A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following actions should the nurse take first?

Refer the AP to the facility procedure manual.

Instruct the AP to request assistance when unsure about a task.

Demonstrate the proper client transfer technique for the AP.

Help the AP assist the client with the transfer.

Answer and Explanation

The Correct Answer is D

A. Referring the AP to the facility procedure manual does not provide immediate support or correct the unsafe practice observed. It may not address the situation in real-time.

B. While instructing the AP to request assistance is important for future situations, it does not immediately rectify the incorrect technique being used at that moment.

C. While demonstrating the correct technique is valuable, the immediate priority is ensuring the client’s safety by assisting with the current transfer. A demonstration should follow after the immediate risk has been managed.

D. The first priority is client safety. If the nurse manager observes an incorrect transfer technique, the immediate response should be to intervene to prevent injury to the client or the AP. Assisting with the transfer ensures that the client is safely positioned while also providing an opportunity to correct the AP's actions in real time.

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Correct Answer is B

Explanation

A. Changing total parenteral nutrition (TPN) tubing every 48 hours is incorrect. According to most guidelines, TPN tubing should be changed every 24 hours to reduce the risk of infection.

B. Changing peripheral IV primary tubing every 96 hours is a recommended practice in many healthcare settings. It balances infection prevention with cost-effectiveness and is widely accepted for maintaining IV line sterility.

C. Replacing peripheral IV solution bags every 96 hours would not be appropriate, as IV fluid bags should typically be replaced every 24 hours to prevent bacterial contamination.

D. Replacing TPN solution bags every 48 hours is not advisable, as TPN solutions should be replaced every 24 hours to minimize infection risks associated with high-sugar content solutions.

A. The client expresses the desire to join a support group. B. The client requires assistance with completing oral hygiene. C. The client has difficulty ambulating with a walker. D. The client reports pain when chewing solid foods.

Correct Answer is B

Explanation

A. Expressing a desire to join a support group indicates a need for emotional support but does not specifically require occupational therapy.

B. Requiring assistance with completing oral hygiene indicates that the client may benefit from occupational therapy to improve fine motor skills and daily living activities, making this the most relevant finding for the referral.

C. Difficulty ambulating with a walker may require physical therapy rather than occupational therapy, as it focuses on mobility rather than daily tasks.

D. Reporting pain when chewing solid foods suggests a need for dietary modifications or possibly speech therapy, but it does not directly indicate a need for occupational therapy.

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A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following actions should the nurse take first?

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