A nurse on a medical-surgical unit is caring for a client who asks about advance directives and states that he wants to appoint a health care proxy. Which of the following responses should the nurse make?

a. A client who is scheduled for an endoscopy later today and requires an enema:

Administering an enema involves basic nursing care, which falls within the scope of practice of an LPN. LPNs are trained to perform such tasks under the supervision of a registered nurse (RN).

b. A newly admitted client who has sickle cell anemia and requires the development of an initial plan of care:

Developing an initial plan of care involves comprehensive assessment, critical thinking, and the ability to formulate nursing diagnoses and interventions. This task typically falls within the scope of practice of the RN, who has advanced education and training in care planning and coordination.

c. A client who had a myocardial infarction and will be transferring to the unit from the CCU:

Transferring a client from one unit to another may involve coordinating care, ensuring continuity of care, and communicating with other members of the healthcare team. This task may be more appropriate for an RN, who has the knowledge and skills to manage such transitions safely and effectively.

d. A newly admitted client who has diabetes mellitus and requires initial teaching on self-administration of insulin:

Providing client education, especially on self-care management such as insulin administration, requires knowledge of disease processes, medication administration, and patient teaching techniques. This task is typically within the scope of practice of the RN, who can assess the client's learning needs, provide tailored education, and evaluate the client's understanding and competency.

a. Is the client’s family present so the AP can show them how to turn the client:

While involving the client's family in care can be beneficial for education and support, this assessment does not directly pertain to the AP's ability to provide care or the client's immediate needs.

b. Does the AP have time to change the client’s central IV-line dressing after turning her:

This assessment is relevant to the AP's workload and scheduling, but it does not directly address the client's care needs related to bathing and turning.

c. Has data been collected about specific client needs related to turning:

This assessment is crucial before delegating care. The nurse should ensure that relevant information about the client's condition, including any specific needs or considerations related to turning, has been gathered and communicated to the AP to provide appropriate care.

d. Has the AP checked the client’s pain level prior to turning her:

This assessment is essential to ensure the client's comfort and safety during care activities. Assessing the client's pain level before turning helps prevent exacerbation of pain and ensures that turning is performed with appropriate consideration for the client's comfort.