A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of overdelegation?

Assigning the most efficient AP to perform glucometer monitoring for each client

Assigning two assistive personnel (AP) to ambulate all clients

Assigning a new graduate nurse to perform a wet-to-dry dressing change

Assigning the most competent RN to perform a central line dressing change

Answer and Explanation

The Correct Answer is C

A.   This task is generally appropriate for an assistive personnel (AP) if it is within their scope of practice and if proper training has been provided. Glucometer monitoring is a routine task that APs can often perform, assuming they are trained in using the glucometer and understanding the importance of accurate readings.

B.   Assigning two APs to ambulate all clients might be seen as overdelegation if the task requires more clinical judgment or if there are other tasks that need to be managed concurrently. Ambulating clients can sometimes be complex depending on their condition, and it’s essential to ensure that APs are appropriately trained and that the workload is balanced.
C.   Assigning a new graduate nurse to perform a wet-to-dry dressing change could be considered overdelegation if the task requires advanced skills and experience that the new graduate might not yet possess. Wet-to-dry dressing changes can be complex and require a certain level of expertise to ensure proper technique and patient safety.
D.   This task is typically appropriate for an RN with the necessary competencies and experience. A central line dressing change requires specific skills and knowledge, and delegating this task to the most competent RN ensures that it is performed correctly and safely. This is not considered overdelegation because it matches the task to the skill level of the RN.

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Correct Answer is D

Explanation

A. The "Plan" section of a SOAP note outlines the strategies for managing the patient’s condition, including further tests, treatments, and follow-up care. While vital signs can influence the plan of care, they are not documented in this section. Instead, the plan focuses on the next steps in treatment and interventions based on the assessment.
B. The "Assessment" section is where the nurse provides a professional judgment or diagnosis based on the subjective and objective data collected. Vital signs are not typically included in this section. Instead, the assessment would include the nurse’s interpretation of the data and overall evaluation of the patient's condition.
C. The "Subjective" section includes information that the patient reports about their own experience, symptoms, and concerns. Vital signs are objective measurements taken by the healthcare provider, so they do not belong in the subjective section. This section is focused on the patient's personal observations and feelings.
D. The "Objective" section is where measurable, observable data are documented. This includes vital signs such as blood pressure, heart rate, temperature, and respiratory rate, as these are concrete data points that can be objectively assessed and recorded by the healthcare provider.

A. A room that is within view of the nurses' station B. A room in the ICU C. A room with air exhaust directly to the outdoor environment D. A room with another nonsurgical client

Correct Answer is C

Explanation

A. While placing the client in a room within view of the nurses' station might allow for closer monitoring, it does not address the specific infection control requirements needed for a patient with active TB. TB is an airborne pathogen, so simply placing the room near the nurses' station does not prevent the spread of TB germs to other patients or staff.
B. This option is not specifically appropriate for TB unless the client requires intensive monitoring or care that cannot be provided on a general medical-surgical unit. The ICU is not designed specifically for airborne isolation and does not offer the specialized ventilation required for managing TB patients.
C. For a patient with active TB, the room should have specialized ventilation to prevent the spread of airborne pathogens. A room with air exhaust directly to the outdoor environment is ideal for TB patients as it ensures that the airborne particles are effectively removed from the healthcare environment, minimizing the risk of transmission to others.
D. Tuberculosis is an airborne infection, so placing a TB patient in a room with another client, regardless of whether they are nonsurgical, poses a risk of transmission. TB requires a single-patient room with proper ventilation to prevent the spread of the disease to other patients and staff.

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A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of overdelegation?

Nursing Test Bank

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Correct Answer is D

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Correct Answer is C

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