CUSTOM: LEADERSHIP & MANAGEMENT/ ROSMERY W-3

A nurse is assisting a newly licensed nurse with delegating tasks to an assistive personnel on the unit. Which of the following statements by the nurse explains the purpose of delegation? "Delegation provides appropriate resources for the client." "Delegation permits a designated individual to meet a goal on your behalf." "Delegation promotes discharge teaching activities for clients." "Delegation decreases health care costs."

"Delegation permits a designated individual to meet a goal on your behalf." Delegation is defined as directing the performance of others to accomplish goals of the nurse and the facility.

A nurse is teaching a group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching? "Disaster drills should be held on a regular basis." "An actual disaster cannot take the place of a disaster drill." "A staff nurse can function as the incident commander." "A physician must triage victims of a disaster in the emergency department."

"Disaster drills should be held on a regular basis." Hospitals should perform disaster drills on a routine basis to ensure effective response in the event of a disaster.

A nurse is caring for a client who has named a person to serve as his health care proxy. The client states he needs clarification about this type of advance directives. Which of the following statements by the client indicates a need for clarification? "I can change who I designate as my health care proxy at any time." "If I become incapacitated, end-of-life choices will be made by my proxy." "I have to choose a family member as my health proxy." "The health care proxy does not go into effect until I am incapable of making decisions."

"I have to choose a family member as my health proxy." The client should choose someone he trusts and knows about his wishes for day-to-day and end-of-life care. It can be a family member, but it does not have to be a family member.

A nurse is teaching a newly licensed nurse about methods to reduce costs of client care. Which of the following statements by the newly licensed nurse indicates understanding of the teaching? "I should wait to empty my client's drainable colostomy until it is three-fourths full." "I should delegate providing closed irrigation to the assistive personnel (AP)." "I should encourage clients to receive an annual flu immunization." "I should recommend that my clients who have an established tracheostomy use sterile technique at home to provide ostomy care."

"I should encourage clients to receive an annual flu immunization." Cost containment is the delivery of effective and efficient care. Cost is maintained without loss of quality. The nurse should encourage clients to receive an annual flu immunization to prevent the need for treatment and hospitalization necessary with influenza.

A nurse manager is reviewing the Good Samaritan laws with a group of newly licensed nurses. Which of the following statements by the nurse manager is appropriate? "If you render aid in an accident, do not leave the scene until another competent person can take over." "Good Samaritan laws prohibit the victim from filing a lawsuit against the nurse." "Federal laws require a licensed nurse to render aid in an emergency." "A nurse who volunteers at a summer camp for children is covered by Good Samaritan laws."

"If you render aid in an accident, do not leave the scene until another competent person can take over." Once the nurse renders aid, she has entered a nurse-client relationship and must continue to provide care until competent help arrives.

A charge nurse hears a provider speaking to a staff nurse in anger concerning incorrect supplies that are available to perform a procedure. Which of the following statements by the charge nurse is appropriate? "You should think about how you make others feel when you lose your temper." "I will help you with this procedure instead of the staff nurse." "It must be very frustrating when you don't have want you need to perform the procedure." "If you let us know ahead of time that you plan to perform a procedure, we could do a better job of having the supplies available."

"It must be very frustrating when you don't have want you need to perform the procedure." The charge nurse is acknowledging the provider's frustration when making this statement. This can lead to resolution of the conflict.

A nurse is caring for a client whose family member requests to view the client's medical record. Which of the following responses should the nurse make? "I will ask the nursing supervisor to obtain the medical records for you." "The health care provider will share this information with you." "The ethics committee will need to approve this request for you." "The client must provide permission to share the records with you."

"The client must provide permission to share the records with you." Client information is shared only with individuals involved directly in the client's care. The client must provide permission for the family to access protected health information.

A nurse is planning to use the SBAR communication tool when calling a provider. Which of the following statements should the nurse include in the B step? "The client should be seen by a neurologist." "The client was found unconscious on the floor in her home." "There are no provider's prescriptions available." "The client is disoriented. Pupils are slow to respond to light."

"The client was found unconscious on the floor in her home." This statement is the background or context of the situation, which is the B step in the SBAR tool. The background portion should provide information that is pertinent to the current situation.

