A charge nurse is observing assistive personnel perform delegated tasks. Which of the following actions by the AP requires the charge nurse to intervene?

Performing a simple dressing change on a client's foot

Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile

Providing postmortem care for a client who has recently died

Emptying an indwelling urinary catheter bag for a client while wearing clean gloves

Answer and Explanation

The Correct Answer is B

A. Performing a simple dressing change on a client's foot - This action is appropriate and within the scope of practice for assistive personnel.
B. Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile - Handwashing with alcohol-based hand rub is not effective against Clostridium difficile spores. Proper hand hygiene for C. difficile requires washing with soap and water. The charge nurse should intervene to correct this action and ensure proper infection control procedures are followed.
C. Providing postmortem care for a client who has recently died - Providing postmortem care is within the scope of practice for assistive personnel and is appropriate.
D. Emptying an indwelling urinary catheter bag for a client while wearing clean gloves - This action is appropriate and within the scope of practice for assistive personnel.

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Correct Answer is A

Explanation

A. Decreased impulsiveness: Methylphenidate is a central nervous system stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD) in children. One of the therapeutic effects of methylphenidate is the reduction of impulsiveness, hyperactivity, and inattention, which are hallmark symptoms of ADHD. Therefore, a decrease in impulsiveness would indicate that the medication is effective.
B. Increased urine output: Methylphenidate is not expected to affect urine output. Increased urine output is not a typical finding indicating the effectiveness of methylphenidate.
C. Increased appetite: Methylphenidate commonly causes appetite suppression as a side effect. Therefore, an increase in appetite would not be indicative of the medication's effectiveness. In fact, a decrease in appetite is a common adverse effect of methylphenidate.
D. Decreased abdominal pain: Methylphenidate is not typically used to treat abdominal pain, and its effectiveness is not evaluated based on the relief of abdominal pain. The primary therapeutic effect of methylphenidate in ADHD is the improvement of attention, focus, and impulse control. Therefore, decreased abdominal pain would not be a reliable indicator of the medication's effectiveness.

A. "Eat a high-fat snack at bedtime." B. "Sip carbonated beverages throughout the day C. "Drink hot herbal tea to relieve symptoms. D. "Lie down for 30 min after meals."

Correct Answer is C

Explanation

A. "Eat a high-fat snack at bedtime": Consuming high-fat foods, especially close to bedtime, can exacerbate heartburn symptoms. Fatty foods delay gastric emptying and can contribute to increased acid production, leading to heartburn. Therefore, advising the client to avoid high-fat snacks before bedtime is essential for managing heartburn.
B. "Sip carbonated beverages throughout the day": Carbonated beverages, including soda and sparkling water, can exacerbate heartburn symptoms due to their acidic nature and carbonation. Therefore, advising the client to avoid or limit carbonated beverages is essential for managing heartburn.
C. "Drink hot herbal tea to relieve symptoms": Herbal teas such as chamomile or ginger tea can help alleviate heartburn symptoms by promoting digestion and soothing the gastrointestinal tract. Warm beverages can have a soothing effect on the esophagus and stomach, potentially providing relief from heartburn discomfort. Therefore, advising the client to drink hot herbal tea to relieve symptoms is an appropriate recommendation.
D. "Lie down for 30 min after meals": Remaining upright for at least 30 minutes after meals can help prevent acid reflux and reduce the risk of heartburn. However, lying down immediately after eating can worsen heartburn symptoms by allowing stomach acid to flow back into the esophagus. Therefore, advising the client to lie down for 30 minutes after meals is not an appropriate instruction for managing heartburn.

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A charge nurse is observing assistive personnel perform delegated tasks. Which of the following actions by the AP requires the charge nurse to intervene?

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