A nurse in an acute care setting is planning care for a group of clients at the beginning of the shift. Which of the following tasks should the nurse assign to the assistive personnel (AP)?
Removal of the nasogastric tube of a client who has been receiving enteral feedings
Monitoring vital signs of a client who had an appendectomy 12 hr ago
Application of antibiotic ointment to the arm of a client who has dermatitis
Obtaining medical history information from a stable client who is being admitted
The Correct Answer is B
Rationale:
A. Removal of the nasogastric tube is a more complex task that typically requires the nurse’s assessment and judgment.
B. Monitoring vital signs is within the scope of tasks that can be assigned to assistive personnel. This task involves routine observation and does not require complex decision-making.
C. Application of antibiotic ointment requires specific knowledge about the condition and treatment, which is generally performed by a nurse.
D. Obtaining medical history information is a task that requires clinical judgment and interaction, and should be done by a nurse rather than an assistive personnel.
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Correct Answer is C
Explanation
Rationale:
A. Reassign the task to another nurse is not immediately necessary; first, the issue needs to be addressed with the LPN.
B. Report the issue to the unit manager should be done if the problem persists, but initial action should involve resolving the immediate issue.
C. Change the client's dressing is essential to address the immediate need and ensure the client’s care is up-to-date.
D. Verify the LPN knows how to do a dressing change might be necessary in the long term, but addressing the immediate issue of the uncompleted task is a priority.
Correct Answer is A
Explanation
Rationale:
A. Transporting a school-age client who is in traction involves handling a medical condition that may require specialized knowledge and skills beyond the volunteer’s capabilities.
B. Reading a book to a client who has AIDS is a supportive activity and does not pose significant risks.
C. Rocking an infant with croup is generally safe and provides comfort to the child.
D. Playing a computer video game with an adolescent is a non-medical activity that is appropriate for a volunteer.