Nokea
A nurse manager is providing an inservice program about delegation to assistive personnel (AP) with staff nurses on the unit. Which of the following statements by a staff nurse indicates an understanding of the teaching?
- A. The nurse relinquishes accountability for client outcomes when care is delegated to an AP.
- B. The nurse should consider the AP's level of experience when making delegation decisions.
- C. The AP can provide client education about how to perform basic self-care to the client.
- D. The AP can re-delegate a task to another AP who has similar work experience.
Correct Answer: B
Rationale: The correct answer is B: The nurse should consider the AP's level of experience when making delegation decisions. This answer demonstrates an understanding of the key principle of delegation, which is to assign tasks based on the competency and skill level of the individual. Considering the AP's experience ensures safe and effective delegation.
Incorrect choices:
A: Incorrect because the nurse remains accountable for client outcomes even when delegating tasks.
C: Incorrect because client education should typically be done by licensed healthcare providers.
D: Incorrect because delegation should not involve re-delegating tasks to another uninvolved AP.
In summary, choice B reflects the importance of assessing the AP's competency when delegating tasks, ensuring safe and quality care.
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A nurse is obtaining informed consent from a client who is preoperative. Which of the following actions should the nurse take? (Select all that apply.)
- A. Verify the client understands the surgical procedure.
- B. Validate the signature is authentic.
- C. Confirm that the consent is voluntary.
- D. Explain the surgical procedure to the client.
- E. Establish that the client is able to pay for the surgical procedure.
Correct Answer: A,B,C
Rationale: Correct Answer: A, B, C
Rationale:
A: Verifying the client understands the surgical procedure ensures they are informed about what will occur during surgery.
B: Validating the signature is authentic confirms the client has personally given consent, enhancing legal protection.
C: Confirming consent is voluntary ensures the client is not coerced or pressured, upholding ethical principles.
Summary:
D: Explaining the surgical procedure is important but not solely the nurse's responsibility for obtaining consent.
E: Ability to pay is not a factor in obtaining informed consent.
Overall, A, B, and C are crucial steps to ensure informed and voluntary consent.
A charge nurse is reviewing the documentation of a newly licensed nurse. Which of the following entries requires follow-up?
- A. Client received 2 mg morphine IV at 0900 for pain rated 6/10.
- B. Client's blood pressure is normal after medication administration.
- C. Client refused morning medications; provider notified.
- D. Client's wound dressing changed at 1100 per protocol.
Correct Answer: B
Rationale: Describing blood pressure as 'normal' is vague and lacks specific data, requiring follow-up to ensure accurate and complete documentation.
A nurse is preparing to discharge a client who has a new prescription for warfarin. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?
- A. Teach the client about dietary restrictions with warfarin.
- B. Provide the client with written discharge instructions.
- C. Assist the client with packing personal belongings.
- D. Schedule a follow-up appointment for the client.
Correct Answer: C
Rationale: Assisting the client with packing personal belongings is a non-clinical task within the AP's scope of practice. Teaching, providing instructions, and scheduling appointments require nursing expertise.
A nurse notes a provider frequently arrives to the unit with bloodshot eyes and smells like alcohol after lunch. Which of the following actions should the nurse take?
- A. Inform the state medical board for an immediate investigation.
- B. Counsel the provider to determine the cause of the substance abuse.
- C. Notify the nursing supervisor of the concerns.
- D. Encourage clients to change to a different provider.
Correct Answer: C
Rationale: The correct answer is C: Notify the nursing supervisor of the concerns. This is the most appropriate action because it allows for immediate intervention by someone in authority to address the provider's behavior. The nursing supervisor is in a position to assess the situation, determine the appropriate course of action, and provide support to the nurse in dealing with this sensitive issue. Reporting to the state medical board (choice A) may be premature and could potentially harm the provider's career without first addressing the issue internally. Counseling the provider (choice B) may not be effective if there is a serious substance abuse problem. Encouraging clients to change providers (choice D) is not the nurse's responsibility and may not address the root cause of the issue.
Admission Assessment
Vital Signs
Nurses' Notes
82-year-old client admitted with nondisplaced hip fracture awaiting surgery. History of mild dementia, and hypotension. The family is concerned about malnutrition and living alone. The client's daughter who is the power of attorney (POA) is currently out of state.
A nurse is caring for a client who is exhibiting increased agitation. The nurse offered toileting, lowered the lights in the client's room and closed door to client's room. The nurse is at risk for which of the following as evidenced by applying wrist restraints to the client?
- A. False imprisonment
- B. Slander
- C. Negligence
- D. Battery
- E. Assault
Correct Answer: A
Rationale: [1, 0, 0, 0, 0]
Correct Answer: A
Rationale: Applying wrist restraints without appropriate justification can lead to false imprisonment, violating the client's rights. Slander (B) is verbal defamation; Negligence (C) is failure to provide reasonable care; Battery (D) is physical harm; Assault (E) is the threat of harm.