It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?

One hour after receiving hydromorphone prescribed for every 4 hours PRN use, a client reports severe pain.

Two hours after receiving morphine for acute pain, a client's vital signs are BP 112/60 mm Hg, pulse 88 beats/minute, and respirations 14 breaths/minute.

After ambulating, a postoperative client grimaces and reports incisional pain at a "9 on a ten-point scale".

The fentanyl transdermal patch for a client with chronic cancer pain needs to be replaced.

Answer and Explanation

The Correct Answer is C

Choice A Reason: This client may need another dose of hydromorphone if the pain is not relieved by the previous one. A PN can administer this medication under the supervision of a RN and monitor the client's response.

Choice B Reason: This client's vital signs are within normal limits and indicate that the morphine is effective and not causing respiratory depression. A PN can assess and document the client's vital signs and pain level.

Choice C Reason: This is the correct answer because this client has acute and severe pain that may require immediate intervention and reassessment. An RN can evaluate the cause and severity of the pain, administer additional analgesics as prescribed, and implement nonpharmacological measures to relieve the pain.

Choice D Reason: This client has chronic and stable pain that is managed by a fentanyl patch. A PN can replace the patch according to the schedule and instructions provided by the RN.

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Correct Answer is B

Explanation

Choice A Reason: Beginning initial sterile wound care for surgical clients is a nursing intervention that requires clinical judgment and cannot be delegated to the PN. The PN may assist with wound care after the initial dressing change, but the RN is responsible for assessing the wound and initiating the plan of care.

Choice B Reason: Validating prescribed intravenous flow rates is a routine task that does not require clinical judgment and can be delegated to the PN. The PN has the knowledge and skill to check the IV orders, calculate the drip rate, and monitor the infusion.

Choice C Reason: Determining the need for urinary catheterizations is a nursing assessment that requires clinical judgment and cannot be delegated to the PN. The PN may perform urinary catheterizations as ordered by the physician, but the RN is responsible for evaluating the indication, risk, and benefit of the procedure.

Choice D Reason: Receiving a postoperative client and conducting the assessment is a nursing intervention that requires clinical judgment and cannot be delegated to the PN. The RN is responsible for receiving reports from the operating room, assessing the client's status, identifying potential complications, and initiating the plan of care.

A. Review the need for the UAP to wear a face mask while in close contact with the client. B. Remind the UAP to apply a fitted respirator mask before entering the client's room. C. Assign the UAP to provide care for another client and assume full care of the client. D. Instruct the UAP to notify the nurse of any changes in the client's respiratory status.

Correct Answer is A

Explanation

Choice A Reason: Influenza is transmitted primarily through respiratory droplets. Droplet precautions require healthcare workers to wear a mask (surgical mask) when in close contact with a client. The UAP is already wearing gloves and a gown, which are appropriate for contact precautions but incomplete without a face mask for droplet protection.

Choice B Reason: A fitted respirator (e.g., N95) is unnecessary unless the client is suspected or confirmed to have an airborne transmissible disease such as tuberculosis. Influenza does not require airborne precautions.

Choice C Reason: Assigning the UAP to provide care for another client and assuming full care of the client is not necessary or feasible because it would increase the workload of the nurse and reduce the quality of care for both clients. The UAP can still assist with care for clients with influenza as long as they follow proper infection control measures.

Choice D Reason: Instructing the UAP to notify the nurse of any changes in the client's respiratory status is important but not a priority action because it does not address the issue of preventing transmission of influenza. The nurse should first ensure that the UAP wears appropriate personal protective equipment before entering the client's room.

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It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse leading a care team on a medical surgical unit is assigning client care to a practical nurse (PN) and an unlicensed assistive personnel (UAP). Which task should the nurse delegate to the PN?

Correct Answer is B

Explanation

A client with influenza is admitted to the medical unit. The nurse observes an unlicensed assistive personnel (UAP) preparing to enter the client's room to take vital signs and assist with personal care. The UAP has applied gloves and a gown. Which action should the nurse take?

Correct Answer is A

Explanation

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