A performance appraisal states that the manager often underdelegates.
What is a potential cause of this delegation error?
A democratic leadership style.
Sufficient time to accomplish unit goals alone.
A high degree of trust in subordinates.
A need for perfectionism.
The Correct Answer is D
Choice A rationale
A democratic leadership style typically encourages participation, collaboration, and the distribution of tasks among team members. This style is characterized by shared decision-making and is more likely to result in effective delegation rather than underdelegation. Leaders who utilize this approach recognize the strengths of their staff and empower them to take on responsibilities, which contrasts with the tendency to hold onto tasks that is seen in those who underdelegate.
Choice B rationale
Nurse managers in modern healthcare environments rarely have sufficient time to accomplish all unit goals and administrative tasks without assistance. The demands of patient care, staffing, and quality improvement require a team-based approach. Underdelegation often stems from a misconception about time management or a lack of trust in others, rather than an actual abundance of time. Believing one can do it all alone often leads to manager burnout and inefficiency.
Choice C rationale
A high degree of trust in subordinates is a primary facilitator of successful delegation. When a manager trusts the competence and reliability of their staff, they are much more comfortable assigning tasks and providing autonomy. Underdelegation is frequently driven by a lack of trust or a fear that the staff will not perform the task to the manager's standards. Therefore, high trust would lead to more delegation, not a pattern of underdelegating.
Choice D rationale
Perfectionism is a common psychological barrier to effective delegation. Managers with perfectionist tendencies may feel that they are the only ones capable of performing a task correctly or to their specific standards. This "if you want it done right, do it yourself" mentality leads to the manager becoming overwhelmed with tasks that could be safely handled by others. This need for total control prevents staff development and creates bottlenecks in unit productivity and workflow.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Breach of duty occurs when a healthcare professional fails to act within the established standard of care. In a malpractice suit, the plaintiff must prove that the nurse had a duty to the patient and that this duty was violated. Sexually explicit remarks clearly violate professional boundaries and the standard of care. Since a breach of duty is a core component of malpractice, it would apply in this situation to support the patient's legal claim.
Choice B rationale
Causation is the legal link between the professional's breach of duty and the resulting harm to the patient. To win a malpractice case, the patient must demonstrate that the nurse's specific actions directly caused the injury. In this scenario, the patient must show that the remarks led to psychological or emotional trauma. Because causation is a mandatory element for proving malpractice, it applies here and would be used to support the patient's legal argument.
Choice C rationale
Injury refers to the actual physical, emotional, or financial harm suffered by the patient due to the professional's negligence. Without proof of injury, a malpractice claim cannot be sustained. Given the patient's history of sexual abuse, explicit remarks are highly likely to cause significant emotional distress or psychological setbacks. Since injury is a required element for a successful malpractice suit, it applies to this situation and supports the patient's claim for damages.
Choice D rationale
Malpractice is technically a form of negligence, which is an unintentional tort, whereas intentional misconduct or criminal battery involves purposeful actions to cause harm or unwanted contact. While the nurse's behavior is egregious and may lead to separate criminal charges or intentional tort claims, these specific categories do not define the legal framework of professional malpractice. Therefore, intentional misconduct does not technically apply to the definition of malpractice, which focuses on failures in professional standards.
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale
Teaching is a complex nursing function that requires specialized knowledge, clinical judgment, and the ability to evaluate the learner's comprehension. This is especially true for a patient with a spinal cord injury and a language barrier. Self-catheterization involves sterile or clean technique and significant patient education. Delegating this to unlicensed assistive personnel is inappropriate because they lack the educational background to assess learning needs or provide the required medical instruction for invasive procedures.
Choice B rationale
The care of a patient who is rapidly deteriorating is inherently unstable and unpredictable. Nursing delegation rules strictly prohibit assigning tasks for unstable patients to unlicensed personnel because these situations require frequent, high-level clinical assessments and rapid decision-making. A head injury that is worsening could indicate rising intracranial pressure or hemorrhage, requiring the advanced skills of a registered nurse to monitor neurological status and intervene immediately. Unlicensed staff are not trained for such critical monitoring.
Choice C rationale
Providing one-to-one observation for a suicidal patient is a task that is frequently delegated to unlicensed assistive personnel or psychiatric technicians in many clinical settings. The primary goal is maintaining patient safety through constant visual contact, which does not inherently require nursing assessment or medical intervention. While the registered nurse remains responsible for the overall treatment plan and the patient's mental health assessment, the physical act of sitting with the patient is a delegable safety task.
Choice D rationale
Basic hygienic care, such as bathing or skin care, for a stable patient who has suffered a myocardial infarction is a standard task that can be safely delegated. Since the patient is noted to be stable, the risk of a sudden cardiac event during routine care is lower, and the task does not require complex clinical judgment. The unlicensed personnel can perform the ADLs while reporting any changes in the patient's comfort or skin integrity back to the RN.
Choice E rationale
Assessment is a fundamental part of the nursing process that cannot be delegated to unlicensed personnel. Admission assessments involve gathering a health history, performing a physical examination, and identifying potential nursing diagnoses. Patients entering through the Emergency Department are often undiagnosed and potentially unstable. The registered nurse must use clinical reasoning to interpret subjective and objective data to prioritize care. Unlicensed staff lack the legal scope and clinical training to perform these essential diagnostic evaluations.
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