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A nurse delegates a task to an assistive personnel (AP) who refuses to complete the task. Which of the following actions should the nurse take first?

A.

Plan time to complete the task.

B.

Assign the task to another AP.

C.

Notify the charge nurse immediately.

D.

Discuss the AP's concerns about the task.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Plan time to complete the task: While the nurse may need to complete the task if it remains undone, doing so without first addressing the AP’s refusal overlooks a potential communication or training issue and does not resolve the underlying problem.

B. Assign the task to another AP: Reassigning the task without understanding the reason for refusal may perpetuate noncompliance and disrupt team dynamics. It is important to first clarify why the AP is unwilling before redirecting the task.

C. Notify the charge nurse immediately: Escalating to the charge nurse is appropriate if the issue cannot be resolved directly. However, the first action should be to attempt communication and resolution with the AP to encourage accountability and collaboration.

D. Discuss the AP's concerns about the task: This is the most appropriate initial response. By opening a discussion, the nurse can identify whether the refusal stems from a misunderstanding, lack of training, or legitimate concern, allowing for timely correction or education.


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Related Questions

Correct Answer is B

Explanation

Rationale:

A. Social worker: A social worker assists with discharge planning, community resources, and emotional or financial support, but does not assess or manage swallowing difficulties.

B. Speech therapist: A speech therapist specializes in evaluating and treating swallowing disorders (dysphagia), especially after neurological events like a stroke. They play a crucial role in preventing aspiration and developing a safe feeding plan.

C. Physical therapist: A physical therapist focuses on mobility, strength, and ambulation training after injury or stroke. While vital for overall recovery, they are not involved in assessing or treating swallowing function.

D. Dentist: Dentists manage oral health, dental structures, and hygiene but are not involved in evaluating or treating swallowing difficulties related to stroke.

Correct Answer is ["B","D","E","F"]

Explanation

Rationale:

  • Ask the client for a list of close contacts: The client exhibits classic symptoms of active tuberculosis (TB), including weight loss, night sweats, hemoptysis (bloody cough), and chest tightness. Identifying close contacts is crucial for contact tracing and limiting disease spread.
  • Obtain a sputum culture: A sputum culture is essential for diagnosing pulmonary TB. This test confirms the presence of Mycobacterium tuberculosis and guides further treatment decisions.
  • Place the client in a negative-pressure room: Clients suspected of having TB should be placed in a negative-pressure isolation room to prevent airborne transmission to others, especially in healthcare settings.
  • Use airborne precautions: Airborne precautions, including the use of an N95 respirator, are required for suspected or confirmed TB due to its airborne transmission risk.
  • Obtain blood cultures: Blood cultures are not the priority in TB diagnosis unless sepsis is suspected. TB is primarily diagnosed through respiratory samples, not blood.
  • Recommend ABGs be drawn: Arterial blood gases (ABGs) are typically unnecessary in TB unless there is respiratory compromise requiring ventilatory support or oxygenation monitoring, which is not indicated here.
  • Request a glucocorticoid prescription from the provider: Glucocorticoids are not standard treatment for TB and may suppress immune response. They may be used in specific TB complications like meningitis or pericarditis, but not in general pulmonary TB management.

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