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A nurse is preparing to delegate tasks to a licensed practical nurse (LPN). Which of the following tasks is appropriate for the LPN to perform?
- A. Develop a care plan for a client with a new diagnosis of diabetes.
- B. Administer a prescribed subcutaneous insulin injection.
- C. Perform an admission assessment for a client with chest pain.
- D. Evaluate the effectiveness of a client's pain management plan.
Correct Answer: B
Rationale: The correct answer is B: Administer a prescribed subcutaneous insulin injection. LPNs are trained to administer medications, including insulin injections, under the supervision of a registered nurse or physician. LPNs have the knowledge and skills necessary to safely administer medications. Choices A, C, and D involve assessments, evaluations, and care planning, which are tasks typically performed by registered nurses. LPNs can assist with these tasks but should not independently perform them. Overall, LPNs are best suited to carry out tasks related to direct patient care, such as medication administration.
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A nurse is caring for a client who is postoperative. Which of the following should the nurse request as a recommendation in an SBAR report to the provider? Select All That Apply
- A. Medication for elevated temperature
- B. Insertion of NG tube for decompression
- C. Oxygen 2 to 4 L/min via nasal cannula
- D. Insertion of urinary catheter
- E. Evaluation of surgical wound drain
Correct Answer: A,E
Rationale: The correct choices are A and E. Requesting medication for an elevated temperature (choice A) is important as it indicates a potential sign of infection postoperatively. Evaluation of the surgical wound drain (choice E) is crucial to monitor for any signs of infection or complications. Choices B, C, and D are not appropriate for an SBAR report as they do not directly address postoperative care needs. NG tube insertion (choice B) and urinary catheter insertion (choice D) are invasive procedures that should not be requested without a specific indication. Oxygen therapy (choice C) may be necessary but is not the priority in this case.
A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take?
- A. Inform the staff member of her appraisal time for that day prior to change-of-shift report.
- B. Schedule the appraisal interview as early in the shift as possible.
- C. Provide the staff member with a copy of the appraisal form in advance.
- D. Provide a chair directly across the desk for the staff member to sit in.
Correct Answer: C
Rationale: The correct answer is C: Provide the staff member with a copy of the appraisal form in advance. This action is essential as it allows the staff member to review the form, prepare their thoughts, and gather any necessary documentation or evidence to support their performance. By providing the form in advance, the staff member can actively participate in the appraisal process and engage in a meaningful discussion during the appraisal interview. This approach promotes transparency, fairness, and constructive feedback.
Other choices are incorrect:
A: Informing the staff member of the appraisal time prior to change-of-shift report may not give them adequate time to prepare for the appraisal.
B: Scheduling the appraisal interview as early in the shift as possible may not allow the staff member enough time to mentally prepare for the appraisal.
D: Providing a chair directly across the desk for the staff member to sit in is a physical setup and does not address the preparation aspect of the performance appraisal.
A nurse on a pediatric unit is reviewing her client assignment following the shift report. Which of the following clients should the nurse plan to assess first?
- A. An infant who has pertussis and is receiving oxygen via nasal cannula
- B. An adolescent who was admitted to the unit in sickle cell crisis and is ready for discharge instructions
- C. A school-age child who has diabetes mellitus and requires blood glucose monitoring
- D. A toddler who has both arms in casts and needs to be fed his breakfast
Correct Answer: A
Rationale: The correct answer is A. The nurse should assess the infant with pertussis receiving oxygen first because pertussis can cause severe respiratory distress. Assessing the infant's respiratory status is crucial as pertussis can lead to respiratory failure. Oxygen therapy is essential for maintaining adequate oxygenation levels. The nurse must monitor the infant's respiratory rate, effort, and oxygen saturation levels to ensure proper oxygenation. This assessment takes priority over the other clients' needs.
Choice B is incorrect because although the adolescent has sickle cell crisis, they are stable and ready for discharge instructions, which can be addressed after the critical assessment of the infant is completed.
Choice C is incorrect as monitoring blood glucose levels in a child with diabetes is important but does not take precedence over assessing a critically ill infant with pertussis.
Choice D is incorrect as feeding a toddler with both arms in casts can be challenging but does not pose an immediate threat to their health compared to the infant with pertussis requiring oxygen.
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A nurse in an emergency department receives report from an emergency responder who states a client is being transported following exposure to a 'dirty bomb'. The nurse should prepare to care for a client that has been exposed to which of the following types of agents?
- A. Radiologic
- B. Anthrax
- C. Chemical
- D. Sarin
Correct Answer: A
Rationale: The correct answer is A: Radiologic. A 'dirty bomb' combines conventional explosives with radioactive material, leading to radiologic exposure. The emergency responder's report of a 'dirty bomb' indicates potential radiation exposure. Choice B, Anthrax, is incorrect as it is a biological agent. Choice C, Chemical, is incorrect as it refers to exposure to toxic chemicals. Choice D, Sarin, is incorrect as it is a nerve agent. In summary, the nurse should prepare for radiologic exposure due to the 'dirty bomb' incident.
A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority?
- A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6
- B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous
- C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL
- D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg
Correct Answer: D
Rationale: The correct answer is D because a significant drop in blood pressure from 138/86 mm Hg at 0800 to 106/60 mm Hg at 1200 indicates potential hypotension, which could be a sign of hemorrhage or shock postoperatively. Hypotension can lead to inadequate tissue perfusion and organ damage. Monitoring and addressing the client's blood pressure promptly is crucial to prevent further complications.
Choice A is not the priority because an increase in pain from 4 to 6 is significant but does not indicate as immediate risk as hypotension. Choice B, a change in wound drainage consistency, may require monitoring but is not as urgent as addressing hypotension. Choice C, an increase in post-meal blood glucose, is important but does not pose an immediate threat to the client's life compared to hypotension in Choice D.