A nurse is delegating client care to an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?

Administering vaginal cream to a client who has a vaginal infection

Providing postmortem care for a client who has just died

Suctioning a tracheostomy for a client who has a recent head injury

Changing a peripheral IV dressing for a client who is postoperative

Answer and Explanation

The Correct Answer is B

A)   Administering vaginal cream to a client who has a vaginal infection - This task involves administration of medication, which typically falls within the scope of licensed nursing practice.

B)   Providing postmortem care for a client who has just died - When delegating tasks to assistive personnel, nurses can assign activities such as providing postmortem care.
C)   Suctioning a tracheostomy for a client who has a recent head injury - Suctioning a tracheostomy requires specialized training and is typically performed by licensed nursing staff.
D)   Changing a peripheral IV dressing for a client who is postoperative - Changing an IV dressing is a task that require skills of a licensed nurse hence cannot be delegated to an assistive personnel.

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Correct Answer is ["B","C","E"]

Explanation

A) A client reports being dissatisfied with the temperature of the meals provided. - This situation does not pose a risk to the client's safety or result in harm, so an incident report is not necessary.

B) A client receives burns from a heating pad. - Any incident resulting in harm to the client, such as burns from a heating pad, should be documented with an incident report.
C) A client becomes disoriented and falls out of bed. - Falls resulting in injury or disorientation require documentation via an incident report.
D) A client is unable to afford the physical therapy that the provider recommends. - Financial constraints do not necessitate an incident report.
E) A client's visitor becomes dizzy and faints in the client's room. - Incidents involving visitors, especially if they occur in the client's presence, should be documented with an incident report.

A. Place the specimen in a clean specimen cup. B. Clamp the catheter tubing below the needleless port. C. Clamp the catheter tubing for 60 min. D. Remove 45 mL of urine from the catheter with a syringe.

Correct Answer is B

Explanation

A) Place the specimen in a clean specimen cup. - Urine collected from an indwelling urinary catheter should be obtained using a sterile technique, not placed directly into a clean specimen cup.
B) Clamping the catheter tubing for 10–30 minutes before collecting the sample allows fresh urine to accumulate in the tubing, ensuring a more accurate culture result. The urine should be collected from the designated port using aseptic technique, not from the catheter bag, as stagnant urine may contain contaminants.

C) Clamp the catheter tubing for 60 min. - Clamping the tubing for an extended period can cause urinary retention and discomfort for the client. It is not appropriate for collecting a urine specimen.
D) Only 3–5 mL of urine is needed for a culture.The nurse should collect the appropriate small amount to avoid unnecessary removal of urine.

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A nurse is delegating client care to an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a group of clients. For which of the following situations should the nurse complete an incident report? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

A nurse is collecting a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

13. A nurse is preparing to provide tracheostomy care to a client who has a chronic tracheostomy. In which order should the nurse complete the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

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