personnel and therefore should not be delegated tasks such as administering oral medications.
What is the duty of the nurse as delegator if the delegatee has limited knowledge and ability to perform a task? Provide guidance. Observe and motivate. Explain what is to be done. Establish mutual expectations.
If the delegatee has limited knowledge and ability to perform a task, the delegator should provide guidance. The delegator is expected to observe and monitor the task performed by the delegatee to ensure he or she has the ability and willingness to establish a relationship and accomplish work. The RN explains the task and how to execute it if the situation involves a new task and the relationship is ongoing. If the delegatee is new to the workplace, but has the ability and willingness to perform a task, the delegator should establish mutual expectations and conditions of performance in order to establish a good relationship.
A client with foot ulcers is admitted to the hospital. Which nursing care professional can be delegated the task of maintaining hygiene? Select all that apply. Registered nurse (RN) Patient care associate (PCA) Licensed practical nurse (LPN) Licensed vocational nurse (LVN) Unlicensed nursing practitioner (UNP)
In clients with a foot ulcer, the PCA or UNP are confined to maintenance of hygiene only. The RN can care for the client and delegate tasks to appropriate personnel to undertake the task of maintaining foot hygiene. LPNs and LVNs can perform tasks such as oral drug administration.
The nurse is caring for a client admitted with fluid overload. Which tasks are most appropriate to be delegated to the patient care associate? Select all that apply. Documenting vital signs Documenting urine output Assessing the laboratory findings Administering diuretic intravenously Repositioning the client every one or two hours
Patient care associates are unlicensed assistive personnel whose scope of practice includes documenting vital signs and urine output and repositioning the client every one or two hours. Assessing the laboratory findings should be carried out by the registered nurse only. Intravenous medications should be administered the registered nurse. Administration of oral and topical medications can be delegated to the licensed practical or vocational nurse.
Which task is achieved by the delegator when he or she engages in self-care to enhance his or her ability to care for the healthcare team? Managing Renewing Explaining Motivating
Renewing is the task achieved by the delegator when he or she engages in self-care to enhance his or her ability to care for the healthcare team. Managing is achieved when the delegator assists the staff in planning, priority-setting, and decision-making. Explaining occurs when the delegator teaches and interprets information for client well-being. Motivating is achieved when the delegator inspires the staff to fulfill a mission.
Which right is applicable when the delegator and delegatee understand a common work-related language? Right of person Right of supervision Right of circumstance Right of communication
Right of communication
The registered nurse (RN) administers intravenous fluids to a client who was in a motorcycle accident. Which assessments made by the nurse would be appropriate based on the principle of right task of delegation? Environmental conditions Resources required for drug administration Institutional policies of drug administration Client's condition prior to drug administration
Right task of delegation includes information on whether the task performed would be appropriate based on institutional policies. Assessing if the environmental conditions are conducive for completing the task determines right circumstance of delegation. Right circumstance of delegation also includes the assessments of resources and equipment available for performing the task. Assessing the client's condition prior to drug administration may not be an appropriate intervention of the nurse under right task 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? Administering analgesics Administering intravenous antibiotics Administering nerve block anesthesia 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.
Which task can the registered nurse safely delegate to the unlicensed assistive personnel (UAP) while caring for a client with gastroesophageal reflex disease? Positioning the bed Evaluating the vitals Tube feeding the client Determining calorie needs
The UAP should be assigned tasks that are simple and do not involve any complications. Positioning the bed at 30 degrees or more is one of the essential tasks that can be assigned to the UAP under supervision. Evaluating vitals is the duty of the registered nurse. Tube feeding the client is a very sensitive procedure that can be done by a registered nurse or trained licensed practical nurse. Determining the calorie needs of the client is the job of a dietician.
Which questions should the delegator assess to determine the right task? Select all that apply. "Is the task legally appropriate to delegate?" "Is the environment conducive to completing the task safely?" "Does the delegator provide clear and concise directions for the task?" "Is the task appropriate to delegate based on institutional policies and procedures?" "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?"
A nurse questions the staff about a change in a client's plan of care. What does this demonstrate? Authority Autonomy Responsibility Accountability
The nurse asking questions about a change in a client's plan of care shows that the nurse has the power to make decisions. This is an example of the nurse's authority over other staff members. Independence in making choices about client care and work is autonomy. Responsibility refers to the duties and activities that an individual is employed to perform. Accountability means that individuals are answerable for their actions. The nurse demonstrates accountability by checking on the client and family after discharge.
What are the three strategies that the nurse can perform while assisting other nurses in making delegation decisions? Select all that apply. Doing Telling Asking Offering 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.
Which step in the nursing process would involve promoting a safe environment for the client? Planning Diagnosis Assessment Implementation
The nurse promotes a safe environment during the implementation stage of the nursing process. During the planning stage, the nurse develops an individualized care plan for the client. The plan contains strategies and alternatives to achieve specific outcomes. During the diagnosis stage, the nurse analyzes the assessment data to determine the health care issues. The nurse collects comprehensive data pertinent to the client's health and situation during the assessment stage.
A client with asthma and depression is admitted to the hospital. Which tasks delegated by the delegator would indicate the task is applicable for the registered nurse? "Administer oral antidepressants." "Administer a pain killer intramuscularly." "Teach the client how to use a meter dose inhaler." "Reinforce tips for stress management with the client."
The registered nurse is delegated to teach the client about using a meter dose inhaler for asthma. Oral administration of drugs is under the scope of practice of a licensed practical nurse (LPN) and a licensed vocational nurse (LVN). Administration of intramuscular medications will also be tasks delegated to an LPN or LVN. Reinforcing teachings is the task of an LPN, LVN, or unlicensed assistive personnel (UAP).
What is the role of unlicensed assistive personnel in intravenous (IV) therapy for a client? Monitoring clinical manifestations Collecting the data to be used in the assessment of the IV site Administering IV fluids and medications Evaluating the client for clinical manifestations
The role of unlicensed assistive professional in IV therapy is to collect the data that can be used in the assessment of the IV site. Monitoring clinical manifestation is performed by the licensed practical nurse (LPN). Administering IV fluids and medications is done by a registered nurse or LPN. Evaluating the client for clinical manifestations is performed by the registered nurse.
