A nurse working on a medical-surgical unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?

A client who is receiving heparin and has an aPTT of 34 seconds (30 to 40 seconds).

A client who has type 1 diabetes mellitus and uses an insulin pump.

A client who has orthostatic hypotension and is receiving IV fluids,

A client who is at risk for pressure injuries and has an albumin level of 4.2 g/dL (3.5 to 5 g/dL).

Answer and Explanation

The Correct Answer is B

A. The client’s aPTT is within the therapeutic range for heparin, so immediate interdisciplinary discussion is not required.

B. Clients using insulin pumps require coordination between the nurse, endocrinologist, and diabetes educator to ensure safe insulin administration and blood glucose management, making an interdisciplinary conference appropriate.

C. Orthostatic hypotension being managed with IV fluids can typically be addressed within routine nursing care without needing an interdisciplinary meeting.

D. The client’s albumin level is within normal limits, and risk for pressure injuries can be managed with standard nursing interventions without requiring a conference.

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Correct Answer is B

Explanation

Choice A reason: This is not the correct choice because checking on a client whose telemetry monitor is continuously beeping is a task that requires nursing judgment and assessment skills. The nurse should not delegate this task to the AP, but rather perform it themselves or notify the health care provider.

Choice B reason: This is the correct choice because tagging a malfunctioning piece of equipment as broken is a task that does not involve direct client care or clinical decision making. The nurse can delegate this task to the AP, who can follow the facility's policy and procedure for reporting and removing faulty equipment.

Choice C reason: This is not the correct choice because determining whether an oxygen flow meter is accurately set at 2 L/min via nasal cannula is a task that involves administering medication and monitoring the client's oxygenation status. The nurse should not delegate this task to the AP, but rather perform it themselves and document the results.

Choice D reason: This is not the correct choice because instructing a client about the use of an incentive spirometer is a task that involves providing client education and evaluating the client's understanding and compliance. The nurse should not delegate this task to the AP, but rather perform it themselves and document the outcomes.

A. Allow the AP to document the vital signs prior to logging out. B. Log out so the AP can log in to document the vital signs. C. Offer to chart the vital signs for the AP. D. Recommend the AP come back later when the record is available.

Correct Answer is B

Explanation

Choice A reason: Allowing the AP to document the vital signs prior to logging out is not a correct action, as it violates the principles of confidentiality and accountability. The nurse should not share their login credentials or allow anyone else to use their electronic record.

Choice B reason: Logging out so the AP can log in to document the vital signs is the correct action, as it ensures that the documentation is accurate, timely, and secure. The nurse should log out of the electronic record after completing their charting and allow the AP to log in using their own credentials.

Choice C reason: Offering to chart the vital signs for the AP is not a correct action, as it delays the documentation and increases the risk of errors. The nurse should not chart the vital signs for the AP, as they are not the ones who obtained them.

Choice D reason: Recommending the AP come back later when the record is available is not a correct action, as it also delays the documentation and reduces the availability of the electronic record. The nurse should not make the AP wait for the record, as it may affect the continuity of care.

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A nurse working on a medical-surgical unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is B

Explanation

A nurse has just completed assessment charting on the electronic record for an assigned client. An assistive personnel (AP) who just measured the client's vital signs asks to chart them while the nurse is still logged into the record. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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