A charge nurse has assigned a group of clients to a licensed practical nurse (LPN). The charge nurse receives reports from her assigned clients about the LPN's lack of care. Which of the following actions should the charge nurse take?
Discuss the LPN's behavior with other nurses on the unit.
Review the LPN's personnel file.
Talk with the clients who have reported the LPN's lack of care.
Reassign some of the LPN's client care to assistive personnel.
The Correct Answer is B
Rationale:
A. Discussing the LPN's behavior with other nurses could potentially lead to gossip and does not address the core issue.
B. Reviewing the LPN's personnel file provides insight into the LPN's past performance and any previous issues, which can help in understanding the current situation and deciding on the next steps.
C. Talking with the clients is important to understand their concerns, but it does not directly address the LPN's behavior and effectiveness.
D. Reassigning client care to assistive personnel does not address the root cause of the problem and may not be an appropriate or effective solution without further investigation.
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Correct Answer is D
Explanation
Rationale:
A. Assigning an RN to perform a central line dressing change is appropriate as it requires specialized skills and knowledge.
B. Assigning an AP to perform glucometer monitoring is within their scope of practice and is a suitable task.
C. Assigning two APs to ambulate clients is reasonable if the workload requires it.
D. Assigning a new graduate nurse to perform a wet-to-dry dressing change may be inappropriate if it requires more experience and skill than the new graduate has.
Correct Answer is B
Explanation
Rationale:
A. "The client works in the hospital radiology department." This information is important for understanding the client's background but does not indicate a need for total care by the nurse.
B. "The client discussed having prior thoughts of suicide." This statement indicates a high-risk situation requiring close monitoring and direct care by the nurse, rather than delegating tasks to an AP. The client's safety and mental health status necessitate the nurse's full attention.
C. "The client's blood pressure and pulse have been fluctuating throughout the day." While this information suggests the need for monitoring, it doesn't necessarily preclude the AP from assisting with certain tasks under the nurse's supervision.
D. "The client's family members have been present most of the day." This statement provides context but does not indicate a need for total care by the nurse.