An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP?
Palpate for possible bladder distention.
Observe the incision site.
Change the abdominal dressing.
Obtain vital signs.
The Correct Answer is D
Rationale:
A. Palpate for possible bladder distention is a task that requires nursing assessment skills and should be done by the nurse.
B. Observe the incision site is a nursing task that involves assessing for signs of complications.
C. Change the abdominal dressing requires sterile technique and should be done by a nurse to prevent infection and ensure proper care.
D. Obtain vital signs is within the AP’s scope of practice and is a task that can be delegated. It is important for monitoring the client’s status and identifying potential issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. "Whether or not I am a good lover is irrelevant." does not directly address the inappropriate nature of the comment.
B. "Let's talk about something else." avoids the issue without addressing the inappropriateness of the behavior.
C. "You need to lower your voice. Others can hear you." addresses the volume but not the content of the comment.
D. "Speaking to me like that makes me uncomfortable." directly addresses the inappropriate behavior and communicates the impact on the nurse, which is the most appropriate response.
Correct Answer is D
Explanation
Rationale:
A. Insisting the client take medications does not respect the client’s autonomy and is not an advocacy action.
B. Informing the client that the medication is the same as taken at home does not necessarily address the client’s concerns or questions.
C. Telling the client that refusal is noncompliance does not support client autonomy and does not address their concerns.
D. Encouraging the client to verbalize questions supports their right to be informed and make decisions about their care, demonstrating advocacy.
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