Delegation Decision-Making Process in Nursing, Exams of Nursing

Download Delegation Decision-Making Process in Nursing and more Exams Nursing in PDF only on Docsity! NR224 / NR 224: FUNDAMENTALS EXAM 1 (2023 UPDATE) CHAMBERLAIN COLLEGE OF NURSING 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 5. Monitoring the task 6.Providing feedback to unlicensed personnel Correct Answer: 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. 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. Correct1 "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." Correct4 "You should administer prescribed antibiotics to the client twice a day." Correct5 "You should collect data that can be used in the assessment of client's condition." Correct Answer: 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. Which client's care can the registered nurse (RN) safely delegate to unlicensed nursing personnel (UNP) based on the given data? Correct1 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 Correct Answer: 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. 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." Correct4 "You will take complete care of the client with diabetes and make sure to record the blood glucose level." Correct Answer: Selling includes ongoing relationships with an explanation of the delegated new task. This is better explained in the statement, "You have to take complete care of the client with diabetes and make sure that you record the blood glucose level." Telling is ordering the delegate to record the client's blood glucose level each morning. Delegation, involving established relationships and expertise, is better explained by, "You may approach me for further assistance and questions. Thank you." Participation is mutual involvement to accomplish the 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." The nurse is assisting the registered nurse with delegation decisions regarding 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 Correct4 Providing constructive feedback about client care management Correct Answer: 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. 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 the primary nurse's written plan is implemented by the associate nurse. The licensed practical nurse (LPN) is not responsible because the LPN follows the written plan given by the RN. A delegator, working in collaboration with a delegatee, allots responsibilities and explains the various procedures and techniques needed to accomplish the task. Which action is the delegator performing, according to the Hersey model? 1 Guiding and directing 2 Observing or monitoring Correct3 Explaining and persuading 4 Encouraging or problem solving Correct Answer: 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 problem solving is characterized as "participating," in which the delegator establishes a working environment in which to complete the task in the specified time. Which questions should the nurse consider to assess and ensure delegation to the right person? Select all that apply. Correct1 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 delegator? 4 Is it clear that the delegatee will provide feedback related to the task when appropriate? Correct5 Does the delegatee have the knowledge and experience to perform the specific task safely? Correct Answer: 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 outcomes. Right direction and documentation are assessed by the delegatee's ability to understand the directions and expected results of the task. It can also be assessed on the basis of the delegatee's understanding of how, what, and when to report to the delegator. The right supervision is providing feedback to the delegatee, related to the task, when appropriate. Which statements are true regarding the primary nursing care developed by Marie Manthey as a method for organizing client care? Select all that apply. Correct1 The associate nurse provides input into the client's plan of care. 2 The charge nurse will be accountable for the care from admission to discharge. Correct3 If the client develops complications, the associate nurse should notify the primary nurse. 4 According to the associate nurse's care specifications, the primary nurse should provide care. Correct5 The registered nurse functions autonomously as the primary nurse throughout the client's hospital stay. Correct Answer: The associate nurse cares for the client according to the care specifications provided by the primary nurse in the care plan. The associate nurse provides input to the client's plan care if the associate nurse notices any complications and also notifies the primary nurse for alterations in the care plan. The registered nurse functions autonomously as the client's primary nurse by taking the responsibility and accountability of the client care from admission through discharge. It is the primary nurse, rather than the charge nurse, who will be accountable for the care of the client from the admission through discharge. According to the primary nurse's care specifications, the associate nurse should provide care. The registered nurse is teaching a newly hired nurse about active delegation. Which statement made by the newly hired nurse indicates the need for further teaching? 1 "I will evaluate the client's pain status." 2 "I will assess the client's laboratory findings." 3 "I will instruct the unlicensed assistive personnel (UAP) to wash the client." Correct4 "I will instruct the licensed vocational nurse (LVN) to administer intravenous (IV) medications." Correct Answer: In active delegation, the registered nurse (RN) assesses the client's situation, determines what is appropriate for client care, directs assistive personnel 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. Which component of delegation is suitable to all the members on the healthcare team? Correct1 Authority 2 Supervision 3 Accountability 4 Communication Correct Answer: 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. Accountability 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. The registered nurse is delegating work to four delegatees. Which delegatee has an established relationship with the delegator? 1 Delegatee A Correct2 Delegatee B 3 Delegatee C 4 Delegatee D Correct Answer: According to Hersey's model, if the relationship between the delegator and delegatee is established, the behavior of the delegator is "observing or monitoring." Telling delegate B that his or her method is correct and to continue doing it in the same way indicates that the delegator is monitoring the delegatee's actions, which indicates an established relationship. Which component of delegation is considered a "two way process"? 1 Authority 2 Supervision Correct3 Responsibility 4 Accountability Correct Answer: Responsibility is a two way process. Authority is the ability to perform 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. 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) Correct3 Licensed practical nurse (LPN) 4 Unlicensed assistive personnel (UAP) Correct Answer: The LPN administers oral and topical medications and monitors all vital signs. The NM is the designated individual to whom all injuries. The nurse manager should usually be the delegator for the registered nurses and healthcare providers. Licensed practical nurses' scope of practice does not include caring for critically ill emergency clients. A primary healthcare provider should treat the client by providing required medications and diagnoses. Which statement is true regarding delegation? Select all that apply. 1 The delegatees are accountable for effective client care. Correct2 Open lines of communication must occur between delegator and delegatee. Correct3 Delegation occurs only when at least two people are involved in a mutual work situation. Incorrect4 The delegation potentials are significantly lower when caregivers such as UNPs are partnered. Correct5 Delegation involves sharing activities with other appropriate authority to accomplish the work. Correct Answer: Open lines of communication between delegator and delegatee helps to eliminate any misunderstanding regarding delegated tasks. Delegation occurs only when at least two people are involved in a mutual work situation; one who has the authority to perform specific tasks and other who holds accountability for the task being performed. Delegation involves sharing activities with other appropriate authority to accomplish the work. When delegating a task to delegatee, the delegator retains accountability for effective client care by ensuring that the task is completed by the right person and that the person is supervised appropriately. The delegation potentials are significantly higher when caregivers such as UNPs are partnered. Which behavior of the delegator with respect to the work delegated to a delegatee is characterized as "selling" according to the Hershey's Model? 1 Guiding or directing Correct2 Explaining or persuading 3 Observing or monitoring 4 Encouraging or problem solving Correct Answer: The delegator's behavior when explaining or persuading the delegatee is characterized as "selling" according to Hershey's Model. The delegator's behavior when guiding or directing the delegatee is characterized as "telling." The delegator's behavior when observing or monitoring the delegatee is characterized as "delegating." The delegator's behavior when encouraging or problem solving is characterized as "participating." Which task can be safely delegated by a registered nurse (RN) to unlicensed nursing personnel (UNP) for a client with thrombocytopenia? 