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NURSING EXAM ON DELEGATION QUESTIONS
WITH CORRECT ANSWERS
- **What order should the nurse follow during the delegation decision-making process when delegating client care? 1.Assessing the health needs exhibited by the client 2.Assessing the abilities demonstrated by unlicensed personnel 3.Seeking client care issues 4.Ensuring the stability of the client
- Monitoring the task 6.Providing feedback to unlicensed personnel:** The delegation process starts with assessing the health needs of the client and the skills of unlicensed personnel (UNP). The key component of delegation decision- making is assessing the UNP's ability to perform the work, including, safety, critical thinking, stability, and time. It is also vital to make client care decisions at the same time. The nurse has to make sure that the client is stable and steady to ensure the best care. The greater the stability of a client, the more likely the UNP can provide safe client care. The nurse should then monitor the task being performed by the UNP. The nurse should also maintain an open line of communication with the UNP to seek client care updates and limitations. The nurse should always provide direct feedback to the UNP for professional growth and development to improve client care outcomes. 2. The registered nurse (RN) is delegating tasks to several health care team members caring for a client with a bacterial infection and high fever. Which statements by the registered nurse would be most appropriate for the licensed practical nurse (LPN)? Select all that apply. Correct "You should administer an antipyretic after the meal." 2 "You should assess the client's condition." 3 "You should change the bed sheets and dress the client every day." Correct "You should administer prescribed antibiotics to the client twice a day." Correct "You should collect data that can be used in the assessment of client's condition.": The delegator can delegate tasks such as administration of antipyretic for the client who has fever. This particular task should be delegated only to the licensed nursing personnel, such as LPN. The
delegator can delegate the task such as administration of antiallergic medication to the licensed professional, such as LPN. The RN is responsible for all the assessments performed, but the UAP or LPN can collect the data that can be used for the assessment. The RN is responsible for assessing the client's condition. The RN should delegate basic tasks such as changing the bed sheets and dressing the client to unlicensed nursing personnel.
3. Which client's care can the registered nurse (RN) safely delegate to unli- censed nursing personnel (UNP) based on the given data? Correct Client A, with chronic hypertension and stable vitals 2 Client B, with drainage from diabetic foot 3 Client C, with myocardial infarction due to atherosclerosis 4 Client D, with foot ulcers from peripheral vascular disease: Care of client A can be safely delegated because the chronic hypertension with stable vitals is not generally associated with any complications. Client B with drainage from diabetic foot is at a risk of aggravating foot issues, so this client's care cannot be safely delegated. Client C with myocardial infarction due to atherosclerosis is at a risk of cardiovascular instability and care should not be delegated. Client D has a risk of foot ulcers due to peripheral heart disease so this client's care also cannot be safely delegated to the UNP. 4. The nurse is delegating someone to care for a client with diabetes mellitus. Which instruction given by the nurse better explains the selling relationship with the delegatee? 1 "Record the client's blood glucose level each morning." 2 "You may approach me for further assistance and questions. Thank you." 3 "I will guide and assist you while you learn how to check the client's blood glucose." Correct "You will take complete care of the client with diabetes and make sure to record the blood glucose level.": Selling includes ongoing relationships with an explanation of the delegated new task. This is better explained
task. It is better explained by the statement, "I will guide and assist you while you learn how to check the client's blood glucose."
