An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP?

Palpate for possible bladder distention.

Observe the incision site.

Change the abdominal dressing.

Obtain vital signs.

Answer and Explanation

The Correct Answer is D

Rationale:

A. Palpate for possible bladder distention is a task that requires nursing assessment skills and should be done by the nurse.

B. Observe the incision site is a nursing task that involves assessing for signs of complications.

C. Change the abdominal dressing requires sterile technique and should be done by a nurse to prevent infection and ensure proper care.

D. Obtain vital signs is within the AP’s scope of practice and is a task that can be delegated. It is important for monitoring the client’s status and identifying potential issues.

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Correct Answer is A

Explanation

Rationale:

A. Nuclear family refers to a family unit consisting of two parents and their children. This definition matches the description provided by the parents.

B. Intergenerational family includes multiple generations living together or having frequent contact, which is not the case here.

C. Blended family involves parents who have remarried and may include children from previous relationships, which does not apply here.

D. Extended family includes additional relatives beyond the nuclear family, such as grandparents, aunts, or uncles, which is not the case in this scenario.

A. Medication for elevated temperature B. Insertion of NG tube for decompression C. Oxygen 2 to 4 L/min via nasal cannula D. Insertion of urinary catheter E. Evaluation of surgical wound drain

Correct Answer is ["A","E"]

Explanation

A. While the client's temperature is not extremely high, it is elevated and persistent. Requesting an antipyretic or further evaluation may be warranted to prevent potential complications.

B. Insertion of NG tube for decompression is not necessary as the client is passing flatus and has bowel sounds in all quadrants, indicating normal gastrointestinal function.

C. Oxygen 2 to 4 L/min via nasal cannula is not necessary since the client's SpO2 levels are within normal range on room air.

D. The client's urinary output is adequate (400 mL over 6 hours), so a catheter is not required at this time.

E. The lack of drainage from the wound drain could indicate a problem that requires immediate attention. This could prevent complications like infection or fluid accumulation.

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An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on a pediatric unit is caring for a child and his family. His parents define family as a husband, wife, and child. This definition is which type of family form?

Correct Answer is A

Explanation

A nurse is caring for a client who is postoperative. Exhibits Which of the following should the nurse request as a recommendation in an SBAR report to the provider? Select All That Apply

Correct Answer is ["A","E"]

Explanation

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