1 Shaving the client Correct2 Positioning the client 3 Maintaining oral hygiene 4 Giving intravenous platelet infusions Correct Answer: Clients with thrombocytopenia are at risk of bleeding with slight bruising. Therefore tasks that do not risk bruising the client may be delegated to the UNP. The RN should shave the client and maintain oral hygiene. Intravenous infusions should not be administered by a UNP to any client. The registered nurse is evaluating the statements of the student nurse after teaching about the span of control in a group of individuals working in a healthcare organization. Which statement made by the student nurse indicates a need for correction? Correct1 "The unit secretary in a healthcare organization has legal recognition." 2 "The nurse manager in a healthcare organization is a designated delegator." 3 "The licensed practical nurse working under a physician has a dependent status." 4 "The registered nurse is designated as being answerable to a designated delegator." Correct Answer: The unit secretary in healthcare organizations has no formal preparation and legal recognition. Therefore, the statement of the student nurse that the unit secretary in healthcare organization has legal recognition is incorrect. The nurse manager in a healthcare organization is a designated delegator. The licensed practical nurse has a dependent status and works under a physician. The registered nurse is designated as being answerable to a designated delegator. In a long-term care facility, the care tasks for a client who is suffering with liver disease are being delegated. Which statement made by the delegator indicates the responsibility for the tasks is with the registered nurse? Select all that apply. 1 "You will be responsible for the whole nursing unit." 2 "You will provide the treatment that is prescribed." Correct3 "You will assess alleviation of the client's symptoms." Correct4 "You will be monitoring the client care on an hourly basis." Correct5 "You will admit the client to the intensive care unit (ICU) if her condition deteriorates." Correct Answer: In a long-term care facility, the registered nurse will be responsible for supervising the licensed nursing professionals who will be the performing the delegated tasks. The registered nurse takes the responsibility of assessing alleviation of symptoms and monitoring the client on an hourly basis. Admission of the client to the ICU is the responsibility of the registered nurse. The licensed practical nurse (LPN) or the licensed vocational nurse (LVN) is responsible for taking the responsibility for the whole nursing unit. The LPN or LVN will be delegated the task of providing the treatments that are prescribed by the primary healthcare provider. The legal authority wants a record of the tasks performed by the delegatees and asks the delegatees to maintain a record of completed tasks. Which task is marked by the licensed practical nurse (LPN)? Correct1 Task A 2 Task B 3 Task C 4 Task D Correct Answer: The LPN is a licensed nursing professional whose scope of practice includes tasks such as the administration of oral medications. Admission of the client to the ophthalmology department is under the scope of a registered nurse. Collection of the data that is used for the assessment of the client is a task that can be performed by an unlicensed nursing practitioner. Provision of basic hygiene care is the task that is to be performed by nursing assistive personnel. The registered nurse delegates the task of feeding a 90-year-old client suffering from dysphagia to the unlicensed assistive personnel (UAP) who has previously performed this task. The client died of choking and aspiration after being fed by the UAP. Which right of delegation was violated for this client? 1 Task 2 Person Correct3 Circumstance 4 Communication Correct Answer: The right circumstance includes whether the delegation process is appropriate to the situation or not. For this client, the nurse is responsible for supervising during feeding or providing feeding as the client is suffering from dysphagia. In accordance with right task, the UAP can be delegated the task of feeding. As the UAP is caring for this client and has performed this task previously, he or she has experience of performing this task. Therefore he or she is the right person to delegate the task of feeding as per the UAP ability and willingness. The right of direction and communication includes the delegator providing clear instructions to the delegatee; there is no indication that this right was violated. What are some challenges faced in the process of delegation? Select all that apply. Correct1 Limited resources Correct2 Large geographic area 3 Nurse manager 3 Licensed practical nurse 4 Primary healthcare provider Correct Answer: Informed consent is the authorization by the client or client's representative to perform some therapeutic intervention. Informed consent is an important concept for nurse managers, and the nurse manager is the person who can clarify queries regarding informed consent. The charge nurse is the registered nurse who has the responsibility of coordinating and assigning client care and supervises the delegatees. A licensed practical nurse is a licensed nursing professional whose scope of practice is limited. It is not the responsibility of the primary healthcare provider to explain the concepts of informed consent of the client to the direct care nurses. Which element creates an integrative process that fosters effective delegation decisions by the registered nurse? 1 Ability 2 Liability Correct3 Stability 4 Ethnicity Correct Answer: Stability is the element that creates an integrative process that fosters effective delegation decisions. Ability is the factor that needs to be assessed to determine the level the leaders determine. Liability is the person's responsibility and accountability for individual actions. Ethnicity does not play a role in the process of delegation. While working with a delegatee, the registered nurse says to the delegate, "It's easy; you can do the procedure tomorrow after watching me do it today. Just follow the steps I have demonstrated." What is the behavior of the registered nurse in this situation? 1 Telling Correct2 Selling 3 Delegating 4 Participating Correct Answer: Telling the delegatee that the procedure is easy and he or she can do it by following the demonstrated steps utilizes persuasion. According to Hersey's model, persuading statements of a delegator indicates selling behavior. According to Hersey's model, directing statements indicate telling behavior. According to Hersey's model, monitoring statements indicate delegating behavior. According to Hersey's model, problem-solving statements indicate participating behavior. The nursing team is involved in effective pain management. Which task would be performed by a registered nurse (RN) in this case? 1 Performing hygiene tasks 2 Taking and reporting vital signs 3 Administering oral pain medications Correct4 Developing a treatment plan for client's pain Correct Answer: The role of the RN is to develop a treatment plan for the client's pain. All hygienic tasks are performed by unlicensed nursing personnel. Administering oral pain medications is done by the licensed practical nurse. Taking and reporting vital signs is done by the licensed practical nurse. The registered nurse is assisting a client who is hospitalized with high fever. Which task delegated to the unlicensed assistive personnel (UAP) would be appropriate? Select all that apply. 1 Assessing the vital signs Correct2 Performing all hygiene tasks 3 Administering oral medications Correct4 Helping the client in changing clothes 5 Administering intravenous medications Correct Answer: The UAP does all the hygiene tasks and also helps in changing the clothes. Assessing the vital signs may not be performed by the UAP. Administering the intravenous medications is performed by the registered nurse. Oral administrating of medication is performed by the licensed practical nurse. The registered nurse (RN) is caring for a client who is currently hospitalized for a stroke. What is the most effective professional management strategy for the RN to improve the safety and quality of client care? Correct1 Delegation 2 Leadership 3 Supervision 4 Assignment Correct Answer: Delegation is the most effective professional management strategy to implement in clinical practice to improve the safety and quality of client care by the registered nurse. Leadership is the action of leading a group, which is not suitable in this situation. Supervision is the active process of directing, guiding, and influencing the outcomes. Assignment is the transfer of both accountability and the responsibility from one person to another. The registered nurse (RN) is teaching a novice RN about delegating tasks to licensed practical nurses (LPN) and unlicensed assistive personnel (UAP). Which statement made by the novice RN indicates a need for further teaching? 