An assistive personnel (AP) comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following statements by the nurse is appropriate? "There is a higher risk of infection for our clients associated with artificial nails." "You should know that artificial nails have a very unprofessional appearance." "I want you to review the facility's policy on personal attire before you begin the shift." "Why would you wear artificial nails to work when you know it's against the rules?"

"There is a higher risk of infection for our clients associated with artificial nails." Short, natural nails are less likely to harbor pathogens that can be harmful to clients. The CDC recommends health care workers avoid wearing artificial nails when caring for clients who are at risk for infection. Additionally, guidelines from the World Health Organization prohibit artificial nails for caregivers in every setting.

A nurse on an obstetrics-gynecology unit is planning care for four clients after receiving change of shift report. Which of the following clients should the nurse assess first? A client who is a 1 day postpartum after a late term miscarriage A client who had a bilateral tubal ligation 12 hr previously A client who is 4 days postpartum and has mastitis A client admitted 1 hr ago for an ectopic pregnancy

A client admitted 1 hr ago for an ectopic pregnancy A client who has an ectopic pregnancy is unstable. The client is at risk for rupture of the fallopian tube, hemorrhage, and shock. Nursing care requires frequent monitoring every 15 min, IV access for fluid resuscitation. The client may also require blood transfusions, oxygen, and pain management. Therefore this client is the highest priority.

A nurse is assigned a group of clients at the start of the shift. Which of the following clients should the nurse plan to care for first? A client who needs assistance with a bath A client requesting a referral for home health services A client asking about his PCA pump that contains morphine A client who has questions about his new prescription

A client asking about his PCA pump that contains morphine Clients who are administered morphine are at risk for respiratory distress. When using the urgent vs. nonurgent approach to client care, this is the clie

A nurse is caring for four clients on a medical-surgical unit. Which of the following clients should the nurse assess first? A client who has a nasogastric tube for decompression and the gastric aspirate is green with a pH of 5.3 A client who had an indwelling urinary catheter removed 5 hr ago and has not voided A client who has COPD and the capillary refill time on both hands is 4 seconds A client who has late-stage cirrhosis and whose breath has a fruity odor

A client who had an indwelling urinary catheter removed 5 hr ago and has not voided After removal of an indwelling urinary catheter, the client should void within 4 hr. If the client has not voided in 4 hr, the nurse may need to reinsert the catheter; therefore, when using the priority-setting framework of urgent vs. nonurgent, this client should be assessed first because he has not voided for 5 hr.

A nurse and an assistive personnel (AP) are providing care for four clients who were admitted to the medical-surgical unit on the previous shift. The nurse should delegate meal assistance for which of the following clients to the AP? A client who has a lumbosacral spinal tumor A client who has Guillain-Barre syndrome A client who has amyotrophic lateral sclerosis (ALS) A client who has systemic sclerosis

A client who has a lumbosacral spinal tumor The nurse should delegate a task to the AP that is safe for a specific client. The client who has a lumbosacral spinal tumor is not at risk for dysphagia; therefore, the nurse should delegate meal assistance to the AP for this client.

A nurse is assessing a group of clients for hospice services. The nurse should recommend hospice care for which of the following clients? A client who has diabetes mellitus and is having difficulty self-administering insulin because of poor eye sight A client who has terminal cancer and needs assistance with pain management A client who is recovering from a stroke and needs someone to provide care while his spouse is at work A client who has dementia and needs help with activities of daily living

A client who has terminal cancer and needs assistance with pain management A client who has a terminal disease and who is deemed to have less than 6 months to live is eligible for hospice services. Hospice care provides the client with physical and psychological support, which includes management of symptoms, such as pain and dyspnea.

A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients? A client who is 1 hr postoperative following a thyroidectomy A client who is 2 hr postoperative following an abdominal hysterectomy A client who is 3 days postoperative following gastric bypass surgery A client who is 3 days postoperative following a craniotomy

A client who is 3 days postoperative following gastric bypass surgery The client's physiologic status and stability of vital signs are considerations when assigning vital signs to an AP. This client is 3 days postoperative and his condition would have stabilized by this time.

An RN from the maternal-newborn unit is being floated to a medical-surgical unit. Which of the following clients should the charge nurse on the medical-surgical unit plan to assign to the RN? A client who has terminal end-stage renal disease A client who has acute pancreatitis A client who is one-day postoperative following a total abdominal hysterectomy A client who had a stroke and is to be admitted

A client who is one-day postoperative following a total abdominal hysterectomy The nurse who floats to another unit must have the skills to provide safe care to clients. This client is stable. This is an appropriate assignment for the RN.

