A nurse on a medical-surgical unit is delegating client care. Which of the following tasks should the nurse delegate to an assistive personnel?

Suctioning a client's long-term tracheostomy

Using a pain rating scale to monitor a client's pain level

Performing a dressing change on a client's peripherally inserted central catheter

Instructing a client on self-administration of a tap water enema

Answer and Explanation

The Correct Answer is B

The correct answer is: B.

Choice A reason:

Suctioning a client's long-term tracheostomy is a complex procedure that involves sterile technique and assessment skills that are beyond the scope of assistive personnel's practice. It requires clinical judgment and the ability to respond to complications, which are responsibilities typically reserved for licensed nursing staff.

Choice B reason:

Using a pain rating scale to monitor a client's pain level is a task that can be delegated to assistive personnel. It involves asking the client to rate their pain on a scale, which does not require clinical judgment or advanced skills. The assistive personnel can then report the pain level to the nurse, who will make decisions regarding pain management.

Choice C reason:

Performing a dressing change on a client's peripherally inserted central catheter (PICC) is not within the scope of assistive personnel. This task requires aseptic technique and knowledge of PICC line management to prevent infection and other complications, which are typically the responsibility of the registered nurse or licensed practical nurse.

Choice D reason:

Instructing a client on self-administration of a tap water enema involves teaching and assessment to ensure the client understands and can perform the procedure safely. This is a task that requires licensed nursing knowledge and skills to educate the client and evaluate their competency.

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Correct Answer is C

Explanation

Choice A reason: This is not the correct choice because training LPNs to reinforce teaching with clients using a standardized teaching plan is a possible solution, but not the first step. The nurse manager should first identify the root cause of the problem before implementing any interventions.

Choice B reason: This is not the correct choice because including documentation of client education as part of unit nurses' annual performance evaluation is a way to monitor and evaluate the staff's performance, but not a way to improve it. The nurse manager should first address the barriers and challenges that prevent the staff from documenting client education effectively.

Choice C reason: This is the correct choice because determining factors that interfere with the documentation of client education is the first step in the quality improvement process. The nurse manager should use data analysis, staff feedback, and observation to find out the reasons for the low documentation results, such as lack of time, knowledge, skills, or resources.

Choice D reason: This is not the correct choice because offering incentives for the staff once the unit's results are back in adherence with the benchmark is a way to motivate and reward the staff, but not a way to solve the problem. The nurse manager should first implement evidence-based strategies to improve the documentation of client education, such as providing education, feedback, and tools.

A. "You should not have signed the consent form if you have reservations about the surgery." B. "Let me provide you with resources you can read about the surgery." C. "If you have any concerns about the procedure, the surgery can be cancelled." D. "I will contact the provider and request medication to help you relax."

Correct Answer is C

Explanation

Choice A reason: This is not the correct choice because this response is insensitive and unprofessional. The nurse should not blame or criticize the client for signing the consent form, as this may make the client feel guilty or pressured. The nurse should respect the client's autonomy and right to change their mind.

Choice B reason: This is not the correct choice because this response is inadequate and irrelevant. The nurse should not assume that the client needs more information about the surgery, as this may not address the client's underlying reasons for being unsure. The nurse should listen to the client's concerns and provide emotional support.

Choice C reason: This is the correct choice because this response is respectful and reassuring. The nurse should acknowledge the client's feelings and let them know that they have the option to cancel the surgery if they are not comfortable with it. The nurse should also inform the provider and the surgical team about the client's situation and facilitate further discussion if needed.

Choice D reason: This is not the correct choice because this response is inappropriate and unethical. The nurse should not offer medication to the client to help them relax, as this may impair their decision-making capacity and consent. The nurse should not coerce or manipulate the client to undergo the surgery.

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A nurse on a medical-surgical unit is delegating client care. Which of the following tasks should the nurse delegate to an assistive personnel?

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