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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.
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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.
A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances?
- A. A young adult client admitted for acute glomerulonephritis following a viral infection
- B. A dependent adult admitted for the treatment of a spiral fracture
- C. A young adult client admitted for asthma and has track marks that may indicate IV drug abuse
- D. An emancipated minor who has acute appendicitis and wants to leave the facility without treatment
Correct Answer: B
Rationale: The correct answer is B because a dependent adult admitted for the treatment of a spiral fracture falls under mandatory reporting requirements for suspected abuse or neglect. The nurse is obligated to disclose information to an outside agency to ensure the safety and well-being of the patient. In cases of suspected abuse or neglect, it is crucial to involve external agencies to investigate and protect the vulnerable adult.
Choices A, C, and D do not necessarily involve mandatory reporting to an outside agency. A young adult with glomerulonephritis or asthma with possible IV drug abuse may not require immediate disclosure unless there is a clear indication of harm or risk to the patient. An emancipated minor with acute appendicitis wanting to leave without treatment raises ethical concerns but may not involve mandatory reporting unless there are specific legal requirements in place.
A nurse is planning client care for herself and an assistive personnel (AP) working with her. Which of the following tasks should the nurse plan to perform?
- A. Assisting a client to cough and deep breathe
- B. Application of antiembolic stockings
- C. Administration of an enema
- D. Assessing a client's sacrum for edema
Correct Answer: D
Rationale: The correct answer is D. The nurse should plan to perform the task of assessing a client's sacrum for edema. This task requires critical thinking and nursing judgment to assess for potential complications such as pressure ulcers. Nurses are trained to assess and identify abnormalities in a client's condition.
Choice A: Assisting a client to cough and deep breathe can be delegated to the AP as it is within their scope of practice.
Choice B: Application of antiembolic stockings is a task that can be safely delegated to the AP as it is a routine procedure that does not require nursing assessment.
Choice C: Administration of an enema is a task that can be delegated to the AP as it is a routine procedure that does not require nursing assessment.
A nurse is leading a debriefing session after a critical incident on the unit. Which of the following actions should the nurse take to support the team?
- A. Focus on assigning blame for the incident.
- B. Encourage staff to share their feelings and experiences.
- C. Criticize staff for errors made during the incident.
- D. Limit the discussion to procedural changes only.
Correct Answer: B
Rationale: Encouraging staff to share their feelings and experiences promotes emotional support and team cohesion, helping staff process the incident and identify areas for improvement.
A nurse is caring for a client who is postoperative following a hip replacement. The client's surgical drain has minimal output. Which of the following actions should the nurse take first?
- A. Notify the provider of the minimal drain output.
- B. Flush the drain with sterile saline.
- C. Document the drain output in the medical record.
- D. Check the drain for kinks or obstructions.
Correct Answer: D
Rationale: Checking the drain for kinks or obstructions is the first step to determine if the minimal output is due to a mechanical issue, which can often be resolved without further intervention.