A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence? A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon. A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge. A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving. A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips.

A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon. Professional negligence is performing practice below the expected standard of care. It can be an act of omission, which is the failure to perform an act that a reasonable prudent person, under similar circumstances, would do. A reasonably prudent nurse would notify the provider of the neurovascular finding immediately.

A nurse is triaging clients in the emergency department. Which of the following clients should the nurse ask the provider to care for first? A toddler who has asthma and has a pulse oximetry reading of 95% while receiving oxygen at 2 L/min A toddler who has otitis media, a temperature of 39.2° C (102.6° F), and purulent ear discharge A school-age child who has acute epiglottitis, is drooling, and has an absence of spontaneous cough An adolescent who has sickle cell disease, reports pain as 7 on a scale of 0 to 10, and requests pain medication

A school-age child who has acute epiglottitis, is drooling, and has an absence of spontaneous cough A client who has acute epiglottitis, is drooling, and has an absence of spontaneous cough is unstable and requires immediate medical attention; therefore, this client is the priority and the nurse should have the provider care for this client first.

Following a tornado, a nurse is determining which of the clients assigned to her care can be discharged to free up beds for injured clients. Which of the following clients should the nurse recommend for discharge? A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy An adolescent client who was admitted 24 hr ago due to a spontaneous pneumothorax A middle adult who is 36 hr postoperative from an open laminectomy An older adult client who was admitted for diabetic ketoacidosis and his most recent ABGs show his pH is now 7.32

A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy A client who is scheduled for an elective surgery is medically stable and is not bedridden; therefore, the nurse should recommend this client for discharge.

A nurse is planning to assign care activities to the assistive personnel (AP) on her team. Which of the following activities can the nurse assign to the AP? (Select all that apply.) Accompany a client who has depression to occupational therapy. Assess a client who has hypomania for exhaustion. Check the position of a client in soft wrist restraints. Set limits with a client who has mania. Sit with a client who has alcohol use disorder and whose last drink was five days ago.

Accompany a client who has depression to occupational therapy is correct. Accompanying a client to occupational therapy is within the scope of practice of an AP. Check the position of a client in soft wrist restraints is correct. Checking the position of a client in soft wrist restraints is within the scope of practice of an AP. The position can be reported to the nurse for follow-up. Sit with a client who has alcohol use disorder and whose last drink was five days ago is correct. Sitting with a client is within the scope of practice of an AP. Any changes in the client can be reported to the nurse for follow-up.

A nurse is planning to assign tasks for a group of clients. Which of the following tasks should the nurse plan to assign to an assistive personnel (AP)? (Select all that apply.) Ambulate an older adult client who has hypertension. Provide discharge instructions for a client who has a new skin graft. Perform an admission assessment on a client. Check a blood product with another nurse prior to administration. Weigh a client who has heart failure.

Ambulate an older adult client who has hypertension is correct. An AP can ambulate an older adult client who has hypertension. Weighing a client who has heart failure is correct. An AP can weigh a client who is stable.

A nurse on a pediatric unit is reviewing her client assignment following the shift report. Which of the following clients should the nurse plan to assess first? A school-age child who has diabetes mellitus and requires blood glucose monitoring An infant who has pertussis and is receiving oxygen via nasal cannula An adolescent who was admitted to the unit in sickle cell crisis and is ready for discharge instructions A toddler who has both arms in casts and needs to be fed his breakfast

An infant who has pertussis and is receiving oxygen via nasal cannula Using the airway, breathing, circulation (ABC) approach to prioritizing client care, this infant should be assessed first because the infant has a compromised airway and requires oxygen.

A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take? Take the specimen to the laboratory. Report the AP to the charge nurse. Complete an incident report. Ask the AP about her concerns with the assignment.

Ask the AP about her concerns with the assignment. Reviewing the incident with the AP allows the nurse to understand the delegated task from the AP's perspective. The nurse should attempt to determine the underlying problem the AP has with the assignment.

A nurse has been reassigned from her regular area of work to a unit that is short staffed. Which of the following actions should the nurse take first? Ask what she will be assigned to do. Determine if she has the skills to complete the assignment. Identify her options. Notify the nurse manager about her concerns for client safety.

