A client with frequent watery stools and a possible Clostridium difficile infection is hospitalized with dehydration. Which nursing action should the charge nurse assign to an LPN?
Performing assessments of the client's hydration status.
Administering the prescribed metronidazole 500 mg orally to the client.
Reviewing client's medical history for any risk factors for diarrhea.
Explaining the purpose of the ordered stool cultures to the client and family.
The Correct Answer is B
A. While LPNs can perform some assessments, the charge nurse should assign this task to an RN. Assessing hydration status requires critical thinking and a comprehensive understanding of the client's overall clinical condition, which typically falls within the RN’s scope of practice.
B. Administering medications, including antibiotics like metronidazole, is within the scope of practice for LPNs. As long as the LPN is competent in administering medications and there are no specific contraindications for the client, this task can be appropriately assigned.
C. This task involves critical thinking and comprehensive analysis of the client's medical history, which is typically conducted by an RN. While LPNs may review aspects of the medical history, the charge nurse should assign more complex evaluations and assessments to RNs.
D. While LPNs can provide some patient education, explaining the rationale behind specific tests, especially in the context of complex infections, typically requires the knowledge and expertise of an RN. This task may involve more detailed clinical reasoning and the ability to address specific questions and concerns that the client or family may have.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Filing an event report after a medication error is a professional and responsible action. This behavior promotes transparency and accountability and is often required by healthcare facilities to improve safety and prevent future errors. Generally, filing such a report itself does not carry disciplinary consequences, especially if done in accordance with the facility's policies.
B. This behavior can have serious disciplinary consequences. Humiliating a colleague can create a hostile work environment, which may lead to formal complaints and disciplinary actions against the nurse manager. Such actions violate workplace professionalism and can result in legal repercussions as well.
C. This behavior can also lead to disciplinary action. Condescension and disrespect undermine teamwork and can discourage open communication, which is critical in healthcare settings. This behavior can be reported and may be addressed by management or human resources.
D. Sexual harassment of a patient is a serious offense that can lead to severe legal and disciplinary consequences. It is a violation of ethical and legal standards in healthcare, resulting in potential termination, loss of licensure, and legal action.
Correct Answer is C
Explanation
A. While monitoring temperature is important in assessing for infection, it is not the priority assessment before administering morphine. Temperature does not directly relate to the immediate effects or risks associated with opioid administration.
B. Blood pressure monitoring is essential, especially in a postoperative patient. However, opioids primarily impact the respiratory system rather than directly causing significant changes in blood pressure. While hypotension can occur with opioids, it is not the most immediate concern when administering morphine.
C. This is the priority assessment. Opioids, including morphine, can cause respiratory depression, which is a serious and potentially life-threatening side effect. Before administering morphine, it is crucial to assess the respiratory rate to ensure the patient is not at risk for respiratory distress. If the respiratory rate is low (typically less than 12 breaths per minute), the nurse may need to hold the medication and notify the healthcare provider.
D. While it is important to monitor heart rate, especially in postoperative patients, the primary concern with morphine administration is its effect on respiration. The heart rate may not be as critical to assess immediately before administering morphine as the respiratory rate is.
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