A nurse is making assignments for staff on an inpatient unit. Which of the following tasks can a nurse legally delegate to assistive personnel?

Choice A reason: Encouraging a final hemodialysis treatment contradicts the client’s advance directives, which refuse life-sustaining treatments. Respecting autonomy is paramount, and persuading the client undermines their decision, making this action unethical and inappropriate in this end-of-life scenario.
Choice B reason: Contacting the family to discuss the decision is unnecessary unless the client is incapacitated, which is not indicated. The client’s advance directives guide care, and family input is secondary to the client’s wishes, making this action incorrect and irrelevant.
Choice C reason: Discussing treatment options with the surrogate is inappropriate, as the client is competent and has clear advance directives refusing treatment. The surrogate’s role applies only if the client cannot decide, making this action misaligned with the client’s autonomy and directives.
Choice D reason: Discussing discharge options respects the client’s refusal of treatment and advance directives, focusing on palliative care or home arrangements. This supports autonomy and aligns with end-of-life care principles, ensuring comfort and dignity, making it the correct action.

Choice A reason: Using two identifiers (e.g., name and medical record number) ensures the correct client receives the medication, preventing errors. This aligns with safety protocols, reducing risks of administering drugs to the wrong person. Verification confirms identity before administration, safeguarding against adverse events and ensuring compliance with standards like The Joint Commission.
Choice B reason: Checking the medication label twice is part of the “rights” of administration but is less specific than using two identifiers for client verification. While important, it addresses medication accuracy, not client identity, which is the primary safety concern to prevent errors, making it less critical in this context.
Choice C reason: Administering medication within 3 hours of the scheduled time relates to timing protocols, not the core action of ensuring safe administration. While timely administration is important, verifying client identity is the priority to prevent errors, as incorrect patient identification can lead to severe adverse events, making this less relevant.
Choice D reason: Administering medications to treat a condition to the actual prescriptions is vague and not a standard safety action. The focus is on verifying client identity and medication accuracy, not a general treatment alignment. This statement does not address a specific, actionable step in safe medication administration, making it incorrect.