A nurse is delegating care to an assistive personnel. Which of the following assignments should the nurse make?

Taking the vital signs of a client who is experiencing acute angina

Collecting a urine specimen from a client who is experiencing dysuria

Answering a telephone inquiry about NPO status from a client who is scheduled for a procedure

Reinforcing teaching with a client about stool specimen collection

Answer and Explanation

The Correct Answer is B

A.   Taking the vital signs of a client who is experiencing acute angina. Acute angina is a potentially unstable condition requiring assessment by a nurse.
B.   Collecting a urine specimen from a client who is experiencing dysuria. APs can perform routine specimen collection tasks.
C.   Answering a telephone inquiry about NPO status from a client who is scheduled for a procedure. Only licensed nurses should provide pre-procedure instructions.
D.   Reinforcing teaching with a client about stool specimen collection. Reinforcement of teaching involves assessment and evaluation, which are the nurse’s responsibilities.

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Correct Answer is ["B","C","D"]

Explanation

A. Decline documenting the first counseling session: Documentation is necessary to maintain accurate records of counseling sessions.
B. Communicate expected behavior to the AP: Reinforcing the expectations helps clarify appropriate behavior.
C. Explain to the AP the consequences of the behavior: Understanding potential consequences encourages adherence to confidentiality standards.
D. Allow the AP time to respond to the counseling information: Allowing the AP to respond fosters a two-way communication approach and encourages accountability.
E. Conduct the counseling session with another AP present: Counseling sessions should remain private to maintain confidentiality.

A. Notify the nurse manager. B. Check the family member's vital signs. C. Obtain the family member's health history. D. Complete an incident report.

Correct Answer is B

Explanation

A. Notify the nurse manager: Informing the manager may be necessary later, but the immediate priority is assessing and addressing the family member's condition.
B. Check the family member's vital signs: Assessing the family member's condition is the first step to determine the severity of the situation and provide appropriate care.
C. Obtain the family member's health history: Health history is valuable but not a priority in an acute event like fainting.
D. Complete an incident report: Incident reporting is necessary but should occur after the situation is managed and the family member's condition is stabilized.

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A nurse is delegating care to an assistive personnel. Which of the following assignments should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a newly licensed assistive personnel (AP) who has violated a client's confidentiality. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

A nurse is admitting a client for an elective surgical procedure. During the client interview, one of the client's family members faints. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

A nurse notices that a client's health information is visible on an unattended computer screen at the nurses' station. Which of the following actions should the nurse take first?

A nurse is preparing to discharge a client who had a cerebrovascular accident and has left-sided weakness. The client is having difficulty completing ADLs. Which of the following is the priority action by the nurse?

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A nurse is assisting with the plan of care for a child whose parents refuse to accept the medical treatment prescribed by the provider. Which of the following actions should the nurse plan to take first to address this ethical dilemma?

A nurse is assisting with the discharge of a client from an acute care unit to a long-term care facility, which of the following should the nurse include in the transfer report?

A home health nurse is visiting the home of a 9-month-old infant who is 2 weeks postoperative following a cleft palate repair. Which of the following questions is the priority for the nurse to ask?

A nurse is assisting in the care of a client. Exhibits The nurse is assisting in the care of the client. Which of the following findings should the nurse report to the provider? Select the 5 findings the nurse should report.

A charge nurse is reviewing the computer documentation of a newly licensed nurse. Which of the following practices by the newly licensed nurse should the charge nurse identify as appropriate documentation practice?