Prioritization 1
Prioritization 2
Prioritization 3
Delegation
Miscellaneous
100
What is the legal document that provides guidelines about scope of practice-delegating and supervising for RN's and LPN's?
The state Nurse practice act.
100
What are the four main principles of delegation?
Delegate tasks for which you are responsible Need to transfer authority. Know the difference between delegation and assignment. Know the difference between delegation and dumping
100
The high-pressure alarm on a patient’s ventilator goes off. When you enter the room to assess the patient, who has ARDS, the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should you take next?
A Reassure the patient that the ventilator will do the work of breathing for him B Manually ventilate the patient while assessing possible reasons for the high-pressure alarm C Increase the fraction of inspired oxygen on the ventilator to 100% in preparation for endotracheal suctioning D Insert an oral airway to prevent the patient from biting on the endotracheal tube
100
A 16-year old patient with cystic fibrosis is admitted with increased shortness of breath and possible pneumonia. Which nursing activity is most important to include in the patient’s care?
A. Perform postural drainage and chest physiotherapy every 4 hours B. Allow the patient to decide whether she needs aerosolized medications C. Place the patient in a private room to decrease the risk of further infection D. Plan activities to allow at least 8 hours of uninterrupted sleep
100
Name the five rights of delegation.
What are the right task, right circumstances, right person, right direction/communication and right supervision?
200
What is the type of nurse who is able to delegate to other RN's, LPN's and CNA's?
Registered nurse
200
What does responsibility mean related to delegation?
The task is within the delegator's scope of practice or something for which they could be responsible
200
The nursing assistant tells you that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should you suggest to improve the patient’s comfort for this problem?
A Suggest that the patient’s oxygen be humidified B Suggest that a simple face mask be used instead of a nasal cannula C Suggest that the patient be provided with an extra pillow D Suggest that the patient sit up in a chair at the bedside
200
A patient with chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to a nursing assistant (PCT)?
A. Assisting the patient to sit up on the side of the bed B. Instructing the patient to cough effectively C. Teaching the patient to use incentive spirometry D. Auscultation of breath sounds every 4 hours
200
Name three criteria used in making a decision about what and when to delegate a task.
What are predicability of outcomes, scope of practice of delegate, knowledge and skills of delegate, potential for harm and frequency of completing the task?
300
What is type of nurse who can monitor others? Explain
LPN's to other LPN's and CNA's and RN's to other RN's, LPN's and CNA's.
300
Empowering the delegate to accomplish the task by allowing them to act, make decisions and give commands if applicable.
What is transfer of authority?
300
When a patient with TB is being prepared for discharge, which statement by the patient indicates the need for further teaching?
A “Everyone in my family needs to go and see the doctor for TB testing.” B “I will continue to take my isoniazid until I am feeling completely well.” C “I will cover my mouth and nose when I sneeze or cough and put my used tissues in a plastic bag.” D “I will change my diet to include more foods rich in iron, protein, and vitamin C.”
300
A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the nursing assistant (PCT)?
A Discuss weight-loss strategies such as diet and exercise with the patient B Teach the patient how to set up the BiPAP machine before sleeping C Remind the patient to sleep on his side instead of his back D Administer modafinil (Provigil) to promote daytime wakefulness
300
What must the RN do before delegating patient tasks to non-RN personnel?
What is assess the patient?
400
The type of nurse who is able to supervise other RN's, LPN's and CNA's?
Professional nurses. RN's.
400
Delegating to another individual because the nurses does not want to complete the work.
What is dumping?
400
Which intervention for a patient with a pulmonary embolus could be delegated to the LPN on your patient care team?
A Evaluating the patient’s complaint of chest pain B Monitoring laboratory values for changes in oxygenation C Assessing for symptoms of respiratory failure D Auscultating the lungs for crackles
400
After the respiratory therapist performs suctioning on a patient who is intubated, the nursing assistant measures vital signs for the patient. Which vital sign value should the nursing assistant report to the RN immediately?
A Heart rate of 98 beats/min B Respiratory rate of 24 breaths/min C Blood pressure of 168/90 mm Hg D Tympanic temperature of 101.4 F (38.6 C)
400
When does a delegate have the right to refuse to accept delegation?
When the nurse or UAP is not qualified to complete the task. When the delegator does not clearly define the task and expectations. When you are a float nurse and it is a speciality area for which you have not been trained.
500
What is the type of delegation when the delegator delegates a task but does not transfer full authority and takes back responsibility or fails to direct the task?
Underdelegation.
500
What is the difference between delegation and work assignment?
In work or task assignment, there is no transfer of responsibility or authority. The job assignment is related to the job description and the organizational structure
500
Which of these medication orders for a patient with a pulmonary embolism is more important to clarify with the prescribing physician before administration?
A Warfarin (Coumadin) 1.0 mg by mouth (PO) B Morphine sulfate 2 to 4 mg IV C Cephalexin (Keflex) 250 mg PO D Heparin infusion at 900 units/hr
500
The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months experience) pulled from the surgical unit to the medical unit?
A 58-year old on airborne precautions for tuberculosis (TB) B 68-year old just returned from bronchoscopy and biopsy C 72-year old who needs teaching about the use of incentive spirometry D 69-year old with COPD who is ventilator dependent
500
The type of nurse who is able to supervise other RN's, LPN's and CNA's?
Professional RN
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