A nurse on a medical surgical unit has received report on four clients. There is an LVN, RN, and UAP working. Which of the following clients would best to assign to the RN?

Reinforcing teaching with a patient who is learning to walk with a quad cane

A new admission to the unit complaining of chest pain

Inserting an NGT for a client who is unable to eat

Calculating intake and output for the unit

Answer and Explanation

The Correct Answer is B

A. Reinforcing teaching with a patient who is learning to walk with a quad cane: Reinforcing teaching can be done by an LVN, as it involves stable, predictable outcomes.
B. A new admission to the unit complaining of chest pain: A new admission with chest pain requires a comprehensive assessment and potential critical thinking and intervention, which are within the scope of an RN.
C. Inserting an NGT for a client who is unable to eat: Inserting an NGT can be done by an RN or LVN, but it does not require the comprehensive assessment and critical thinking that managing a new admission with chest pain does.
D. Calculating intake and output for the unit: Calculating intake and output is a task that can be delegated to a UAP.

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Correct Answer is C

Explanation

A. Preparing the client for discharge: Discharge preparation typically requires a comprehensive assessment to ensure all aspects of the client’s health and care needs are addressed.
B. On initial evaluation by the home health nurse: The initial evaluation requires a comprehensive assessment to establish a baseline for the client's overall condition and care plan.
C. Reassessing a client for pain after giving pain medication: A focused assessment targets a specific problem area, such as evaluating pain levels after an intervention.
D. Checking skin assessment on a patient with a medical device in place: This is an example of a focused assessment, concentrating on the skin integrity around the medical device.

A. The nurse determines the client’s readiness to learn B. The nurse discusses types of food that the client needs to avoid C. The nurse describes which supplies would be needed D. Ask the client to demonstrate emptying of the colostomy bag

Correct Answer is A

Explanation

A. The nurse determines the client’s readiness to learn: Assessing the client's readiness to learn is part of the assessment phase of the teaching plan. It involves evaluating the client’s emotional and cognitive state to ensure they are prepared to absorb new information.
B. The nurse discusses types of food that the client needs to avoid: This is part of the teaching or implementation phase, not the assessment phase.
C. The nurse describes which supplies would be needed: Describing necessary supplies is also part of the teaching or implementation phase.
D. Ask the client to demonstrate emptying of the colostomy bag: This is part of the evaluation phase, where the nurse assesses the client’s ability to perform the task taught.

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A nurse on a medical surgical unit has received report on four clients. There is an LVN, RN, and UAP working. Which of the following clients would best to assign to the RN?

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Naxlex Comprehensive Predictor Exams

In what patient situations would a focused assessment be best to perform?

Correct Answer is C

Explanation

The nurse is preparing a teaching plan for a client who is learning how to care for their colostomy. The nurse should identify the following actions as part of the assessment step in the teaching plan.

Correct Answer is A

Explanation

Which patient below is best assigned to the LPN?

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