A nurse delegates a task to an assistive personnel (AP) and the AP refuses to complete the assigned task. Which of the following actions should the nurse take?

Assign the task to another AP.

Report the AP to the risk manager.

Discuss the AP's concerns about performing the task.

Perform the task on behalf of the AP.

Answer and Explanation

The Correct Answer is C

A. "Assign the task to another AP" is not the best first response. The nurse should first understand why the AP is refusing the task and address any concerns before reassigning the task.

B. "Report the AP to the risk manager" is premature. The nurse should first attempt to understand the AP’s reasons for refusal and resolve any concerns directly. Reporting should only occur if the issue persists and cannot be resolved.

C. "Discuss the AP's concerns about performing the task" is correct. The nurse should open a dialogue with the AP to understand why they are refusing the task. This allows the nurse to assess if the refusal is due to lack of knowledge, skill, or comfort, and then provide the necessary support, guidance, or training.

D. "Perform the task on behalf of the AP" is not ideal. The nurse should not assume the task but rather address the issue with the AP. The nurse should only intervene if the task needs to be completed urgently, but the first step should be to explore the reasons for refusal.

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Correct Answer is D

Explanation

A. Verifying the amount of TPN solution the client is receiving every 4 hours is incorrect. While monitoring the TPN infusion rate is important, the rate and amount are typically verified at the start of the infusion and with each new bag change, not every 4 hours.

B. Placing the client in Sims' position for catheter insertion is incorrect. The preferred position for central venous catheter insertion is Trendelenburg or supine with a slight head turn, which helps dilate the veins and reduce the risk of air embolism.

C. Using clean technique when changing the catheter dressing is incorrect. Central venous catheter care requires sterile technique to prevent infections, including catheter-related bloodstream infections (CRBSIs).

D. Preparing the client for a chest x-ray to verify catheter placement is correct. A chest x-ray is required to confirm correct catheter placement before TPN administration to ensure the catheter tip is in the superior vena cava and to rule out complications like pneumothorax.

A. Tinnitus with ear pain B. Diplopia C. Hyperreflexia D. Skin rash with fever

Correct Answer is D

Explanation

A. Tinnitus with ear pain: While tinnitus can be a side effect of some medications, it is not associated with Stevens-Johnson syndrome (SJS). This symptom is more common with other medications or conditions, like aspirin or certain antibiotics, but not allopurinol.

B. Diplopia: Diplopia (double vision) is not a common sign of Stevens-Johnson syndrome. This symptom could be related to other conditions but is not characteristic of SJS.

C. Hyperreflexia: Hyperreflexia is not a typical manifestation of Stevens-Johnson syndrome. While neurological symptoms may sometimes occur, they are not central to the diagnosis of SJS.

D. Skin rash with fever: A skin rash with fever is a classic early sign of Stevens-Johnson syndrome. It is a potentially life-threatening reaction to certain medications, including allopurinol, and requires immediate medical attention. The rash often begins with a mild erythema, which may progress to blistering and sloughing of the skin.

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A nurse delegates a task to an assistive personnel (AP) and the AP refuses to complete the assigned task. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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