A patient at a long-term care facility makes the following statements regarding management of his constipation. Which statement would require follow-up teaching by the nurse?

Choice A reason: This is the correct answer because it shows that the RN understands delegation as a way of managing time effectively. Delegation is the process of assigning tasks to other members of the health care team who are competent and qualified to perform them. By working with the LPN and nursing assistant on dividing up patient care tasks, the RN can ensure that the tasks are done safely, efficiently, and according to the scope of practice of each team member.

Choice B reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Working overtime until everything is finished is not a sustainable or productive strategy, as it can lead to fatigue, burnout, and errors. The RN should prioritize the tasks that are most important and urgent, and delegate the tasks that can be done by others.

Choice C reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Checking to make sure that the tasks are done correctly is part of the supervision and evaluation of delegation, but it is not the main goal of delegation. The main goal of delegation is to optimize the use of resources and skills of the health care team, and to provide quality care to the patients. The RN should trust and respect the abilities of the LPN and nursing assistant, and only intervene if there is a problem or a concern.

Choice D reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Completing every nursing intervention or report by the end of the shift is not always possible or realistic, especially in a busy and dynamic health care environment. The RN should focus on the outcomes and quality of care, rather than the quantity of tasks. The RN should also communicate and collaborate with the other members of the health care team, and hand over any unfinished tasks to the next shift.

Choice A reason: The client will be able to return to work is not a SMART goal. SMART stands for Specific, Measurable, Achievable, Relevant, and Time-bound. This goal is not specific, as it does not state what kind of work the client will do, or how the client's back pain will affect their work performance. It is also not measurable, as it does not state how the client's work ability will be assessed. It may not be achievable, as the client's work-related injury may prevent them from returning to their previous occupation. It may not be relevant, as the client may have other priorities or preferences than work. It is also not time-bound, as it does not state when the client will return to work.

Choice B reason: The client will verbalize diminished pain at the conclusion of physical therapy is not a SMART goal. This goal is not specific, as it does not state how much pain the client will experience, or what level of pain is acceptable for the client. It is also not measurable, as it relies on the client's subjective report of pain, which may vary depending on the client's mood, expectations, or coping skills. It may not be achievable, as the client's chronic back pain may not be fully resolved by physical therapy. It may not be relevant, as the client may have other outcomes or indicators of improvement than pain. It is also not time-bound, as it does not state how long the physical therapy will last, or when the client will verbalize their pain level.

Choice C reason: The client will be able to perform self-care is not a SMART goal. This goal is not specific, as it does not state what aspects of self-care the client will perform, or how the client's back pain will affect their self-care abilities. It is also not measurable, as it does not state how the client's self-care performance will be evaluated. It may not be achievable, as the client's chronic back pain may limit their range of motion, strength, or endurance for self-care tasks. It may not be relevant, as the client may have other goals or needs than self-care. It is also not time-bound, as it does not state when the client will achieve this goal.

Choice D reason: The client will engage in desired activities without the pain level increasing above a pain scale level of 3 out of 10 within one month is a SMART goal. This goal is specific, as it states what activities the client wants to do, and how the client's pain level will be monitored. It is measurable, as it uses a numeric pain scale that can be easily recorded and compared. It is achievable, as it sets a realistic and attainable pain threshold that allows the client to enjoy their activities. It is relevant, as it reflects the client's personal interests and values, and enhances their quality of life. It is time-bound, as it states a clear and reasonable deadline for achieving this goal.