A nurse is planning to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?

Perform gastrostomy feedings through a client's established gastrostomy tube

Determine if the PRN pain medication administered 30 min ago has helped

Provide instructions about client care to a family member over the telephone

Teach a client how to measure their own blood pressure

Answer and Explanation

The Correct Answer is D

A. While an AP may assist with certain feeding tasks, performing gastrostomy feedings typically requires nursing judgment and assessment skills, especially in monitoring for potential complications (e.g., aspiration, tube displacement). This task is usually within the RN’s scope of practice.
B. Incorrect. Determining if the PRN pain medication has helped is an evaluation and should bot be delegated.
C. Incorrect. Providing instructions about client care to a family member over the telephone is a task that requires clinical judgment and communication skills. The nurse should not delegate this task to an AP who might not have the knowledge or authority to answer questions or address concerns.
D. Teaching a client how to measure their own blood pressure can be delegated to an AP, provided that the AP has received proper training on the procedure. This task is more straightforward and does not require the clinical judgment or assessment skills that are necessary for the other options.

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Correct Answer is D

Explanation

Choice A rationale:

Taking corrective measures to enforce hand hygiene should not be the first step. It is important to establish a baseline and understand the current situation through data collection and analysis before implementing corrective measures.

Choice B rationale:

Establishing methods for collecting data within the facility is a crucial first step. Gathering information about the current hand hygiene practices, compliance rates, and areas of improvement is essential for the audit process. Data collection provides a factual basis for identifying problems and implementing targeted interventions.

Choice C rationale:

Comparing the facility's data with the established criteria for hand hygiene is a subsequent step after data collection. This step helps in evaluating the current practices against the accepted standards and guidelines. However, it is not the first step in the audit process.

Choice D rationale:

Determining the accepted standards for hand hygiene is an essential first step. It involves researching and understanding the national and international guidelines, protocols, and recommendations related to hand hygiene. Knowing the standards helps the task force establish a benchmark against which the facility's practices can be evaluated. It provides a foundation for data collection and subsequent analysis.

A. "I have experienced physical discomfort when intimate with my partner since my diagnosis." B. "I wish other women would stop socializing with my partner." C. "I told my doctor that I would like to start a support group for other women who are sick in my community." D. "I used to mistrust my doctor, but now I know that she is the best one to care for me during my illness."

Correct Answer is C

Explanation

- A is incorrect because it is an example of self-disclosure, not altruism. Self-disclosure is sharing personal information or feelings with others.

- B is incorrect because it is an example of jealousy, not altruism. Jealousy is feeling threatened or resentful by someone else's success or happiness.

- C is correct because it is an example of altruism, which is helping others without expecting anything in return. Altruism can enhance self-esteem and coping skills for clients who have breast cancer.

- D is incorrect because it is an example of trust, not altruism. Trust is believing that someone is reliable and honest.

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A nurse is planning to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is part of a task force planning to audit a facility's nursing units concerning adherence to hand-hygiene protocols.Which of the following steps should the task force take first?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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