5. The nurse is assisting the registered nurse with delegation decisions re- garding management of a client with shortness of breath. Which action by the nurse indicates a need for correction? 1 Asking questions about the client's respiratory rate 2 Asking the client to perform breathing exercises regularly 3 Administering oxygen to the client with shortness of breath Correct Providing constructive feedback about client care management: The nurse may not provide constructive feedback about the client care management during delegation decisions. The nurse may, however, provide constructive feedback to the delegatee to maximize the efficiency of the client care. 6. The registered nurse (RN) is caring for a client who has severe abdominal pain. The RN plans to work with the assistance of an unlicensed nursing personnel (UNP). The RN starts the client care. What should the RN consider during the process of active delegation? Select all that apply. Correct Assessing the level of the client's abdominal pain Correct Directing the UNP to assist the client while toileting 3 Advising the client to take pain medication when needed Correct Ensuring that the UNP is accountable for successful completion of the task 5 Explaining to the client about the reason and cause of abdominal pain: In active delegation the RN assesses the client's situation to ensure the client is stable enough to be handed over to the UNP. The RN can then delegate specific basic tasks to the UNP such as oral care and toileting. The RN then holds the UNP accountable for successful completion of the task. It is within the scope of practice of the RN to advise the client to take pain medication in accordance with the primary health care provider's prescription. Likewise, the RN can explain the reason and cause of the condition diagnosed by the primary health care provider.
These tasks are considered passive delegation.
delegatee and delegator have an ongoing relationship and a new task is being delegated. The delegator's behavior is characterized as "delegating" when the delegatee has expertise and an established relationship with the delegator. If the delegatee has willingness and
ability, but the relationship with the delegator is new, then the delegator's behavior is characterized as "participating."
9. Which action in the delegation process represents accountability? 1 Providing open and honest feedback to the delegatee 2 Assisting other registered nurses with delegation decisions Correct Monitoring the client care given and determining outcomes 4 Assessing the ability of the delegatee and educating him or her about the task: Monitoring client care and determining outcomes represents accountability of the task in case of conflicts. Providing open and honest feedback to the delegatee improves work performance and client care outcomes. The nurse can assist other registered nurses with delegation decisions when there are safety issues, an urgent need to intervene, or potential negative client outcomes. Assessing the ability of the delegatee and educating him or her about the task indicates responsibility. 10. The client is admitted to the medical unit with a diagnosis of pulmonary edema. The client care is assigned to the registered nurse (RN) by the charge nurse. The RN admits and provides a written plan and assigns the client to a licensed practical nurse. Which healthcare personnel is accountable and responsible for the client if there is development of any complications in the client? 1 Charge nurse 2 Associate nurse Correct Registered nurse 4 Licensed practical nurse: The registered nurse is responsible and accountable for the client if complications develop. The registered nurse is responsible for the client because he or she delegated client care and wrote the care plan. The charge nurse may be accountable but may not be responsible since the charge nurse gets the task in the absence of the RN. The associate nurse is responsible for the client's condition if
11. A delegator, working in collaboration with a delegatee, allots responsi- bilities and explains the various procedures and techniques needed to ac- complish the task. Which action is the delegator performing, according to the Hersey model? 1 Guiding and directing 2 Observing or monitoring Correct Explaining and persuading 4 Encouraging or problem solving: Hersey's model describes the leader's behavior as explaining or persuading, which is characterized as "selling." In this situation, the delegator is assigning the work to the delegatee and explaining the various procedures and techniques to accomplish the specified task. A leader's behavior described as guiding or directing is characterized as "telling," in which the delegate simply assigns the task to the delegatee. The leader's behavior of observing or monitoring is characterized as "delegating," in which the delegator is responsible and accountable for the entire task. A leader's behavior that is encouraging or prob- lem solving is characterized as "participating," in which the delegator establishes a working environment in which to complete the task in the specified time. 12. Which questions should the nurse consider to assess and ensure delega- tion to the right person? Select all that apply. Correct Is the prospective delegatee a willing and able employee? 2 Does the delegatee understand the directions and expected results of the task? 3 Does the delegatee understand how, what, and when to report to the delega- tor? 4 Is it clear that the delegatee will provide feedback related to the task when appropriate? Correct Does the delegatee have the knowledge and experience to perform the spe- cific task safely?: The right delegatee is chosen on the basis of the
person's willingness and ability. The nurse should assess the knowledge and experience of the prospective delegatee to perform the specific task safely and fulfill the expected
findings." 3 "I will instruct the unlicensed assistive personnel (UAP) to wash the client." Correct
"I will instruct the licensed vocational nurse (LVN) to administer intravenous (IV) medications.": In active delegation, the registered nurse (RN) assesses the client's situation, determines what is appropriate for client care, directs assistive per- sonnel to perform certain tasks, and holds the individuals accountable. Instructing the LVN to administer intravenous (IV) medications is beyond the practice scope for an LVN. Evaluating the client's pain status is a part of active delegation. Assessing the client's laboratory findings is active delegation. Instructing the UAP to wash the client is an active delegation as the RN is directing a task that is to be performed by the UAP for the client.