1 "I will delegate the task of reinforcing client teaching to the LPN." Correct2 "I will delegate the task of assisting the client with bathing to the LPN." 3 "I will delegate the task of recording vital signs of the client to the UAP." Incorrect4 "I will delegate the task of administering intramuscular injections to the LPN." Correct Answer: Assisting the client with bathing is related to providing basic care, comfort, and hygiene and is a task better suited to unlicensed assistive personnel. The scope of practice of an LPN includes reinforcing the client teaching. Recording vital signs is within the scope of practice of UAP. Administering intramuscular injections is within the scope of practice of an LPN, not UAP. A client with postural hypotension requires nursing care. Which task can be safely delegated by the registered nurse to unlicensed nursing personnel (UNP)? Select all that apply. Incorrect1 Mobilizing the client 2 Assessing the pulse rate 3 Assessing the blood pressure Correct4 Managing foot care of the client Correct5 Maintaining oral hygiene of the client Correct Answer: In postural hypotension, any sudden change in posture will lower the blood pressure. Therefore, the client should be carefully evaluated before delegation. Managing foot care and maintaining oral hygiene can be done by the UNP because there is no foreseeable risk associated with the condition. Mobilizing the client and assessing vital signs such as pulse rate and blood pressure should be carefully monitored and performed by the registered nurse. Total client care is delegated to a registered nurse. Which member of the healthcare team is responsible for consulting other healthcare professionals in planning and delivering client care? Incorrect1 Charge nurse Correct2 Primary nurse 3 Associate nurse 4 Nurse navigator Correct Answer: The primary nurse is responsible for consulting other healthcare professionals in planning and delivering client care. The charge nurse delegates work to other healthcare team members in the absence of the delegator. The associate nurse is The registered nurse (RN) is getting ready to leave the client care unit for a lunch break. The RN asks the LPN to take care of a client during the lunch break. Which concept is emphasized in this situation? 1 Leadership Correct2 Delegation 3 Supervision 4 Assignment Correct Answer: Delegation is the concept of a transfer of authority between two people to perform some type of task, e.g., between an RN and licensed staff. Leadership is the action of leading a group or an organization. Supervision is defined as the active process of directing, guiding, and influencing the outcome of an individual's performance. Assignment is the transfer of both accountability and responsibility. Which client's care is least likely to be delegated to unlicensed nursing personnel (UNP)? 1 Client A 2 Client B 3 Client C Correct4 Client D Correct Answer: UNP can safely care for clients in stable condition because these cases will not require critical nursing assessment and decision-making. In an emergency setting, the client with accidental poisoning should be kept under constant monitoring and any small detail of fluctuation should be noted. Therefore, client D cannot be safely delegated to UNP. Clients undergoing home care, extended care, or long-term care do not require exhaustive monitoring and do not have life-threatening conditions, so they can be safely delegated to UNP. The registered nurse (RN) is teaching a newly hired nurse how to communicate with a delegatee while delegating a task. Which statements made by the newly hired nurse indicate effective learning? Select all that apply. Correct1 "I will keep the information simple." 2 "I will share more information than required." Correct3 "I will share the information using electronic media." Correct4 "I will provide an opportunity to clarify the information." Incorrect5 "I will repeat the information in the same way until the new nurse understands it." Correct Answer: While communicating with the delegatee, the information should be simple to enable better understanding. Electronic media is used as a primary communication mechanism to share information. Providing an opportunity to clarify the information helps evaluate the ability of the delegatee. Giving more information than required may lead to confusion. The information should be repeated in different ways if necessary, to ensure better understanding. The charge nurse is teaching the newly-hired registered nurse (RN) about delegating tasks to unlicensed nursing personnel (UNPs). Which statement made by the newly hired RN indicates the need for further teaching? 1 "I should assist the staff in interpreting." Incorrect2 "I should assist the staff in decision-making." 3 "I should assist the staff in achieving optimal functioning." Correct4 "I should assist the staff in sorting out and articulating values." Correct Answer: The RN does not assist the staff in sorting out and articulating the values, the healthcare provider or the physicians do. The RN should assist the staff in interpreting to achieve better outcomes. As a delegator, it is the duty of the RN to help the staff in decision-making. The RN should assist the staff in achieving optimal functioning because the allotted task can have a better outcome only under the supervision of the RN. What does the decision strategy of "offering" include in delegation? Incorrect1 Allowing the delegator to examine the situation differently 2 Demonstrating the specific task or behavior to improve client care 3 Asking questions related to the problem or issue regarding client care Correct4 Making a suggestion to facilitate the achievement of a desirable client care outcome Correct Answer: The decision strategy of offering involves making a suggestion to facilitate the achievement of a desirable client care outcome. The decision strategy of asking allows the delegator to examine the situation differently. The decision strategy of doing includes demonstrating the specific task or behavior to improve client care. The decision strategy of asking includes questioning issues related to the problem regarding client care. A registered nurse teaches a student nurse about delegation. Which statement made by the student nurse indicates appropriate learning? 1 "Licensed practical nurses are accountable for the tasks they perform." 2 "Complete client care can be delegated to the licensed practical nurse." Incorrect3 "Professional aspects of care can be carefully delegated to the licensed practical nurse." Correct4 "Licensed practical nurses can be expected to perform tasks with which they have experience." Correct Answer: The delegator can safely delegate the task to the LPN if the task is within the scope of function or if the LPN is very experienced in performing the task. The LPN, being a delegatee, is not held accountable for the delegated work; the LPN is held responsible for the delegated task. The delegator is held accountable for the LPN's work. The delegator can never delegate complete client care to the LPN, but can only transfer functions and tasks. Basic skills such as activities of daily living and personal hygiene can be delegated by the delegator, but professional aspects of care should not be delegated. Which of these clients is most appropriate for delegation to a cross-trained technician? Correct1 Client A 2 Client B Incorrect3 Client C 4 Client D Correct Answer: A cross-trained technician, when paired with a registered nurse (RN), may perform respiratory therapy, phlebotomy, and electrocardiography. Care of client A can be safely delegated to a cross-trained technician. Though the cross-trained technician can record the ECG, he or she may not monitor the continuous ECG. Monitoring of vital signs is also the role of the RN. Leg exercises may be taught by the RN or by a physician. The other licensed assistive personnel may be delegated the task of reinforcing the teaching, but this is not an appropriate role for the cross-trained technician. After assigning a task, the delegator makes sure that the instructions are clear to provide feedback related to the task. Which delegation right is referred in this situation? 1 Task 2 Person 3 Direction Correct4 Supervision Correct Answer: Ensuring that the delegatee is clear to provide feedback related to the task refers to the right supervision. Knowing whether the task is appropriate to delegatee based on institutional policies and procedures refers to the right task. Knowing whether the delegatee has the knowledge and experience to perform the specific task safely refers to the right person. Knowing whether the delegatee understands the assignment and directions of the task refers to the delegation right direction. Which client care can be safely delegated to the unlicensed nursing personnel (UNP) to provide oral hygiene? Correct1 Client A 2 3 Express satisfaction with the LPN's execution of the task. 4 Ignore the task for now but stop considering the LPN for further delegation. Correct Answer: The delegator should provide constructive and positive, yet honest, feedback about the work of the delegatee. A verbal attack will destroy the relationship between the delegatee and delegator. The RN would lose credibility by conveying satisfaction with the delegatee's work, which is not satisfactory. Ignoring the task and not giving feedback will not promote a healthy relationship. The client with methicillin-resistant staphylococcus aureus (MRSA) is admitted to the medical unit. Which of the following tasks should be performed by the registered nurse? 