Managing Multiple Patient's (Module 2)

Question 1

The RN team leader asks the members of the nursing team if there are any special requests prior to making the patient assignment. What leadership type style is the RN team leader exhibiting?

Answer 1

Democratic

Question 2

The RN requests to be assigned to provide nursing care for a patient recovering from bladder cancer surgery? Which statement by the RN would be the most professional reason for honoring the request?

Answer 2

“I did admit the patient yesterday and can assess his recovery process

Question 3

What are the “rights” of delegation? Select all that apply

Answer 3

A. Right evaluation
B. Right Person
C. Right circumstance
D. Right communication

Question 4

What are some factors that the RN must consider to effectively delegate? Select all that apply

Answer 4

A. Identification of the required activities necessary to perform the task
B. Knowledge of the scope of practice of the team member
C. Provide a match between the task and the ability of the person
D. Ability to supervise the performance of the task

Question 5

Place in correct order the steps that will help ensure the best practice outcomes when the nurse delegates a task

Answer 5

A. Assess all aspects of the clinical situation
B. Identify the specific person to perform the task
C. Provide complete, easy to understand instructions
D. Provide ongoing supervision until task is completed
E. Evaluate outcomes of care

Question 6

When identifying tasks for unlicensed assistive personnel (UAP), which characteristics of the task would you consider? Select all that apply

Answer 6

A. What is the degree of risk associated with the task?
B. How invasive is the task?
C. Is the task routine and has it been done before by the UAP
D. Is the outcome of the task predictable?

Question 7

A patient requires a chair alarm as a means to help prevent a fall. What is the appropriate communication by the RN to the UAP?

Answer 7

“The chair alarms are located in the supply room, please obtain one now”

Question 8

One hour after delivering a 9 pound baby, a patient feels faint, dizzy and states she feels a “gush” of blood from the vagina. Which task should the RN assign the unlicensed assistant personnel (UAP)?

Answer 8

Obtain an automatic BP machine

Question 9

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*Harrison Smith’s plan of nursing care includes maintaining a toileting schedule. To which team member should this task be delegated?

Answer 9

UAP (unlicensed assistant personnel)

Question 10

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*What direction by the RN should the UAP receive in assisting with the care of Harrison Smith?

Answer 10

Mr. Smith is to be in the chair for supper with an activated chair alarm

Question 11

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*Jung Lee’s priority goal for the next shift is to ambulate in the hall followed by obtaining an oximetry measurement. Which team member most appropriate to perform this task?

Answer 11

LPN

Question 12

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*Jack Black’s priority goal is pain control. Which team member is the person to perform pain assessment and education about pain medication?

Answer 12

RN

Question 13

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*Mary Jackson may require a unit of packed red blood cells during the shift. Which team member would be required to initiate and monitor blood administration?

Answer 13

RN

Question 14

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*Match the patient with the team member who would be assigned to provide care?

Answer 14

A. Jack Black (RN)
B. Harrison Smith (LPN)
C. Jung Lee (LPN)
D. Mary Jackson (RN)

Question 15

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR.
*After the nursing team has been given the change of shift or “hand off” report, the RN team leader communicates to the team members to report which of the following information as soon as it is obtained? Select all that apply

Answer 15

A. Mr. Lee’s oximetry reading after he ambulates in the hall
B. Mrs. Jackson’s hemoglobin report
C. Mrs. Jackson’s vital signs

Question 16

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR and midshift huddle.
*Identify the appropriate nursing staff member (RN,LPN,UAP) to perform the following activities for Faith Snyder When she is admitted to the unit.

Answer 16

A. Admission Health History (RN)
B. Admission physical assessment (RN)
C. V/S (UAP)
D. Medication administration (LPN)
E. Continuous oximetry monitoring with activation of appropriate alarm settings (RN)
F. Nursing Care Plan (RN)

Question 17

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR and midshift huddle.
*Which team member would be delegated to provide primary care for Mary Jackson?

Answer 17

John White, RN

Question 18

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR and midshift huddle.
*Which team member would be delegated to provide primary care for Harrison Smith?

Answer 18

Anna Garret, LPN

Question 19

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR and midshift huddle.
*Which team member would be delegated to provide primary care for Jack Black?

Answer 19

John White, RN

Question 20

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR and midshift huddle.
*Which team member would be delegated to provide primary care for Jung Lee?

Answer 20

Anna Garret, LPN

Question 21

Base answers to the question on the ECHO Hospital Policy and Procedure Statement and the Patient’s SBAR and midshift huddle.
*Which team member would be delegated to provide primary care for Faith Snyder?

Answer 21

RN team leader

Question 22

What is the appropriate statement by the RN team leader to team members at the end of the shift?

Answer 22

“Thank you all. We provided quality care tonight.”