15. Which component of delegation is suitable to all the members on the healthcare team? Correct Authority 2 Supervision 3 Accountability 4 Communication: Authority is the component of delegation that is suitable for all the members on the healthcare team. Supervision is a right of delegation in which the delegator supervises the other assistive personnel to perform the task. Accountabil- ity is the component of delegation that is suitable for delegators such as registered nurses (RNs). Communication is the right of delegation in which the delegator gives the directions to perform the task. 16. The registered nurse is delegating work to four delegatees. Which delega- tee has an established relationship with the delegator? 1 Delegatee A Correct Delegatee B 3 Delegatee C 4 Delegatee D: According to Hersey's model, if the relationship between the delegator and delegatee is established, the behavior of the delegator is "observing or moni- toring." Telling delegate B that his or her method is correct and to continue doing it in the same way
17. Which component of delegation is considered a "two way process"? 1 Authority 2 Supervision Correct Responsibility 4 Accountability: Responsibility is a two way process. Authority is the ability to per- form duties in a specific role. Supervision is defined as the "provision of guidance and oversight of a delegated nursing task." Accountability may not be a two-way process. It determines if the actions were appropriate and provides a detailed explanation of what occurred. 18. A client presents to the physician with a rash. The physician orders the application of a topical medication. Which healthcare team member will most likely carry out this order? 1 Nurse manager (NM) 2 Registered nurse (RN) Correct Licensed practical nurse (LPN) 4 Unlicensed assistive personnel (UAP): The LPN administers oral and topical medications and monitors all vital signs. The NM is the designated individual to whom all nursing professionals are answerable regarding a given task. The RN is responsible for performing the administration of intravenous medications and the delegation of tasks to LPNs and UAPs. The UAP assistive personnel performs all hygiene tasks. 19. The registered nurse (RN) who delegates work to a newly hired licensed practical nurse (LPN) says, "Please tell me how you will go about performing this procedure, and I will share my expectations with you." Which behavior strategy of Hersey's model is being applied? 1 Telling 2 Selling
Delegating
The delegatee has limited knowledge and ability to perform the task. Correct
The delegatee has willingness and ability, but the relationship is new. 4 The delegatee has an established relationship with the delegator, but a new task has been delegated.: When the delegatee has the willingness and ability to perform the task but the relationship is new, the delegator tries to establish mutual expectations and conditions for performing the task. The delegator must open the lines of communication with the delegatee. When the delegatee has expertise and an established relationship with the delegator, the delegator asks the delegatee to communicate if any issue or concern arises. When the delegatee has limited knowledge and ability to perform the task, the delegator would provide more guidance to the delegatee by giving detailed instructions. If the delegatee has an established relationship with the delegator but a new task has been delegated, the delegator will need to provide explanation of what is needed to accomplish the task.
22. When evaluating a task performed by a delegatee, the registered nurse finds that the delegatee fails to provide appropriate feedback. Which right of delegation is compromised in this situation? 1 Right task 2 Right person Correct Right supervision Incorrect Right communication: The "right supervision" includes assessing whether the delegatee can provide feedback related to the task when appropriate. "Right task" involves providing tasks to the delegatee in accordance with legal and institutional policies. "Right person" involves delegating tasks to team members who are com- petent and show willingness towards the task. "Right communication" involves the delegator providing clear, concise instructions and the delegate understanding those instructions. 23. A critically injured client was brought to the hospital following a car acci- dent and the client should be immediately triaged for determining the nature and acuity of the injuries. Who is delegated to perform the task? 1 Nurse manager
