A nurse is caring for a client who is scheduled for a hysterectomy and has signed the informed consent form. The client tells the nurse she is unsure about having the procedure. Which of the following responses should the nurse make?

Rationale:

A. Inserting a nasogastric (NG) tube is an invasive procedure that requires knowledge of anatomy, patient assessment, and potential complications. It involves clinical judgment and skill; therefore, it cannot be delegated to an assistive personnel (AP). Only licensed nurses with the necessary competency should perform this task.

B. Performing a simple dressing change is considered a routine, non-invasive task that follows established protocols and does not require independent nursing judgment. An AP can safely remove and replace clean dressings or assist with basic wound care, allowing the nurse to focus on more complex care, assessments, or procedures that require critical thinking.

C. Providing advice to a client over the telephone involves assessing symptoms, prioritizing care, and making clinical decisions. This is within the scope of practice of a registered nurse, as it requires professional judgment, and cannot be delegated to an AP. Providing advice incorrectly could lead to harm.

D. Teaching a client how to walk on crutches is an educational intervention that requires the nurse to assess the client’s physical ability, balance, and coordination. The nurse also ensures safety and correct technique. This task cannot be delegated to an AP, as it requires assessment, instruction, and judgment.

Rationale:
A. Admitting clients directly to positive-pressure rooms is inappropriate in chemical exposure incidents because positive pressure could spread contaminants to other areas. Initial decontamination should occur outside the facility.

B. Placing shower caps over hair does not remove chemical contaminants. Decontamination requires removing the source of exposure, not just covering it.

C. Scrubbing clients’ skin with betadine solution is not recommended. Harsh antiseptics can cause chemical reactions or skin injury. Decontamination should be performed with copious amounts of water.

D. Removing contaminated clothing is the priority step in chemical exposure incidents. This eliminates the primary source of chemical contamination, reducing absorption and preventing further harm to the client and the environment. Clothing should be carefully removed and contained to prevent secondary contamination.