Ask what she will be assigned to do. Before accepting the assignment, the nurse should clarify the complexity of the assignment, such as how many clients she will be assigned to care for, what skills are needed, and what resources are available to her.

A nurse on a surgical unit is caring for a group of clients. Which of the following is the priority action of the nurse? Taking a telephone prescription about a client who is to be transferred from PACU Assessing a client who experiences unilateral calf pain when ambulating Reinforcing a client's dressing for the surgical site of an above-the-knee amputation Reassuring the partner of a client who sustained a closed head injury

Assessing a client who experiences unilateral calf pain when ambulating When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority action is assessing a client who has manifestations of a deep vein thrombosis, which can lead to pulmonary embolus. The nurse should assess this client and report the findings immediately to the provider.

A nurse is planning client care for herself and an assistive personnel (AP) working with her. Which of the following tasks should the nurse plan to perform? Administration of an enema Application of antiembolic stockings Assessing a client's sacrum for edema Assisting a client to cough and deep breathe

Assessing a client's sacrum for edema Assessment requires the nurse's specialized knowledge and cannot be delegated to an AP.

A nurse is planning care for a group of clients at the beginning of the shift. Which of the following tasks should the nurse assign to the licensed practical nurse (LPN)? Developing the plan of care for a client who has an amputation Evaluating the outcomes of a new postoperative client Analyzing data to identify issues for a client who has uncontrolled diabetes mellitus Assisting a client with crutch walking following knee replacement surgery

Assisting a client with crutch walking following knee replacement surgery Assisting a client with crutch walking is within the LPN's scope of practice.

A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time? Check the client's medical record for the provider's prescription. Explain to the client that the provider prescribed the procedure. Assure the client that enemas are commonly prescribed for constipation. Inform the charge nurse that the client refused the enema.

Check the client's medical record for the provider's prescription. The nurse should use the client's medical record to verify the provider prescribed an enema for the client.

A nurse manager is preparing an inservice program for the nurses on the unit about the use of a new infusion pump. Which of the following teaching strategies is the most effective way to ensure that the staff can use the device correctly? Provide a written procedure for the use of the device for the staff to review. Demonstrate using the device and observe the staff returning the demonstration. Remind the staff to review the procedure manual prior to using the new pump. Identify the differences and new features of the device in a written brochure.

Demonstrate using the device and observe the staff returning the demonstration. The most effective strategy to ensure the staff nurses can perform a psychomotor skill, such as using an infusion pump, is to show them how to use the device and provide the opportunity for a return demonstration.

A nurse suspects that a coworker is diverting opioid analgesics. Which of the following is an adverse effect of opioid medications? Euphoria Rhinorrhea Hallucinations Dilated pupils

Euphoria Euphoria is an adverse effect of opioid analgesics and is due to activation of mu receptors.

A nurse manager has recently become aware of a conflict between the pharmacy and the staff nurses regarding sending and receiving medications. Which of the following actions should the nurse take first to resolve the conflict? Implement a resolution. Brainstorm solutions. Identify the problem. Evaluate the results.

Identify the problem. The first action the nurse should take using the nursing process is to assess the situation and identify the problem so that a solution is found.

A charge nurse has access to the facility's electronic client records. It is appropriate for the charge nurse to share her personal password with whom? The nurse manager No one A nursing student who is completing a preceptorship on the unit The unit clerk

No one Computer passwords cannot be shared with others for any reason. Any facility employee authorized to have access to the database on a computer will have a personal password.

A nurse is providing care for a surgeon on a medical-surgical unit. A nurse from another unit asks the nurse about the surgeon's medical diagnosis. The nurse responds that he is unable to provide the information requested. The nurse is displaying which of the following ethical principles? Utility Paternalism Justice Nonmaleficence

Nonmaleficence The nurse is obligated to protect the client's confidential information. A breach of confidentiality can place the client at risk of harm. Nonmaleficence is the ethical duty to prevent harm to the client.

A nurse notes a provider frequently arrives to the unit with bloodshot eyes and smells like alcohol after lunch. Which of the following actions should the nurse take? Counsel the provider to determine the cause of the substance abuse. Encourage clients to change to a different provider. Inform the state medical board for an immediate investigation. Notify the nursing supervisor of the concerns.