1 Feeding 2 Administrating oral medication Correct3 Initiating intravenous (IV) antibiotic therapy 4 Changing the dressing of a postoperative wound Correct Answer: The registered nurse performs the task of administering the IV medication. Feeding the hospitalized client is done by the unlicensed nursing professional. Oral administration of medicine is done by the licensed practical nurse. Changing the dressing of a postoperative wound is done by the unlicensed nursing professional. The registered nurse is evaluating the statements made by a student nurse after teaching Hersey's situational leadership model regarding core competencies of a situational leader. Which statement made by the student nurse indicates a need for correction? 1 "A situational leader partners for performance." Correct2 "A situational leader is inflexible towards the work." 3 "A situational leader is able to identify the commitment of delegatee." 4 "A situational leader is able to diagnose the performance of a delegatee." Correct Answer: According to Hersey's situational leadership model, a situational leader is flexible towards work and adapts to the given situation. A situational leader collaborates with others to achieve the goals. A situational leader is able to identify the commitment of a delegatee. A situational leader is able to diagnose the performance of a delegate. The registered nurse is caring for a client suffering from skin infections. The nurse delegates the client care tasks to the health care team. Which task delegated is correct as per guidelines? 1 Daily changing of wet dressings by the unlicensed assistive personnel (UAP) Correct2 Topical administration of medication by the licensed practical nurse (LPN) 3 Administering intravenous antibiotics by the licensed practical nurse (LPN) 4 Teaching the client to minimize sun exposure by the unlicensed assistive personnel (UAP) Correct Answer: LPN scope of practice is limited to administering oral, topical, and parenteral medications except intravenous. The LPN can be delegated the task of administering topical medication to the client. The scope of practice for an unlicensed assistive personnel involves maintaining the client's hygiene and daily changing of wet dressings is delegated to a certified technician. Administering intravenous antibiotics to a client with infection is an inappropriate task to be delegated to an LPN. Teaching the client to minimize sun exposure cannot be delegated to the UAP. UAP can only reinforce the teaching provided by the registered nurse. The legal authority has delegated the tasks according to the model of analysis type of care. Which statements are true regarding the model analysis? Select all that apply. Correct1 Model analysis improves client satisfaction. Correct2 Model analysis is a cost-effective idea for client care. 3 Quality control is better in the model analysis type of care. Correct4 Model analysis promotes organizational decision-making at lower levels. 5 Model analysis promotes adequate communication among the staff members. Correct Answer: Model analysis is a type of care that benefits clients in terms of satisfaction of care being provided. In model analysis, the team nursing method is followed. It is a cost-effective system because it works with an expected ratio of unlicensed to licensed personnel. Organizational decision making occurs at lower levels in model analysis. Control of quality is lower in model analysis. There may be inadequate communication among staff members due to the higher potential for fragmentation of care. The registered nurse finds information decay during the process of delegation. What possible causes may have contributed to this? Select all that apply. Correct1 Frequent changes in the heart rate of the client Correct2 Rapid change in the blood pressure of the client Correct3 Frequent changes in the client's perception of pain Incorrect4 Diverse cultural background of the delegator and delegatee Incorrect5 Different educational background of the delegator and delegatee Correct Answer: Information decay is a characteristic of communication that occurs when the client's health status changes rapidly and specific information loses its value or becomes irrelevant to the client's condition. Rapid change in the blood pressure, frequent changes in the heart rate, and frequent changes in the client's perception to pain can all cause rapid changes in information and lead to information decay. Diverse cultural backgrounds of the delegator and delegatee refer to another characteristic of communication, "information salience." Different educational backgrounds of the delegator and delegatee refer to another characteristic of communication, "information salience." A healthcare team is caring for a postsurgical client who underwent knee surgery. Which task is most suitable to be delegated to a licensed practical nurse (LPN) to provide effective client care? Select all that apply. Correct1 Changing the dressing 2 Ambulating the client Correct3 Administration of oral analgesics Correct4 Reinforcing leg exercise instructions 5 Administering intravenous antibiotics Correct Answer: The LPN scope of practice includes changing the dressing of the surgical site and administration of oral analgesics. Reinforcing leg exercise instructions may also be performed by the LPN. Ambulating the client who underwent knee surgery is usually performed by a physical therapist. Instructing the LPN to administer intravenous medication may not be appropriate according to guidelines. A healthcare team is delegated the task of assisting a client with bathing. Which member of the healthcare team is responsible and accountable for this aspect of client care? Incorrect1 Nursing aide Correct2 Registered nurse (RN) 3 Patient care associate (PCA) 4 Licensed vocational nurse (LVN) Correct Answer: Bathing is often delegated to a patient care associate (PCA) on the healthcare team. The registered nurse (RN) is accountable for the client care, but is not delegated the task of basic hygiene care such as bathing. Though the nursing aide is responsible for client care, he or she is not accountable for the client care. Similarly, a PCA may be responsible but not accountable for client care. As bathing is not generally delegated to a licensed vocational nurse (LVN), the LVN is neither responsible nor accountable for client care. What would the nurse describe as the challenges of delegation? Select all that apply. Correct1 Limited resources 2 More staff availability Correct3 Larger geographic area become familiar with the changing trends in health care delivery in context of delegation. Seeking high-quality clinical delegation experience early in a nurse's career helps nurses gain confidence in delegation skills. Practicing the nursing care process in various clinical settings helps the nurses to improve patient outcomes, but would not specifically help develop delegation and supervisory strategies. Becoming familiar with the hierarchy of authority in the health care organization may help nurses understand management-related issues. However, this knowledge would not directly help nurses develop delegation and supervisory strategies. Which condition may increase the potential for nursing malpractice? 1 When the client care is satisfactorily provided 2 When the delegatee is unable to perform the specified task 3 When the nursing assistant adapts to the changing situation Correct4 When the delegation task is not within acceptable standards Correct Answer: The delegator is personally responsible for prudent action. A potential for nursing malpractice emerges when the delegation task is not performed within acceptable standards. Satisfactory client care results from successful delegation. The expected outcome of a specified task may be affected when the delegatee is unable to perform the specified task. The nursing assistant usually adapts to the changing situation; if not, a gap in the delivery of client care will be generated. The delegator explains the procedure of the task to the delegatee and asks to provide regular feedback on the events. Which delegation right is the delegator referring to in this situation? 1 The right person Correct2 The right supervision 3 The right circumstances 4 The right communication Correct Answer: The delegator is supervising the task by asking the delegatee to provide regular feedback on the events of the specific assigned task. The delegator has to understand and assess the abilities and skills of the delegatee to determine that the right person is selected to perform the specified task. The right circumstance may be assessed by checking the environment, equipment, and resources to perform the task. The delegator has to develop and maintain open lines of communication to promote a positive work environment. Which hospital care setting is most appropriate for a case manager to perform tasks as a delegatee? 