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A licensed practical nurse (LPN) has delegated a task to unlicensed assistive personnel (UAP). Who is accountable for evaluating the results of the tasks?
- A. Physician
- B. Shift supervisor
- C. UAP
- D. LPN
Correct Answer: D
Rationale: An LPN or licensed vocational nurse (LVN) who delegates tasks to a UAP is accountable for evaluating the results of the tasks. The UAP is responsible for performing the actual task. The physician or shift supervisor is not accountable for evaluating the results of the tasks.
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During which client-nurse interaction would the nurse most appropriately use the authoritarian leadership style?
- A. The nurse is assisting the client to the bathroom when wound dehiscence occurs.
- B. The nurse is presenting meal options to a resistant diabetic client.
- C. The nurse is instructing on how to obtain blood glucose readings.
- D. The nurse is preparing discharge instructions per physician's prescription.
Correct Answer: A
Rationale: During an emergency, such as when a wound dehiscence occurs, an authoritarian leadership style with one person in tight control of the situation is best. At this time, the focus is on accomplishing the tasks of client safety, wound care, and physician notification. All of the other interactions would best be managed with a therapeutic nurse client interaction.
The nurse is planning care for the day for a client with multiple diagnoses. Which of the following criteria should the nurse consider first when setting priorities for the care of the client?
- A. Consider the priority of maintaining vital signs.
- B. Consider the priority of symptom management.
- C. Consider the priority of management of pain.
- D. Consider the priority of preventing spread of disease.
Correct Answer: A
Rationale: When prioritizing, vital signs provide data on maintaining life and are considered first. All other options come after.
A nurse is caring for clients on a surgical unit. Which nursing action(s) positively impacts the goal of healthcare cost containment? Select all that apply.
- A. Completing a nursing assessment and setting up a breakfast tray in an isolation client's room
- B. Teaching and encouraging the use of an incentive spirometer.
- C. Delegating the ambulation of a client three times daily in the hall
- D. Completing client wound dressing change prior to physician rounds
- E. Checking the completion of Foley catheter care with the nursing assistant.
- F. Initiating a turning protocol for a bedbound client
Correct Answer: A,B,C,E,F
Rationale: Cost-consciousness measures include prudent use of expensive supplies, careful monitoring of clients to reduce potential complications and lengths of stay, and reduction of waste of limited resources. Completing client wound dressing change prior to physician rounds is not an example of cost containment.
Staff is assembling for shift assignments. Which of the following nursing action(s) identifies the manager's responsibility on the clinical unit? Select all that apply.
- A. The manager assesses the clients on the clinical unit and updates the physician.
- B. The manager assures that adequate care is given by the staff and assesses the flow of activities on the clinical unit.
- C. The manager removes the physician prescriptions from the chart and notes completion.
- D. The manager attends facility meetings and set objectives.
- E. The manager completes the first medication pass of the shift.
Correct Answer: B,D
Rationale: The key feature of the manager's position is the individual responsibility and accountability for the accomplishment of tasks on the clinical unit. Part of this responsibility includes assuring that adequate care is given by the staff and assessing the flow of activities on the clinical unit. A manager attending faculty meeting and setting objectives also reflects manager and leadership duties. The other options are task oriented, and, although the manager may assist staff, it is not the focus of the manager's responsibility.
A nurse is caring for a client with stage IV colon cancer and multiple-stage two wounds on the coccyx area. The client confides feeling very weak and wanting to discontinue further aggressive treatment. Which nursing action best demonstrates the nurse in the role of the client advocate?
- A. The nurse relays the message to the physician and requests an antidepressant.
- B. The nurse asks the client how might their family feel with this decision.
- C. The nurse sits with the client and suggests that the client reconsider.
- D. The nurse offers to be present to support the client at a family meeting.
Correct Answer: D
Rationale: Advocacy means promoting the cause of another person. The nurse functions as a client advocate by supporting the client and the client's decisions. Offering to support the client as the client expresses healthcare decisions is the best example of a client advocate. Relaying the message to the physician and asking for an antidepressant does not demonstrate supporting the client. Opening conversation related to family response is appropriate for discussion but is not the best choice to support the client. The nurse would not ask the client to reconsider because this is a block to communication.