A nurse is considering the delegation of administering topical medications to an unlicensed assistive personnel (UAP). What is the first query the nurse must ask herself before doing so?
Does the nurse practice act and agency policy allow this delegation?
Has the unlicensed assistive personnel been trained to perform the task?
Is appropriate supervision available for the unlicensed assistive personnel?
Has the nurse evaluated the client's response to this treatment in the past? . . .
The Correct Answer is A
Choice A rationale
The nurse practice act and agency policy provide the legal and organizational framework for nursing practice and delegation. Determining if the delegation of topical medication administration is permissible under these guidelines is the foundational first step to ensure legality and adherence to established protocols.
Choice B rationale
Assessing the UAP's training is crucial for safe delegation, but it's secondary to ensuring that the task is delegable in the first place according to legal and policy guidelines. Training is irrelevant if the task cannot be delegated.
Choice C rationale
Ensuring appropriate supervision is essential for delegated tasks, but again, it's contingent on whether the task can be legally and organizationally delegated. Supervision protocols come into play after the initial permissibility of delegation is established.
Choice D rationale
Evaluating the client's past response to the treatment is important for ongoing care but doesn't determine the initial delegability of the task to a UAP. The focus of the first question is on the legal and policy aspects of delegation. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Before delegating any nursing task, the nurse must first determine if the action is permissible under the state's nurse practice act and the employing agency's policies. These regulations define the scope of practice for nurses and the tasks that can be safely and legally delegated to unlicensed personnel. If delegation is not allowed by these governing bodies, the subsequent questions become irrelevant.
Choice B rationale
While it is crucial to ensure that the UAP has been adequately trained and is competent to perform the delegated task safely and correctly, this consideration comes after establishing the legality and permissibility of the delegation according to the nurse practice act and agency policy. Training is important for safe implementation but not the initial determining factor.
Choice C rationale
Appropriate supervision is necessary when delegating tasks to UAPs to ensure client safety and provide guidance. However, the ability to delegate the task itself must first be established by legal and policy guidelines. Supervision is a component of safe delegation but not the primary question determining if delegation is even an option.
Choice D rationale
Evaluating the client's past response to a treatment might inform how the task is performed or any specific observations needed, but it does not determine the fundamental question of whether the task can be delegated to a UAP in the first place. Legal and policy frameworks dictate the scope of delegation, regardless of the client's history. .
Correct Answer is D
Explanation
Choice A rationale
Refusing to administer the medication without further investigation could jeopardize the client's timely treatment. While safety is paramount, the nurse's initial action should be to gather more information rather than outright refusal, which could delay necessary care.
Choice B rationale
Administering a medication that appears to be abnormally high without verifying the order is unsafe and could lead to serious adverse effects for the client. Nurses have a professional responsibility to question orders that seem incorrect or potentially harmful.
Choice C rationale
Documenting concerns is an important step in the process, but it is not the best *next* action. While documentation is crucial for legal and communication purposes, directly addressing the potentially erroneous order with the prescriber takes precedence to ensure patient safety.
Choice D rationale
Querying the physician about the order is the most appropriate immediate action. This allows the nurse to clarify the dosage, route, and rationale for the high dose. It opens a dialogue with the prescriber to confirm the order's accuracy or identify a potential error, directly addressing the safety concern.
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