1 Hospice care 2 Extended care Incorrect3 Long-term care Correct4 Rehabilitative care Correct Answer: Rehabilitative care settings are the most suitable for a case manager to perform tasks as a delegatee. Hospice care settings are generally delegated to the registered nurse (RN). In extended care and long-term care settings, tasks are delegated to unlicensed assistive personnel (UAP). Which characteristics of the delegatee should be considered to determine that he or she is the "right person"? Select all that apply. Correct1 Experience 2 Supervision Correct3 Willingness Correct4 Competence 5 Communication Correct Answer: The delegatee should be assigned a task if he or she has experience that would allow the delegator to provide minimal guidance. The willingness of the delegatee is also important to consider before assigning the task. The competence of the delegatee must be assessed before assigning the task. The delegator should supervise the tasks performed by the delegatee. The delegatee's communication skills are assessed to ensure right direction and communication. While caring for a client, the registered nurse (RN) needs the assistance of a licensed practical nurse (LPN). The RN feels that the LPN requires supervision as the LPN has previously only worked in a physician's office. Which action by the RN would help diminish any negative feelings the LPN might have about being supervised? 1 Initiating a conversation about the limited skills of the LPN Incorrect2 Appreciating the performance of the LPN when providing feedback 3 Explaining the policies and procedures of the organization Correct4 Initiating a conversation about the new role and functions of the LPN Correct Answer: Initiating a conversation related to new role and functions of the LPN opens up the lines of communication and provides an opportunity to explain why the supervision is necessary. It also helps eliminate or diminish the negative feelings of the LPN regarding the supervision. The RN can open up the line of communication by briefing the drawbacks of the LPN, but this may not help in diminishing the negative feelings about supervision. Appreciating the LPN's work may be welcome and appropriate, but would not necessarily address the LPN's negative feelings about being supervised. Likewise, an explanation of the organization's policies and procedures is important for a LPN who is new to the organization, but this would not necessarily diminish the LPN's negative feelings about supervision. A client underwent angioplasty and is hospitalized for several days for observation. Which task can be delegated by the registered nurse (RN) to a licensed practical nurse (LPN)? Incorrect1 Assisting 2 Assessing 3 Evaluating Correct4 Monitoring Correct Answer: The LPN is eligible to monitor the client who underwent angioplasty. Any change in the condition of the client should be reported to the RN in an emergency. Assistance can be given by unlicensed nursing professional (UPN). Assessment of the client's reports is done by the RN. The LPN and UNP are not eligible for assessing reports. Evaluation of the client's reports can be done only by the physician. Which right of delegation would the nurse describe as most instrumental in shaping quality and safety outcomes according to Anthony and Vidal? 1 Right task 2 Right person 3 Right supervision Correct4 Right communication and direction Correct Answer: Right communication and direction is most instrumental in shaping quality and safety outcomes because timely and effective communication enhances the safety and quality of client care. Right task is important to prevent legal issues. Right person is important for ensuring the delegatee has the knowledge and experience to perform the specific task safely. Right supervision is important for monitoring and evaluating appropriately. After assigning a specific task, the registered nurse observes that the delegatee is unable to perform the task accurately. What will be the appropriate statement of the registered nurse in this situation? 1 "It's better if I do the work myself." 2 "We will do the task some other time." 3 "You can't do even this work properly." Correct4 "Just follow my steps and you can do it." Correct Answer: Delegation is a complex process of sharing activities among team members. If a team member is not competent to perform a given task, the registered nurse lowers expectations and helps the delegatee accomplish the task. Therefore the appropriate statement of the registered nurse in this situation is to follow his or her 2 Assigning a task to a new licensed practical nurse(LPN) 3 Providing feedback to the delegatee while performing the task Correct4 Supervising and monitoring the licensed practical nurse (LPN) about the different activities Correct Answer: The delegator should supervise and monitor the delegatee when the work is being assigned to the delegatee. The communication between delegatee and delegator should always be two-way to get the expected outcome. The delegator should evaluate the ability of the delegatee and should supervise the different tasks before assigning the work to the new delegatee. The delegator should always provide feedback at the end of the task. The licensed practical nurse (LPN) has been asked to monitor the blood pressure of a client with hypertension. The LPN reports to the registered nurse (RN) that the blood pressure monitor is malfunctioning. Which component of the duty is the LPN practicing? 1 Authority 2 Supervision Correct3 Responsibility 4 Accountability Correct Answer: Responsibility refers to the reliability, dependability, and obligation to accomplish a task; it is allocated by the delegator and accepted by the delegatee. Authority is the ability of an individual to perform duties in a specific role, it also involves the responsibility of the delagatee to inform the delegator about limitations that may impede completion of a task, such as malfunctioning equipment. Supervision involves the delegator providing guidance and oversight. Accountability involves the delegator determining whether the appropriate actions are being performed and the delegatee providing a detailed explanation of what is happening in the ongoing process. A registered nurse is teaching a group of newly hired licensed registered nurses, licensed practical nurses, and unlicensed nursing professionals. Which teaching strategies would be appropriate to develop competencies? Select all that apply. Correct1 Case studies Correct2 Online learning 3 Teaching experience Correct4 Clinical nursing practice Incorrect5 Demographics of learning group Correct Answer: Competencies can be developed through different teaching strategies such as case studies, online learning, and clinical nursing practice. These strategies can help in improving the learning ability of the student nurses, licensed practical nurses, and unlicensed nursing professionals. Teaching experience and demographics may not be required to develop competencies. An elderly client with periods of confusion underwent surgery and requires assistance for feeding. To which healthcare professional should the registered nurse delegate the task? 1 Charge nurse 2 Nurse manager Correct3 Licensed practical nurse Incorrect4 Unlicensed assistive personnel (UAP) Correct Answer: The registered nurse should delegate the task of feeding to the licensed practical nurse. The charge nurse may delegate the task in the absence of a registered nurse, but he/she is not likely to feed the client. The nurse manager is the designated individual to whom all nursing professionals should be answerable regarding a given task. The UAP performs all hygienic tasks. Feeding the client can be performed by the UAP but only for uncomplicated, low-risk clients. A client underwent extraction of a tooth due to an underlying tumor one day ago. Which healthcare professional is appropriately involved in caring for the postoperative oral hygiene needs of this client? Correct1 Registered nurse (RN) 2 Licensed practical nurse (LPN) 3 Licensed vocational nurse (LVN) Incorrect4 Unlicensed nursing practitioner (UNP) Correct Answer: If there is any anticipated risk in client care, the task should not be delegated but should be carried out by the RN. Because there is a risk of infection and oral bleeding, the RN should not delegate the task of postoperative oral hygiene to the LPN, LVN, or UNP. The registered nurse delegates a task to the unlicensed assistive personnel (UAP). After the UAP starts the task, the registered nurse (RN) asks for feedback related to the task. Which right of delegation is the RN following? 1 Task Correct2 Supervision 3 Circumstance Incorrect4 Communication Correct Answer: The delegation right of supervision refers to obtaining feedback, monitoring, and evaluating the delegatee appropriately. Right task refers to the delegation of an appropriate task based on institutional policies and procedures. Right circumstance refers to evaluation of the working environment and ensuring adequate supervision of delegatees. To ensure right communication, the RN should communicate properly and accurately to the delegatee and provide clear and concise directions for the task. Which actions in the delegation process represent accountability? Select all that apply. Correct1 Monitoring client care Correct2 Seeking the outcome report 3 Assessing the ability of the delegatee 4 Providing honest feedback to the delegatee Incorrect5 Assisting registered nurses with delegation decisions Correct Answer: Monitoring client care and seeking the outcome report represents accountability of the task in case of conflicts. Assessing the ability of the delegatee and educating about the task indicates responsibility. 