Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Essential elements of effective delegation by an LPN include: (SELECT ALL THAT APPLY)
A. Compliance with state and institutional policies.
B. Direct supervision of tasks assigned to others.
may not always be necessary as direct supervision may not always be required for all tasks assigned to others.
C. Evaluation of the patient's response to care.
D. Knowledge of each patient's condition.
E. Determination of tasks that can be safely delegated.
This question is an excerpt from Nurse Dive's nursing test bank - ATI PN Medical Surgical Leadership Proctored Exam. Take the full exam now
Full Explanation
Effective delegation by an LPN includes compliance with state and institutional policies, evaluation of the patient's response to care, knowledge of each patient's condition, and determination of tasks that can be safely delegated.
Option B may not always be necessary as direct supervision may not always be required for all tasks assigned to others.
Similar Questions
Mr. Smith did not receive his medication on time, as ordered, because his nurse forgot about it and went on her lunch break. Consequently, Mr. Smith's condition deteriorated, and he was sent to the emergency room. What legal term describes this form of professional negligence?
A. Liability
Option A refers to legal responsibility for one's actions, but it does not specify the type of wrongdoing.
B. Malfeasance
Option B refers to wrongdoing or misconduct, but it is not specific to the medical profession.
C. Malpractice
In this situation, the nurse's failure to administer Mr. Smith's medication on time as ordered, resulting in harm to the patient, could be considered malpractice. Malpractice refers to a failure to meet the standard of care that results in harm to a patient.
D. Dereliction of duty
Option D refers to a failure to fulfill one's duties or obligations, but it does not necessarily imply harm to a patient.
Full Explanation
In this situation, the nurse's failure to administer Mr. Smith's medication on time as ordered, resulting in harm to the patient, could be considered malpractice. Malpractice refers to a failure to meet the standard of care that results in harm to a patient.
Option A refers to legal responsibility for one's actions, but it does not specify the type of wrongdoing.
Option B refers to wrongdoing or misconduct, but it is not specific to the medical profession.
Option D refers to a failure to fulfill one's duties or obligations, but it does not necessarily imply harm to a patient.
A nurse is working with an assistive personnel (AP) who refuses a client assignment. When resolving this conflict, which of the following comments is appropriate for the nurse to make?
A. "You always get your choice of assignment and don't work your fair share."
Option A is accusatory and unprofessional.
B. "I have to let the human resources department know about this situation."
Option B may be necessary at some point, but it should not be the first response.
C. "I feel that you are being inconsiderate of the other nursing assistants."
Option C is also accusatory and unprofessional.
D. "I need to talk to you about the unit policies regarding client assignments."
When resolving a conflict with an assistive personnel (AP) who refuses a client assignment, it would be appropriate for the nurse to say "I need to talk to you about the unit policies regarding client assignments." This comment addresses the issue directly and professionally and provides an opportunity for the nurse to clarify the unit policies and expectations.
Full Explanation
When resolving a conflict with an assistive personnel (AP) who refuses a client assignment, it would be appropriate for the nurse to say "I need to talk to you about the unit policies regarding client assignments." This comment addresses the issue directly and professionally and provides an opportunity for the nurse to clarify the unit policies and expectations.
Option A is accusatory and unprofessional.
Option B may be necessary at some point, but it should not be the first response.
Option C is also accusatory and unprofessional.
A nurse is preparing to obtain consent from a client who has a tibia fracture. The client received IV morphine sulfate prior to arrival on the unit and is scheduled for surgery. Which of the following actions should the nurse take?
A. Obtain consent from the client.
Option A may not be appropriate if the client is not able to give informed consent.
B. Acknowledge the client and sign the consent.
Option B is not appropriate as it is not within the nurse's scope of practice to sign consent on behalf of a client.
C. Obtain consent from a relative of the client.
When a client is under the influence of opioids and lacks decision-making capacity, consent must be obtained from a legally authorized representative, such as a relative or healthcare proxy. Morphine alters consciousness and impairs executive function, making the client temporarily incompetent. Legal surrogates are empowered to make healthcare decisions in such cases. This ensures ethical compliance and protects patient rights. The nurse must verify documentation of proxy authority before proceeding with consent.
D. Delay the procedure.
Delaying the procedure may be necessary if no authorized proxy is available, but it is not the first action. The priority is to identify and contact a legally authorized representative to obtain valid consent. Delays can compromise care, especially in urgent surgical cases. The nurse must act promptly to secure proxy consent, ensuring procedural integrity and patient safety. Only if no proxy is reachable should delay be considered, with documentation of rationale.
Full Explanation
The correct answer is Choice C.
Choice A rationale: Obtaining consent directly from a client who has received IV morphine sulfate is invalid due to impaired cognitive function. Morphine acts on mu-opioid receptors in the central nervous system, reducing alertness, memory retention, and decision-making capacity. Informed consent requires full comprehension of risks, benefits, and alternatives. Morphine’s sedative effects compromise this standard. Normal Glasgow Coma Scale should be 15 for full alertness; sedation lowers this, rendering consent legally and ethically unsound.
Choice B rationale: The nurse cannot legally sign the consent on behalf of the client, even if the client is acknowledged. This violates the principle of autonomy and informed decision-making. The nurse’s role is to witness the client’s signature, not substitute it. Morphine impairs cognition, and any consent obtained under its influence is invalid. Legal standards require that the client be alert, oriented, and capable of understanding the procedure. Proxy consent must be pursued if capacity is compromised.
Choice C rationale: When a client is under the influence of opioids and lacks decision-making capacity, consent must be obtained from a legally authorized representative, such as a relative or healthcare proxy. Morphine alters consciousness and impairs executive function, making the client temporarily incompetent. Legal surrogates are empowered to make healthcare decisions in such cases. This ensures ethical compliance and protects patient rights. The nurse must verify documentation of proxy authority before proceeding with consent.
Choice D rationale: Delaying the procedure may be necessary if no authorized proxy is available, but it is not the first action. The priority is to identify and contact a legally authorized representative to obtain valid consent. Delays can compromise care, especially in urgent surgical cases. The nurse must act promptly to secure proxy consent, ensuring procedural integrity and patient safety. Only if no proxy is reachable should delay be considered, with documentation of rationale.