All patient teaching occurs in a formalized teaching session.

Choice A reason:

Monitoring for shortness of breath or fatigue after ambulation is a critical task that requires clinical judgment and assessment skills. Certified Nurse Assistants (CNAs) are trained to assist with basic patient care activities but are not typically trained to assess and interpret clinical symptoms such as shortness of breath or fatigue. These symptoms could indicate serious complications such as pulmonary embolism or cardiac issues, which require immediate attention from a licensed nurse or physician. Therefore, this task is not appropriate for delegation to a CNA.

Choice B reason:

Determining whether the patient is ready to increase activity involves assessing the patient’s overall condition, including their vital signs, pain levels, and physical capabilities. This requires a comprehensive understanding of the patient’s medical history and current status, which falls within the scope of practice of a registered nurse (RN) or licensed practical nurse (LPN). CNAs do not have the training to make such determinations, as it involves critical thinking and clinical decision-making skills. Therefore, this task should not be delegated to a CNA.

Choice C reason:

Obtaining the patient’s blood pressure and pulse rate after ambulation is a task that is appropriate for delegation to a CNA. CNAs are trained to measure and record vital signs, including blood pressure and pulse rate. This task does not require clinical judgment or decision-making, making it suitable for delegation. The CNA can report the findings to the nurse, who can then interpret the results and make any necessary clinical decisions. This delegation allows the nurse to focus on more complex tasks that require their advanced training and expertise.

Choice D reason:

Instructing the patient on how to use an incentive spirometer involves patient education, which is a responsibility that typically falls to licensed nurses. Proper use of an incentive spirometer is crucial for preventing postoperative complications such as atelectasis and pneumonia. Ensuring that the patient understands how to use the device correctly requires not only demonstrating its use but also assessing the patient’s comprehension and ability to perform the task. This level of patient education and assessment is beyond the scope of practice for a CNA.

Choice A: True

The statement that a patient with alkalosis can develop hyperkalemia is generally incorrect. Alkalosis, which is a condition characterized by a higher-than-normal pH in the blood, typically leads to hypokalemia rather than hyperkalemia. This occurs because alkalosis causes potassium to shift from the extracellular fluid into the cells, reducing the plasma potassium concentration. Therefore, it is uncommon for alkalosis to result in hyperkalemia.

Choice B: False

The correct answer is that a patient with alkalosis is unlikely to develop hyperkalemia. Alkalosis usually causes a decrease in plasma potassium levels, leading to hypokalemia. This is due to the movement of potassium ions into the cells in exchange for hydrogen ions, which are moved out of the cells to help buffer the increased pH. Consequently, the plasma potassium concentration drops, making hyperkalemia an unlikely outcome in the presence of alkalosis.

The next 3 questions relate to this case study:

Exhibits

Select 4 appropriate interventions for the prevention and management of chemotherapy-induced nausea and vomiting (CINV) in Ms. Anderson.