Delegation
What can you delegate to a C.N.A.?
a. Assess a patient’s swallowing reflex
b. Teach the patient how to use incentive spirometer
c. Administer the morning medications
d. Feed patient their lunch
What is d. Feed patient their lunch
You are reviewing the complete blood count of a patient that has been admitted for total hip replacement. Which value is most important to report to the physician before surgery?
a. Hematocrit of 33%
b. Hemoglobin level of 11.1 g/dl
c. Platelet count of 343
d. White blood cell count of 17,500/mm3
What is d. WBC 17,500 mm3
A routine schedule can help with time management during the shift and should include things like:
a. daily weather forecast
b. patient's mood
c. head to toe assessment in the beginning of shift
d. patient's family
What is c. head to toe assessment in the beginning of the shift
Should an oral dose of medication be the same dosage for an IV medication?
True or False
What is FALSE
IV medications should be a lower dosage. The drug taken orally has a slower absorption rate to be metabolized. IV medications generally have a rapid onset of action since they directly enter the bloodstream.
How often should a nurse be changing trach ties on a tracheostomy patient?
a. Every 6 hours
b. Every 24 hours
c. Every 48 hours
d.Weekly
What is b. Every 24 hours
and PRN
Which of the following should you not delegate to a CNA?
a. Check vital signs
b. Increase from 2 to 4 Liters Oxygen via Nasal Cannula
c. Ambulate patient
d. Assist patient to bedside commode
What is b. Increase from 2 to 4 Liters Oxygen via Nasal Cannula
An ED nurse is assigned to triage patients. The nurse should see which patient first?
a. A patient complaining of muscle aches and headaches
b. A patient complaining that she twisted her ankle while rollerblading
c. A patient with a minor laceration on her index finger while cutting vegetables
d. A patient with chest pain who states that he just ate hot wings
What is d. A patient with chest pain who states that he just ate hot wings
Which of the following illustrate the best example of time management?
a. Waiting to do all charting until after medication pass
b. Nurse performs all of the skills herself
c. deciding not to plan the day and go with the flow
d. Nurse gathers supplies and all equipment prior to going into the room to perform a task
What is d. Nurse gathers supplies and all equipment prior to going into the room to perform a task
A nurse is caring for a patient who weighs 70 kilograms. The patient's family asks for the weight in pounds for better understanding. What is the patient’s weight in pounds?
What is 154 pounds
1kg = 2.2 lbs
A nurse is caring for a patient with an infiltrated intravenous (IV) catheter. What is the most appropriate action for the nurse to take?
a. Remove the infiltrated IV catheter immediately.
b. Apply warm compresses to the infiltrated site.
c. Elevate the extremity with the infiltrated IV catheter.
d. Continue the infusion
What is a. Remove the infiltrated IV catheter immediately
Which of the following can you delegate an IV certified LVN to?
a. Administer IV zosyn
b. Blood transfusion
c. K-rider
d. ½ NS with sodium bicarbonate
What is b. Blood transfusion
A nurse received shift report for day shift. Who should the nurse assess first?
a. A postoperative day 2 patient who just received PO Tylenol
b. A patient who has a fever, diaphoretic, and restless
c. COPD patient on 2 liters NC
d. Rule out TIA patient resting comfortably in bed
What is b. A patient who has a fever, diaphoretic, and restless
Which plan is an effective way of handling a large task?
a. Plan to finish the task with few breaks
b. Delegate portions of teh taks to qualifed staff
c. Break the task into smaller, less intimidating units
d. Delay beginning the task until it has your undivided attention
What is c. Break the task into smaller, less intimidating tasks
Breaking down a task, or chunking prevents the person from becoming overwhelmed by the size of the task. It may not be possible or advisable to finish the task without breaks or delegating it to staff.
What are some important considerations for nurses when administering enteric-coated medications to patients. Select all that apply
a. Follow the specific administration instructions provided for enteric-coated medications
b. Crush or break the tablets or capsules for easier administration
c. Administer enteric-coated medications on an empty stomach to enhance absorption
d. Store enteric-coated medications in direct sunlight to maintain their effectiveness
e. Monitor patients for gastrointestinal symptoms and report any adverse effects.
What is a&e
a. Follow the specific administration instructions provided for enteric-coated medications: This is the correct answer because it emphasizes the importance of adhering to the specific instructions provided for enteric-coated medications. Enteric coatings are designed to protect medications from the acidic environment of the stomach, and following the instructions ensures that the medication is properly absorbed in the intended site, usually the small intestine.
e. Monitor patients for gastrointestinal symptoms and report any adverse effects: This is the correct answer. Monitoring patients for gastrointestinal symptoms, such as abdominal pain, nausea, or vomiting, is important when administering enteric-coated medications. These symptoms may indicate potential issues with medication absorption or tolerability. Prompt reporting of adverse effects to the healthcare team allows for appropriate assessment and management.
A nurse is preparing to insert a nasogastric (NG) tube for a patient. Which of the following actions demonstrates the correct process for measuring the tube length before insertion?
a. Measuring the tube length from the nose to the xiphoid process.
b. Measuring the tube length from the nose to the chin.
c. Measuring the tube length from the nose to the earlobe and then from the earlobe to the xiphoid process.
d. Measuring the tube length from the mouth to the sternum.
