Problems in Delegation: A Busy Day on the Floor

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

d. Take vital signs every two hours for the patient with the cholecystectomy in Room 6022.

The charge nurse (an RN) must determine how best to assign another RN and one licensed practical nurse/licensed vocational nurse (LPN/LVN) to provide care to a group of clients on the day shift. What is the appropriate assignment? a. The LPN/LVN is assigned to care for a 41-year-old male, post resection of a malignant melanoma lesion 2 days ago. b. The LPN/LVN is assigned to provide discharge teaching about medications and maintenance of nephrostomy tube to a 35-year-old man. c. The RN is assigned to care for an unemployed 26-year-old woman, newly diagnosed with acquired immunodeficiency syndrome (AIDS). d. The RN is assigned to obtain vital signs on all patients on the unit because one of the nursing assistants will not be into work until 11 am.

c. The RN is assigned to care for an unemployed 26-year-old woman, newly diagnosed with acquired immunodeficiency syndrome (AIDS).

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

a. A school-aged child with a fractured femur who is in balanced suspension traction

A charge nurse is planning client activities for the day. Which tasks should the charge nurse delegate to the nursing assistant? (Select all that apply.) a. Take and record temperatures, pulses, respirations, and blood pressures on all assigned patients. b. Restock pediatric patient care rooms with oral rehydration fluids using a standardized check list. c. Check the emergency crash cart (cardiopulmonary resuscitation cart) for necessary supplies using a checklist. d. Empty and record the amount of urine out of Foley bags at the end of each shift. e. Assist the pharmacy technician in refilling the automatic medication dispenser. f. Assist with delivering breakfast trays to clients after checking for correct patient, room number, and diet.

a. Take and record temperatures, pulses, respirations, and blood pressures on all assigned patients. b. Restock pediatric patient care rooms with oral rehydration fluids using a standardized check list. d. Empty and record the amount of urine out of Foley bags at the end of each shift. f. Assist with delivering breakfast trays to clients after checking for correct patient, room number, and diet.

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

b. A client requiring a dressing change to the foot c. A client requiring reinforcement of teaching about a diabetic diet d. A client requiring frequent suctioning

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

c. Obtain a urine specimen from a client with an indwelling Foley catheter.

During the admission of pediatric client with a compound fracture of the right femur following a sports injury, which delegation by the charge nurse is most appropriate? a. Ask the LPN/LVN to obtain the admissions vital signs on the client while the RN obtains telephone orders from the admitting physician. b. Request the LPN/LVN to assess the peripheral pulses of the client's left leg while the nurse completes the admission form. c. Request that the nursing assistant obtain equipment for the client's care while the RN talks with the client and the family. d. Request the nursing assistant to obtain the client's vital signs while the nurse obtains a history from the family.

c. Request that the nursing assistant obtain equipment for the client's care while the RN talks with the client and the family.

The charge nurse is determining morning care assignments for several elderly clients awaiting discharge to an assisted living facility, including a client on bed rest with a skin tear and hematoma from a fall 5 days ago. What is the best care assignment for this client? a. Delegate complete care to unlicensed assistive personnel (ULAP). b. Assign an RN to provide total care to the client. c. Supervise the nursing assistant who will be performing skin care. d. Assign a nursing assistant to help the client with self-care activities.

d. Assign a nursing assistant to help the client with self-care activities.

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? a. Proximity of client rooms to each other and the nurses' station b. Developmental needs of clients c. Staff preference for specific clients d. Skill level and scope of practice of each staff member

d. Skill level and scope of practice of each staff member

The charge nurse is preparing the patient care assignments for the day shift, assigning clients to a LPN/LVN and a certified nursing assistant (CNA). Which clients should be assigned to the CNA? (Select all that apply.) a. A client requiring reinforcement of teaching about a diabetic diet. b. A client requesting to use the bedpan after a lumbar puncture procedure. c. A client requiring a sterile dressing change to a decubitus ulcer. d. A client with throat cancer and a tracheostomy requiring frequent suctioning. e. A client requesting assistance packing his belongings for discharge later today. f. A client pending discharge after a laparoscopic hernia repair who is requesting to ambulate to the bathroom

e. A client requesting assistance packing his belongings for discharge later today. f. A client pending discharge after a laparoscopic hernia repair who is requesting to ambulate to the bathroom