Notify the nursing supervisor of the concerns. The nurse should notify hospital or nursing management of the concerns, and then ensure client safety. It is the responsibility of management to conduct an investigation. Client safety is the responsibility of the nurse.

A nurse is discussing emergency response with a newly licensed nurse. The nurse should identify which of the following as a triage officer during the time of a disaster? Members of the Federal Emergency Management Agency (FEMA) Responding law enforcement officers Representatives from the American Red Cross Nurses and other emergency medical personnel

Nurses and other emergency medical personnel Nurses and other emergency personnel such as physicians, EMTs, and paramedics are responsible for performing triage duties.

An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP? Change the abdominal dressing. Obtain vital signs. Palpate for possible bladder distention. Observe the incision site.

Obtain vital signs. Obtaining vital signs is a skill within the scope of practice for an AP; therefore, the nurse can delegate this task to the AP.

A nurse and an experienced licensed practical nurse (LPN) are caring for a group of clients. Which of the following tasks should the nurse delegate to the LPN? (Select all that apply.) Provide discharge instructions to a confused client's spouse. Obtain vital signs from a client who is 6 hr postoperative. Administer a tap-water enema to a client who is preoperative. Initiate a plan of care for a client who is postoperative from an appendectomy. Catheterize a client who has not voided in 8 hr.

Obtaining vital signs from a client who is 6 hr postoperative is correct. Obtaining is a task that is appropriate to the education and skills of an LPN. Administering a tap-water enema to a client who is preoperative is correct. Administering a tap-water enema is a task that is appropriate to the education and skills of an LPN. Catheterizing a client who has not voided in 8 hr is correct. Urinary catheterization is a task that is appropriate to the education and skills of an LPN.

A nurse in a provider's office is reviewing the laboratory findings for a client who is scheduled for surgery. Which of the following findings requires follow up by the nurse? BUN 15 mg/dL Platelet count 60,000/mm3 WBC 6,000/mm3 Hemoglobin 14 g/dL

Platelet count 60,000/mm3 This platelet count is below the expected reference range. A low platelet count places the client at risk for bleeding; therefore, the nurse should follow up on this finding.

A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take? Inform the staff member of her appraisal time for that day prior to change-of-shift report. Schedule the appraisal interview as early in the shift as possible. Provide a chair directly across the desk for the staff member to sit in. Provide the staff member with a copy of the appraisal form in advance.

Provide the staff member with a copy of the appraisal form in advance. The charge nurse should ensure the staff member knows the standards by which her work will be evaluated and that she has a copy of the appraisal form.

A nurse overhears two assistive personnel (AP) from the medical-surgical unit discussing a hospitalized client while in the cafeteria. Which of the following is the priority nursing action? Quietly tell the APs that this is not appropriate. Ask the nurse manager to provide an inservice program about confidentiality to the staff on the unit. Complete an incident report. Document the occurrence in a personal log.

Quietly tell the APs that this is not appropriate. The nurse has a professional duty to protect the client's confidential information. When using the urgent vs. nonurgent approach to client care, the nurse determines the priority is to stop the APs before there is an additional breach of confidentiality.

A charge nurse is reviewing the list of tasks that have been delegated to the assistive personnel (AP) by the staff nurse. Which of the following tasks should the charge nurse reassign to a licensed nurse? Transporting a client who experienced a stroke 72 hr ago to the radiology department Providing a back rub to a client who has right-sided paralysis Removing and cleaning the cannula of a client who has a new tracheostomy Performing oral hygiene for a client who is 1 day postoperative following an amputation of the right arm

Removing and cleaning the cannula of a client who has a new tracheostomy Removing and cleaning the cannula of a client who has a new tracheostomy requires use of the nursing process, specialized knowledge, and clinical judgment; therefore, this task should be reassigned to a licensed nurse.

A nurse who is leading a team of nurse managers is planning to make a major announcement. The nurse should use which of the following nonverbal communication techniques to enhance the importance of the announcement? Sit in front of the group for the meeting and then stand for the announcement. Cross her arms over her chest when beginning the announcement. Stare at the people the announcement will affect the most. Lean gently over the back of a chair sitting to one side of the room when making the announcement.

Sit in front of the group for the meeting and then stand for the announcement. The weight of a message increases when the sender stands.

