Deck 14: Delegation in the Clinical Setting

Question 1

To optimally use the level of preparation of the LPN who previously worked in an emergency department,which task should the registered nurse delegate to the LPN?

A)Transporting a patient to the laboratory
B)Assisting with a thoracentesis
C)Restocking and counting the sterile supplies
D)Passing afternoon nutrition supplements and waters

Answer 1

Assisting with a thoracentesis

Question 2

What would be the best example of supervision?

A)Assigning nursing care for a group of five patients to a nurse
B)Following up with a CNA on the assigned task of ambulation and feeding two patients
C)Assigning a urinary catheterization and collection of sterile culture to an LPN
D)Scheduling the LPN to administer medications on the unit for the afternoon

Answer 2

Following up with a CNA on the assigned task of ambulation and feeding two patients

Question 3

The nurse has just given a patient an opioid medication for pain relief.Because the nurse must leave the unit for lunch and a 1-hour meeting,the task of evaluating the patient's response to the pain medication must be delegated.To whom should the nurse delegate this responsibility?

A)Nursing assistant
B)Student nurse
C)Licensed practical nurse
D)Nurse manager

Answer 3

Nurse manager

Question 4

There is a temporary agency registered nurse assigned to the nursing unit.You have no knowledge of this nurse's skills,and you want to assign the nurse to a patient who has a fresh tracheostomy.How should you handle this situation?

A)Assign the nurse to the patient with the tracheostomy and hope for the best.
B)Ask the nurse about his or her competency to care for the patient with the tracheostomy.
C)Assign the patient to another nurse,and use the temporary agency nurse to do simple care tasks.
D)Call the agency and ask for a nurse skilled in the care of a patient with a tracheostomy.

Question 5

What are potential causes of performance inadequacies?

A)The person to whom the task was assigned had appropriate educational qualifications to complete the task.
B)The task was assigned to a person capable of carrying out the assignment.
C)The person who delegated the task confirmed the recipient's ability to perform the task.
D)The person to whom the task was assigned did not understand what the task involved.

Question 6

The nurse is making assignments for the team.There are two LPNs and a nursing assistant on the team.Which of the following assignments would the nurse choose for him/herself?

A)A patient with left-sided paralysis who needs help with bathing
B)A patient with a chest tube who is ambulating in the hall
C)A patient receiving chemotherapy for bone cancer
D)A patient receiving tube feedings with a J-tube

Question 7

The nurse has a full assignment.The charge nurse adds a newly admitted patient who will require close monitoring.Which task can the nurse delegate to the CNA who is co-assigned to the same patients?

A)Teaching insulin self-administration
B)Updating a care plan
C)Evaluating goal attainment for a patient who is learning to walk with a below-the-knee prosthesis
D)Bathing an unconscious patient

Question 8

Based on the goal of making optimal use of the level of preparation of the licensed practical nurse (LPN),which task should the nurse (RN)delegate to the LPN?

A)Assisting with a lumbar puncture
B)Transporting a patient to the radiology department
C)Restocking the sterile supplies
D)Distributing afternoon nutrition supplements

Question 9

Determine how the registered nurse's role is different from that of the LPN in assessment of the patient.

A)Collects data during the health history and physical exam
B)Contributes to the development of the care plan
C)Assist in updating the care plan
D)Uses findings from the assessment to create a care plan

Question 10

A nurse is reviewing delegation with a graduate nurse.The nurse knows that the teaching has been successful when the graduate nurse states which of the following?

A)"The nurse can delegate assessments to the nurse assistants."
B)"The nurse must create the care plan based on assessment findings."
C)"The nursing assistants cannot perform bed baths on postsurgical patients."
D)"The LPN can perform discharge teaching."

Question 11

What should the nurse do to assess competence before delegating a task to an LPN?

A)Ask if the LPN has previous experience performing the task.
B)Ask if the LPN is willing to perform the task.
C)Ask another nurse if the LPN is competent.
D)Assume the LPN is competent due to her years of service.

Question 12

What would be the best example of delegation?

A)Transferring to another nurse the responsibility of caring for a patient requiring a blood transfusion
B)Providing guidance to an LPN to hang blood on a patient
C)Assigning a series of nursing unit tasks to the certified nursing assistant
D)Assisting a new nurse to understand the rules and regulations of the Nurse Practice Act

Question 13

Which of the following tasks can the nurse safely delegate to the nursing assistant?

A)Assessing the patients who are being discharged later today
B)Giving discharge instructions to a patient
C)Helping a patient select food according to the specified diet
D)Educating the patient on what foods to eat for his/her diet plan

Question 14

The nurse needs to discuss a problem with the nursing assistant.The nursing assistant has left several rooms cluttered with trash and not cleaned appropriately.Which comment by the nurse would be the best way to approach the problem?

A)"I checked on the four rooms you were assigned,and they are really a mess."
B)"Have you had a problem completing your work assignment today?"
C)"All four of the patient rooms assigned to you today are messy with a lot of trash in them."
D)"Family members have been really upset today.Why have you not cleaned up the rooms assigned to you?"

Question 15

Which of the following statements indicates the nurse's understanding of accountability in the delegation process?

A)"I am solely accountable for the actions of the delegate."
B)"I am accountable for assessing the delegate's competency before delegation."
C)"The delegate is responsible for telling the nurse if he/she is competent."
D)"The manager is responsible for providing feedback to the delegate."

Question 16

Which task could a staff nurse delegate to a certified nursing assistant (CNA)?

A)Evaluating a patient's response to pain
B)Making rounds with a physician
C)Feeding a stroke patient who has minimal dysphagia
D)Assessing a patient's central venous line site

Question 17

A registered nurse is feeling overwhelmed.Which of the following would be most appropriate for the registered nurse to delegate to an LPN?

