Ch. 14 N470 Exam 1

A registered nurse (RN) is working on a medicalsurgical unit functioning as a team leader for five patients with a licensed practical nurse (LPN) and a certified nurse's aide (CNA). Which action should not be delegated to the CNA?

1. Positioning the patient for comfort by raising the head of the bed 2. Performing a pain assessment

3. Assisting the patient with transfer from bed to chair

4. Offering the patient fluids

2. Performing a pain assessment

Which statement best reflects the concept of accountability with regard to delegation of tasks?

1. Nursing state practice acts do not require nurses to be held accountable for their actions.

2. Accountability exists at both nursing and organizational levels.

3. An organization's obligation to accountability is based on its ability to offer quality care regardless of nurse staffing.

4. The competency of the nurse is not considered as being relevant to accountability.

2. Accountability exists at both nursing and organizational levels.

Which situation provides an example of the right circumstances as defined by the five rights of delegation?

1. Completion of the task does not require nursing judgment

2. Assessing needs of the population in the context of available resources

3. Identifying competency level

4. Providing correct information to a patient

2. Assessing needs of the population in the context of available resources

A nurse manager is educating a staff nurse with regard to the five rights of delegation. Which statement by the staff nurse indicates that additional training is needed with regard to right supervision or evaluation?

1. Once a task has been delegated, the nurse is absolved of responsibility.

2. Nurses should provide feedback relative to task completion.

3. It is important to provide clear directions relative to task delegation.

4. Performance of the delegated task should be monitored.

1. Once a task has been delegated, the nurse is absolved of responsibility.

Which observation, if made by a registered nurse (RN) who is working with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP), would require immediate intervention based on the delegation process?

1. UAP was transferring a patient out of bed who was 2 days postoperative laparoscopic surgery

2. LPN was administering oral pain medication following performing a pain assessment

3. LPN was monitoring a blood transfusion

4. UAP was providing information to a patient who was just placed on isolation relative to neutropenic precautions

4. UAP was providing information to a patient who was just placed on isolation relative to neutropenic precautions

A physician has ordered a rectal suppository to be administered to a 25-year-old male patient. The registered nurse (RN) delegates this task to the licensed practical nurse (LPN). The LPN would prefer not to complete this task. The RN tells the nurse manager about this issue. How would the nurse manager interpret this refusal by the LPN to perform a delegated task?

1. Underdelegation

2. Possibility of a delegate-related barrier

3. Overdelegation

4. Possibility of a delegator-related barrier

2. Possibility of a delegate-related barrier

A group of nurse managers are reviewing a new job description for a staff nurse on a medical-surgical unit. Which observation if found would indicate that the job description needs revision with regard to delegation?

1. Delineation of roles and responsibilities

2. A listing of tasks that the nurse can complete

3. No mention of the nursing position authority

4. Listing of minimum qualifications for the nursing position

3. No mention of the nursing position authority

Nonlicensed staff members (unlicensed assistive personnel [UAP]) have asked for a meeting with the nurse manager as they are unhappy with how one of the nursing staff (registered nurse [RN]) has been delegating tasks with regard to patient care. Which statement, if made by a nonlicensed staff member, would indicate that additional instruction is needed for the nursing staff with regard to effective delegation principles?

1. "The RN told me that I couldn't obtain a urine specimen from a patient."

2. "I was told by the RN that I had to wait until the order was written in the patient's chart before I could act on it."

3. "The RN told me that I should wait until after lunch before I gave the patient AM care as the patient had just been medicated for pain."

4. "The RN told me that I had to change all of the bed linen for the patients before I went home at the end of the shift."

1. "The RN told me that I couldn't obtain a urine specimen from a patient."

Which task should not be delegated to a licensed vocational nurse (LVN) by a registered nurse (RN) who is working with an LVN and unlicensed assistive personnel (UAP) as part of the team?

1. Performing oral hygiene for a patient who has oral ulcerations

2. Feeding a patient with dysphagia

3. Transferring a patient from the bed to a chair

4. Monitoring a blood transfusion

3. Transferring a patient from the bed to a chair

Which patient activity could be performed by either a registered nurse (RN) or a licensed practical nurse (LPN) or delegated as a task even if there is an unlicensed assistive personnel (UAP) present on the unit?

1. Initiation of blood transfusion

2. Tracheostomy care

3. Assisting a patient with feeding

4. Obtaining daily weight

2. Tracheostomy care

A registered nurse (RN) refuses to delegate any patient care tasks to other members of the nursing unit staff, preferring to complete all tasks herself. What type of delegation practice would this demonstrate?

1. Underdelegation

2. Effective delegation

3. Overdelegation

4. Recognition of right person

1. Underdelegation

A registered nurse (RN) delegated specimen collection to an unlicensed assistive personnel (UAP) for a patient who had a urine analysis ordered by the physician. The UAP did not obtain the specimen. When checking the patient's chart later in the shift, the RN noticed that there was no documentation that a urine specimen was collected. The RN asked the UAP to provide an explanation for why the specimen was not obtained. The UAP told the RN that she was going to obtain the specimen from the patient after lunch. Which stated action would correlate with the delegation right of right communication?

1. The RN followed up later in the shift, checking the patient's chart for documentation of the specimen collection.

2. The RN delegated the task to the UAP.

3. The UAP told the RN that she was going to obtain the specimen from the patient after lunch.

4. The RN monitored the task completion process.

3. The UAP told the RN that she was going to obtain the specimen from the patient after lunch.

Which examples represent improper use of delegation in the clinical setting by a registered nurse (RN), licensed practical nurse (LPN), or unlicensed assistive personnel (UAP)? Select all that apply.

1. UAP delegating a task to an LPN

2. RN delegating a task to a UAP or an LPN

3. LPN delegating a task to an RN

4. RN delegating a task to an RN

5. UAP delegating a task to an RN

1. UAP delegating a task to an LPN

3. LPN delegating a task to an RN

5. UAP delegating a task to an RN

Which aspects are included in how nurses develop nursing judgment? Select all that apply.

1. Academic experience

2. Use of experience to help form an opinion

3. Analysis of information to help arrive at a decision

4. Leadership style

5. Level of administrative experience as opposed to being a staff nurse

1. Academic experience

2. Use of experience to help form an opinion

3. Analysis of information to help arrive at a decision

Which actions should not be delegated to a licensed vocational nurse (LVN) on a medical unit in a hospital setting by a registered nurse (RN)? Select all that apply.

1. Initiating a blood transfusion

2. Inserting a urinary catheter

3. Administering chemotherapy infusion

4. Completing initial admission assessment

5. Performing postoperative dressing changes

1. Initiating a blood transfusion

3. Administering chemotherapy infusion

4. Completing initial admission assessment