Quizzes

PRE-CLINICAL QUIZ 2 DELEGATION

PRE-CLINICAL QUIZ 2 DELEGATION

The student nurse is taking home a print out from the electronic health record in order to have data to complete a care plan. Which protected health information (PHI) must the student remove prior to taking the print out home? (Select all that apply) date of care medical conditions insurance group number room number medication list birth date marital status

date of care insurance group number room number birth date Any information that can be used to identify the patient should be removed: demographics, name, address, telephone number, date of birth, identifying numbers such as medical number, room numbers, insurance numbers, specific dates of care. Marital status is not specific enough, race, ethnicity, and age to identify a person.

Which instruction provided by the nurse reflects effective communication regarding delegation to assistive personnel? Take vital signs every two hours for the patient with the cholestectomy in room 6022 Report to me if the chest tube drainage is excessive for Bed 2 in Room 2433 Check the urinary output on Bed 9 sometime this shift and let me know the results, OK? Please notify me of any client whose vital signs or blood glucose are significant

Take vital signs every two hours for the patient with the cholestectomy in room 6022 The goals of a delegated task should include time frame and limitations. Words such as "significant" "excessive" "sometime" are vague.

Kelly decided to report Sara to the nurse manager for leaving for an extended period of time without giving a proper hand off report. The nurse manager feels that Sara's actions constitute neglect of duty. This is the second time that the manager has discussed with Sara, her leaving the unit without a proper hand off. What form of discipline should the nurse manager use in this instance? Dismissal Suspension Written admonishment Verbal admonishment

Written admonishment 2nd offense, written is progressive from verbal, a first offense warning. Suspension and dismissal is appropriate for 3rd and 4th infractions, respectively.

A nurse receives a telephone call requesting patient information. In which instance can the nurse legally breach confidentiality and provide the requested information? neighbor calling to find out results of pt's MRI public health official asking about a suspected case of ebola emergency department nurse following up on a pt the nurse had sent to the unit an insurance provider seeking information about drug and alcohol screening

public health official asking about a suspected case of ebola Breaches in confidentiality are allowed for information that must be shared with another who will providing care. The mantra is "need to know" basis. Information may be provided to a health care proxy. Insurance companies should follow their proper hospital administrator pathway to obtain information. As the emergency department nurse is no longer responsible for the care of the patient, information cannot be provided to that nurse.

The charge nurse of a step down coronary care unit has 24 clients in varying degrees of cardiac rehabilitation. The charge nurse must assign the clients to a team consisting of RNs, LPN/LVNs, and one CNA. What is the primary factor for the charge nurse to consider when delegating care? proximity of client rooms to each other and the nurse's station staff preference for specific clients developmental needs of clients skill level and scope of practice of each staff member

skill level and scope of practice of each staff member The individual state practice act as well as the American Nurses Association (ANA) and the National Council on State Boards of Nursing (NCSBN) all contain scope of practice and delegation information.

The charge nurse is developing patient care assignments for the evening shift and needs to assign clients to a licensed practical / licensed vocational nurse (LPD/LVN) and a certified nursing assistant (CNA). Which clients should the nurse assign to the LPN/ LVN based on skill level and practice? (select all that apply). A client requiring reinforcement of teaching about a diabetic diet A client requiring collection of a urine specimen for urinalysis testing A client on bed rest requiring vital sign measurement every 4 hours A client requiring frequent suctioning A client requiring a dressing change to the foot A client requiring range of motion exercises twice daily

A client requiring reinforcement of teaching about a diabetic diet A client requiring frequent suctioning A client requiring a dressing change to the foot LVN/LPN: stable patients with predictable outcomes such as suctioning, reinforcement teaching already performed by an RN, performing sterile and unsterile dressing changes, administering NONparenteral medications. CNA or unlicensed assistive personnel: Range of Motion, collection of urine specimen as long as NO assessment, NO interpretation or decision making is needed.

Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/ LVN? A toddler with larnygotracheobraonchitis who had a tracheostomy performed 48 hours ago A school aged child who has an order for a gastric lavage because of acetaminophen (Tylenol) ingestion An infant with congestive heart failure A school aged child with a fractured femur who is in balanced suspension traction

A school aged child with a fractured femur who is in balanced suspension traction The client with the fractured femur on bed rest is the least acute patient and should be delegated to the LVN/ LPN. This client has a predictable outcome. The other clients are unstable and require frequent assessment.

A nurse takes a break without informing any of the nurse's colleagues. Which ethical principle has the nurse violated in relation to the nurse's patients? confidentiality justice fidelity veracity

Fidelity In being assigned to a patient, the nurse has accepted responsibility for their care, and thus has made an inherent promise to the patient to provide care throughout the shift. If the nurse leaves the patient without informing colleagues who could then look out for that patient in the nurse's absence, the nurse has broken the promise of care, and thus violated the ethical principle of fidelity. Veracity and confidentiality is broken if the nurse shared private information or provided false information. The nurse also did not show any preferential treatment for one patient over another, there is no violation of justice.

Two unit nurses are having lunch in the hospital cafeteria when one of the nurses begins talking about a difficult patient. What response by the second nurse indicates the best understanding of the Health Insurance Portability and Accountability Act (HIPAA)? I am worried the family may be near. Tell me when we are walking back. Be careful not to mention any names or room numbers It is not appropriate for us to discuss patients in the lunch room You need to speak more quietly so people can not over hear

It is not appropriate for us to discuss patients in the lunch room Nurses should not be discussing patient information in areas where they may overheard as this is violating HIPPA and breaching privacy and confidentiality.

Which task is appropriate for the nurse to delegate to the experienced nursing assistant? Assist a client admitted with dehydration in selecting flavored fluids by mouth for replacement of electrolytes. Observe a newly diagnosed client with a deep vein thrombosis practice subsuctaneous (SQ) heparin injections Obtain a urine specimen from a client with an indwelling Foley catheter Collect and record the amount of nasogastric (NG) contents from an intermittent suction container in a patient who is four hours post traditional cholecystectomy

Obtain a urine specimen from a client with an indwelling Foley catheter National council on State boards of Nursing posts activities the nurse may delegate to unlicensed assistive personnel. Collection of urine specimen from a closed indwelling urinary catheter is a routine procedure that does not involve teaching, assessing, interpretation, or decision making, therefore it is appropriate to delegate to the assistant. Selecting fluid replacement involves teaching. UAP are not allowed to disconnect the suction to empty the container. Observing an injection by a client requires assessment and patient teaching. UAPs are not allowed this scope of practice.

In the case scenario, Sara left her patient without providing a proper hand off report and was gone for an extended time. In which of the following situations would the patient be able to take legal action against her for patient abandonment? The patient was angry due to a lack of response to the call bell. The patient had an allergic reaction to a prescribed antibiotic The patient who is a fall risk and broke a hip- The patient overheard nurses talking about the situation

The patient who is a fall risk and broke a hip 4 elements must be present for patient abandonment: duty to patient, breach of duty, causation, and harm.

A nurse has repeated infractions, and the nurse manager is preparing a written admonishment to be reviewed with the nurse and placed in the nurse's personnel file. What elements should the nurse manager include in the written admonishment? (Select all that apply.) statements by other nurses demosntrating a pattern of bhvr plan of action for addressing bhvr List of patients affected by the violation Date and time violations occurred Consequences for further violation occurred List of the policies that have been violated

[PARTIAL POINTS] Plan of action for addressing behavior List of the policies that have been violated Date and time violations occurred Written admonishment should include specific policies violated, plan of action, description of events. It should not include patient identifiers. If nurses are asked to provide narratives, it should only be on the specific infraction, not perceptions patterns of behavior.

When the nurse manager found out about Sara's inappropriate access of the medical record, she terminated Sara. What information provided by the nurse manager indicated that Sara had adequate forewarning, one of the four rules of fair and effective discipline? (select all that apply) hospital policies and procedures orientation conference attendance online continuing education annual training

hospital policies and procedures orientation annual training HIPPA reviewed during orientation, mandated annual training, and hospital policies. These hospital sponsored activities ensure hospital compliance is completed and understood. Outside sources for HIPPA can not be used to ensure compliance.