A nurse is delegating care to assistive personnel. Which of the following assignments should the nurse make?
Reinforcing teaching with a client about stool specimen collection
Collecting a urine specimen from a client who is experiencing dysuria
Taking the vital signs of a client who is experiencing acute angina
Answering a telephone inquiry about NPO status from a client who is scheduled for a procedure
The Correct Answer is B
A) Reinforcing teaching with a client about stool specimen collection:
This task involves providing education to the client, which requires nursing knowledge and judgment. It is not appropriate to delegate to assistive personnel, as they may not have the necessary training or expertise to provide accurate and comprehensive teaching.
B) Collecting a urine specimen from a client who is experiencing dysuria:
Collecting a urine specimen from a client who is experiencing dysuria is an appropriate task to delegate to assistive personnel. This task involves following a standard procedure for specimen collection and does not require specialized nursing judgment or assessment skills.
C) Taking the vital signs of a client who is experiencing acute angina:
Assessing vital signs, especially in a client experiencing acute angina, requires nursing judgment and the ability to recognize and respond to changes in the client's condition. This task should not be delegated to assistive personnel, as they may not have the training to recognize signs of deterioration or respond appropriately.
D) Answering a telephone inquiry about NPO status from a client who is scheduled for a procedure:
Providing information over the phone regarding NPO (nothing by mouth) status involves assessing the client's specific situation, understanding the procedure's requirements, and potentially making clinical decisions based on the client's condition. This task requires nursing judgment and should not be delegated to assistive personnel.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
A) Ensure the client wears nonskid slippers when walking around the house:
Wearing nonskid slippers can help improve traction and stability, reducing the risk of slips and falls, especially on smooth or slippery surfaces commonly found in homes. Ensuring the client wears nonskid slippers is a proactive measure to prevent falls.
B) Install a raised toilet seat in the client's bathroom:
A raised toilet seat can make it easier for older adults with mobility issues to sit down and stand up from the toilet safely. It reduces the distance the client needs to lower themselves, decreasing the risk of falls, especially for those with balance or strength limitations.
C) Encourage an annual review of the medications the client is taking:
Medication review is essential to identify any medications that may increase the risk of falls due to side effects such as dizziness, drowsiness, or orthostatic hypotension. An annual review ensures that any potential fall-inducing medications can be identified and addressed promptly.
D) Attach full-length side rails to the client's bed:
While side rails may prevent falls out of bed, they can also increase the risk of entrapment and injury. The use of side rails is controversial and should be based on individualized assessment and risk-benefit analysis. In many cases, alternative interventions to prevent falls should be considered before resorting to side rails.
E) Place throw rugs on uncarpeted floors in the client's home:
Throw rugs can be tripping hazards, especially for older adults with mobility issues. They can easily slip or bunch up, leading to falls. Removing throw rugs or securing them firmly to the floor is recommended to reduce the risk of falls in the home.
Correct Answer is A
Explanation
A) Perform CPR on the client:
Performing CPR is a critical intervention during cardiac arrest to maintain circulation and oxygenation. Assistive personnel are trained in basic CPR techniques and can effectively administer chest compressions according to established protocols. Assigning this task to assistive personnel allows the nurse to focus on other aspects of resuscitation and coordination of care.
B) Assist with airway intubation:
Airway intubation requires specialized training and skills, typically performed by licensed healthcare providers such as nurses or physicians. While assistive personnel may assist with preparing equipment or positioning the client, they are not trained to perform airway intubation procedures.
C) Place defibrillator pads on the client:
Placing defibrillator pads requires knowledge of proper positioning and electrode placement to deliver effective defibrillation shocks. This task is typically performed by healthcare providers with training in advanced cardiac life support (ACLS). Assistive personnel may assist with tasks such as preparing the client's chest and clearing the area for defibrillation, but they do not typically apply the pads themselves.
D) Maintain IV access:
Maintaining IV access involves monitoring the IV site, adjusting flow rates, and administering medications or fluids as ordered. While assistive personnel may assist with tasks related to IV access, such as holding the IV bag or adjusting tubing, they are not typically responsible for the overall management and maintenance of IV access during a cardiac arrest situation.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
