A charge nurse is planning care for a group of clients on a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

Giving a glycerin suppository to a client for constipation

Evaluating the effectiveness of ibuprofen administered to a client who reported a headache

Discussing dietary changes with a client who has a prescription for a gluten-free diet

Measuring hourly urinary output for a client who is postoperative

Answer and Explanation

The Correct Answer is D

A. Giving a glycerin suppository to a client for constipation: Medication administration, including rectal suppositories, requires assessment of bowel function, knowledge of contraindications, and evaluation of effectiveness, which fall under the responsibilities of a licensed nurse.

B. Evaluating the effectiveness of ibuprofen administered to a client who reported a headache: Assessing a client’s response to medication requires critical thinking, monitoring for adverse effects, and determining if additional interventions are needed, which are nursing responsibilities that cannot be assigned to assistive personnel.

C. Discussing dietary changes with a client who has a prescription for a gluten-free diet: Providing dietary education involves assessing the client’s current knowledge, identifying nutritional risks, and ensuring understanding of food choices, which requires professional nursing judgment or a consultation with a dietitian.

D. Measuring hourly urinary output for a client who is postoperative: Recording urinary output involves a simple measurement process that does not require clinical decision-making. Assistive personnel can accurately collect and document this data, allowing nurses to focus on interpretation and intervention if necessary.

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Correct Answer is A

Explanation

A. Crowded living conditions: The epidemiological triangle consists of the agent, host, and environment. Environmental factors include external conditions that influence the likelihood of violence, such as overcrowding, lack of resources, and social instability. High-density living situations can increase stress levels, competition for basic needs, and exposure to conflict, all of which may contribute to violent behavior.

B. Traumatic brain injury: This is a host factor, as it directly affects an individual’s neurological function, potentially contributing to aggressive behavior. Damage to specific brain regions, such as the frontal lobe, can impair impulse control and increase the risk of violent actions, but it does not originate from the external environment.

C. Alzheimer's disease: As a condition affecting the individual, this is also a host factor. Cognitive decline may increase impulsivity or aggression, particularly in later stages, as judgment and emotional regulation deteriorate. However, the disease itself is an internal factor and not an external environmental influence.

D. Impaired coping abilities: This is a host factor because it pertains to an individual's psychological and emotional regulation, affecting how they respond to stress or conflict. Poor coping mechanisms can increase vulnerability to engaging in violent behavior, but they arise from personal experiences and mental health conditions rather than external environmental influences.

A. "If you accept this assignment today, I will let you choose your assignment tomorrow." B. "Let's just focus on giving out client medications on time." C. "If you don't agree with the assignment, I will have to report your decision to the nursing supervisor." D. "You have a lot of experience, so I'm sure you're capable of these tasks."

Correct Answer is A

Explanation

A. "If you accept this assignment today, I will let you choose your assignment tomorrow.": This statement exemplifies smoothing as a conflict resolution strategy. By offering a compromise or incentive, the charge nurse is attempting to reduce tension and create a more favorable situation for the staff nurse, thereby smoothing over the disagreement about the assignment.

B. "Let's just focus on giving out client medications on time.": This statement diverts attention from the conflict but does not actively seek to resolve it. It may minimize the issue temporarily but does not address the underlying disagreement or concern regarding the assignment.

C. "If you don't agree with the assignment, I will have to report your decision to the nursing supervisor.": This statement is confrontational and may escalate the conflict rather than resolve it. It places pressure on the staff nurse and does not foster a collaborative atmosphere for finding a solution.

D. "You have a lot of experience, so I'm sure you're capable of these tasks.": While this statement acknowledges the staff nurse's experience, it may not effectively address the conflict regarding the assignment. It could come across as dismissive of the nurse's concerns rather than facilitating a resolution to the disagreement.

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