A nurse is planning to assign tasks for a group of clients.Which of the following tasks should the nurse plan to assign to an assistive personnel (AP)? (Select all that apply)
Weigh a client who has heart failure.
Provide discharge instructions for a client who has a new skin graft.
Perform an admission assessment on a client.
Ambulate an older adult client who has hypertension.
Check a blood product with another nurse prior to administration.
Correct Answer : A,D
Choice A rationale
Weighing a client with heart failure is a non-invasive and routine task that can be performed by an assistive personnel (AP). Accurate daily weights are essential for monitoring fluid balance in these clients.
Choice B rationale
Incorrect, as providing discharge instructions for a client requires professional nursing judgment and assessment, tasks outside the scope of practice for APs.
Choice C rationale
Incorrect, as performing an admission assessment requires critical thinking and clinical judgment, which are responsibilities of a licensed nurse.
Choice D rationale
Ambulating an older adult client with hypertension can be safely done by an AP. This helps in maintaining the client's mobility and preventing complications such as blood clots and muscle atrophy.
Choice E rationale
Incorrect, as checking a blood product with another nurse prior to administration involves a critical safety check that must be performed by licensed nurses to ensure the right blood is given to the right patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
DIC is not controllable with lifelong heparin usage. Heparin may be used to manage DIC, but it is not a permanent solution, and the underlying cause of DIC must be addressed.
Choice B rationale
DIC is caused by abnormal coagulation involving fibrinogen. It is characterized by widespread activation of the clotting cascade, leading to both clot formation and bleeding due to consumption of clotting factors and platelets.
Choice C rationale
DIC is not a genetic disorder involving a vitamin K deficiency. It is an acquired condition resulting from severe illnesses or injuries that trigger abnormal clotting and bleeding processes.
Choice D rationale
DIC is not characterized by an elevated platelet count. Instead, it involves thrombocytopenia due to the consumption of platelets in widespread clotting, leading to a decreased platelet count.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Administering IV opioids can help manage the intense pain associated with frostbite, improving patient comfort during rewarming and recovery.
Choice B rationale
After rewarming, the extremity should be elevated, not lowered, to reduce edema by encouraging fluid return to the central circulation.
Choice C rationale
Immersing hands and feet in warm water is a crucial step in the rewarming process, which helps restore blood flow and prevent further tissue damage.
Choice D rationale
Elevating affected limbs after rewarming helps reduce edema and prevents further swelling and complications.
Choice E rationale
Tetanus prophylaxis is recommended in frostbite cases as frostbite injuries can break the skin, increasing the risk of tetanus infection. Hence, avoiding tetanus prophylaxis is incorrect.
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