Question 1

Which task is most likely to be considered in a state's practice act as appropriate to delegate to a LPN/LVN if the patient's condition is stable and competence in the task has been established?

Accepted Answer

Administering an enema for an elective surgery patient is a task that falls within the scope of practice for an LPN/LVN, especially when the patient's condition is stable and the LPN/LVN has demonstrated competence in performing this task. Tasks like administering IV medications while interpreting cardiac rhythms, developing care plans, and patient education often require more advanced assessment and evaluation skills, which are typically within the scope of practice of a registered nurse (RN) rather than an LPN/LVN.

Question 2

Care delivery using the team-based approach is used on a telemetry nursing unit.The team consists of one registered nurse (RN),two licensed practical nurses (LPNs),and one unlicensed assistive personnel (UAP).Staff have been charged to improve quality of care while ensuring cost containment.Which assignments would meet both criteria?

Accepted Answer

The experienced UAP placing telemetry electrodes and attaching them to the cardiac monitor meets both criteria for improving quality of care while ensuring cost containment. This task is within the scope of practice for a UAP under RN supervision, allowing the RN and LPNs to focus on tasks that require their higher level of licensure and training.

Question 3

An RN recently relocated to another region of the country and immediately assumed the role of charge nurse.When determining the appropriate person to whom to delegate,the RN bases decisions on what fact?

Accepted Answer

The scope of practice for LPNs/LVNs varies by state, and it is defined by each state's nurse practice act. Therefore, reviewing the state's nurse practice act is essential to understand what tasks can be legally delegated to an LPN/LVN in that specific region.

Question 4

A student nurse is concerned about delegation practices and wonders why hospitals employ unlicensed assistive personnel (UAP)and LPN/LVNs.The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to focus on what?

Accepted Answer

UAPs and LPN/LVNs aid the RN by performing tasks that have been appropriately delegated to them, allowing the RN to focus on more complex care needs. This delegation enhances the efficiency and effectiveness of patient care.

Question 5

A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit.The staffing consists of LPNs and two unlicensed assistive personnel.The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas,which lacks clarity on some tasks.What should the RN do to best acquire the necessary information?

Accepted Answer

Contacting the state board of nursing is the most appropriate action to determine the legal scope of practice for LPNs in Arkansas. The state board of nursing is the authoritative body that regulates nursing practice and can provide accurate and legally sound information regarding the scope of practice.

Question 6

An RN delegates to the unlicensed assistive personnel (UAP)the task of performing blood pressure checks for a group of patients on a nursing unit.The UAP accepts the task and is responsible for what associated task?

Accepted Answer

The UAP, after accepting the task of performing blood pressure checks, is responsible for keeping the RN informed of any abnormal readings. This is because the RN needs to be aware of any potential issues with the patients under their care to make appropriate clinical decisions. The UAP does not have the authority to delegate tasks, call physicians directly, or make dietary changes, as these actions require clinical judgment and are the responsibility of licensed personnel.

Question 7

An RN makes the following assignments at the beginning of the shift.Which assignment would be considered high-risk delegation?

Accepted Answer

Assigning an unlicensed assistive person (UAP) the task of assisting a patient with late stages of Huntington's disease to ambulate is considered high-risk delegation. This is because patients with late-stage Huntington's disease have significant physical and cognitive impairments, making ambulation potentially dangerous without professional nursing or therapeutic supervision.

Question 8

The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to whom?

Accepted Answer

The initial assessment of a newly admitted patient, especially one who is about to undergo a procedure, is a complex task that requires the clinical judgment and skills of a registered nurse (RN). This task involves collecting comprehensive health information, performing a physical examination, and making critical decisions based on the findings, which are beyond the scope of practice for licensed practical/vocational nurses (LPN/LVN) and unlicensed assistive personnel (UAP).

Question 9

Which situation would be appropriate for the supervisory level of initial direction and/or periodic inspection?

Accepted Answer

In this scenario, the RN is providing initial direction to the LPN by assigning tasks and then performing periodic inspections by checking back during the shift to ensure the tasks are completed correctly. This level of supervision is appropriate for ensuring that tasks delegated to someone with a different scope of practice are carried out safely and effectively.

Question 10

Which task is appropriate for the RN to delegate to the unlicensed assistive personnel (UAP)provided the delegate has had experience and training?

Accepted Answer

Obtaining a sterile urine sample from a patient with a Foley catheter that is connected to a closed drainage system is a task that can be delegated to unlicensed assistive personnel (UAP) if they have received proper training and experience. This task does not require clinical judgment or assessment skills, which are necessary for the other options listed.

Question 11

A patient is admitted with hypotension,shortness of breath,flushing,and hives.All levels of staff have been trained to assess vital signs.Given budget restrictions and proper delegation rules,to which care provider would the RN delegate the task of obtaining the initial blood pressure reading?

Accepted Answer

The answer of A patient is admitted with hypotension,shortness of...

Question 12

During orientation,an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives.It is important for the RN to understand that what is the basis for this practice?

Accepted Answer

The answer of During orientation,an RN learns that LPN/LVNs in...

Question 13

When determining the scope of practice for licensed practical nurses (LPN)and unlicensed assistive personnel (UAP),which statement accurately describes the common policies which exist in most state practice acts?

Accepted Answer

The RN must assess the patient's condition and needs before determining which tasks can be safely delegated to LPNs or UAPs. This ensures that the delegation is appropriate and that patient safety is maintained.

Question 14

An LPN/LVN has transferred to a nursing unit and arrives for the first day.The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed.The RN is providing which level of supervision?

Accepted Answer

The RN is providing continual supervision by frequently checking in with the LPN/LVN to ensure they are supported and competent in their tasks.

Question 15

Which statement related to delegation is correct?

Accepted Answer

The RN must be knowledgeable about the laws and regulations that govern nursing practice, including those for unlicensed assistive personnel (UAP), even when parameters are not clearly defined. This ensures safe and effective delegation and supervision of tasks.

Question 16

The RN instructs the LPN to "Give an enema to the discharged patient in room 327 who is reporting being constipated.Then be sure to document on the medication administration record when given." Which of the five rights was missing in this situation? The right of

Accepted Answer

The RN did not provide the LPN with the right of direction and communication by not giving specific instructions on how to administer the enema.

Question 17

An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients.The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room.What is the RN's initial intervention?

Accepted Answer

The RN should stop the LPN/LVN immediately and discuss the potential consequences of documenting medication administration before actually administering the medications. This is to ensure patient safety and adherence to proper medication administration procedures.

Question 18

A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel.What is the best way for the nurse to determine competency of an inexperienced delegatee?

Accepted Answer

Personally observing the delegatee perform the assigned task is the most direct and reliable method for assessing competency, as it allows the nurse to evaluate the delegatee's skills and abilities in real-time.

Question 19

An RN is counseled by the nurse manager regarding inappropriate delegation when the RN engages in what activity?

Accepted Answer

Assigning the task of completing a plan of care for a patient is a responsibility that requires the assessment and critical thinking skills of an RN, not an LPN/LVN. This task involves creating a comprehensive care plan based on the patient's specific needs, which is beyond the scope of practice for LPNs/LVNs.

Question 20

A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP)the task of assisting with oral hygiene,knowing that this assignment "does not require decisions based on the nursing process." The nurse is correctly using which of the five rights of delegation?

Accepted Answer

The right circumstance involves ensuring the task is appropriate for the delegatee considering the context of the patient's condition and the working environment. Assisting with oral hygiene is a task that does not require complex decision-making or nursing judgment, making it suitable for delegation to UAP under the right circumstances.

Quiz 20: Effective Delegation and Supervision