A registered nurse (RN) and an experienced licensed practical nurse (LPN) are caring for a group of clients. Which of the following tasks should the RN delegate to the LPN? SELECT ALL THAT APPLY
Monitoring vital signs of postoperative clients.
Administering routine medications to stable clients.
Performing wound care on a client with a Stage III pressure ulcer.
Developing a teaching plan for a client newly diagnosed with Type II Diabetes.
Providing oral care to an unconscious client.
Correct Answer : A,B,C,E
Choice A reason:
Monitoring vital signs of postoperative clients is a task that can be safely delegated to an experienced LPN. LPNs are trained to monitor and report vital signs, which is a routine and essential part of postoperative care. This task does not require the advanced assessment skills of an RN, making it appropriate for delegation.
Choice B reason:
Administering routine medications to stable clients is within the scope of practice for LPNs. They are trained to administer medications and monitor clients for adverse reactions. As long as the clients are stable and the medications are routine, this task can be delegated to an LPN.
Choice C reason:
Performing wound care on a client with a Stage III pressure ulcer is a task that an experienced LPN can perform. LPNs are skilled in wound care and can manage complex dressings and treatments under the supervision of an RN. This delegation allows the RN to focus on more complex tasks that require their advanced skills.
Choice D reason:
Developing a teaching plan for a client newly diagnosed with Type II Diabetes is a task that should not be delegated to an LPN. This task requires comprehensive knowledge of diabetes management, patient education, and individualized care planning, which are within the RN’s scope of practice. The RN should develop the teaching plan and may involve the LPN in reinforcing the education.
Choice E reason:
Providing oral care to an unconscious client is a task that can be delegated to an experienced LPN. Oral care is essential for preventing infections and maintaining hygiene, and LPNs are trained to perform this care safely and effectively.
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Correct Answer is B
Explanation
Choice A reason:
Assisting a client with a bed bath who has a history of falls is important for maintaining hygiene and preventing skin breakdown. However, this task does not address an immediate physiological need. While it is essential to ensure the safety of clients with a history of falls, this task can be scheduled after more urgent needs are met. The priority in nursing care is to address tasks that have the most immediate impact on a client’s health and safety.
Choice B reason:
Providing a snack to a diabetic client who is feeling lightheaded is the most urgent task. Lightheadedness in a diabetic client can be a sign of hypoglycemia, which requires immediate intervention to prevent serious complications such as loss of consciousness or seizures. Hypoglycemia occurs when blood sugar levels drop too low, and providing a quick source of glucose can help stabilize the client’s condition. This task addresses an immediate physiological need and is critical for the client’s safety and well-being.
Choice C reason:
Feeding a client who has bilateral casts due to upper arm fractures is necessary to ensure the client receives adequate nutrition. However, this task does not address an immediate threat to the client’s health. While it is important to assist clients who are unable to feed themselves, this task can be performed after more urgent needs are addressed. Prioritizing tasks that address immediate physiological needs is essential in nursing care.
Choice D reason:
Ambulating a postoperative client for the first time is important for preventing complications such as deep vein thrombosis, pneumonia, and muscle weakness. Early ambulation is a key component of postoperative care and helps promote recovery. However, this task can be scheduled after addressing more immediate physiological needs. Ensuring the safety and stability of clients with urgent conditions takes precedence over routine postoperative care activities.
Correct Answer is ["B","C","E"]
Explanation
Choice A reason:
The central nervous system is not a common portal of entry for anthrax. Anthrax primarily enters the body through the skin, respiratory tract, or gastrointestinal tract. While it can affect the central nervous system if it spreads, it is not a primary entry point.
Choice B reason:
The integumentary system, or skin, is a common portal of entry for anthrax. Cutaneous anthrax occurs when Bacillus anthracis spores enter the body through a cut or abrasion on the skin. This form of anthrax is characterized by a localized infection that can develop into a painless ulcer with a black center.
Choice C reason:
The respiratory system is another primary portal of entry for anthrax. Inhalation anthrax occurs when spores are inhaled into the lungs. This form of anthrax is particularly dangerous and can lead to severe respiratory distress and systemic infection if not treated promptly.
Choice D reason:
The renal system is not a typical portal of entry for anthrax. While anthrax can affect multiple organ systems if it becomes systemic, it does not enter the body through the kidneys or urinary tract.
Choice E reason:
The gastrointestinal system is a potential portal of entry for anthrax. Gastrointestinal anthrax occurs when spores are ingested, typically through contaminated food or water. This form of anthrax can cause severe gastrointestinal symptoms and systemic infection.