Delegation

Which tasks should the registered nurse (RN) delegate to the licensed practical nurse (LPN)? Select all that apply. 1.Assessment 2.Urinary catheterization 3.Endotracheal suctioning 4.Intramuscular medication administration 5.Subcutaneous medication administration 6.Intravenous push medication administration

2, 3, 4, 5

A nurse asks the patient if pain was relieved after receiving medication. What is the purpose of the evaluation phase of the nursing process? a. To determine if interventions have been effective in meeting patient outcomes b. To document the nursing care plan in the progress notes of the medical record c. To decide whether the patient's health problems have been completely resolved d. To establish if the patient agrees that the nursing care provided was satisfactory

A

Which information will the nurse consider when deciding what nursing actions to delegate to a licensed practical/vocational nurse (LPN/LVN) who is working on a medical-surgical unit (select all that apply)? a. Institutional policies b. Stability of the patient c. State nurse practice act d. LPN/LVN teaching abilities e. Experience of the LPN/LVN

A, B, C, E

A nurse is caring for a group of patients on the medical-surgical unit with the help of one float registered nurse (RN), one unlicensed assistive personnel (UAP), and one licensed practical/vocational nurse (LPN/LVN). Which assignment, if delegated by the nurse, would be inappropriate? a. Measurement of a patient's urine output by UAP b. Administration of oral medications by LPN/LVN c. Check for the presence of bowel sounds and flatulence by UAP d. Care of a patient with diabetes by RN who usually works on the pediatric unit

C

A nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the health care facility. The nurse is told that the nursing model is a team nursing approach. The nurse determines that which scenario is characteristic of the team-based model of nursing practice? 1. Each staff member is assigned a specific task for a group of clients. 2.A staff member is assigned to determine the client's needs at home and begin discharge planning. 3.A single registered nurse (RN) is responsible for providing care to a group of 6 clients with the aid of an unlicensed assistive personnel (UAP). 4.An RN leads 2 licensed practical nurses (LPNs) and 3 UAPs in providing care to a group of 12 clients.

4

A patient with a bacterial infection has a nursing diagnosis of deficient fluid volume related to excessive diaphoresis. Which outcome would the nurse recognize as most appropriate for this patient? a. Patient has a balanced intake and output. b. Patient's bedding is changed when it becomes damp. c. Patient understands the need for increased fluid intake. d. Patient's skin remains cool and dry throughout hospitalization.

A

The nurse is developing a client care assignment for a group of unlicensed assistive personnel (UAPs). What is the nurse's first step in planning and assigning clients? 1.Determine what skills can be delegated. 2.Determine the years of experience of each UAP. 3.Determine how much supervision is required for each client assigned. 4.Determine how many clients the agency allows to be delegated to each UAP.

1

The nurse manager is planning to implement a change in the nursing unit from team nursing to primary nursing. The nurse anticipates that there will be resistance during the change process. Which primary technique should the nurse use in implementing this change? 1.Introduce the change gradually. 2.Use coercion to implement the change. 3.Manipulate the participants in the change process. 4.Confront the individuals involved in the change process.

1

A registered nurse is delegating activities to the nursing staff. Which activities are most appropriate for the unlicensed assistive personnel (UAP)? Select all that apply. 1. Collecting a urine specimen from a client 2.Obtaining frequent oral temperatures on a client 3.Accompanying a client being discharged to his transportation to home 4.Assisting a postcardiac catheterization client who needs to lie flat to eat lunch 5.Monitoring the amounts of fluid remaining in intravenous (IV) solution bags for a client receiving IV fluids

1, 2, 3

A client refuses to take a medication. Which is the most therapeutic response by the nurse? 1. "I'll come back later to see if you have changed your mind." 2."You don't have to take the medication if you don't want to." 3."This medication is going to help you get better, so why don't you go ahead and take it?" 4."Do you want me to call your health care provider (HCP) and tell him you won't take your medication?"

2

The graduate nurse is interviewed by the manager of a unit and is told that the manager's leadership style is laissez-faire or one of letting the staff nurses make the decisions about the unit's operations. Which question by the graduate nurse indicates the best understanding of the laissez-faire leadership style? 1. "As the manager, do you maintain control and make all decisions?" 2."As the manager, do you assume a passive, nondirective approach?" 3."As the manager, do you facilitate decision making within the group?" 4."As the manager, do you change style according to the needs of the group?"

2

The registered nurse (RN) is beginning a new job in a clinic and attends an orientation session. After the session, another new employee asks the RN to describe case management, a component of the discussions in the orientation session, because the employee did not clearly understand the concept. Which statement made by the nurse is the most appropriate? 1. "Case management is an important concept, but it doesn't promote appropriate use of personnel." 2."Case management will maximize hospital revenues and at the same time provide optimal outcome of client care." 3."Case management saves money for the institution because clients with similar problems are all treated in the same manner." 4."Case management requires an experienced nurse because it represents a primary health prevention focus and is managed by a single nurse."

2

The nurse is administering medications to a patient. Which actions by the nurse during this process are consistent with promoting safe delivery of care (select all that apply)? a. Throws away a medication that is not labeled b. Uses a hand sanitizer before preparing a medication c. Identifies the patient by the room number on the door d. Checks lab test results before administering a diuretic e. Gives the patient a list of current medications upon discharge

A, B, D, E

A home care nurse is planning care for a patient who has just been diagnosed with type 2 diabetes mellitus. Which task is appropriate for the nurse to delegate to the home health aide? a. Assist the patient to choose appropriate foods. b. Help the patient with a daily bath and oral care. c. Check the patient's feet for signs of breakdown. d. Teach the patient how to monitor blood glucose.