Question 23

Two nurses are requesting the same supper break but only one nurse can leave the nursing unit. One nurse tells the charge nurse “it’s OK to give the early supper break to my co-worker. I really don’t want to deal with the complaints.” How is the first nurse reacting to the potential conflict?

Answer 23

Withdrawing

Question 24

How does the RN team leader organize patient rounds at the beginning of the shift?

Answer 24

Start with the patient returning from an invasive procedure

Question 25

The RN delegated to the UAP to reposition the patient in room 305. Two hours later, the RN notices the patient has not been repositioned. What should the RN have communicated to ensure that the task was completed?

Answer 25

Inform the UAP of the expected time frame to reposition the patient

Question 26

Which action must the RN perform and cannot delegated to the LPN?

Answer 26

Evaluate the patient’s ability to identify symptoms requiring medical care

Question 27

At the end of the shift, the RN tells the team leader. “Nobody ever helps me- and I help everyone.” What is the appropriate action by the RN team leader?

Answer 27

“How did you communicate that you need help?”

Question 28

**What are the appropriate assignments for the nursing team caring for pediatric patient’s? Select all that apply

Answer 28

A. UAP to comfort a child when the child has night terrors
B. RN to review recommended immunization schedule with the parent
C. LPN to provide play activity to a child with a fractured leg and on bed rest

Question 29

The evening nursing staff complains to the RN team leader that a staff member frequently comes to work 15 minutes late. What is the RN team leader’s response?

Answer 29

Begin a private dialogue with the staff member about perceptions and expectations

Question 30

The RN is assigned to care for several patients. Which nursing interventions must the RN plan to perform? Select all that apply

Answer 30

A. Teach medication action with patient/family
B. Initiate a transfusion of packed red blood cells
C. Update patient care outcomes

Question 31

The RN hears the UAP say “All I do is clean patients who are incontinent.” What is an appropriated response by the RN?

Answer 31

The patients really appreciate what you do

Question 32

A patient is being transferred from the PACU (post anesthesia care unit) after a bowel resection. The LPN offers to help the RN with the admission process. WHat activities can be delegated to the LPN? Select all that apply

Answer 32

A. Obtain v/s and spo2 level
B. Place the patient on oxygen as prescribed
C. Apply intermittent compression devices

Question 33

Which care activity is best delegated by the RN to the UAP for a patient who is one day post abdominal surgery and who has a nasogastric tube (NG)?

Answer 33

Maintain the head of the bed elevated 30 degrees

Question 34

The RN is admitting a pateint with diarrhea and sever dehydration with the assistance of the UAP and LPN, What is the appropriate delegation by the RN to the nursing team?

Answer 34

Have the RN monitor the first dose of antibiotics

Question 35

Which assignments demonstrate appropriate delegation of patient care activities? Select all that apply

Answer 35

A. RN monitor a patient receiving fresh frozen plasma
B. UAP to obtain and record daily weights
C. RN to complete the morning assessments

Question 36

During nursing rounds, the RN team leader receives report that the patient with heart failure experienced liht headedness and tachypnea afer ambulating in the hall. Should the RN assign a UAP to assist the patient to ambulate during the shift?

Answer 36

No, the patient needs to be assessed during ambulation

Question 37

The RN who workd on a medical nursing unit is asked to work in the ER after a hurricane. Which type of patient would be the most appropriate patient care assignment for the medical surgical RN temporarily working in the emergency department?

Answer 37

The patient with an elevated temperature and acute confusion

Question 38

The UAP obtains the morning VS and reports to them to the RN. Which vs finding requires the RN to notify the physician/provider immediately?

Answer 38

A temperature of 101 F (38.3C) on a patient with a kidney transplant

Question 39

A newly hired UAP is assisting a patient with dementia with activities of daily living. Which action taken by the UAP requires the RN to intervene?

Answer 39

Rearrange the patient’s room after cleaning and plce objects in the closet

Question 40

A patient is admitted with the medical dx of peripheral disease and an ischemic right leg. Which element of care for this patient can be assigned to the LPN by the RN?

Answer 40

Administer the oral anticoagulants

Question 41

The RN is preparing a patient for emergent placement of a chest tube. What is the priority task for the RN?

Answer 41

Complete the pre procedure verification process

Question 42

The UAP has been assigned the task of obtaining oral intake and output (I&O) on patients at the end of the shift. The LPN reports to the RN that this task has not been completed. What is the RNs best action?

Answer 42

Ask the UAP what instructions were given regarding the task

Question 43

The nursing staff initiates basic CPR on a patient in cardiac respiratory arrest. What is an appropriate task for the RN to delegate to the UAP after the resuscitation team arrives?

Answer 43

Obtain additional supplies as directed