A nurse on an obstetrics-gynecology unit is planning care for four clients after receiving change of shift report. Which of the following clients should the nurse assess first?
A client who is 4 days postpartum and has mastitis
A client who had a bilateral tubal ligation 12 hr previously
A client admitted 1 hr ago for an ectopic pregnancy
A client who is a 1 day postpartum after a late term miscarriage
The Correct Answer is C
Rationale:
A. A client who is 4 days postpartum and has mastitis should be assessed, but this condition is less acute compared to the others.
B. A client who had a bilateral tubal ligation 12 hr previously requires post-operative monitoring, but this is less urgent than the client with an ectopic pregnancy.
C. A client admitted 1 hr ago for an ectopic pregnancy is the priority as this condition can be life-threatening and requires immediate assessment.
D. A client who is 1 day postpartum after a late-term miscarriage requires care, but the immediacy is less than that of the ectopic pregnancy client.
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Correct Answer is D
Explanation
Rationale:
A. Agency policies for the LPN are important but secondary to ensuring the tasks fall within the scope of practice.
B. The documented experience level of the LPN is relevant but should be considered in conjunction with the scope of practice.
C. The documented skill level of the LPN is important for assigning tasks but must align with legal scope of practice.
D. State Nurse Practice Act for the LPN is the priority criterion as it defines the legal scope of practice and ensures that tasks delegated to the LPN are within their legal and professional boundaries.
Correct Answer is D
Explanation
Rationale:
A. Telling other nurses is useful for team morale but does not directly recognize the AP.
B. Detailing contributions to the manager is valuable but can be done after initial direct recognition.
C. Nominating for an award is an excellent formal recognition but should follow immediate feedback.
D. Giving direct positive feedback immediately acknowledges the AP’s efforts and encourages continued good performance.