A)An initial assessment on a new patient
B)Educational teaching on diabetes management
C)Creating a care plan for a patient
D)Updating the care plan for a patient who is postop day 2

Question 18

The charge nurse is assigning patients for care.There are two registered nurses (RNs),an LPN,and a certified nursing assistant (CNA).The charge nurse would assign which of the following patients to the LPN?

A)An older adult who is receiving IV chemotherapy through a central line and will need a dressing change
B)An adult patient diagnosed with insulin-dependent diabetes who will need dressing changes on several stasis ulcers on the lower extremities
C)An adult patient with a right fractured femur and right arm in a cast who needs to urinate
D)An older patient with terminal cancer who will be transferred to hospice

Question 19

Which of the following represents appropriate feedback for an assignment to an LPN?

A)"Did you understand the assignment that you received in the staff report?"
B)"Have you completed the urinary catheterization and care of the new patient?"
C)"The patient in Room 430 looks much better,and you did a good job of making the patient comfortable."
D)"I know you are busy;however,you need to get caught up with your pain medications."

Question 20

A day shift nurse has come into work and notices that the glucometers were not tested overnight as they typically are.What is the best way for the nurse to question the nurse assistant in order to give feedback?

A)"Why didn't you test the glucometers?"
B)"What did you do last night?"
C)"How was your night? I noticed the glucometers weren't tested."
D)"Couldn't you have asked one of the nurses to check the glucometers if you were busy?"

Question 21

Which actions by the nurse show an understanding of what the nurse is accountable for? (Select all that apply.)

A)Assessing patients according to priority
B)Determining the need to delegate a task to a nursing assistant
C)Deciding that the nursing assistant is competent to perform the task delegated
D)Following up to determine completion of the task that was delegated
E)Delegating assessments of low-acuity patients to the nursing assistant

Question 22

The charge nurse is determining tasks that can be delegated to keep the unit running smoothly.What factors should the charge nurse consider before delegating? (Select all that apply.)

A)Staff who are working
B)Acuity of patients
C)Unit tasks needing to be done
D)Teaching obligations of the nurses
E)How many patients are waiting for beds on the unit

Question 23

A nurse manager is discussing the "five rights of clinical delegation." Which statements indicates understanding? (Select all that apply.)

A)"The nurse should determine if the task can safely be delegated."
B)"The nurse should determine if this is a task that will fit into the schedule."
C)"The nurse should delegate the task to the right person."
D)"The nurse should determine whether this is a task that would enhance learning."
E)"The nurse should provide feedback to the delegate."

Question 24

A patient in the medical-surgical unit is diagnosed with anemia and complains of weakness.Which of the following assignments could be given to the nursing assistant?

A)Organize the patient's meal tray for dinner.
B)Talk with the patient about managing rest and activities.
C)Get a diet history and list of the patient's favorite foods.
D)Take an apical pulse and listen to the lungs for crackles.

Question 25

The Delegation Decision Tree,which was prepared and adopted by the ANA and NCSBN,has specific steps.Identify the steps in this Decision Tree.(Select all that apply.)

A)Monitoring
B)Surveillance and supervision
C)Read back and response
D)Assessment and planning
E)Evaluation
F)Communication

Question 26

Which of the following statements made by the charge nurse indicate appropriate delegation? (Select all that apply.)

A)The LPN can delegate dressing changes to the nursing assistant.
B)The LPN can administer a DPT immunization to a child.
C)The LPN can add a dose of chemotherapy to an existing IV infusion.
D)The nursing assistant can transfer a paraplegic patient from a wheelchair to the bed.
E)The nursing assistant can assess vital signs on a patient 15 minutes after the transfusion has been started.

Question 27

An experienced nursing assistant could be assigned by the nurse to do which of the following?

A)Help teach new diabetic clients to give themselves injections.
B)Report on quality and quantity of urine,and adjust drip rate on continuous bladder irrigation.
C)Assist the client to obtain a clean-catch urine specimen.
D)Chart the dietary intake of a client with an eating disorder.

Question 28

Which statement(s)will help the nurse give feedback to a coworker? (Select all that apply.)

A)"Can you tell me what happened?"
B)"You did a great job positioning the postoperative patient."
C)"What do you think can be done to ensure that the blood pressures are charted?"
D)"I don't understand why you didn't do what I asked you to do."
E)"I only gave you one job to complete."

Question 29

The nurse manager understands the causes of performance weaknesses when making which of the following statements? (Select all that apply.)

A)"The employee does not know what is expected."
B)"The employee is getting adequate feedback."
C)"The employee requires additional education."
D)"The employee lacks motivation."
E)"The employee needs additional supervision."

Question 30

The nurse is preparing to delegate work to the nurse aide.What can be done to ensure that work is delegated in a manner that is understood by the nurse aide? (Select all that apply.)

A)Determine if the nurse aide understands what is being asked.
B)Ensure that the directions given are in accordance with policy.
C)Delegate more difficult tasks because the nurse aide is experienced.
D)Ask the nurse aide if he/she has the information needed to complete the task.
E)Refrain from delegating and complete the tasks him/herself.

Question 31

The nurse is preparing assignments in a pediatric unit for the night shift.Which of the following would be appropriate to assign the LPN?

A)A 5-year-old child who had an appendectomy about 6 hours ago
B)A 4-year-old child admitted for severe epiglottitis who is running a fever of 102° F
C)A 6-year-old child admitted with dehydration and receiving IV therapy
D)A 7-year-old child who received inhalation burns 2 days ago and has a tracheostomy