A nurse is teaching about delegation with a newly licensed nurse.
Which of the following statements if made by the newly licensed nurse indicates understanding?

"There are 4 rights of delegation.”.

"It is the duty of the delegatee to perform a task without asking questions when it is delegated.”.

"The nurse manager is responsible for delegating nursing tasks during each shift.”.

"I am responsible for ensuring that a delegated task is completed.”.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

There are actually five rights of delegation: right task, right circumstance, right person, right direction/communication, and right supervision/evaluation. This statement is not accurate.

Choice B rationale:

It is not the duty of the delegatee to perform a task without asking questions. Effective delegation involves clear communication, including the opportunity for the delegatee to ask questions and seek clarification as needed.

Choice C rationale:

While the nurse manager plays a role in delegation, the responsibility for delegation does not solely rest on the nurse manager. Delegation is a shared responsibility among all nurses, and the person delegating the task must ensure it is appropriate and clear.

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Correct Answer is B

Explanation

The correct answer is B.

Choice A reason: Using a stiff toothbrush to clean the client’s teeth is not recommended. A stiff toothbrush can cause damage to the gums and teeth, especially in clients who may have sensitive oral tissues due to medications or medical treatments.

Choice B reason: Turning the client on his side before starting oral care is the most appropriate action. This is to prevent aspiration, especially in immobile clients who may have difficulty swallowing or clearing their throat.

Choice C reason: Using the thumb and index finger to keep the client’s mouth open is not recommended. This could be uncomfortable or even harmful for the client. Instead, a padded tongue blade could be used if necessary, but only with extreme caution and the client’s comfort in mind.

Choice D reason: Applying petroleum jelly to the client’s lips after oral care is also a good practice. This helps to prevent dryness and cracking of the lips, which can be a common problem for hospitalized patients, especially those who are dehydrated or receiving oxygen therapy. However, when compared to choice B, it is not as critical in terms of immediate safety concerns.

A. Hyperlipidemia. B. Diabetes mellitus. C. Medication history. D. Cholesterol level. E. Prealbumin level.

Correct Answer is ["A","B","C","E"]

Explanation

Choice A rationale:
Hyperlipidemia is a condition characterized by elevated levels of lipids (cholesterol and triglycerides) in the blood. High lipid levels are associated with atherosclerosis and impaired blood flow, which can hinder wound healing. Therefore, having hyperlipidemia places the client at risk for delayed wound healing.
Choice B rationale:
Diabetes mellitus is a chronic condition that can lead to impaired wound healing. High blood sugar levels in diabetes can damage blood vessels and nerves, reducing blood flow to wounds and impairing the body's ability to fight infection. Therefore, diabetes mellitus places the client at risk for delayed wound healing.
Choice C rationale:
The medication history is a crucial factor to consider in wound healing. Prednisolone, a corticosteroid, can suppress the immune system and impair the body's ability to heal wounds. Long-term use of prednisolone, as in this case (20 mg/day for the past 2 years), increases the risk of delayed wound healing. Therefore, the medication history places the client at risk for delayed wound healing.
Choice D rationale:
The cholesterol level, in this context, is less relevant to the immediate risk of delayed wound healing. While high cholesterol levels are a risk factor for atherosclerosis and cardiovascular diseases, they do not have a direct impact on wound healing. The other choices (A, B, and C) are more directly related to delayed wound healing in the context of this surgical patient.
Choice E rationale:
Prealbumin is a protein that reflects a person's nutritional status. A low prealbumin level indicates malnutrition or inadequate protein intake, which can hinder wound healing. Therefore, a low prealbumin level places the client at risk for delayed wound healing. Now, let's move on to the last question.

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A nurse is teaching about delegation with a newly licensed nurse.Which of the following statements if made by the newly licensed nurse indicates understanding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing oral care for a client who is immobile. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a client who is scheduled for surgery. Which of the following findings places the client at risk for delayed wound healing? Select all that apply.

Correct Answer is ["A","B","C","E"]

Explanation

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A nurse is teaching about delegation with a newly licensed nurse.
Which of the following statements if made by the newly licensed nurse indicates understanding?