Deck 9: Delegation

Question 1

Delegating requires clear and skillful _____ to avoid liability.

A) negotiation
B) communication
C) corrective action
D) planning

Answer 1

communication

Question 2

With regards to delegation, what organizational principles are considered (select all that apply)?

A) Communication is culturally appropriate.
B) The person receiving the communication is treated respectfully.
C) Nursing staff is accountable for establishing systems to assess, monitor, verify, and communicate requirements for delegation.
D) The chief nursing officer is responsible for monitoring delegation.
E) RNs monitor organizational policies, procedures, and position descriptions to ensure that the nurse practice act is not violated.

Answer 2

Communication is culturally appropriate.
The person receiving the communication is treated respectfully.
RNs monitor organizational policies, procedures, and position descriptions to ensure that the nurse practice act is not violated.

Question 3

When determining that delegation of an element of patient care needs to occur, the nurse delegates with a clear, concise description of the task, including its objectives, limits, and expectations. The nurse allows the delegate to clarify without fear of repercussion. Which of the following five rights of delegation is being demonstrated?

A) Right task
B) Right circumstance
C) Right person
D) Right direction/communication
E) Right supervision/evaluation

Answer 3

Right direction/communication

Question 4

The five rights of delegation are right task, right circumstance, right person, right direction and communication, and right:

A) interaction.
B) outcome.
C) supervision.
D) time.

Question 5

Transferring the authority to perform a selected nursing task in a selected situation to a competent individual is:

A) authorization.
B) delegation.
C) empowerment.
D) supervision.

Question 6

When the licensed nurse makes a determination to delegate a task, which of the following occurs in the process (select all that apply)?

A) The nurse assesses the situation and need for delegation.
B) A plan for specific task delegation is established.
C) The needs of the nurse are considered.
D) The nurse determines the available resources and patient safety.
E) Accountability is transferred to the manager.

Question 7

The nurse's two main legal responsibilities in delegation are to assess the competency of the delegatee and to assess:

A) how many nurses are available to supervise.
B) how much supervision time is needed.
C) the client condition severity level of the patient population.
D) the expiration date of the license.

Question 8

A manager should never delegate:

A) disciplining.
B) hiring.
C) interviewing.
D) scheduling.

Question 9

When making a decision to delegate a nursing task, which of the following factors are assessed (select all that apply)?

A) Potential for harm
B) Complexity of the task
C) Amount of problem solving required
D) Predictability of the outcome
E) Level of patient interaction

Question 10

Which of The Joint Commission (TJC) National Patient Safety Goal is most applicable to delegation?

A) Implement a standardized approach to hand-off communication.
B) Maintain and communicate accurate medication information.
C) Reduce the risk of health care-associated infections.
D) Use two patient identifiers when providing care.

Question 11

What tool is used as a systematic, proactive method for evaluating a process to identify where and how care delivery might fail?

A) American Nurses Association (ANA)
B) UAP
C) Failure Mode and Effects Analysis (FMEA)
D) Institute for Healthcare Improvement (IHI)

Question 12

The charge nurse is making assignments on a surgical unit. Which client should be assigned to the least experienced nurse?

A) Client who had a vaginal hysterectomy and still has an indwelling catheter
B) Client who had an open cholecystectomy and has gray drainage in the T-tube drainage tube and bag
C) Client who had a hip replacement and stated that something popped while walking
D) Client who had a Whipple procedure and is reporting being thirsty all the time

Question 13

Individuals who are trained to help the registered nurse (RN) in the provision of patient-client care activities as delegated by and under the supervision of the RN are known as:

A) certified assistive personnel.
B) health care assistive personnel.
C) medical assistive personnel.
D) UAP.

Question 14

According to the American Association of Critical Care Nurses, there are five factors that a nurse should assess when making a decision to delegate nursing tasks. These factors are assessing the potential for harm, the complexity of the task, the amount of problem solving and innovation required, the unpredictability of the outcome, and the:

A) amount of time that the task will take.
B) degree of comfort the delegatee has with the task.
C) level of patient interaction.
D) method of measuring outcomes.

Question 15

Which of the following colleagues would a nurse typically delegate to in the health care setting (select all that apply)?

A) Students
B) LPNs/LVNs
C) Family members at bedside
D) Physicians
E) Nursing assistants

Question 16

The provision of guidance or direction, evaluation, and follow-up by the licensed nurse for accomplishment of a nursing task delegated to unlicensed assistive personnel (UAP) is:

A) authorization.
B) delegation.
C) observation.
D) supervision.

Question 17

Which staff member should be assigned to a dying client who is experiencing symptoms of emotional distress?

A) UAP who can be spared to sit with the client
B) LPN/LVN who has grown attached to the family
C) RN who has experience as a hospice nurse
D) Newly graduated RN

Question 18

If an error occurs as a result of delegation, the nurse is accountable for supervision, follow-up, intervention, and:

A) corrective action of the event.
B) documentation of the event.
C) evaluation of the process.
D) summation of the occurrence.

Question 19

The nurse has asked a nurse's aide to greet a postoperative patient who has just arrived on the unit and to determine whether he is in stable condition. This act of delegation is an example of a nurse inappropriately delegating:

A) assessment of the patient.
B) evaluation of an intervention.
C) nursing judgment.
D) teaching to a delegate.

Question 20

If a licensed practical/vocational nurse (LPN/LVN) provides discharge teaching, who is legally responsible?

A) Chief executive officer
B) Institution where the LPN/LVN works
C) Risk manager
D) UAP

Question 21

A unit manager is utilizing her staff as a resource for educational presentations. An RN in her unit has been requested to create a PowerPoint on delegation and supervision. What resources should she include for staff to obtain additional information on delegation and supervision (select all that apply)?

A) State nurse practice act
B) Organization's policies and procedures
C) TJC
D) ANA
E) Board of Registered Nursing

Question 22

The process of delegation may be undermined in the health care setting as one member of the team moves work in a downward direction. What are some of the reasons for delegatees to resist responsibility (select all that apply)?

A) Lack of ability to direct
B) Fear of criticism for mistakes
C) Overwhelming workload
D) Lack of confidence
E) Lack of resources

Question 23

Which principles are important to consider when an RN delegates tasks to UAP (select all that apply)?

A) Tasks are delegated that will challenge the UAP to use critical thinking.
B) Assess the condition and stability of the patient.
C) Delegate tasks that are within the expertise of the RN, particularly if the UAP is a student.
D) Evaluate the effectiveness of the task.
E) Document the delegation.

Question 24

Delegation to unlicensed staff is most common in which settings (select all that apply)?

A) Operating room
B) Emergency department
C) Critical care unit
D) Long-term care (LTC)
E) Assisted living

Question 25

Which of the following are the responsibilities of the delegatee in a situation (select all that apply)?

A) Corrective action
B) Own acts
C) Accepting the delegation
D) Appropriate notification and reporting
E) Accomplishing the task

Question 26

Teams within a health care organization utilize FMEA to identify possible failures and prevent them by correcting the processes proactively. Which of the following processes or questions are answered using the FMEA approach (select all that apply)?

A) Identify the steps in the process.
B) Who is at fault?
C) What could go wrong?
D) Why would the failure happen?
E) What would be the consequences of the failure?