The nurse and licensed practical nurse (LPN) are caring for a group of clients on a medical-surgical unit. The following tasks have been ordered on their clients. Which task would be most appropriate to assign to the LPN?
Administer a tap water enema to a client who is constipated.
Assess a new admission client who just transferred to the unit.
Evaluate a client reporting new onset chest pain.
Administer Morphine 1 mg IV push to a client for pain.
The Correct Answer is A
Choice A reason: Administering a tap water enema is within the scope of practice for an LPN. This task is a routine procedure that does not require the clinical judgment of a registered nurse (RN). The LPN can safely perform this task under the supervision of the RN.
Choice B reason: Assessing a new admission client is a comprehensive process that involves obtaining a detailed medical history, performing a thorough physical assessment, and developing an initial plan of care. This task requires the clinical judgment and decision-making skills of an RN, making it inappropriate to delegate to an LPN.
Choice C reason: Evaluating a client with new onset chest pain is a critical task that requires immediate attention and advanced assessment skills. It involves determining the cause of the chest pain, assessing the severity, and initiating appropriate interventions. This task must be performed by an RN due to the potential for serious underlying conditions such as myocardial infarction.
Choice D reason: Administering Morphine IV push requires specific knowledge about the medication, potential side effects, and monitoring for adverse reactions. This task involves clinical judgment and decision-making, making it inappropriate to delegate to an LPN. The RN is responsible for administering medications that require close monitoring and assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Fidelity refers to the principle of keeping promises and being faithful to one's commitments. It involves loyalty and maintaining trust in the nurse-client relationship. While fidelity is important, it is not the most relevant principle in the context of respecting a client's decision to discontinue treatment.
Choice B reason: Autonomy is the ethical principle that recognizes an individual's right to make their own decisions and choices regarding their healthcare. Respecting a client's autonomy means acknowledging their right to refuse or discontinue treatment, even if the healthcare team disagrees with their decision. In this case, continued treatment against the client's wishes would violate their autonomy.
Choice C reason: Justice refers to the principle of fairness and equality in the distribution of resources and care. It involves ensuring that all clients receive equitable treatment. While justice is a key ethical principle, it is not the primary issue when considering the client's wish to discontinue ventilator support.
Choice D reason: Veracity refers to the principle of truthfulness and honesty in communication with clients. It involves providing accurate and complete information to enable clients to make informed decisions. While veracity is essential, it does not directly address the issue of respecting the client's decision to discontinue treatment.
Correct Answer is B
Explanation
Choice A reason: The yellow category in the START triage system is for clients who are unable to walk but have stable conditions that do not require immediate life-saving intervention. Since this client is ambulatory, she does not fit into the yellow category.
Choice B reason: The green category is for clients who are ambulatory with minor injuries and do not require urgent medical attention. This client is awake, alert, oriented, and able to follow commands, indicating that she is stable and her injuries are not life-threatening.
Choice C reason: The black category is for clients who are deceased or have injuries so severe that they are not expected to survive even with immediate medical intervention. This client is stable and responsive, so she does not fit into this category.
Choice D reason: The red category is for clients who need immediate life-saving intervention. Although this client has a headache and neck pain, her vital signs and ability to follow commands indicate that she does not require immediate life-saving intervention.
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