It is most important for the registered nurse (RN) who is working on a medical unit to provide direct supervision in which situation?

A practical nurse is preparing to assist the healthcare provider with a lumbar puncture at the bedside.

A postpartum nurse pulled to the unit needs to start a transfusion of packed red blood cells.

An unlicensed assistive personnel is preparing to weigh an obese bedfast client using a bed scale.

A graduate nurse needs to access a client's implanted port to start an infusion of Ringer's Lactate.

Answer and Explanation

The Correct Answer is A

Choice A: A practical nurse assisting the healthcare provider with a lumbar puncture at the bedside is a high-risk procedure that requires direct supervision by an RN or a qualified healthcare provider. The RN should ensure the procedure is performed safely and effectively, as it involves potential risks and complications.

Choice B: Starting a transfusion of packed red blood cells is an important nursing intervention, but it does not necessarily require direct supervision by an RN, especially if the nurse has been trained and is competent in administering blood transfusions.

Choice C: Weighing an obese bedfast client using a bed scale is a routine nursing task that can be performed by unlicensed assistive personnel (UAP) with appropriate training. While the RN should ensure that the UAP is properly trained, direct supervision may not be required for this specific task.

Choice D: Accessing a client's implanted port to start an infusion of Ringer's Lactate is a nursing task that can be performed by a graduate nurse, especially if they have received appropriate training and competency validation. Direct supervision by an RN may not be necessary in this situation.

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Correct Answer is A

Explanation

A. Document the findings in the record – A bluish-black discoloration over the lumbosacral area is most likely a Mongolian spot, a benign congenital birthmark commonly seen in infants with darker skin tones. It does not require intervention, only documentation.
B. Report possible child abuse to protective services – Mongolian spots may resemble bruises, but they are not a sign of abuse. Reporting without further assessment is inappropriate.
C. Gently rub the area with skin cream to promote healing – Mongolian spots are not injuries and do not require treatment.
D. Ask the mother about the discoloration – While obtaining history is important, Mongolian spots are well-known benign findings that do not require further clarification from the parent.

A. Double room with a 4-month-old who has RSV. B. Private room with negative air pressure. C. Private room furthest from the nurses station. D. Double room with a 6-month-old on droplet precautions.

Correct Answer is A

Explanation

A. Double room with a 4-month-old who has RSV: This is the best option. RSV is highly contagious but children with the same infection may be cohorted (roomed together) to minimize transmission to other clients and conserve private rooms for uninfected or immunocompromised children.
B. Private room with negative air pressure: Negative pressure rooms are reserved for airborne infections like tuberculosis, not RSV, which is spread through contact and droplets.
C. Private room furthest from the nurses station: While a private room is acceptable, location relative to the nurses station is not a priority. Cohorting with another RSV-positive child is equally effective.
D. Double room with a 6-month-old on droplet precautions: Unless the other child also has confirmed RSV, placing them together risks spreading the virus if their infections differ. Droplet precautions alone do not confirm the same diagnosis.

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It is most important for the registered nurse (RN) who is working on a medical unit to provide direct supervision in which situation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During assessment of a 2-month-old infant, the nurse notices a bluish-black discoloration over the lumbosacral area. Which action should the nurse take?

Correct Answer is A

Explanation

The nurse-manager of a pediatric unit needs to assign a room for a 6-month-old diagnosed with respiratory syncytial virus (RSV). Which room assignment is best for the nurse-manager to make?

Correct Answer is A

Explanation

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Which statement by an adolescent client with acute osteomyelitis in the right leg indicates the best understanding of the appropriate activity level after discharge?

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