The nurse delegates the positioning of an older client with immobility to unlicensed assistive personnel (UAP). Which action taken by the UAP requires the nurse to intervene?

The UAP keeps the head of the bed flat when repositioning the client.

The UAP uses assistive transferring devices when transferring the client.

The UAP places pillows to support the client's head, arms, and legs.

The UAP positions the client with the head of the bed at 45 degrees.

Answer and Explanation

The Correct Answer is D

A. The UAP keeps the head of the bed flat when repositioning the client: Keeping the bed flat during repositioning can reduce strain on the client and caregiver. This is an appropriate action that maintains safety and comfort.

B. The UAP uses assistive transferring devices when transferring the client: Utilizing devices such as slide sheets or mechanical lifts reduces the risk of injury to both client and caregiver. This action aligns with safe patient handling principles.

C. The UAP places pillows to support the client's head, arms, and legs: Proper positioning with pillows prevents pressure injuries, promotes comfort, and maintains body alignment. This reflects correct delegation and care practices.

D. The UAP positions the client with the head of the bed at 45 degrees: Placing the client in a semi-Fowler’s position at 45 degrees may increase pressure on the sacrum and heels, raising the risk of pressure injuries in immobile older adults. The nurse should intervene and ensure proper positioning, typically less than 30 degrees, to minimize pressure.

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Correct Answer is B

Explanation

A. All visitors should wear hair and shoe covers: Hair and shoe covers are not part of standard contact precautions for MRSA. Transmission occurs primarily through direct contact with contaminated surfaces or wounds rather than hair or footwear. Routine use of these items does not reduce MRSA spread.

B. All visitors should wear a gown and gloves: MRSA requires contact precautions to prevent transmission via hands and clothing. Gowns protect clothing from contamination, and gloves reduce direct contact with infectious material. This practice is consistent with infection prevention guidelines for multidrug-resistant organisms.

C. All visitors should wear goggles and gloves: Eye protection is reserved for situations with a risk of splashing or spraying of body fluids. MRSA wound care does not typically pose this risk during routine contact. Goggles are not routinely indicated.

D. All visitors should wear an N95 mask and gown: N95 respirators are used for airborne pathogens such as tuberculosis, not contact-spread organisms like MRSA. Respiratory protection is unnecessary unless aerosol-generating procedures are involved.

A. By focusing on medical diagnoses B. By examining interrelationships C. By following a linear approach D. By reducing assessment time

Correct Answer is B

Explanation

A. By focusing on medical diagnoses: Limiting a concept map to medical diagnoses restricts the nurse’s perspective and does not fully engage critical thinking. Concept maps integrate multiple aspects of patient care, including psychosocial, physiological, and nursing considerations, rather than focusing solely on diagnoses.

B. By examining interrelationships: Concept maps visually display the connections among patient problems, interventions, and outcomes, helping nurses identify patterns and prioritize care. Examining these interrelationships promotes deeper understanding, clinical reasoning, and the ability to anticipate complications. It enhances critical thinking and holistic patient care.

C. By following a linear approach: Concept maps are nonlinear tools that allow flexible exploration of complex patient situations. A strictly linear approach limits the ability to see connections and interactions, reducing opportunities for critical analysis.

D. By reducing assessment time: Concept maps do not shorten assessment but instead organize and synthesize data. Their value lies in improving understanding and decision-making rather than accelerating the assessment process.

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The nurse delegates the positioning of an older client with immobility to unlicensed assistive personnel (UAP). Which action taken by the UAP requires the nurse to intervene?

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