A nurse is assigning tasks to an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?

Change a dressing on an implanted central venous access device.

Suction a new tracheostomy.

Perform postmortem care.

Remove an NG tube.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Change a dressing on an implanted central venous access device: This is a sterile procedure that requires assessment skills and knowledge of infection control. It must be performed by a licensed nurse, not an assistive personnel (AP).

B. Suction a new tracheostomy: Suctioning a new tracheostomy is a high-risk procedure requiring specialized knowledge to prevent hypoxia or trauma. Only a licensed nurse should perform this intervention.

C. Perform postmortem care: Postmortem care is within the scope of practice for an AP. It involves cleansing, positioning, and preparing the body for the family or mortuary, and does not require advanced clinical judgment or sterile technique.

D. Remove an NG tube: Removal of a nasogastric tube requires assessment and understanding of client tolerance and potential complications, which are responsibilities of a licensed nurse. It is not appropriate to delegate this task to an AP.

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Correct Answer is B

Explanation

Rationale:

A. "You will receive a dose of misoprostol to initiate contractions.": Misoprostol is used for cervical ripening and induction of labor, not for a contraction stress test. A CST uses nipple stimulation or low-dose oxytocin to produce mild contractions. Using misoprostol would create strong, prolonged contractions that could endanger the fetus.

B. "I will apply an external fetal heart rate monitor during the test.": A contraction stress test evaluates how the fetal heart rate responds to contractions. External fetal monitoring is required to record the fetal heart pattern and contraction frequency, allowing the provider to assess for late decelerations that indicate uteroplacental insufficiency. This reflects accurate and essential teaching for the procedure.

C. "I will give you a terbutaline injection after the test.": Terbutaline is a tocolytic used to stop contractions, but it is not routinely administered after a CST. The contractions produced during a CST are mild and temporary, and terbutaline is only given if excessive contractions occur, which is not expected in normal testing.

D. "I will apply an oxygen face mask during the test.": Oxygen is not routinely administered during a CST because the goal is to observe how the fetus tolerates normal physiologic contractions. Oxygen is used only if fetal distress occurs, so including it in routine teaching suggests an incorrect understanding of the procedure.

A. "I will remove my shoes when I'm inside my house. B. "will floss between my teeth every time I brush C. "I will wipe my nose instead of blowing it." D. "I will use an enema to manage my constipation.

Correct Answer is C

Explanation

Rationale:

A. "I will remove my shoes when I'm inside my house.": While keeping the environment safe from tripping hazards is good for general safety, removing shoes does not specifically prevent bleeding, which is the main concern in thrombocytopenia. This action does not demonstrate understanding of bleeding precautions.

B. "I will floss between my teeth every time I brush": Flossing can cause gum bleeding, which is risky for clients with low platelet counts. Effective teaching would emphasize avoiding activities that may cause mucosal or skin bleeding, so this statement reflects a misunderstanding.

C. "I will wipe my nose instead of blowing it.": Gentle wiping reduces the risk of nasal bleeding, which is important in clients with thrombocytopenia. This statement shows the client understands the need to minimize trauma to areas prone to bleeding and demonstrates correct application of bleeding precautions.

D. "I will use an enema to manage my constipation.": Using an enema can cause mucosal trauma and rectal bleeding, which is unsafe for clients with thrombocytopenia. Safe constipation management would involve gentle measures such as stool softeners and increased hydration.

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A nurse is assigning tasks to an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?

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