A nurse is assessing a client prior to administering the influenza vaccine. The nurse should assess if the client has an allergy to which of the following foods?

Rationale:

A. You should not delegate this task because it requires nursing judgment: Weighing clients is a routine, non-invasive task that does not involve clinical decision-making. It does not require nursing judgment and is appropriate for delegation if the AP is competent.

B. You can delegate this task to an AP for new clients before performing a nursing assessment: Initial assessments must be performed by a licensed nurse. Weighing can be part of the assessment, but the nurse should first evaluate the client to determine whether delegation is appropriate.

C. You can delegate this task if the AP has been trained to use our scales: Delegation depends on the AP’s competence and familiarity with facility equipment. If trained, the AP can safely and accurately weigh clients, freeing the nurse for tasks requiring professional judgment.

D. You should not delegate this task because you have the capability to obtain clients weights: Delegation decisions should be based on scope of practice and task appropriateness, not whether the nurse is physically able to perform the task. Efficient delegation supports safe and effective care delivery.

Rationale:

A. Protamine: Protamine is used to reverse the effects of heparin, particularly in cases of heparin overdose or to stop excessive bleeding. It does not treat allergic reactions like urticaria.

B. Naloxone: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression or overdose. It has no effect on histamine-mediated symptoms such as urticaria.

C. Hydralazine: Hydralazine is an antihypertensive medication that lowers blood pressure by relaxing arterial smooth muscle. It is not appropriate for managing allergic skin reactions.

D. Diphenhydramine: Diphenhydramine is an antihistamine that blocks histamine receptors, making it effective for treating allergic reactions such as urticaria (hives). It reduces itching, swelling, and redness caused by histamine release.