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 regarding safety issues, urgency to intervene, or potential negative client outcomes. The delegatee is performing a task and in the process loses confidence in what he or she is doing. Which delegator's action may have contributed to the delegatee's loss of confidence? Correct1 Intervening when the delegatee is performing the task 2 Providing feedback about the work performed Incorrect3 Communicating with the delegatee about the work being performed 4 Stating that the task should be completed by a specified time Correct Answer: The delegatee may lose confidence and get frustrated if the delegator intervenes. Therefore intervening in tasks is not encouraged. The delegator can instead provide feedback about the task being performed to help improve the effectiveness of the delegation. Communication generally opens lines between the delegator and delegatee and will be helpful in effective delegation. The delegator should brief the delegatee about the specified time the task should be completed; this would not make the delegatee lose confidence. A delegator is providing feedback to four delegatees. Which feedback is constructive feedback that can help the delegatee to improve quality of care? 1 A 2 B 3 C Correct 4 D Correct Answer: Providing feedback to delegatee D that the procedure properly performed followed by demonstrating a more effective way to perform the task improves quality recognition. The registered nurse performs other activities such as treatment, admissions, and administering intravenous medications. The licensed practical nurse performs activities such as providing oral medications. The registered nurse (RN) delegates a task to a licensed practical nurse (LPN) to take care of the client who underwent a tracheostomy. Which task should be performed by the LPN in this situation? 1 Developing a plan to avoid aspiration 2 Assessing the client's condition after tracheostomy Correct3 Providing tracheostomy care using sterile techniques 4 Teaching a client and caregiver about home tracheostomy care Correct Answer: The licensed practical nurse provides tracheostomy care using sterile techniques. Developing a plan to avoid aspiration in a client with tracheostomy is done by the registered nurse. Assessing the client's condition after tracheostomy is done by the registered nurse. Teaching a client and caregiver about home tracheostomy care is done by the registered nurse. A healthcare team is caring for clients after a fire. The charge nurse delegates different tasks to the healthcare team according to the functional model of nursing. Which team member is eligible and accessible to provide oral medications to any clients? 1 Nursing manager 2 Chief nursing officer Correct3 Licensed practical nurse 4 Unlicensed nursing professional Correct Answer: The licensed practical nurse is eligible and accessible to provide oral medications to clients. The nursing manager is responsible for more than one unit and has other managerial responsibilities and may not be available for providing oral medications to the clients. The chief nursing officer is busy assessing, monitoring, and verifying requirements. The unlicensed nursing professional is not eligible to provide oral medications; they can only monitor and assist the clients. After delegating the task of administering oral medications to a licensed practical nurse (LPN), the registered nurse (RN) ensures that the LPN is supervised until the task is accomplished. Which right of delegation does the scenario reflect? 1 The right task 2 The right person Incorrect3 The right direction Correct4 The right circumstance Correct Answer: The right circumstance is indicated by the appropriate supervision, availability of equipment and resources, and appropriateness of the given situation. If the task is appropriate to the delegate based on institutional policies and is legal then it represents the right task of delegation. If the delegatee has adequate knowledge and experience to perform a task safely and effectively, it represents the right person of delegation. The right direction is indicated by the clear and concise directions provided for the task. Which question does the registered nurse recognize as related to the right of circumstance when delegating? Correct1 "Is the delegation appropriate to the situation?" 2 "Is the task within the delegatee's scope of practice?" 3 "Is the prospective delegate a willing and able employee?" Incorrect4 "Is the delegator able to monitor and evaluate the client appropriately?" Correct Answer: The question, "Is the delegation appropriate to the situation?" is related to right circumstance. The question, "Is the task within the delegatee's scope of practice?" is related to right task. The question, "Is the prospective delegate a willing and able employee?" is related to right person. The question, "Is the delegator able to monitor and evaluate the client appropriately?" is related to right supervision. While caring for a post-operative client, the delegator has assigned a task to a delegatee. Which statements made by the delegator indicates that the delegatee has the experience to perform the task? Select all that apply. Correct1 "I am available to you at any time for report." Correct2 "I am aware of your technical competencies." 3 "I will tell you what is necessary to perform the task." Incorrect4 "I will share my expectations about your performance." Incorrect5 "I will tell you what conditions are important to notify each other." Correct Answer: A delegatee with good experience may need little guidance. He or she knows what to do and when to report. As the delegatee has experience, he or she should just remember that the delegator is available at all times; the delegate can report at any time. The delegator should also make it known that the delegatee's competencies are known. The delegator tells a delegatee who is new to a task what is necessary to perform that task. The delegator will share expectations about the delegatee's performance when that delegatee can do the work and when he or she is new in assisting the registered nurse (RN). When the delegatee can do the work and is new in assisting the RN, the delegator tells the delegatee the appropriate conditions for notifying one another. The registered nurse (RN) has delegated a task to an unlicensed nursing personnel (UNP). After performing the task, the UNP reports to the RN for appraisal. Which statement by the UNP is related to individual accountability? Select all that apply. Correct1 "I take full responsibility for the action performed." Correct2 "I have ensured that the action has achieved the desired outcome." 3 "I have ensured that there is a ventilator placed in every intensive care unit." 4 "I have established systems for assessing and monitoring the tasks assigned." Incorrect5 "I have evaluated whether the work environment is conducive to work or not." Correct Answer: Individual accountability is a component of delegation. It refers to the individual's ability to take responsibility for the actions performed and outcomes related to the task, which are obtained after the action. Ensuring that there is a ventilator placed in the intensive care unit, establishing systems for assessing and monitoring the competencies, and evaluation of the work environment are all related to organizational accountability, not individual accountability. When assigning a task, the delegator should understand the delegatee's personal values and align them with the organizational values. Which task can be achieved from this delegation? Correct1 Affirming 2 Managing Incorrect3 Renewing 4 Motivating Correct Answer: In the task of affirming values, sharing the personal values of the delegatee and aligning them with organizational values enables the delegatee to achieve an outcome. In managing, the delegator assists the delegatee with planning. In renewing, the outcome is achieved by enhancing the ability to care for the delegatee. In motivating, the delegatee is inspired to achieve the outcome. The registered nurse (RN) delegates obtaining and recording a client's pulse every 30 minutes. During the last hour, the licensed practical nurse (LPN) fails to report the client's elevated heart rate to the RN. Which factor best explains the situation? 1 Limited delegation 2 Information salience Correct3 Decayed information 4 Ineffective supervision Correct Answer: Information decay is the characteristic feature of communication that occurs when the client's health status changes rapidly; this might include a Correct2 The institution remains legally responsible for the situation. Correct3 The accountability for care remains with the registered nurse (RN). 