Nokea
The charge nurse is planning client care assignments for a licensed practical/vocational nurse (LPN/VN). Which of the following would be an appropriate assignment(s) for the LPN? Select all that apply.
- A. A 67-year-old one-hour post-procedure from a cardiac catheterization.
- B. An 88-year-old client who was just admitted for intractable pain secondary to metastatic cancer.
- C. A 42-year-old being discharged following a diagnosis of type 2 diabetes mellitus.
- D. A 75-year-old inpatient client with colon cancer needing colostomy care.
- E. A 50-year-old client being treated for herpes zoster with prescribed oral antivirals.
Correct Answer: B, D, E
Rationale: LPNs can manage stable clients with pain (B), colostomy care (D), and oral antivirals (E) within their scope. A client one-hour post-cardiac catheterization (A) requires RN monitoring for complications, and discharge teaching for diabetes (C) involves complex education best suited for an RN.
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The nurse is planning client care assignments. Which task should be delegated to the unlicensed assistive personnel (UAP)?
- A. The initial ambulation of a client following a laparoscopic hernia repair.
- B. Feed a client who has dysphagia.
- C. Applying sequential compression devices to a client’s lower extremities.
- D. Calling in prescriptions to the local pharmacy for a client ready for discharge.
Correct Answer: C
Rationale: Applying sequential compression devices (C) is a non-clinical task within the UAP’s scope. Initial ambulation (A), feeding with dysphagia (B), and calling prescriptions (D) require clinical judgment or RN/LPN skills due to risk or complexity.
The nurse is precepting a graduate nurse as they perform resuscitation on an adult with cardiac arrest. Which action by the graduate requires immediate follow-up by the nurse?
- A. Assesses the client’s pulse by palpating the carotid artery.
- B. Allows for chest recoil after every chest compression.
- C. Compresses at a depth of 2 inches on the center breastbone.
- D. Asks for an automated external defibrillator after one cycle of CPR.
Correct Answer: C
Rationale: Compressing at a depth of 2 inches (C) is inadequate for adult CPR, as guidelines require 2.4 inches (6 cm) for effective circulation, requiring immediate correction. Pulse check (A), chest recoil (B), and requesting a defibrillator (D) are correct actions.
The nurse is precepting a newly hired nurse on the medical-surgical unit. Which of the following actions, if performed first by the newly hired nurse, would demonstrate appropriate prioritization?
- A. Initiates a referral for a client needing home health care.
- B. Performs a central line dressing change on a client receiving 0.9% saline infusion.
- C. Collects a urine specimen from a client's indwelling urinary catheter.
- D. Obtains capillary blood glucose for a client receiving continuous regular insulin.
Correct Answer: D
Rationale: Obtaining blood glucose for a client on continuous insulin (D) is the priority to prevent hypo- or hyperglycemia, which can be life-threatening. Home health referral (A), dressing change (B), and urine collection (C) are important but less urgent, as they do not address immediate physiological risks.
The nurse has received the following information about assigned clients. The nurse should initially assess the client who is at
- A. 15 weeks gestation who reports not feeling any fetal movement.
- B. 28 weeks gestation who reports swollen feet and ankles.
- C. 36 weeks gestation who reports contractions that are irregular.
- D. 37 weeks gestation experiencing variable decelerations.
Correct Answer: D
Rationale: Variable decelerations at 37 weeks (D) indicate possible umbilical cord compression, a fetal emergency requiring immediate assessment. No fetal movement at 15 weeks (A) is normal, edema at 28 weeks (B) is common, and irregular contractions at 36 weeks (C) are non-urgent.
The nurse manager plans to establish quality metrics for the nursing unit based on national metrics and compare them to other healthcare organizations. This process is identified as
- A. benchmarking.
- B. continuous quality improvement.
- C. performance improvement.
- D. quality management.
Correct Answer: A
Rationale: Comparing unit metrics to national standards (A) is benchmarking, a process to measure performance against external standards. Continuous quality improvement (B), performance improvement (C), and quality management (D) are broader processes, but benchmarking is specific to this action.