A nurse is delegating care tasks for a group of clients. Which of the following tasks should the nurse delegate to an assistive personnel?
Inserting a nasogastric tube
Converting a continuous IV infusion catheter to an intermittent infusion lock
Changing an appliance for a client who has an established ostomy
Evaluating the care of a client who is receiving speech therapy following a stroke
The Correct Answer is C
Choice A reason: Inserting a nasogastric tube requires specialized knowledge and skill. It involves assessing the client’s gag reflex, airway protection, and verifying placement, often with radiographic confirmation. This procedure carries risks such as aspiration, airway trauma, or incorrect placement into the lungs. Because of these risks, it is considered a nursing responsibility and cannot be delegated to assistive personnel.
Choice B reason: Converting a continuous IV infusion catheter to an intermittent infusion lock requires sterile technique and knowledge of vascular access. It involves flushing the catheter, maintaining patency, and preventing infection. These tasks require clinical judgment and are outside the scope of practice for assistive personnel.
Choice C reason: Changing an appliance for a client who has an established ostomy is appropriate to delegate. Once the ostomy is established and stable, the task becomes routine and does not require complex assessment. Assistive personnel can safely perform this under the nurse’s supervision, as it involves hygiene, comfort, and routine care rather than advanced clinical judgment.
Choice D reason: Evaluating the care of a client receiving speech therapy requires assessment skills and professional judgment. Evaluation involves determining progress, identifying barriers, and coordinating with the interdisciplinary team. This is a nursing responsibility and cannot be delegated to assistive personnel.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: Documenting that a client is "uncooperative" is subjective and judgmental. Medical records should contain objective, factual information rather than personal opinions or interpretations. This entry does not meet professional standards of documentation.
Choice B reason: Documenting the exact size and description of purulent drainage is objective, measurable, and factual. This entry provides clear clinical data that can be used for ongoing assessment and treatment planning. It avoids judgmental language and adheres to proper documentation standards. This makes it the correct answer.
Choice C reason: Documenting a medication error from a previous shift is inappropriate because nurses should only document events that occurred during their own shift. Errors should be reported through incident reporting systems, not in the client’s medical record. Including this information in the chart is incorrect.
Choice D reason: While documenting medication administration is appropriate, this entry is incomplete because it lacks essential details such as the route, time, and site of administration. Proper documentation requires comprehensive information to ensure continuity of care and safety.
Correct Answer is A
Explanation
Choice A reason: Allopurinol is the correct answer because it reduces uric acid production by inhibiting xanthine oxidase. This prevents recurrent gout attacks and long-term complications such as tophi and kidney stones. It is the standard medication for chronic gout management.
Choice B reason: Ibuprofen is an NSAID that can relieve acute pain and inflammation during a gout flare but does not prevent future attacks. It is supportive, not a long-term treatment.
Choice C reason: Lisinopril is an antihypertensive ACE inhibitor and has no role in treating gout.
Choice D reason: Atorvastatin is a lipid-lowering agent used for hypercholesterolemia, not gout.
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