Achievable Tasks or Mission Impossible?
What is the RN’s accountability during delegation?
A. Teach the extern how to perform a task.
B. Verify the extern's competency.
C. Reassess the patient after the task is performed.
D. All of the above
D. All of the above
Nurse externs may independently perform a 12-lead EKG after validating the skill twice.
A. True
B. False
True
If the nurse signs into the pyxis and tells you to pull all the medications for their patients, are you allowed to complete this task?
A. Abso-freaken-lutely!!!
B. Heck no!!
B. Heck no!!
You are the Extern Preceptor, and your extern has been validated for assisting with vital signs and patient ambulation. A patient, Mrs. Taylor, experiences a sudden drop in oxygen saturation during ambulation, and the extern reports this to you.
If the patient’s condition stabilizes, which tasks can you safely reassign to the extern?
A. Vital sign monitoring
B. Continued ambulation
C. Charting a full assessment
D. Turn off the oxygen to the patient
A. Vital sign monitoring
Who can delegate tasks to a nurse extern?
A. Facility Administrator
B. RN preceptor
C. A patient
D. Kitchen supervisor
B. RN preceptor
The extern competency checklist requires _______ validations before independence is granted.
A. significant
B. Three
C. infinity
D. two
B. Three
Which of these skills must always be supervised?
A. Nasogastric tube insertion
B. Foley catheter care
C. Digital stool removal
D. Vital signs
A. Nasogastric tube insertion
Your nurse asks you to hang a new bag of fluids, what do you?
A. Tell them you would love to observe them hang the fluids, but you cannot handle any medications.
B. Help the nurse with the task.
C. Turn off the fluids and walk away
D. Call a rapid
A. Tell them you would love to observe them hang the fluids, but you cannot handle any medications.
A patient under suicide precautions asks the extern to bring their belongings into the room, including a phone charger with a long cord. The extern is unsure how to respond and seeks your guidance.
What advice should you give the extern about the patient’s request?
A. Allow the patient to keep the belongings if they appear calm.
B. Deny the request and explain the restrictions for suicide precautions.
C. Consult the patient's family before making a decision.
D. Let the patient keep their belongings.
A. Deny the request and explain the restrictions for suicide precautions.
A patient’s condition becomes unstable. What should you do as the delegating RN?
A. Rescind delegation of all tasks for the unstable patient.
B. Allow the extern to continue performing tasks independently.
C. Delegate a new set of tasks to the extern.
A. Rescind delegation of all tasks for the unstable patient.
Nurse externs can perform phlebotomy under direct supervision after being validated three times.
A. True
B. False
True
A patient requires a central line dressing change. What should the extern’s role be?
A. Perform it under supervision
B. Observe while the RN performs it
C. Perform it independently after a check-off.
D. Inform the nurse that the dressing on the patient doesn't need to be changed since it appears to be clean and intact.
A. Perform it under supervision
The patient's IV pump is beeping, your nurse asks you to turn it off, what do you do?
A. Select channel off.
B. Increase volume.
C. Select restart.
D. Tell nurse you are not allowed to do so.
D. Tell nurse you are not allowed to do so.
You are short on staff, and the extern is temporarily floated to act as a PCT. They have not completed all PCT competencies but have assisted with hygiene care and vital signs.
Which tasks can you safely delegate to the extern in this situation?
A. Ambulation assistance
B. IV discontinuation
C. Medication Administration
D. All of the above
A. Ambulation assistance
During a safety huddle, an extern mentions they feel unprepared for a delegated task. What should the preceptor do?
A. Assign the task to another staff member and review the task with the extern
B. Encourage the extern to attempt the task
C. Remove the extern from the patient care team
A. Assign the task to another staff member and review the task with the extern
Which of the following is a responsibility of an RN when delegating a task to a Nurse Extern?
A. Verifying the extern's competence to perform the task.
B. Supervising the extern during task performance.
C. Writing the extern's performance evaluation at the end of the shift.
D. Ensuring the patient's condition is stable and predictable.
All of the above!
