A nurse is coordinating care of a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?
Measure the intake and output of a client who has received furosemide.
Reinforce teaching with a client about crutch-gait walking.
Check a client's peripheral IV site for redness or swelling.
Assess the pain level of a client who has received acetaminophen.
The Correct Answer is A
Choice A Reason:
Measuring the intake and output of a client who has received furosemide is correct. This task involves recording and measuring fluid intake and output, which is typically within the scope of practice for assistive personnel. It requires accurate documentation and doesn't involve making clinical judgments.
Choice B Reason:
Reinforcing teaching with a client about crutch-gait walking is incorrect. Teaching and instructing clients about specific medical procedures or techniques usually require specialized knowledge and assessment skills, typically within the nurse's scope of practice.
Choice C Reason:
Checking a client's peripheral IV site for redness or swelling is incorrect. Assessing for redness or swelling at an IV site involves clinical judgment and assessment skills to identify potential complications. This task is better suited for a licensed nurse who can interpret findings and take appropriate action if needed.
Choice D Reason:
Assessing the pain level of a client who has received acetaminophen is incorrect. Assessing pain levels involves subjective interpretation and understanding of pain scales, which generally falls under the scope of licensed healthcare providers who can evaluate and manage pain interventions based on assessments.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
"Aren't you interested in learning how to perform this test?" is incorrect. This response might come across as accusatory or judgmental, potentially making the client feel uncomfortable or defensive, further hindering communication.
Choice B Reason:
"Let's talk about what you're thinking." Is correct. This response acknowledges the client's distraction and aims to understand and address their thoughts or concerns that might be hindering their focus. It invites the client to express any worries or questions they might have, allowing the nurse to provide reassurance or clarification.
Choice C Reason:
"I'll discuss this with your partner instead." Is incorrect. Redirecting the conversation to the client's partner without understanding the client's concerns directly could undermine the client's autonomy and miss the opportunity to address their needs.
Choice D Reason:
"Is this something you think you can do?" is incorrect. While this question aims to assess the client's confidence, it might not effectively address the underlying reason for the client's distraction or encourage open communication about their concerns.
Correct Answer is D
Explanation
Choice A Reason:
Chicken is incorrect. Chicken is a type of poultry and is a meat product. Lacto-vegetarians do not consume meat, including poultry, as part of their dietary choices.
Choice B Reason:
Clam chowder is incorrect. Clam chowder is a soup typically made with clams and often contains ingredients like broth or cream, which may not align with a lacto-vegetarian diet. It includes seafood, which is excluded in lacto-vegetarian dietary practices.
Choice C Reason:
Tuna fish is incorrect. Tuna fish is a type of seafood and is not consumed in lacto-vegetarian diets. Lacto-vegetarians exclude all types of fish and seafood from their diet and primarily consume dairy products along with plant-based foods.
Given that the client follows a lacto-vegetarian diet, the most appropriate food choice from the options provided would be:
Choice D is Reason:
Cheese is correct. A lacto-vegetarian diet includes dairy products but excludes meat and seafood. Cheese, being a dairy product, aligns with the lacto-vegetarian dietary pattern as it is derived from milk and fits within the dietary preferences of this individual.
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