4 The licensure of the licensed practical nurse (LPN) would be revoked. Incorrect5 The accountability for care remains with the licensed practical nurse (LPN). Correct Answer: If the delegated task is not performed within acceptable standards, a potential for nursing malpractice emerges. Failure to delegate and supervise within acceptable standards may extend to direct corporate liability for the institution. Whenever care is provided by staff other than a registered nurse (RN), the accountability for care remains with the delegator who is an RN. The licensure of the licensed practical nurse (LPN) would not be cancelled because the LPN is not held accountable for the situation. When the work is assigned to the LPN, only responsibility of the task is transferred. The nurse is managing a client who underwent cardiac bypass surgery. Which healthcare member can be safely delegated the task of monitoring electrocardiography? 1 Nurse aide 2 Certified technician Correct3 Cross-trained technician Incorrect4 Licensed vocational nurse (LVN) Correct Answer: A cross-trained technician is suitable for monitoring electrocardiography in a client who underwent bypass surgery. A nurse aide is an unlicensed individual who can assist the client with basic hygiene; this aide cannot monitor electrocardiography. A certified technician is also an unlicensed member who can only record the vital signs or provide basic hygiene to the client. A licensed vocational nurse (LVN) can administer oral and intramuscular medications and record the vital signs. A registered nurse (RN) delegates the task of foot care for a client to an unlicensed nursing personnel (UNP). The UNP is skillful and willing to perform the given task, but was recently hired and is unfamiliar with the client's condition. What should the RN do in this situation? 1 Provide guidance to the UNP. 2 Observe and motivate the UNP. Correct3 Establish mutual expectations and conditions. Incorrect4 Explain what to do and how to perform the task. Correct Answer: If the delegatee is new to the workplace, but has the ability and willingness to perform a task, the RN should establish mutual expectations and conditions of performance to establish a good relationship. If the delegatee has limited knowledge and ability to perform a task, the delegator is expected to guide the UNP. The RN is expected to observe and monitor the task performed by the delegate to ensure the delegatee has the ability and willingness to establish a relationship and accomplish the work. The RN can also explain the task and how to execute it if the situation involves a new task and relationship is ongoing. A nursing assistant is working with a delegator. Which action of the nursing assistant may negatively affect client care management? 1 Addressing challenges together Correct2 Performing the same tasks as the delegator 3 Initiating conversation about the new roles and functions Incorrect4 Communicating the cultural perspectives with the delegator Correct Answer: Nursing assistants who have similar strengths as the delegator should adapt to changing situations. A nursing assistant performing the same tasks as the delegator may create a gap in the delivery of client care. Building on the strengths and minimizing the challenges of the team proves to be an effective strategy. Initiating a conversation about the new roles and functions in the organization can open lines of communication to explain why supervision is necessary. It also helps to eliminate or diminish any negative feelings about being supervised. The lines of communication between the delegator and the nursing client can be improved by appreciating and valuing cultural perspectives. The registered nurse is delegating tasks for nursing assistants caring for a client who requires more attention. Which element should be considered when selecting the suitable nursing assistant for delegation of a task? 1 Time Incorrect2 Safety 3 Stability Correct4 Critical thinking Correct Answer: Critical thinking is of utmost importance for selecting a suitable nursing assistant for delegation of a task in a situation where a client requires more attention, as the delegatee should be able to perform the task effectively. Time, safety, and stability are also the elements for effective delegation, but these are suitable depending on the situation for assigning a task and delegation. Which delegatee requires little guidance from the delegator? Correct1 Delegatee who is familiar with the task but not the client 2 Delegatee who has experience but is unfamiliar with the task 3 Delegatee who has little experience but has willingness to do the task 4 Delegatee who is very familiar with the client but has a lack of ability to do the task Correct Answer: A delegatee who has experience and is familiar with the task requires less guidance and support from the delegator as he or she has the ability to accomplish the task. A delegatee who has work experience may have ability but requires guidance as he or she is new to the delegated task. A delegatee who shows willingness to do the task but has little experience requires supervision. A delegatee who is familiar with the client but has a lack of ability to do the task requires supervision or guidance. The registered nurse is caring for a client admitted with sudden paralysis in the legs and an inability to walk. Which interventions made by the registered nurse (RN) indicates correct active delegation? Select all that apply. 1 The RN assessing the client's diagnostic and laboratory findings 2 The RN administering an intravenous (IV) calcium gluconate injection Correct3 Instructing the licensed practical nurse (LPN) to report client's vital signs Correct4 Instructing the licensed practical nurse (LPN) to administer vitamin B12 injection 5 Instructing the unlicensed nursing personnel (UNP) to administer oral vitamin D3 Correct Answer: In active delegation, the RN assesses the situation, determines what is appropriate for client care, directs assistive personnel to perform certain tasks, and holds the individual accountable. Instructing the LPN to report the client's vital signs is an active delegation that includes directing the assistive personnel to perform the task. Instructing the unlicensed nursing personnel to administer oral vitamin D3 is beyond their scope of practice. The RN assessing the client's diagnostic and laboratory findings does not involve delegation. The RN administering an intravenous calcium gluconate injection does not involve delegation. Instructing the LPN to administer a vitamin B12 injection is within the scope of practice for the LPN. What happens when a registered nurse does not trust other individuals in the healthcare organization? Select all that apply. Correct1 Altered client care 2 Appropriate delegation Correct3 Compromised healthcare Correct4 Limited career opportunity 5 Efficient time management Correct Answer: Registered nurses who do not trust other individuals in a healthcare organization may choose to perform the tasks themselves and this leads to altered client care. Consistently choosing to perform tasks themselves may lead to A patient care associate (PCA) is delegated a task that can be completed in 2 hours. The PCA has limited knowledge and willingness regarding that particular task. Which leadership style should be implemented by the delegator in this situation? 1 Selling Correct2 Telling Incorrect3 Monitoring 4 Participating Correct Answer: If the ability and willingness of the delegatee is low and the work assigned to the delegatee can be completed in 2 hours, it means the nature of relationship between delegator and delegatee is limited. In such situation, the leadership style of the delegator should be telling, because it provides a fair amount of guidance and also limits the time spent on the interactions. The selling style of leadership should be used when the relationship is ongoing; that is, individuals who usually work together continue to work together. The monitoring style should be used when the delegatee has the ability and willingness, and has an established relationship with the delegator. The participating style can be implemented when the delegatee is willing to perform the task. A registered nurse (RN) diagnosed with chemical impairment issues is transferred to work at a rehabilitation center as a part of treatment. Which actions performed by the nurse manager at the new work place result in effective outcome of treatment for chemical impairment? Select all that apply. Correct1 Restricting the RN from working near the abused chemical 2 Delegating other staff to assist the RN in providing client care Correct3 Restricting the RN from administering any controlled substances 4 Requiring the RN to share what he or she is doing to control the problem Incorrect5 Permitting the RN to share the problem with other members of the healthcare team Correct Answer: The RN's job has been moved to a rehabilitation center because of chemical impairment issues and the RN is restricted from working at a facility where the drug is used, which helps the RN in his or her recovery. Controlled substances may be abused, so restricting the RN from administering such substances may result in effective outcome of therapy. Delegating the other staff the task of assisting the RN in providing client care may be a positive experience for the staff, but this intervention may not result in positive outcome of the treatment. Requiring the RN to share what he or she is doing to control the problem or allowing the RN to share his or her problem with other staff of the healthcare team may not result in positive outcome of the treatment. The nurse is assessing the level of readiness before delegating tasks to unlicensed assistive personnel (UAP). According to Hersey's model of situational leadership, what specific factors reflect the level of readiness? Select all that apply. Correct1 Ability 2 Honesty Incorrect3 Reliability Correct4 Willingness Incorrect5 Conscientiousness Correct Answer: Ability and willingness are two factors that determine the level of readiness according to the Hersey's model. Honesty and reliability may not determine the readiness of the UAP to perform a delegated task. Conscientiousness is the desire to complete a task, which may not determine readiness if the UAP does not have sufficient knowledge to perform the task. After assessing the delegatee's inability to perform an assigned task, the delegator explains the procedure and demonstrates the task to the delegatee. What can be inferred about the delegatee? 