Examkin

Question

Difficulty: MediumAssignment, Delegation and Supervision

A registered nurse (RN) on a medical oncology unit is organizing the shift assignments. The care team consists of the RN, a licensed practical/vocational nurse (LPN/VN), and an unlicensed assistive personnel (UAP). Which of the following task assignments are appropriate for the RN to delegate? Select all that apply.

  1. UAP: Assisting a client experiencing severe fatigue with routine morning oral hygieneAnswer
  2. B
    LPN/VN: Formulating a comprehensive discharge teaching plan for a client newly prescribed oral chemotherapy
  3. LPN/VN: Administering a scheduled subcutaneous antiemetic injection to a client reporting nauseaAnswer
  4. D
    UAP: Evaluating the relief of bone pain after an analgesic has been administered to a client
  5. UAP: Documenting the oral fluid intake and urine output for a client on maintenance intravenous fluidsAnswer
  6. F
    LPN/VN: Performing the comprehensive admission assessment for a client arriving from the emergency department

Answer

The appropriate tasks to delegate are: having the UAP assist with oral hygiene, having the LPN/VN administer the subcutaneous antiemetic, and having the UAP document intake and output.
Safe delegation requires assigning tasks that fall within each team member's legal scope of practice. The UAP is fully qualified to assist with basic activities of daily living (ADLs), such as oral hygiene, and to perform routine measurements like documenting intake and output. The LPN/VN is licensed to administer routine medications, including subcutaneous injections, to clients whose conditions are stable.

Step-by-Step Solution

1
Analyze the client needs and the specific requirements of each task.
Determine whether each task involves clinical judgment, nursing assessment, evaluation, or initial teaching.
Tasks requiring independent nursing judgment or application of the nursing process must be retained by the RN.
2
Evaluate the scope of practice for the LPN/VN.
Identify that administering a subcutaneous medication is within their scope, but performing an initial assessment or formulating a teaching plan is not.
The LPN/VN cares for stable clients with predictable outcomes and can reinforce teaching, but cannot initiate complex care plans or perform initial assessments.
3
Evaluate the scope of practice for the UAP.
Identify that assisting with ADLs and recording intake/output are appropriate, but evaluating pain relief is outside their scope.
UAPs are trained to perform routine, standard tasks that do not require clinical nursing judgment.

Key Concept

Scope of practice and safe delegation principles based on the NCSBN guidelines (RNs do not delegate Evaluation, Assessment, or Teaching).
Estimated Time:1m 30s
Rate this question

Topics

Assignment, Delegation and Supervision

More questions from this topic