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Which of the following would be considered an indirect activity that may be delegated to unlicensed assistive personnel?
- A. Delivering meal trays
- B. Obtaining vital signs
- C. Ambulation
- D. Specimen collection
Correct Answer: A
Rationale: Indirect activities are focused on environmental tasks, such as cleaning equipment, emptying trash or soiled linen receptacles, and delivering meal trays. Direct activities are those that help clients meet basic needs, including vital signs, weights, specimen collection, and ambulation.
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An LPN is a team leader for three nursing assistants covering a unit in a long-term care facility. At the beginning of each shift, the LPN instructs the nursing assistants to decide among themselves their client assignments. The LPN administers the clients' medications and some treatments but rarely checks in with the nursing assistants during the shift. The LPN's behavior reflects which managerial style?
- A. Authoritarian
- B. Laissez-faire
- C. Democratic
- D. Multicratic
Correct Answer: B
Rationale: Laissez-faire leadership involves the least structure and control. In this scenario, the LPN allows the nursing assistants to make their own assignments and rarely checks in with them during the shift. This allows for minimal communication, which is one of the characteristics of the laissez-faire leadership style. Authoritarian leadership entails strong control by the manager over the work group, which is not demonstrated in this scenario. Democratic leadership involves more participation in decision-making by the work group. Although the nursing assistants decided among themselves about the client assignments, the LPN did not participate in the decision-making at all. There is also no communication between the nursing assistants and the LPN, which is not a characteristic of the democratic leadership style. Multicratic leadership allows a leader to determine which approach is best for a particular circumstance. This characteristic is not demonstrated in the scenario.
A nurse manager who denies vacation time to an employee who failed to meet expectations is exhibiting what type of power?
- A. Legitimate
- B. Coercive
- C. Reward
- D. Referent
Correct Answer: B
Rationale: Coercive power is the ability to threaten or punish someone who fails to meet expectations. Legitimate power is obtained through a designated position. Reward power occurs when a person attains power through the ability to grant favors or rewards. Referent power is the power a person has because of an association with others who are powerful.
A licensed practical nurse (LPN) has delegated a task to unlicensed assistive personnel (UAP). Who is accountable for evaluating the results of the tasks?
- A. Physician
- B. Shift supervisor
- C. UAP
- D. LPN
Correct Answer: D
Rationale: An LPN or licensed vocational nurse (LVN) who delegates tasks to a UAP is accountable for evaluating the results of the tasks. The UAP is responsible for performing the actual task. The physician or shift supervisor is not accountable for evaluating the results of the tasks.
A nurse is caring for a client with stage IV colon cancer and multiple-stage two wounds on the coccyx area. The client confides feeling very weak and wanting to discontinue further aggressive treatment. Which nursing action best demonstrates the nurse in the role of the client advocate?
- A. The nurse relays the message to the physician and requests an antidepressant.
- B. The nurse asks the client how might their family feel with this decision.
- C. The nurse sits with the client and suggests that the client reconsider.
- D. The nurse offers to be present to support the client at a family meeting.
Correct Answer: D
Rationale: Advocacy means promoting the cause of another person. The nurse functions as a client advocate by supporting the client and the client's decisions. Offering to support the client as the client expresses healthcare decisions is the best example of a client advocate. Relaying the message to the physician and asking for an antidepressant does not demonstrate supporting the client. Opening conversation related to family response is appropriate for discussion but is not the best choice to support the client. The nurse would not ask the client to reconsider because this is a block to communication.
When delegating tasks to unlicensed assistive personnel (UAP), a licensed practical nurse (LPN) should assess the situation. Which of the following is the first step involved in assessing the situation?
- A. Communicate expectations clearly to UAP.
- B. Identify the UAP who will best handle the delegated tasks.
- C. Know the client's needs and priorities.
- D. Trust the UAP to complete the task.
Correct Answer: C
Rationale: To delegate tasks successfully, an LPN should first assess the situation. The steps taken to assess the situation involve understanding the client's needs, the skills of the UAP, and the priorities. The LPN should ensure that the UAP's skills map with the tasks to be completed. When planning the actions, the LPN should identify the UAP who will best handle the delegated tasks. When implementing the plan, the LPN should communicate expectations clearly to UAP, including what must be done, what to watch for, and potential problems. The LPN should trust the UAP to complete the task.