The hospice nurse is working with a volunteer.
Which task could the nurse delegate to the volunteer?

Provide spiritual support for the client and family members.

Check the home to see that all necessary medical equipment is available.

Give the client a sponge bath and rub lotion on the bony prominences.

Sit with the client while they reminisce about life experiences.

Answer and Explanation

The Correct Answer is D

This question involves delegation principles in hospice care. Knowledge of the scope of practice for volunteers versus clinical staff is required. It focuses on identifying non-clinical, psychosocial support tasks appropriate for an unlicensed, non-medical volunteer to perform.

Choice A rationale

Providing spiritual support is a specialized role typically reserved for chaplains or trained clergy members. While volunteers are supportive, this task involves professional spiritual counseling and assessment beyond a general volunteer scope of practice.

Choice B rationale

Assessing the availability and functionality of medical equipment is a clinical responsibility. The nurse or a medical technician must ensure that the home environment is safe and that technical care requirements are met appropriately.

Choice C rationale

Personal care, such as sponge baths and skin assessments for bony prominences, involves physical contact and monitoring for skin breakdown. These tasks are typically delegated to nursing assistants or home health aides, not volunteers.

Choice D rationale

Volunteers in hospice are trained to provide companionship and emotional presence. Sitting with a client to reminisce provides psychosocial support and comfort, which falls within the volunteer's role of enhancing the client's quality of life.

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Correct Answer is A

Explanation

Biliary obstruction prevents the flow of bile into the duodenum, leading to systemic accumulation of bile components. This scenario requires applying knowledge of hepatic and biliary biochemical markers to differentiate between hepatocellular damage and obstructive cholestatic patterns.

Choice A rationale

Biliary obstruction causes cholestasis. Total bilirubin (normal 0.3 to 1.0 mg/dL), alkaline phosphatase (normal 30 to 120 units/L), and GGT (normal 8 to 38 units/L) all rise because they are concentrated in the obstructed bile ducts.

Choice B rationale

In an obstructive process, alkaline phosphatase and GGT are typically significantly elevated alongside bilirubin. Normal levels of these enzymes would point toward a hemolytic cause of jaundice rather than a mechanical obstruction of the biliary tree.

Choice C rationale

Obstructive jaundice is characterized by the accumulation of bile pigments and enzymes in the blood. Low levels of these markers are inconsistent with the clinical presentation of jaundice, dark urine, and pruritus from bile salt deposition.

Choice D rationale

Amylase and glucose elevations are markers for pancreatic dysfunction or metabolic stress. While biliary stones can cause pancreatitis, low AST levels are unlikely in hepatobiliary disease, and these markers do not confirm a biliary obstruction..

A. Monitor and manage airway, breathing, and circulation (ABCs). B. Initiate physical therapy to prevent contractures. C. Administer intravenous antibiotics. D. Perform a comprehensive neuropsychological assessment.

Correct Answer is A

Explanation

Management of traumatic brain injury requires immediate application of the ABC protocol and neurologic monitoring. This scenario necessitates understanding the Glasgow Coma Scale, where a score of 10 indicates moderate brain injury requiring stabilization to prevent secondary hypoxic injury or herniation.

Choice A rationale

Traumatic brain injury can compromise respiratory drive and gag reflexes. Prioritizing airway, breathing, and circulation prevents secondary brain ischemia. Maintaining adequate oxygenation and perfusion is the gold standard for preventing further neuronal damage in patients with moderate head injuries.

Choice B rationale

While preventing contractures is a component of long term rehabilitative care, it is not a priority during the acute emergency phase of a traumatic brain injury. Initial management must focus on life saving physiological stabilization and monitoring.

Choice C rationale

Antibiotics are indicated if there is an open head wound or suspected infection, but they are not the primary focus for a patient presenting with a Glasgow Coma Scale score of 10. Physiological stabilization precedes pharmacological infection prophylaxis.

Choice D rationale

Neuropsychological assessments are complex evaluations of cognitive function typically performed during the recovery or rehabilitation phase. In the emergency department, rapid neurological assessments like the Glasgow Coma Scale and pupil checks are utilized to guide immediate treatment.

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The hospice nurse is working with a volunteer. Which task could the nurse delegate to the volunteer?

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Naxlex Comprehensive Predictor Exams

The nurse suspects a client with jaundice, dark urine, and pruritus has a biliary obstruction. Which set of lab results would support the nurse's suspicion?

Correct Answer is A

Explanation

A client with a traumatic brain injury (TBI) presents to the emergency department with a Glasgow Coma Scale (GCS) score of 10. What should be the nurse's primary focus in this situation?

Correct Answer is A

Explanation

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The hospice nurse is working with a volunteer.
Which task could the nurse delegate to the volunteer?