A nurse is planning assignments for the upcoming shift.
Which of the following tasks should the nurse delegate to an assistive personnel? (Select all that apply.)
Transfer a client to physical therapy.
Obtain a client's vital signs every 4 hr.
Instruct a client on the use of an incentive spirometer.
Insert an NG tube for a client who requires enteral feedings.
Record a client's intake after each meal.
Correct Answer : A,B,E
Choice A rationale:
Transferring a client to physical therapy is a task that can be safely delegated to an assistive personnel (AP) as long as the client does not have any specific medical restrictions or requires specialized assistance during the transfer. APs are trained to assist with activities of daily living, including transferring clients from one place to another. However, it is essential for the nurse to assess the client's condition and provide clear instructions to the AP to ensure a safe transfer.
Choice B rationale:
Obtaining a client's vital signs every 4 hours is a routine task that can be delegated to an assistive personnel. APs are trained to measure vital signs such as blood pressure, heart rate, respiratory rate, and temperature under the supervision of licensed healthcare providers. Regular monitoring of vital signs is crucial in assessing the client's overall health status and detecting any changes that might require immediate medical attention.
Choice E rationale:
Recording a client's intake after each meal is a task that can be delegated to an assistive personnel. APs can document the amount and type of food and fluids consumed by the client. Monitoring the client's intake is important, especially if the client has specific dietary restrictions, allergies, or medical conditions that require close monitoring of their food and fluid intake.
Choice C rationale:
Instructing a client on the use of an incentive spirometer requires specialized knowledge and assessment of the client's respiratory status. This task should be performed by a licensed healthcare provider, such as a nurse or respiratory therapist, who can properly assess the client's lung function, demonstrate the correct technique, and ensure the client's safety during the process. Delegating this task to an AP could result in improper use of the spirometer, potentially leading to complications or ineffective therapy.
Choice D rationale:
Inserting an NG tube for a client who requires enteral feedings is a complex medical procedure that should be performed by a licensed nurse or healthcare provider with appropriate training and expertise. This procedure carries risks, including the risk of aspiration if not done correctly. Delegating this task to an AP is outside their scope of practice and could jeopardize the client's safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Donepezil is a medication used to treat Alzheimer's disease and is expected to improve cognitive function, including short-term memory.
B. Incorrect. Donepezil is not typically associated with changes in food intake.
C. Incorrect. While improved functional ability is a goal of treatment, performing ADLs independently might not be solely indicative of donepezil's effectiveness.
D. Incorrect. Donepezil is primarily focused on improving cognitive function rather than mood enhancement.
Correct Answer is A
Explanation
A. Correct. Infants with heart failure may tire easily during feedings, so limiting oral feedings to 30 minutes helps prevent excessive fatigue and ensures they are able to feed effectively without becoming overtired.
B. Incorrect. This is not frequent enough for an infant with heart failure. Oxygen saturation should be monitored more frequently, such as every 1-2 hours or as indicated by the clinical situation, to ensure adequate oxygenation and detect any changes promptly.
C. Incorrect. Weighing the infant daily is more appropriate to monitor fluid balance and heart failure progression.
D. Incorrect. Placing the infant in the prone position is contraindicated due to the risk of compromising respiratory function.
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