A nurse has several tasks to delegate to an assistive personnel (AP). Which of the following tasks should the nurse ask the AP to perform first? Take an arterial blood gas (ABG) specimen to the laboratory. Transport a client to the radiology department for an x-ray. Pass fresh water to clients on the unit. Obtain a routine urine sample from a newly-admitted client.

Take an arterial blood gas (ABG) specimen to the laboratory. When using the urgent vs. nonurgent approach to client care, the nurse should determine the priority action is to take the ABG blood sample to the laboratory. ABG samples are placed on ice and must be transported to the laboratory immediately or the specimen will deteriorate, making any results inaccurate.

When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation. Which of the following should the nurse consider when using one of the five rights of delegation? The AP's ability to prioritize The AP has the knowledge and skill to perform the task The AP's rapport with clients The AP's ability to complete the task without assistance

The AP has the knowledge and skill to perform the task The right person is one of the five rights of delegation. The nurse should seek information from the AP about his individual skill level before delegating the task.

An RN is making nursing staff assignments for his team consisting of himself, two licensed practical nurses (LPNs), and an assistive personnel (AP). Which of the following clients should he assume responsibility for? The client who requires frequent ambulation The client who is in protective isolation The client who is actively dying and requires IV pain medication The client who is 3 days postoperative and requires a dressing change

The client who is actively dying and requires IV pain medication The nurse should assume responsibility of this client because IV pain medications should be administered by RNs. Although this client may require less physical care, he may require more emotional care. The nurse should plan to spend extensive time with both the client and his family.

A nurse finds that a client did not receive a scheduled dose of furosemide (Lasix). Which of the following should the nurse include in the incident/variance report? (Select all that apply.) The date of the incident The name of the provider who prescribed the medication The potential adverse effects of the medication The time the client was to receive the medication The client's vital signs

The date of the incident is correct. When a nurse discovers a medication error, it is her legal responsibility to complete an incident report. A health care agency can use incident reports to monitor incidents and accidents in order to prevent future occurrences. The report should only include factual information about the incident such as the date. The time the client was to receive the medication is correct. The nurse should include the time the client was to receive the medication because this pertains directly to the incident of the omitted medication. The client's vital signs is correct. The nurse should assess the client as soon as she discovers the error and should include the assessment data in the report.

A charge nurse is making assignments for nursing personnel who will be caring for clients during the oncoming shift. Which of the following factors should the charge nurse consider? The most experienced nurse receives the more complex clients Personal comfort level in making the assignments Social relationships between nurses working the oncoming shift The physiologic status of the clients on the unit

The physiologic status of the clients on the unit Making assignments requires knowing the physiologic status of the clients on the unit, such as the stability of the clients' vital signs, the amount of health education they need, and the complexity of care involved. Clients who have an unstable physiologic status may require a higher level of skilled care.

A nurse is planning to delegate tasks to a licensed practical nurse (LPN). Which of the following entities is important for the nurse to understand when delegating tasks to the LPN? The state Nurse Practice Act The National Association for Practical Nurse Education and Services The National Council of State Boards of Nursing Decision Tree The Omnibus Budget Reconciliation Act of 1987

The state Nurse Practice Act The state Nurse Practice Act identifies the skill or education level needed by a nurse to complete a task, as well as indicating items that can and cannot be delegated from a legal perspective.

A volunteer assigned to the pediatric unit reports to the charge nurse for an assignment. Which of the following assignments is unsafe for the volunteer? Transporting a school-age client who is in traction to another department Playing a computer video game with an adolescent who has sickle cell disease Reading a book to a preschool client who has AIDS Rocking an infant who was admitted for croup

Transporting a school-age client who is in traction to another department To ensure client safety, the nurse is responsible for delegating tasks to the right people. The nurse should avoid assigning this task to the volunteer because the individual who performs this task must understand the principles of traction. A volunteer does not have the requisite skill to perform this task.

While caring for a client, the nurse experiences a needle stick injury. Which of the following actions should the nurse take first? Complete an incident report. Request the risk manager obtain consent for HIV testing from the client. Wash the site of injury with soap and water. Consent to postexposure treatment with antiretroviral medications.

Wash the site of injury with soap and water. The greatest risk to the nurse is infection transmission; therefore, the nurse should first wash the area with soap and water to reduce the risk of transmission.