A nurse is working on a medical-surgical unit that uses the total patient care delivery method. For each shift, the nurse should plan to take which of the following actions?

Delegate low-skilled tasks to assistive personnel.

Receive cross-training in multiple departments

Perform a specific nursing task for a group of clients.

Provide complete care for a caseload of clients.

Medications scheduled four times a day are administered 2 hr after the scheduled time.

Answer and Explanation

The Correct Answer is D

A. Delegate low-skilled tasks to assistive personnel.

Delegating low-skilled tasks to assistive personnel is not consistent with the total patient care delivery method. In this model, the nurse assumes responsibility for providing comprehensive care to a smaller number of patients rather than delegating tasks to others. The nurse remains directly involved in all aspects of patient care, including assessment, planning, implementation, and evaluation.

B. Receive cross-training in multiple departments

Receiving cross-training in multiple departments may be beneficial in some healthcare settings but is not a characteristic of the total patient care delivery method. This model focuses on nurses providing individualized care to a specific group of patients within their assigned unit. Cross-training in multiple departments would not align with this model, as it could lead to divided attention and potentially compromise the quality of care provided.

C. Perform a specific nursing task for a group of clients.

Performing a specific nursing task for a group of clients is not consistent with the total patient care delivery method. In this model, the nurse is responsible for providing comprehensive care to a smaller number of patients, rather than focusing on specific tasks for multiple patients. Each patient's care is individualized and encompasses all aspects of nursing care, not just specific tasks.

D. Provide complete care for a caseload of clients.

Providing complete care for a caseload of clients is characteristic of the total patient care delivery method. In this model, the nurse assumes responsibility for the holistic care of a smaller number of patients during each shift. This approach allows for continuity of care, fosters therapeutic nurse-patient relationships, and promotes better patient outcomes.

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Correct Answer is C

Explanation

A) Vital signs flow sheet:

While vital signs are essential for assessing the client's health status, the home health agency typically focuses on the client's ongoing care needs rather than retrospective data such as vital sign trends.

B) Nursing admission assessment:

The nursing admission assessment provides valuable information about the client's initial condition upon admission to the acute care facility. However, the home health agency primarily requires information relevant to the client's current health status and ongoing care needs.

C) Current medications:

Providing the home health agency with a list of the client's current medications is essential for continuity of care. It allows the home health agency to ensure that the client receives the appropriate medications and dosages after discharge. This information helps prevent medication errors, adverse drug interactions, and omissions in the client's care plan. Additionally, the home health agency can use the medication list to reconcile medications and update the client's medication regimen as needed.

D) Nurses' notes:

While nurses' notes contain valuable information about the client's care during their stay in the acute care facility, they may not be immediately relevant to the home health agency's provision of care in the community setting. The focus of the home health agency is typically on the client's current status and needs rather than historical documentation.

A. Administer PRN haloperidol IM to the client B. Engage the client in a repetitive activity as a distraction. C. Apply wrist restraints to the client. D. Place the client in a seclusion room.

Correct Answer is B

Explanation

A) Administer PRN haloperidol IM to the client:

Administering haloperidol is not the first-line intervention for managing behavioral disturbances in clients with dementia, especially in response to acute agitation. While antipsychotic medications like haloperidol may be prescribed in some cases, they should be used judiciously due to the risk of adverse effects, particularly in elderly clients. Additionally, administering medication should not be the first action taken without attempting non-pharmacological interventions.

B) Engage the client in a repetitive activity as a distraction:

This is the most appropriate initial intervention when dealing with an agitated client with dementia. Engaging the client in a repetitive, calming activity can help redirect their focus and reduce agitation. Simple, familiar tasks or activities tailored to the client's preferences can be effective in providing comfort and reducing distress.

C) Apply wrist restraints to the client:

Using physical restraints should be avoided unless absolutely necessary for the safety of the client or others. Restraints can cause physical and psychological harm, increase agitation, and compromise the client's dignity and autonomy. Therefore, restraint use should be a last resort and implemented only after other interventions have been attempted and deemed ineffective or when there is an imminent risk of harm.

D) Place the client in a seclusion room:

Seclusion should not be used as an initial intervention for managing agitation in clients with dementia. Seclusion can exacerbate distress and increase feelings of isolation and fear, which may escalate agitation further. It should only be considered as a last resort for managing severe agitation or aggression when all other interventions have failed and there is a risk of harm to the client or others.

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A nurse is working on a medical-surgical unit that uses the total patient care delivery method. For each shift, the nurse should plan to take which of the following actions?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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