An experienced charge nurse is providing mentoring to a new charge nurse. The new charge nurse is making the shift assignment for a licensed practical nurse (LPN). Which assignment requires intervention by the experienced nurse?

Providing nasopharyngeal suctioning for a client with pneumonia

Assisting a client who is 24 hours post-operative to use an incentive spirometer

Teaching a new client who has asthma to use a metered-dose inhaler

Collecting a clean catch urine from an ambulatory client with a wound

Answer and Explanation

The Correct Answer is C

Choice A reason: Providing nasopharyngeal suctioning for a client with pneumonia is within the scope of practice for an LPN. This task involves performing a procedure to clear the airway, which is a common responsibility for LPNs.

Choice B reason: Assisting a client who is 24 hours post-operative to use an incentive spirometer is appropriate for an LPN. This task involves helping a client with breathing exercises to prevent post-operative complications, which is a standard part of post-operative care.

Choice C reason: Teaching a new client who has asthma to use a metered-dose inhaler requires educational and assessment skills that typically fall within the scope of practice for a registered nurse (RN). While LPNs can reinforce education, the initial teaching and assessment of a client's understanding should be done by an RN.

Choice D reason: Collecting a clean catch urine from an ambulatory client with a wound is within the scope of practice for an LPN. This task involves obtaining a urine sample, which is a routine procedure that LPNs are trained to perform.

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Correct Answer is C

Explanation

Choice A reason: Containing the fire by closing all the doors is an important step to prevent the spread of fire and smoke, but it is not the priority action. The primary concern should be the safety of the client, which involves removing them from immediate danger.

Choice B reason: Extinguishing the fire using the nearest fire extinguisher is a critical action to control the fire, but it should not take precedence over ensuring the client's safety. The nurse must first ensure that the client is out of harm's way before attempting to put out the fire.

Choice C reason: Removing the client from immediate danger is the priority action. The nurse's first responsibility is to ensure the safety of the client by getting them to a safe area away from the fire. This action minimizes the risk of injury or harm to the client.

Choice D reason: Activating the fire alarm is essential to alert other staff and initiate emergency procedures, but it should be done after ensuring that the client is safe. The primary focus should be on the immediate safety of the client, followed by actions to manage the fire.

A. Taking vital signs and pulse oximetry readings every hour. B. Checking the ventilator setting to make sure they are set as prescribed. C. Observing if the client's endotracheal tube needs suctioning every 2 hours. D. Assessing the client's respiratory status every 4 hours.

Correct Answer is A

Explanation

Choice A reason: Taking vital signs and pulse oximetry readings is a task that can be safely delegated to an experienced unlicensed assistive personnel (UAP). This task involves routine monitoring and does not require clinical judgment or decision-making, making it appropriate for UAPs to handle.

Choice B reason: Checking the ventilator settings requires specific knowledge about ventilator operation and adjustments. This task should be performed by a licensed nurse or respiratory therapist to ensure the settings are correct and appropriate for the client's condition.

Choice C reason: Observing if the client's endotracheal tube needs suctioning requires clinical assessment and judgment to determine the necessity and frequency of suctioning. This task should be performed by a licensed nurse who can evaluate the client's respiratory status and make appropriate decisions.

Choice D reason: Assessing the client's respiratory status involves comprehensive evaluation of the client's breathing, lung sounds, and overall respiratory function. This task requires clinical judgment and should be performed by a licensed nurse who can interpret the findings and respond appropriately.

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