What is c. Measuring the tube length from the nose to the earlobe and then from the earlobe to the xiphoid process.
Which of the follow medications can a LVN administer?
a. Administer IV zosyn
b. Blood transfusion
c. K-rider
d. ½ NS with sodium bicarbonate
What is c. 5 units insulin subcutaneous
Which of the following patients should the nurse prioritize first?
a. A patient with a blood pressure 70/47
b. A patient with a blood glucose of 460 and he's eating dinner but you haven't given him insulin
c. A post-op patient that had arrived to the floor
d. A patient that needs to use the bedside commode
What is a. A patient with a blood pressure 70/47
What is the most critical skill in good time management?
a. allow adequate time for planning
b. recognizing the need for daily planning
c. priority setting
d. handling situation as they arise
What is c. Priority setting
Priority setting is perhaps the most critical skill in time management because actions taken are some type of relative importance.
A nurse is caring for a patient with atrial fibrillation with rapid ventricular response (AFib RVR) who is prescribed Cardizem (diltiazem). Which of the following statements best describes the rationale for administering Cardizem in this patient?
a. Cardizem is an anticoagulant that helps prevent blood clots associated with AFib RVR. b. Cardizem reduces heart rate by blocking beta-adrenergic receptors, restoring normal sinus rhythm.
c. Cardizem inhibits the conversion of angiotensin I to angiotensin II, promoting vasodilation and reducing ventricular rate.
d. Cardizem is a calcium channel blocker that slows atrioventricular (AV) node conduction, reducing ventricular rate in AFib RVR.
What is d. Cardizem is a calcium channel blocker that slows atrioventricular (AV) node conduction, reducing ventricular rate in AFib RVR.
Cardizem (diltiazem) is a calcium channel blocker primarily used for its negative chronotropic effect in atrial fibrillation with rapid ventricular response (AFib RVR). It works by blocking calcium channels in the AV node, thereby decreasing the conduction velocity and prolonging the AV nodal refractory period. This results in a slower ventricular response, allowing for better control of the heart rate in AFib RVR.
A nurse is caring for a patient with a Foley catheter in place. Which of the following interventions is the most effective in preventing catheter-associated urinary tract infections (CAUTIs)?
a. Emptying the catheter bag regularly and maintaining a closed drainage system.
b. Irrigate the catheter regularly
c. Applying antibiotic ointment to the urethral meatus daily.
d. Replacing the Foley catheter every 24 hours.
What is a. Emptying the catheter bag regularly and maintaining a closed drainage system.
This helps prevent the backflow of urine and reduces the risk of bacterial contamination. Regular emptying of the catheter bag ensures that urine does not accumulate and create a stagnant environment for bacterial growth.
Which of the following task can a RN delegate to the LVN?
a. Assess a head-to-toe assessment
b. Change a surgical dressing post op-day
c. Educate the patient on their new diagnosis
d. Administer influenza vaccination
What is d. Administer influenza vaccination
A nurse is working in the emergency room and receives four patients simultaneously. Which of the following patients should the nurse prioritize for assessment and intervention?
a. A patient with a deep laceration on the forearm, actively bleeding.
b. A patient with a known history of hypertension with a blood pressure of 165/99 with a headache 2/10 pain.
c. A patient with a sprained ankle requesting ice for pain relief. D.
d. patient with a rash and itching after coming into contact with a plant.
What is a. A patient with a deep laceration on the forearm, actively bleeding.
When prioritizing patients in the emergency room, the nurse should prioritize patients with potentially life-threatening conditions requiring immediate attention. In this scenario, a patient with a deep laceration on the forearm, actively bleeding, requires prompt assessment and intervention to control bleeding and prevent further complications.
A nurse is working in a high-stress, fast-paced emergency department and needs to effectively manage time while caring for multiple patients. Which of the following actions best demonstrates effective time management?
a. Spending additional time updating the EMR with detailed notes.
b. Administering medications to all patients simultaneously to save time
c. Delegating patient education tasks to a nursing student
d. Prioritizing care based on the severity of patient's conditions.
What is d. Prioritizing care based on the severity of patient's conditions.
By prioritizing the care of the critically ill or unstable patients over those with less urgent needs, the nurse can allocate their time and resources to address immediate patient care requirements.
What are the 8 rights of medication administration?
What is Patient, Medication, Dose, Route, Time, Documentation, Reason, Response
A nurse is providing care for a patient with a chest tube following thoracic surgery. Which of the following actions should the nurse prioritize when caring for the chest tube?
a. Assessing the patient's vital signs and respiratory status.
b. Securing the chest tube to prevent accidental dislodgment.
c. Monitoring the drainage system for proper functioning.
d. Administering pain medication as prescribed.
What is a. Assessing the patient's vital signs and respiratory status.
When caring for a patient with a chest tube, the priority action is to assess the patient's vital signs and respiratory status. This includes monitoring blood pressure, heart rate, respiratory rate, and oxygen saturation. Assessing for signs of respiratory distress, such as decreased oxygen saturation, increased respiratory rate, or asymmetrical chest movement, is crucial to identify any complications related to the chest tube, such as pneumothorax or hemothorax. Prompt intervention can be initiated if any respiratory compromise is detected.