A nurse is assigned to care for a client who is receiving a continuous IV infusion of insulin.

The nurse does not possess the skills to care for the client and requests that the charge nurse change her assignment.

Which of the following statements by the nurse demonstrates assertiveness?

Choice A rationale

Integrity in nursing involves acting in accordance with an appropriate code of ethics and accepted standards of practice. It is reflected when the nurse is honest and provides care based on an ethical framework. While a preceptor should certainly possess integrity, the specific act of volunteering time and expertise to mentor students is more accurately defined by the selfless concern for the well-being and professional growth of others within the nursing community.

Choice B rationale

Altruism is defined as a selfless concern for the well-being of others. In a professional context, a nurse demonstrates altruism by advocating for patients or mentoring peers and students without expecting personal gain. By volunteering to be a preceptor, the nurse is dedicating energy to ensure the next generation of nurses is well-prepared, which benefits the profession and future patients. This commitment to the collective good over individual convenience is a hallmark of altruism.

Choice C rationale

Social justice is a professional value rooted in upholding moral, legal, and humanistic principles. It is demonstrated when a nurse works to ensure equal treatment under the law and equal access to quality healthcare for all populations. While educating students eventually improves care quality, the act of precepting does not directly address the systemic inequalities or the distribution of health resources that are the primary focus of social justice initiatives in nursing.

Choice D rationale

Autonomy refers to the right of self-determination and the ability to make independent decisions within one's scope of practice. For a nurse, this involves exercising professional judgment in patient care. While the nurse is making an autonomous choice to volunteer, the value being modeled to the students through the act of precepting is the support of others. Autonomy is more about the nurse's right to practice and the patient's right to choose their treatment.

Choice A rationale

The right person involves ensuring that the individual delegating the task has the correct authority and that the person receiving the delegation possesses the necessary skills and knowledge. In this scenario, the nurse has the authority to delegate, and an assistive personnel is generally the appropriate person to perform basic activities of daily living like morning care. There is no indication in the prompt that the personnel lacks the fundamental competency for this role.

Choice B rationale

The right direction or communication requires the nurse to provide a clear, concise description of the task, including its objective, limits, and expectations. Simply instructing the AP to provide morning care to a client with left-sided weakness is insufficient. The AP needs to know specific safety precautions, which side to support, how to position the client, and what specific observations to report back to the nurse. Lack of detail makes this direction incomplete.

Choice C rationale

The right task refers to delegating activities that are repetitive, require little supervision, and do not require nursing judgment or complex application of the nursing process. Providing morning care, which includes bathing and grooming, is within the standard scope of tasks for assistive personnel. Since this is a routine functional task that does not involve clinical assessment or medication administration, the task itself is appropriate for delegation to an AP.

Choice D rationale

The right circumstance involves considering the setting, the stability of the patient, and the available resources. While a patient with left-sided weakness has a physical deficit, providing basic morning care is typically safe if the patient is stable. If the patient's condition were rapidly changing or required complex monitoring during the care, the circumstance might be inappropriate, but the primary issue here is the vague instructions provided by the nurse.