A nurse is assigning care for four clients. Which of the following tasks should the nurse plan to delegate to an assistive personnel (AP)?
Instruct a client how to take their blood pressure.
Administer subcutaneous medications to a client.
Determine a client's intake and output.
Provide a status update to a client's family member.
The Correct Answer is C
The correct answer is Choice C.
Choice A rationale:
Instructing a client on how to take their blood pressure is a task that involves providing education to the client on a non-invasive procedure that they can perform independently. However, this task requires a certain level of knowledge and understanding that an assistive personnel (AP) may not possess. Therefore, it is not the best task to delegate to an AP.
Choice B rationale:
Administering subcutaneous medications to a client is a task that requires a high level of skill and knowledge. It involves understanding the medication, its side effects, and the correct administration technique. This is a task that should be performed by a nurse or a healthcare professional with the appropriate training and licensure. Delegating this task to an AP could potentially put the client’s health at risk.
Choice C rationale:
Determining a client’s intake and output is a task that can be delegated to an AP. This task does not require the use of the nursing process and is within the range of function of an AP. It involves measuring and recording the amount of fluid a client consumes and excretes, which is a task that an AP is capable of performing.
Choice D rationale:
Providing a status update to a client’s family member is a task that requires a high level of discretion and understanding of the client’s condition. It involves communicating sensitive information about the client’s health status, which should be done by a nurse or a healthcare professional with the appropriate training and licensure. Delegating this task to an AP could potentially lead to miscommunication or a breach of the client’s privacy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
The National League for Nursing (NLN) focuses on nursing education standards and resources for nursing faculty. While it could provide useful insights, it's not the primary resource for policy creation related to procedures like catheter insertion.
Choice B rationale:
The American Academy of Nursing (AAN) is a professional organization that promotes leadership and education within nursing. While it might offer recommendations, it's not the primary resource for policy related to procedural changes in clinical settings.
Choice C rationale:
The Agency for Healthcare Research and Quality (AHRQ) is involved in research and quality improvement initiatives in healthcare. While it could provide evidence-based practices, it's not the primary source for policies specific to nursing procedures.
Choice D rationale:
The State Nurse Practice Act (NPA) outlines the scope of nursing practice within a particular state. It governs what nurses are allowed to do, including procedures like catheter insertion. The NPA ensures that nursing actions are within legal and regulatory bounds, making it the most relevant resource for creating a policy about catheter insertion.
Correct Answer is B
Explanation
The correct answer is choice B: Perform a chart review to gather data about the clients who developed infections.
Choice A rationale: Conducting an in-service on proper catheter insertion and maintenance may be helpful in addressing the issue but should not be the first step.
Choice B rationale: Performing a chart review to gather data about the clients who developed infections is an essential first step. This allows the nurse manager to analyze potential trends or common factors contributing to the infections, which can help identify specific areas for improvement or intervention (NurseLabs, n.d.).
Choice C rationale: Observing each staff nurse perform a urinary catheter insertion could help identify improper techniques that contribute to the infections. However, this is time-consuming and should be done after a chart review has been conducted.
Choice D rationale: Requiring completion of a self-paced instruction program might improve staff knowledge, but it should not be the first action taken by the nurse manager.
In conclusion, the nurse manager should first perform a chart review to gather data about the clients who developed urinary tract infections. This will help identify possible factors contributing to the infections and guide the nurse manager in developing targeted interventions to address the issue.
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