The licensed practical nurse has been pulled to the medical surgical unit to take clients. Which clients should the charge nurse delegate to the licensed practical nurse? Select All That Apply.

The client with a history of asthma who is being treated for acute asthma exacerbation.

The client admitted for wound care to the left lower extremity after wound debridement.

The client transferred from the progressive unit who is to be discharged the next day.

The client who is transferred to the unit 2 hours after an open appendectomy.

The client who requires frequent assessments after a change in their level of consciousness.

Answer and Explanation

Correct Answer : B,C,D

Effective delegation is based on the scope of practice and the stability of the client’s physiological status. Licensed Practical Nurses (LPNs) are qualified to care for clients with stable, predictable outcomes and perform standardized procedures such as wound care and monitoring post-operative progress. The Registered Nurse (RN) must retain responsibility for clients requiring complex clinical judgment, initial assessments of instability, or frequent evaluations of a deteriorating neurological status.

Rationale:

A. An acute asthma exacerbation is an unstable respiratory condition that can rapidly progress to status asthmaticus or respiratory failure. This client requires continuous assessment of lung sounds, work of breathing, and the potential for titrating emergency medications. Because the outcome is currently unpredictable, this client must remain under the direct care of an RN.

B. Wound care following a debridement is a standardized nursing procedure that falls within the LPN’s scope of practice. The client’s condition is relatively stable, and the treatment plan involves established protocols for infection control and dressing changes. The LPN is well-trained to observe the wound bed for healing and report any significant changes to the RN.

C. A client who is ready for discharge the following day is considered physiologically stable. The nursing care focuses on reinforcing previous education and completing routine tasks. Since the acute phase of their illness has passed and their response to treatment is well-documented, they are an appropriate assignment for an LPN.

D. Two hours after an open appendectomy, a client has typically bypassed the immediate post-anesthesia recovery risks. While they require monitoring for pain and surgical site integrity, their care follows a predictable postoperative pathway. LPNs can safely monitor vital signs and surgical dressings for clients who have achieved initial stability following uncomplicated procedures.

E. A change in the level of consciousness (LOC) indicates a potentially life-threatening neurological or metabolic crisis. This client requires high-level assessment skills and rapid clinical reasoning to identify the underlying etiology. Because the situation is acutely unstable and requires frequent, complex evaluations, it cannot be delegated to an LPN.

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

Explanation

Nurse management functions in clinical settings involve leadership, resource allocation, staff supervision, budget planning, and ensuring safe, efficient delivery of care while adhering to organizational policies, professional standards, and ethical workforce management principles.

Rationale:

A. This is incorrect because nurse managers do not independently develop legislation or policies exclusively for nurses. Policy development is done at organizational, institutional, or governmental levels, not solely by a unit-level nurse manager.

B. This is correct because nurse managers are responsible for leadership and supervision, guiding staff performance, coordinating care delivery, and ensuring that team members fulfill their assigned clinical roles effectively and safely.

C. This is incorrect because nurse managers oversee staffing for the entire unit, including both licensed and unlicensed personnel, not only UAPs. Staffing decisions require balancing skill mix and patient acuity needs.

D. This is incorrect because terminating employees based on disagreement violates ethical leadership principles, employment law, and organizational due process. Nurse managers must follow formal disciplinary procedures, not personal judgment.

E. This is correct because nurse managers are responsible for budget preparation and resource management, ensuring staffing levels and supply allocation align with unit needs, patient acuity, and cost-effective healthcare delivery.

A. The 42-year-old client who has a temperature of 100.2°F (37.8°C) B. The 10-month-old infant who has a pulse rate of 140 beats per minute. C. The 3-year-old toddler who has a respiratory rate of 28 breaths per minute D. The 24-week gestational woman who has a blood pressure of 142/96 mm Hg

Correct Answer is D

Explanation

Vital sign prioritization relies on detection of hemodynamic instability, gestational hypertensive disorders, systemic infection indicators, and age-adjusted physiologic vital ranges. In pregnancy, elevated blood pressure after 20 weeks suggests preeclampsia risk, uteroplacental insufficiency, and potential progression to eclampsia or organ dysfunction.

Rationale:

A. Temperature of 100.2°F (37.8°C) indicates low-grade pyrexia, commonly associated with mild viral illness or early infection. It does not meet criteria for systemic inflammatory response or sepsis. The client is stable and does not require immediate assessment.

B. A pulse of 140 beats per minute in a 10-month-old infant may be within normal physiologic range depending on activity, crying, or stress. Infants commonly have heart rates between 100–160 bpm. No immediate cardiovascular instability is indicated.

C. A respiratory rate of 28 breaths per minute in a 3-year-old toddler falls within normal pediatric range (20–30 breaths per minute). There are no signs of respiratory distress such as retractions or hypoxia. This finding is physiologically appropriate for age.

D. A blood pressure of 142/96 mm Hg at 24 weeks gestation indicates gestational hypertension, highly suspicious for evolving preeclampsia. This condition poses immediate risk of maternal-fetal compromise including seizure, placental abruption, and end-organ damage. This client requires urgent evaluation.

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The licensed practical nurse has been pulled to the medical surgical unit to take clients. Which clients should the charge nurse delegate to the licensed practical nurse? Select All That Apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which duties are required of a nurse manager in a clinical setting? Select All That Apply.

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

Explanation

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Correct Answer is D

Explanation

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