The RN and certified nursing assistant/patient care assistance (CNA/PCA) are caring for five clients on a medical/surgical unit. Which of the following tasks would be most appropriate for the nurse to delegate to the CNA/PCA?
Performing chest percussion on a client with atelectasis
Auscultate lungs on a client with audible wheezing
Taking vital signs on a male client with severe dyspnea
Suctioning a client with hemoptysis (bloody sputum)
Setting up a meal tray for a client with COPD
The Correct Answer is E
A. Chest percussion is a specialized skill that should be performed by a nurse or respiratory therapist due to the risk of complications.
B. Lung auscultation requires assessment skills and clinical judgment, which is within the RN’s scope of practice, not the CNA’s.
C. Taking vital signs on a client with severe dyspnea may require immediate interpretation and intervention, best handled by an RN.
D. Suctioning requires skill and knowledge of the procedure and potential complications, which should be performed by the RN.
E. Setting up a meal tray is an appropriate task for a CNA, as it does not require nursing judgment and supports the client’s nutritional needs.
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Correct Answer is E
Explanation
A. Normal sounds against the sternum would not be low-pitched or soft; they would typically be more pronounced.
B. Bronchovesicular sounds are medium-pitched and are not expected in the lower lobes; they are usually heard in the central area.
C. Bronchial sounds are high-pitched and hollow, typically heard over the trachea, not in the lower lobes.
D. Normal sounds over the trachea would not be described as low-pitched or soft.
E. Vesicular breath sounds are soft, low-pitched, and normal over peripheral lung fields, including the lower lobes, making this the correct interpretation.
Correct Answer is ["A","B"]
Explanation
A. S4 is often considered a normal finding in older adults due to decreased ventricular compliance.
B. While it can be non-pathologic, it is more commonly associated with underlying conditions such as hypertension or heart failure.
C. The statement about being heard just after S2 is incorrect; S4 can be heard in various populations, particularly older adults.
D. An S4 sound is associated with a stiff or hypertrophied ventricle, not a dilated ventricle.
E. An S4 sound is not typically an expected finding in children; it is more common in older adults.