A nurse is preparing to delegate client care to an assistive personnel (AP). Which of the following information should the nurse verify prior to delegation?

The client's length of facility stay

The AP's job description

The AP's years of experience

The client's age

Answer and Explanation

The Correct Answer is B

Rationale:

A. The client's length of facility stay: The duration of a client’s admission does not determine the appropriateness of delegation. Delegation decisions are based on the client’s current condition and the nature of the task, not how long they have been in the facility.

B. The AP's job description: Verifying the AP’s job description ensures the task falls within their authorized scope of practice. It helps confirm that the AP has the appropriate training and legal authority to carry out the delegated activity safely and competently.

C. The AP's years of experience: While experience may influence efficiency, it is not the primary factor in deciding what can be delegated. A newly trained AP may be competent for certain tasks, while years of experience do not guarantee suitability for all delegated care.

D. The client's age: Age alone does not dictate whether a task can be delegated. Delegation decisions depend more on the client's acuity, stability, and the complexity of care required, rather than demographic factors like age.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C","dropdown-group-3":"A"}

Explanation

Rationale:

• An endoscopy is necessary to visualize the upper gastrointestinal tract for potential ulcers or bleeding sites, especially given the client’s positive fecal occult blood and anemia. This procedure will help identify active bleeding and confirm a diagnosis of peptic ulcer disease.

• An antifungal prescription is inappropriate because there is no evidence of fungal infection such as thrush or candidiasis. The client’s symptoms and diagnostic findings are more consistent with a gastrointestinal disorder, particularly peptic ulcer disease.

• Oxygen via nonrebreather mask is not indicated because the client's oxygen saturation is normal at 98% on room air. There are no respiratory symptoms or signs of hypoxia that would necessitate supplemental oxygen at this level of intensity.

• Low hemoglobin and hematocrit indicate a state of anemia, which is likely due to chronic gastrointestinal bleeding. The client’s history of dark, tarry stools (melena) further supports ongoing blood loss from the upper GI tract, necessitating diagnostic evaluation.

• History of gnawing epigastric pain is suggestive of peptic ulcer disease but does not on its own justify urgent endoscopy. This history becomes more significant when paired with other alarming signs like bleeding or anemia, but alone it is not a definitive indicator.

• Stool test results showing a positive hemoccult test confirm the presence of gastrointestinal bleeding. Combined with anemia and pain, this is a key indicator for immediate endoscopic evaluation to locate and treat the bleeding source.

• H. pylori results support a peptic ulcer etiology, but the infection alone does not require urgent visualization unless there are complications like bleeding, anemia, or severe symptoms, which would necessitate further diagnostic action.

• Presence of epigastric tenderness is a non-specific physical finding that could result from many conditions and is not sufficient to determine the need for endoscopy without other supportive clinical evidence pointing toward bleeding or ulceration.

• Smoking and alcohol intake history increase the risk for peptic ulcer disease but are not acute indicators for endoscopy. They contribute to the etiology and chronic risk but do not demonstrate the immediate need for invasive diagnostics.

A. Shortness of breath when climbing stairs B. Periodic numbness of the fingers C. Leukorrhea D. Blurred vision

Correct Answer is D

Explanation

Rationale:

A. Shortness of breath when climbing stairs: Mild dyspnea is common in the third trimester due to the upward displacement of the diaphragm by the enlarging uterus. This is typically not a concerning sign unless it occurs at rest or is accompanied by other symptoms like chest pain.

B. Periodic numbness of the fingers: Numbness or tingling in the hands and fingers during pregnancy can be caused by carpal tunnel syndrome due to fluid retention. While uncomfortable, it is a benign and relatively common symptom that usually resolves postpartum.

C. Leukorrhea: Leukorrhea, or increased vaginal discharge, is a normal finding in late pregnancy. It helps prevent ascending infections and is only concerning if it becomes foul-smelling, itchy, or changes in color, which could indicate infection.

D. Blurred vision: Blurred vision during the third trimester can be a sign of pregnancy-induced hypertension or preeclampsia. It may indicate cerebral involvement or elevated blood pressure and requires immediate evaluation by the healthcare provider.

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A nurse is preparing to delegate client care to an assistive personnel (AP). Which of the following information should the nurse verify prior to delegation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who is admitted to the medical-surgical unit. Exhibits Complete the following sentence by using the lists of options. The nurse anticipates the client will likely require dropdown as evidenced by the client's dropdown and dropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C","dropdown-group-3":"A"}

Explanation

A nurse at a provider's office is caring for a client who is in the third trimester of pregnancy. Which of the following findings should the nurse report to the provider?

Correct Answer is D

Explanation

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A nurse is assisting with the care of an adolescent. Exhibits Complete the following sentence by using the lists of options. The adolescent is at risk for developing as dropdown evidenced by dropdown