Deck 16: Delegation and Supervision

Question 1

A nurse has the reputation of delegating tasks that are time-consuming or distasteful. What should the nurse manager consider before addressing this situation?

A) Misuse of delegation is an ethical issue.
B) One of the privileges of loyalty to the hospital is being able to delegate distasteful tasks to others.
C) Doing distasteful tasks is part of the learning process for new nurses.
D) The nurse reserves the right to delegate any task he or she wishes.

Answer 1

Misuse of delegation is an ethical issue.

Question 2

A newly hired nursing assistant can work only when under direct supervision by a registered nurse. In which way can this assistant provide care?

A) The nursing assistant charts care in the patient's medical record and the nurse reviews that charting on a regular basis.
B) The nursing assistant provides hygienic care according to protocols approved by the nurse.
C) The nurse and the nursing assistant work together to provide care to a team of six patients.
D) The nurse is available on the unit while the nursing assistant provides care.

Answer 2

The nurse and the nursing assistant work together to provide care to a team of six patients.

Question 3

A nurse has delegated the task of ambulating a patient to two nursing assistants. Despite the patient's appearance, assistance of two people is needed for safe ambulation. The nurse discovers the patient being ambulated by only one aide. What nursing actions are indicated?

A) Scold the second aide for not carrying through with the delegated task.
B) Determine why only one person is ambulating the patient.
C) Assume that something important must have taken the second assistant away from this task.
D) Assist the aide in completion of the ambulation.
E) Notify the patient's physician of the incident.

Answer 3

Determine why only one person is ambulating the patient.
Assist the aide in completion of the ambulation.

Question 4

The charge nurse has delegated a task to another staff member. Who assumes accountability for the task?

A) It is held jointly by the charge nurse and the person performing the task.
B) It can be imputed to either the charge nurse or the person performing the task.
C) The charge nurse retains the accountability.
D) Accountability is transferred to the person performing the task.

Question 5

The unit is extremely busy when the physician orders that a urinary catheter be inserted in a patient. The patient's assigned nurse is new, has seen the procedure done, but has never done it independently. How should the charge nurse handle this situation?

A) The charge nurse should assist the new nurse with the procedure.
B) The charge nurse should ask the new nurse to try the procedure alone.
C) The charge nurse should assign the task to a different nurse.
D) The charge nurse should do the procedure to save time.

Question 6

A nurse working in the intensive care unit (ICU) notes that a patient is more confused and agitated than yesterday. Which nursing actions are evidence of patient advocacy?

A) The nurse assesses for common causes of confusion and agitation.
B) Tell the family that confusion and agitation frequently occur after ICU admission.
C) The nurse contacts the patient's primary care provider regarding the confusion.
D) The nurse documents findings and actions in the medical record.
E) Ask for assistance from the nurse manager if necessary.

Question 7

The preceptor nurse delegates a complex nursing procedure to a newly licensed nurse. The new nurse makes an error, which results in the patient's death. Does the preceptor hold any liability in this case?

A) Yes, but only because the event resulted in patient demise.
B) Yes, the preceptor is responsible for delegating appropriately and supervising completion of tasks.
C) No, since the new nurse has a license, all liability is retained by the new nurse.
D) No, since the new nurse is employed by the medical facility, all liability is corporate.

Question 8

The registered nurse has delegated the task of ambulating a patient to two nursing assistants. The patient appears to ambulate without assistance, but must be ambulated with two assistants due to a history of unexpected fall. What is the most important aspect of delegating this task?

A) The aides understand the importance of walking with the patient.
B) The patient is comfortable walking with the aides.
C) The aides understand the patient is to be ambulated twice daily.
D) The patient understands the need for assistance.

Question 9

The nurse is searching for information about nurses' responsibility and accountability for appropriate delegation of tasks. Where should this nurse look for this information?

A) State nurse practice acts
B) ANA Code of Ethics for Nurses
C) State medical association bylaws
D) ANA Nursing Scope and Standards of Practice
E) Nursing rules and regulations as promulgated by the state

Question 10

The nurse would correctly state that an assignment had been made in which situation?

A) The nurse says to the charge nurse, "Please watch my patients while I run down and pick up some lunch from the hospital cafeteria."
B) The nurse says to the UAP, "Please take all of the vital signs before you begin to deliver breakfast trays."
C) The charge nurse divides the patient load into one team for each staff nurse who works the shift.
D) The nurse asks a housekeeper to clean a bed quickly for a new admission.

Question 11

The nurse has recently assumed the position of chief nurse in a long-term care facility with a record of poor patient care. How should this nurse approach the issue of effective discipline regarding patient care activities?

A) Fire any nurse who does not meet established standards of care.
B) Firmly enforce the standards of care guiding the facility.
C) Set variable standards of care depending upon the nurse's previous experience.
D) Establish a discipline system that is progressive.
E) Encourage supervisors to be consistent in applying discipline.

Question 12

In which scenario is the nurse providing indirect supervision of a nursing assistant?

A) The nursing assistant and nurse work on the same team, jointly providing care to inpatients.
B) The nurse is easily contactable by pager but is not present in the care environment.
C) The nurse makes rounds on the patient care units, observing the nursing assistant's work, at least every two hours.
D) The nursing assistant receives constant instruction regarding patient care from the nurse.

Question 13

A nurse returning to practice remarks that delegation is much more regulated and complicated than when she last practiced 20 years ago. What rationale would the nurse manager provide for this change?

A) "The shortage of nurses has been the major reason that there are so many rules to follow when delegating."
B) "Since nursing is trying to move back to the team approach to care delegation has become more important."
C) "The introduction of multiple levels of professional staff members increases need for delegation rules and regulations."
D) "The widespread return to primary nursing makes delegation more risky."

Question 14

A patient who requires vasoactive intravenous medications was just admitted. Which person should the charge nurse ask to measure this patient's vital signs?

A) The licensed practical nurse who has worked on this unit for 5 years
B) The registered nurse who has worked on this unit for 8 months
C) The unlicensed assistive personnel (UAP) who was recently transferred to the unit from an acute care environment
D) The nursing assistant who has worked in this unit for 7 years

Question 15

The nurse manager walks in on a conversation in the break room concerning the hospital's plan to employ unlicensed assistant personnel (UAPs) to help relieve a nursing shortage. Which statements would the manager correct?

A) "I can't believe our state board authorized this plan."
B) "I don't want to have these UAPs working under my license."
C) "The hospital will have to assure that the UAPs they hire are competent."
D) "It will be important that the UAPs hired have adequate orientation to our nursing units."
E) "It will be even more important that we follow delegation policy and procedure."