A registered nurse is contemplating delegating the task of administering medications to an Unlicensed Assistant Personnel (UAP). What is the primary question that the registered nurse must ask themselves before proceeding?
Is there adequate supervision available for the UAP?
Has the client’s response and approval to this task been evaluated?
Has the UAP received sufficient training to perform this task?
Does the nurse practice act and healthcare facility policy permit this delegation?
The Correct Answer is D
Choice A rationale:
While adequate supervision is essential for safe delegation, it's not the primary question the nurse should ask. The nurse must first determine if delegation is legally and organizationally permissible.
If the nurse practice act or facility policy prohibits delegation of medication administration to UAPs, no amount of supervision can override those regulations.
Ensuring compliance with legal and professional standards is paramount to protect patient safety and the nurse's license.
Choice B rationale:
The client's response and approval are important considerations, but they don't supersede legal and organizational guidelines. If delegation isn't permitted, the client's preferences cannot justify a violation of these standards. Obtaining client consent is a crucial aspect of ethical care, but it must align with established regulations.
Choice C rationale:
UAP training is crucial for safe delegation, but it's again not the primary question.
If delegation itself isn't allowed, the UAP's level of training becomes irrelevant.
It's essential to verify the UAP's competency only after confirming the legality and organizational acceptability of delegation.
Choice D rationale:
This is the primary question because it addresses the fundamental legality and appropriateness of delegation within the specific context of the nurse's practice and workplace.
Nurse practice acts outline the scope of nursing practice and define which tasks can be delegated to unlicensed personnel.
Healthcare facility policies further delineate delegation guidelines within the institution, ensuring consistency and adherence to best practices.
By consulting these regulations first, the nurse can make an informed decision that aligns with professional standards and protects patient safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
While it's true that gastrointestinal peristalsis may be slowed after surgery, this is not the primary reason for administering a cleansing enema before colon surgery.
The main goal of the enema is to evacuate stool from the colon, ensuring a clear and unobstructed surgical field. This helps to:
Reduce the risk of infection
Facilitate better visualization of the colon during surgery
Minimize the potential for complications
Choice B rationale:
Cleansing enemas are not administered solely based on patient request.
They are prescribed for specific medical reasons, such as preparing for colon surgery or certain diagnostic procedures. Patient preference may be considered, but it's not the determining factor.
Choice C rationale:
While decreased gas and discomfort post-operatively can be a potential benefit of a cleansing enema, it's not the primary reason for its use before colon surgery.
The primary goal, as mentioned earlier, is to clear the colon for a safe and effective surgical procedure. However, reduced gas and discomfort can contribute to a smoother post-operative recovery.
Choice D rationale:
Multiple cleansing enemas are not routinely given to all surgical patients.
The decision to administer an enema is based on the specific type of surgery, the patient's condition, and other factors. In some cases, a single enema may be sufficient, while others may require more than one.
Correct Answer is D
Explanation
Choice A rationale:
Straight catheters are single-use catheters that are inserted into the bladder to drain urine and then immediately removed. They are not suitable for long-term use in clients with obstructed urethras because they would need to be inserted repeatedly, causing discomfort and potential trauma to the urethral tissues. Additionally, the obstruction itself would make it difficult or impossible to insert a straight catheter.
Choice B rationale:
Indwelling urethral catheters, also known as Foley catheters, are inserted into the bladder and remain in place for a period of time. They are typically used for clients who cannot void on their own or who require continuous bladder drainage. However, they are not the best option for clients with obstructed urethras for the following reasons:
The presence of the catheter within the urethra can further irritate or damage the already obstructed tissues. The balloon that holds the catheter in place could potentially worsen the obstruction.
The risk of urinary tract infections (UTIs) is increased with indwelling catheters.
Choice C rationale:
Intermittent urethral catheters are inserted into the bladder to drain urine and then removed. They are typically used by clients who can self-catheterize several times a day. However, they are not suitable for clients with complete prostatic obstruction, as the obstruction would make it difficult or impossible to insert the catheter.
Choice D rationale:
Suprapubic catheters are inserted directly into the bladder through a small incision in the abdomen, bypassing the urethra entirely. This makes them the most suitable option for clients with obstructed urethras, as it eliminates the need to pass a catheter through the obstructed area. Suprapubic catheters offer several advantages in this situation:
They avoid further irritation or damage to the urethral tissues.
They provide a more comfortable and convenient option for long-term bladder drainage.
They may reduce the risk of UTIs compared to indwelling urethral catheters.
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