Examkin

Question

Difficulty: HardAssignment, Delegation and Supervision

During a high-volume shift in an emergency department observation unit, a nurse is coordinating care with an unlicensed assistive personnel (UAP). Which of the following tasks should the nurse delegate to the UAP? Select all that apply.

  1. Obtaining the final set of vital signs for a client who sustained a minor concussion and is awaiting discharge instructionsAnswer
  2. B
    Measuring the blood pressure of a client with a chest contusion who is becoming increasingly restless and diaphoretic
  3. C
    Demonstrating to a client with a newly casted radial fracture how to maintain continuous arm elevation on pillows
  4. Assisting a client who has a stable, non-surgical pelvic fracture onto a fracture bedpanAnswer
  5. E
    Palpating the suprapubic region for distension in a client who has not voided six hours post-catheter removal
  6. Reattaching a continuous pulse oximetry sensor that slipped off the finger of a sleeping client with asthmaAnswer

Answer

The nurse should delegate obtaining vital signs on the discharge-ready client, assisting the stable client onto the fracture bedpan, and reattaching the pulse oximetry sensor.
The correct selections represent standard, repetitive tasks that have predictable outcomes and do not require independent nursing judgment. Obtaining vital signs on a stable client ready for discharge, assisting a stable client with basic elimination needs, and reattaching a non-invasive monitor are all safely within the UAP's scope of practice.

Step-by-Step Solution

1
Analyze the clinical stability of each client presented in the scenario.
Identify that the client awaiting discharge, the client with a stable pelvic fracture, and the sleeping asthma client are clinically stable. The restless, diaphoretic client with a chest contusion is unstable.
Delegation requires the 'Right Circumstance.' Unstable clients require continuous monitoring and assessment by a registered nurse.
2
Evaluate the nature of each task against the registered nurse's scope of practice.
Identify that demonstrating elevation is 'teaching' and palpating the suprapubic area is 'assessment'.
According to national delegation guidelines, the RN cannot delegate Evaluation, Assessment, or Teaching (EAT).
3
Select the tasks that are safe and legally permissible for the UAP.
Select the routine vital signs, bedpan assistance, and sensor reattachment.
These are standard, repetitive tasks with predictable outcomes performed on stable clients, fitting the UAP scope of practice perfectly.

Key Concept

Delegation to Unlicensed Assistive Personnel (UAP)
Rate this question

Topics

Assignment, Delegation and Supervision

More questions from this topic