When working in the urology/nephrology clinic, which patient's care could the nurse delegate to an experienced licensed practical/vocational nurse (LPN/VN)?
Patient who requires teaching about possible post-cystoscopy complications
Patient who is scheduled for a renal biopsy after a recent kidney transplant.
Patient who will need monitoring for several hours after a renal arterogram
Patient who will have catheterization to check for residual urine after voiding
The Correct Answer is D
A. Patient who requires teaching about possible post-cystoscopy complications: Teaching requires assessment and specialized knowledge, which are within the registered nurse’s scope of practice. The LPN/VN can reinforce teaching but cannot take primary responsibility for initial patient education.
B. Patient who is scheduled for a renal biopsy after a recent kidney transplant: This patient is at high risk for complications such as bleeding and graft rejection, requiring close monitoring and advanced clinical judgment. Care for this patient should remain with the registered nurse.
C. Patient who will need monitoring for several hours after a renal arterogram: Post-arterogram monitoring involves assessing for bleeding, circulation changes, and possible contrast-related complications. These tasks require frequent assessment and higher-level clinical decision-making by the RN.
D. Patient who will have catheterization to check for residual urine after voiding: This is a stable patient requiring a routine procedure within the scope of practice for an experienced LPN/VN. Catheterization is a skill LPNs are trained to perform safely under the RN’s supervision, making this the appropriate delegation choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Asking the patient to empty the bladder completely and then collecting the next specimen is not specific enough for a clean-catch technique. This method does not reduce contamination from the urethral meatus or surrounding genital area.
B. Using povidone iodine is not recommended for routine clean-catch urine collection because it can irritate the urethral area and does not offer additional benefit over standard cleansing with mild soap and water or antiseptic wipes.
C. Cleaning the urethral area reduces contamination, and discarding the initial urine flushes out bacteria from the urethra. Collecting midstream urine ensures that the sample accurately reflects bladder contents for culture and sensitivity testing.
D. Catheterization is an invasive procedure and is reserved for patients who cannot provide a clean-catch specimen. Routine midstream collection is preferred to reduce infection risk and discomfort while still providing an uncontaminated sample.
Correct Answer is C
Explanation
A. It shows that the access site is not safe for dialysis: The presence of a thrill and bruit does not indicate danger; instead, it signals that blood flow is adequate. An unsafe access would be suspected if no thrill or bruit is present, suggesting poor patency.
B. It suggests a blockage in the access site: A blockage would diminish or eliminate the thrill and bruit rather than create them. Detecting these signs means blood is moving effectively through the fistula without significant obstruction.
C. It confirms the maturation of the access site: A palpable thrill and an audible bruit are expected findings that confirm adequate blood flow and fistula maturation. These signs indicate that the fistula is functioning well and is ready or preparing for use in hemodialysis.
D. It indicates the presence of an infection: Infection of an AV fistula is characterized by redness, warmth, swelling, pain, or purulent drainage. A thrill and bruit are not infection signs but rather vascular flow indicators confirming patency.
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