A. Rescind delegation of all tasks for the unstable patient.
B. Supervising the extern during task performance.
C. Writing the extern's performance evaluation at the end of the shift.
D. Ensuring the patient's condition is stable and predictable.
A respiratory therapist asks you to draw an arterial blood gas that is due in an hour. How should you respond?
A.I would be happy to draw that for you.
B. Do I need to doppler the artery while doing it?
C. I am so excited as this is my first time!
D. I'm sorry I am not allowed to perform that task, but I would love to watch you!
D. I'm sorry I am not allowed to perform that task, but I would love to watch you!
You are assigned to a patient who is receiving pain medication via an IV push. The nurse instructs you to administer a dose of morphine IV push.
Can you, as a nurse extern, administer the morphine IV push to the patient? Why or why not?
No, nurse externs are not typically allowed to administer IV push medications. Only licensed nurses, such as registered nurses (RNs), are permitted to administer IV push medications due to the need for skill in assessing patient response and monitoring for potential adverse reactions.
A patient is receiving a blood transfusion, and 10 minutes into the transfusion, the patient begins to complain of itching and has developed hives on their arms and chest.
What are your immediate actions as the nurse extern upon noticing these symptoms?
A. Watch the patient for 5 minutes to ensure the reaction stops.
B. Tell the patient that this is a normal reaction when receiving blood products.
C. Notify the nurse immediately.
D. Clamp off the blood and bolus the patient with normal saline.
C. Notify the nurse immediately.
The RN preceptor is unavailable during an emergency. What should the extern do after activating the code?
A. Wait for further instructions from another RN
B. Attempt CPR without validation
C. Leave the scene to find the preceptor
D. Assess for a pulse and if there isn't one start CPR
D. Assess for a pulse and if there isn't one start CPR
A patient is stable, and an extern is validated to perform suctioning tasks. What should the RN do?
A. Delegate the task and leave the extern unsupervised.
B. Delegate the task with instructions and observe.
C. Perform the task themselves without involving the extern.
D. Ask someone else to complete the task.
B. Delegate the task with instructions and observe.
What are two tasks a nurse extern can NEVER perform?
A. Collect specimens and provide hygiene assistance.
B. Suctioning and oral care
C. Take vital signs and empty out foley's.
D. Administer medications and chart assessments
D. Administer medications and chart assessments
You are given an order for a pediatric patient to receive an IV medication. The nurse asks you to calculate the correct dose based on the patient’s weight and administer it.
Are you allowed to calculate and administer the IV medication as a nurse extern?
No, while you may be allowed to assist in calculating medication dosages, nurse externs are generally not permitted to independently administer IV medications. This responsibility is typically reserved for licensed nurses, who are trained in evaluating patient responses to IV medications and managing potential complications.
You are caring for a 60-year-old patient on the medical-surgical floor who suddenly becomes unresponsive. The patient’s blood pressure is 70/40 mmHg, heart rate is 140 bpm, and they have cool, clammy skin. You are the first to notice these signs.
What initial actions should you take as the nurse extern in this emergency situation?
A. Scream in the patient's ear to wake up.
B. Assess if the patient is breathing.
C. Continue on helping your next patient.
D. Call for help immediately!
D. Call for help immediately!!
A patient who has been intubated for several days after undergoing surgery is now showing signs of recovery. The healthcare team, including the respiratory therapist and physician, has evaluated the patient and believes the patient may be ready for extubation. As a nurse extern, you are asked to assist in the procedure.
Which of the following is the best rationale for why you, as a nurse extern, are not permitted to perform extubation?
A. Extubation is a complex procedure that requires advanced airway management skills, including ensuring the patient can breathe adequately on their own post-extubation, which falls outside the scope of practice for nurse externs.
B. Extubation should only be performed after ensuring the patient is on mechanical ventilation, which is not within the duties of a nurse extern.
C. Extubation is not considered a critical procedure and can be safely performed by the nurse extern as long as the physician supervises them.
D. The extubation procedure is primarily for removing foreign objects from the airway and is only within the scope of practice for respiratory therapists, not nurses.
A. Extubation is a complex procedure that requires advanced airway management skills, including ensuring the patient can breathe adequately on their own post-extubation, which falls outside the scope of practice for nurse externs.