B

The nurse is providing education to nursing staff on quality care initiatives. Which statement would be the most accurate description of the impact of health care financing on quality care? a. "Hospitals are reimbursed for all costs incurred if care is documented electronically." b. "Payment for patient care is primarily based on clinical outcomes and patient satisfaction." c. "If a patient develops a catheter-related infection, the hospital receives additional funding." d. "Because hospitals are accountable for overall care, it is not nursing's responsibility to monitor care delivered by others."

B

The nurse teaches a student nurse about how to apply the nursing process when providing patient care. Which statement, if made by the student nurse, indicates that teaching was successful? a. "The nursing process is a scientific-based method of diagnosing the patient's health care problems." b. "The nursing process is a problem-solving tool used to identify and treat patients' health care needs." c. "The nursing process is based on nursing theory that incorporates the biopsychosocial nature of humans." d. "The nursing process is used primarily to explain nursing interventions to other health care professionals."

B

A nurse is caring for a patient with heart failure. Which task is appropriate for the nurse to delegate to experienced unlicensed assistive personnel (UAP)? a. Monitor for shortness of breath or fatigue after ambulation. b. Instruct the patient about the need to alternate activity and rest. c. Obtain the patient's blood pressure and pulse rate after ambulation. d. Determine whether the patient is ready to increase the activity level.

C

A patient has been admitted to the hospital for surgery and tells the nurse, "I do not feel comfortable leaving my children with my parents." Which action should the nurse take next? a. Reassure the patient that these feelings are common for parents. b. Have the patient call the children to ensure that they are doing well. c. Gather more data about the patient's feelings about the child-care arrangements. d. Call the patient's parents to determine whether adequate child care is being provided.

C

A patient who is paralyzed on the left side of the body after a stroke develops a pressure ulcer on the left hip. Which nursing diagnosis is most appropriate? a. Impaired physical mobility related to left-sided paralysis b. Risk for impaired tissue integrity related to left-sided weakness c. Impaired skin integrity related to altered circulation and pressure d. Ineffective tissue perfusion related to inability to move independently

C

The nurse interviews a patient while completing the health history and physical examination. What is the purpose of the assessment phase of the nursing process? a. To teach interventions that relieve health problems b. To use patient data to evaluate patient care outcomes c. To obtain data with which to diagnose patient problems d. To help the patient identify realistic outcomes for health problems

C

The nurse is caring for an older adult patient who had surgery to repair a fractured hip. The patient needs continued nursing care and physical therapy to improve mobility before returning home. The nurse will help to arrange for transfer of this patient to which facility? a. A skilled care facility b. A residential care facility c. A transitional care facility d. An intermediate care facility

C

Which nursing diagnosis statement is written correctly? a. Altered tissue perfusion related to heart failure b. Risk for impaired tissue integrity related to sacral redness c. Ineffective coping related to response to biopsy test results d. Altered urinary elimination related to urinary tract infection

C

A nurse is assigned as a case manager for a hospitalized patient with a spinal cord injury. The patient can expect the nurse functioning in this role to perform which activity? a. Care for the patient during hospitalization for the injuries. b. Assist the patient with home care activities during recovery. c. Determine what medical care the patient needs for optimal rehabilitation. d. Coordinate the services that the patient receives in the hospital and at home.

D

The nurse admits a patient to the hospital and develops a plan of care. What components should the nurse include in the nursing diagnosis statement? a. The problem and the suggested patient goals or outcomes b. The problem with possible causes and the planned interventions c. The problem, its cause, and objective data that support the problem d. The problem with an etiology and the signs and symptoms of the problem

D

The nurse completes an admission database and explains that the plan of care and discharge goals will be developed with the patient's input. The patient states, "How is this different from what the doctor does?" Which response would be most appropriate for the nurse to make? a. "The role of the nurse is to administer medications and other treatments prescribed by your doctor." b. "The nurse's job is to help the doctor by collecting information and communicating any problems that occur." c. "Nurses perform many of the same procedures as the doctor, but nurses are with the patients for a longer time than the doctor." d. "In addition to caring for you while you are sick, the nurses will assist you to develop an individualized plan to maintain your health."

D

The nurse describes to a student nurse how to use evidence-based practice guidelines when caring for patients. Which statement, if made by the nurse, would be the most accurate? a. "Inferences from clinical research studies are used as a guide." b. "Patient care is based on clinical judgment, experience, and traditions." c. "Data are evaluated to show that the patient outcomes are consistently met." d. "Recommendations are based on research, clinical expertise, and patient preferences."

D

The nurse documenting the patient's progress in the care plan in the electronic health record before an interdisciplinary discharge conference is demonstrating competency in which QSEN category? a. Patient-centered care b. Quality improvement c. Evidence-based practice d. Informatics and technology

D

Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/LVN)? a. Complete the initial admission assessment and plan of care. b. Document teaching completed before a diagnostic procedure. c. Instruct a patient about low-fat, reduced sodium dietary restrictions. d. Obtain bedside blood glucose on a patient before insulin administration.

D

The nurse uses the Situation-Background-Assessment-Recommendation (SBAR) format to communicate a change in patient status to a health care provider. In which order should the nurse make the following statements? a. "The patient needs to be evaluated immediately and may need intubation and mechanical ventilation." b. "The patient was admitted yesterday with heart failure and has been receiving furosemide (Lasix) for diuresis, but urine output has been low." c. "The patient has crackles audible throughout the posterior chest and the most recent oxygen saturation is 89%. Her condition is very unstable." d. "This is the nurse on the surgical unit. After assessing the patient, I am very concerned about increased shortness of breath over the past hour."

D, B, C, A