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A nurse in the health care provider's office must provide care to the following clients. From first to last, in what order should the nurse provide needed care to the clients?
- A. A client in an examination room who reports flulike symptoms
- B. A client seated in the office reception area who reports chest heaviness
- C. A client on the phone inquiring about doubling a dose of medication because of a missed dose the day before
- D. A client requires a call back by the nurse for advice on a medication dosage change
- E. A client who stopped into the office to pick up sample medications
Correct Answer: B,A,C,D,E
Rationale: All nurses must manage multiple client needs in a timely manner. Nurses must prioritize to determine the proper order of response. Nurses should address issues critical to maintaining life first (airway, breathing, circulation). A client with chest heaviness potentially could be having a life-threatening condition requiring immediate attention. Next, the client in the exam room needs vital signs and a history of present illness before the health care provider enters. To maintain the flow of the office, this client is a priority. Next, the nurse would answer the question of the client on the phone who may otherwise incorrectly ingest a double dose of medication. Next, a client needs to be called with a medication dosage change. Last, the client in the office who has come to obtain sample medication needs medication instruction on dosage and side effects.
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When delegating tasks to unlicensed assistive personnel (UAP), a licensed practical nurse (LPN) should assess the situation. Which of the following is the first step involved in assessing the situation?
- A. Communicate expectations clearly to UAP.
- B. Identify the UAP who will best handle the delegated tasks.
- C. Know the client's needs and priorities.
- D. Trust the UAP to complete the task.
Correct Answer: C
Rationale: To delegate tasks successfully, an LPN should first assess the situation. The steps taken to assess the situation involve understanding the client's needs, the skills of the UAP, and the priorities. The LPN should ensure that the UAP's skills map with the tasks to be completed. When planning the actions, the LPN should identify the UAP who will best handle the delegated tasks. When implementing the plan, the LPN should communicate expectations clearly to UAP, including what must be done, what to watch for, and potential problems. The LPN should trust the UAP to complete the task.
A parent of a 10-year-old client, newly diagnosed with diabetes, expresses concern that the child will not follow through with the diabetic regimen. The nurse suggests developing a calendar of daily requirements with a weekly prize for completion. Which type of power is the nurse suggesting the parent use?
- A. Coercive power
- B. Expert power
- C. Legitimate power
- D. Reward power
Correct Answer: D
Rationale: Reward power is using rewards and favors to obtain a particular action. In this case, the parent rewards the child when the child completes the prescribed diabetic regimen. Coercive power is when a threat or punishment is used to meet expectations. Expert power results from the respected knowledge in a particular situation. It could be said that parents exert legitimate power through their position as caregivers; however, in this case, the parent is providing a reward for the child completing the daily tasks.
Which of the following roles of a nurse is an example of legitimate power?
- A. Director of nursing
- B. Team leader making assignments
- C. Head nurse scheduling vacations
- D. Shift supervisor
Correct Answer: A
Rationale: Legitimate power is power by virtue of the management position. Director of nursing is an example of legitimate power. Team leader making assignments is an example of reward power. Head nurse scheduling vacations is an example of coercive power. Shift supervisor is an example of referent power.
Which of the following would be considered an indirect activity that may be delegated to unlicensed assistive personnel?
- A. Delivering meal trays
- B. Obtaining vital signs
- C. Ambulation
- D. Specimen collection
Correct Answer: A
Rationale: Indirect activities are focused on environmental tasks, such as cleaning equipment, emptying trash or soiled linen receptacles, and delivering meal trays. Direct activities are those that help clients meet basic needs, including vital signs, weights, specimen collection, and ambulation.
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.