Nokea
A nurse on a medical-surgical unit has accepted a transfer to the Intensive care unit (ICU). Prior to transfer to the ICU, the nurse completes an online critical care and emergency nursing course. The nurse is demonstrating which of the following ethical principles?
- A. Nonmaleficence
- B. Veracity
- C. Autonomy
- D. Fidelity
Correct Answer: A
Rationale: The correct answer is A: Nonmaleficence. Nonmaleficence is the ethical principle of doing no harm to patients. By completing a critical care course before transferring to the ICU, the nurse is ensuring that they have the necessary knowledge and skills to provide safe and competent care to critically ill patients, thereby upholding the principle of nonmaleficence. Veracity refers to truthfulness, autonomy to patient's right to make decisions, and fidelity to keeping promises, which are not directly related to the nurse's situation in this scenario.
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At the beginning of the shift, an RN is preparing assignments for a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following tasks should the nurse assign to the LPN?
- A. Measuring a client's 1&O
- B. Obtaining a client's weight
- C. Providing postmortem care for a client
- D. Inserting a nasogastric tube for a client
Correct Answer: D
Rationale: Correct Answer: D - Inserting a nasogastric tube for a client
Rationale: LPNs are trained to perform more complex nursing tasks than APs. Inserting a nasogastric tube requires specialized skills and knowledge that LPNs are educated and licensed to carry out safely. LPNs have the training to assess, insert, and manage nasogastric tubes under the supervision of an RN, making this task appropriate for delegation to an LPN.
Incorrect Choices:
A: Measuring a client's 1&O - This task can be safely performed by an AP as it does not require the clinical judgment and skills of an LPN.
B: Obtaining a client's weight - This is within the scope of practice for an AP and does not require the nursing expertise of an LPN.
C: Providing postmortem care for a client - This task involves specialized knowledge and emotional support, typically handled by RNs, not LPNs.
A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients?
- A. A client who is 3 days postoperative following a craniotomy
- B. A client who is 3 days postoperative following gastric bypass surgery
- C. A client who is 2 hr postoperative following an abdominal hysterectomy
- D. A client who is 1 hr postoperative following a thyroidectomy
Correct Answer: B
Rationale: The correct answer is B because a client who is 3 days postoperative following gastric bypass surgery is stable and unlikely to have immediate complications. Vital signs can be safely delegated to an assistive personnel (AP) for this client.
Choice A is incorrect because a client who is 3 days postoperative following a craniotomy may still be at risk for neurological complications that require close monitoring by a nurse.
Choice C is incorrect because a client who is only 2 hours postoperative following an abdominal hysterectomy is still in the immediate postoperative period and requires frequent monitoring by a nurse.
Choice D is incorrect because a client who is only 1 hour postoperative following a thyroidectomy is in the immediate postoperative period and may have potential complications that require close monitoring by a nurse.
Overall, the key factor in delegating obtaining vital signs to an AP is the stability of the client's condition postoperatively.
A nurse checks with assistive personnel on the unit throughout the shift to determine if they are completing tasks. The nurse is demonstrating which of the following rights of delegation?
- A. Right circumstances
- B. Right supervision
- C. Right communication
- D. Right person
Correct Answer: B
Rationale: The correct answer is B: Right supervision. By checking with assistive personnel on the unit throughout the shift, the nurse is ensuring that tasks are being completed under their supervision. This demonstrates the nurse's responsibility to oversee and monitor the work of the assistive personnel, ensuring that tasks are being carried out correctly and safely. The other choices are incorrect because: A) Right circumstances pertains to ensuring the task is appropriate for delegation; C) Right communication involves clear instructions and feedback; D) Right person involves selecting the appropriate individual for the task.
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 charge nurse is assigning tasks for a client who is postoperative following a cholecystectomy. Which of the following tasks should the charge nurse delegate to an assistive personnel (AP)?
- A. Assess the client's incisional pain.
- B. Assist the client with ambulation to the bathroom.
- C. Evaluate the client's response to pain medication.
- D. Monitor the client's surgical drain output.
Correct Answer: B
Rationale: Correct Answer: B
Rationale: The charge nurse should delegate assisting the client with ambulation to the bathroom to an assistive personnel (AP) as it is within the AP's scope of practice and does not require specialized nursing knowledge. This task helps promote the client's mobility and independence postoperatively. The AP can provide physical support and ensure the client's safety during ambulation.
Incorrect Choices:
A: Assessing the client's incisional pain requires nursing judgment and assessment skills, which should be done by a licensed nurse.
C: Evaluating the client's response to pain medication involves assessing for effectiveness, side effects, and potential complications, which requires nursing knowledge and assessment skills.
D: Monitoring the client's surgical drain output involves assessing for signs of infection, leakage, or other complications that require nursing judgment and intervention.