1 The delegatee may have limited knowledge and ability to perform the task. 2 The delegatee has an established relationship with the delegator and expertise. Incorrect3 The delegatee has the willingness and ability, but the relationship with the delegator is new. Correct4 The delegatee may have an ongoing relationship with the delegator, but a new task is assigned. Correct Answer: When the delegatee has an ongoing relationship with the delegator, but a new task is assigned, the delegator should explain and demonstrate the procedure. When the delegatee has limited knowledge and ability to perform the task, the delegator should provide more guidance. When the delegatee has an established relationship with the delegator and the expertise, little guidance is needed from the delegator to perform the task. When the delegatee has the willingness and ability to perform a task, but the relationship is new, it requires both individuals to create mutual expectations and the conditions for performance. The registered nurse (RN) who was caring for a postsurgical client went out for a break. The RN assigns the work to a healthcare professional who is also an RN. Which is the correct statement regarding this situation? 1 The situation describes delegation. Correct2 The situation describes assignment. 3 The second nurse holds accountability rather than responsibility for the client. Incorrect4 The second nurse holds responsibility rather than accountability for the client. Correct Answer: When the work is assigned to another registered nurse (RN), it indicates assignment. The RN holds responsibility and also accountability of the assigned task. When the work is assigned to other practitioners, it indicates only responsibility is transferred. Which assets of the nurse as a licensed health care professional help in planning effective nursing care? Select all that apply. Correct1 Critical thinking Correct2 Diagnostic reasoning Correct3 Ability to synthesize information Incorrect4 Establishment of assessment system for the organization Incorrect5 Communication of competency requirements Correct Answer: The nurse uses critical-thinking skills to analyze the process of delegation. Diagnostic reasoning and the ability to synthesize information from various sources are also skills that allow the nurse to deliver an effective nursing care plan that is beneficial for the client. Establishing systems for assessment and the communication of competency requirements are the responsibilities of a chief nursing officer. Which right does the question, "Do staffing ratios demand the use of high-level delegation strategies?" indicate? 1 The right task 2 The right person Incorrect3 The right supervision Correct4 The right circumstance Correct Answer: The right circumstance can be assessed by asking, "Do staffing ratios demand the use of high-level delegation strategies?" The right task is assessed by the legally appropriate delegate, using institutional policies and procedures. The right person is selected when the delegatee has the knowledge and experience to perform the specific task safely. Providing feedback related to the task and monitoring the client promote right supervision. The healthcare team is caring for a client with neutropenia. Which task is delegated to unlicensed assistive personnel? 1 Administering antibiotics Correct2 Assisting with personal hygiene Incorrect3 Monitoring for signs and symptoms of infection (UNP) can provide safe client care. It is not ideal to increase the numbers of UNPs in the emergency department due to client instability. The nursing assistant has to adapt to changing situations to deliver proper client care. The delegator must train and monitor the performance of the nursing staff, who are responsible for completing tasks in a specified time. This helps in improving the performance of any incompetent nursing staff. The intensity and length of the interactions with the client are also significant factors to consider in planning client care. The UNP can provide efficient client care in long-term care facilities because the clients are stable. Which statement is correct regarding delegation? Select all that apply. Correct1 It involves transfer of authority. Correct2 The delegator retains accountability for the outcome. Incorrect3 The delegatee retains accountability for the outcome. 4 It is the transfer of both responsibility and accountability. Correct5 Principles of delegation outline what nurses need to know about the task. Correct Answer: Delegation involves two people—delegator and delegatee—with the transfer of authority to perform the task. The delegator retains accountability for the outcome of the task delegated. The delegatee holds responsibility but not accountability for the task. Assignment involves the transfer of both responsibility and accountability of the work to the delegatee. Principles of delegation outline what nurses need to know and do in relation to completing the task. Which factors does the registered nurse consider in the decision to delegate process? Select all that apply. 1 Evaluation Incorrect2 Nursing judgment Correct3 Predictability of outcomes Incorrect4 Pervasive functions of assessment Correct5 Complexity of the task to be performed Correct Answer: Two factors responsible for the decision to delegate process are predictability of outcomes and complexity of the task to be performed. Evaluation, nursing judgment, and pervasive functions are not factors in the decision to delegate process. What does the nurse say is the advantage of an appropriate delegation? 1 Assistance 2 Accountability Incorrect3 Empowerment Correct4 Reduced stress Correct Answer: Appropriate delegation reduces stress and increases time efficiency by providing timely care to the client. Assistance or direction is asked by the delegatee to complete the task if the nurse provides limited information on an assigned task. The nurse is accountable and responsible for the task assigned to the delegatee if the delegation does not work properly. Delegation requires empowerment of the delegatee to accomplish a task. Before assigning a task, the registered nurse makes sure that the prospective delegatee is willing to complete the task. Which delegation right does this situation reference? Correct1 Person 2 Supervision 3 Circumstance Incorrect4 Communication Correct Answer: Ensuring that the prospective delegatee is willing to complete the task refers to the delegation right person. Knowing whether the delegator is able to monitor and evaluate the client appropriately refers to the delegation right supervision. Ensuring whether the equipment and resources are available to complete the delegation process refers to circumstance. Ensuring whether the delegator and delegatee understand a common work-related language refers to the delegation right communication. Which characteristic of the nurse as a delegator is reflected in the statement, "Let me show you how this procedure is done; then you can do it yourself"? Correct1 Doing 2 Asking Incorrect3 Offering 4 Delegating Correct Answer: Doing occurs by demonstrating the specific task or behavior to improve client care. The statement, "Let me show you how this procedure is done; then you can do it yourself," indicates doing. Asking begins with questions related to the problem or issue regarding client care and can open lines of communication between the delegator and the delegatee. Offering involves making a suggestion to facilitate the achievement of a desirable outcome. Delegating refers to transferring responsibility for the performance of a task nurse or delegator to the delegatee while retaining the accountability for the outcome. While caring for a client with asthma, the delegator assigns the client to a registered nurse (RN) and to a licensed practical nurse (LPN). Which component of delegation is transferable to the RN? Select all that apply. Correct1 Authority Incorrect2 Supervision Correct3 Responsibility Correct4 Accountability 5 Communication Correct Answer: Authority, a component of delegation, is transferred to the registered nurse (RN) by the delegator. Responsibility is the component of delegation that is transferable to the RN. Accountability is also a component of delegation that is transferable to the RN. Supervision and communication are rights of delegation. Which component of delegation is defined as the ability to perform duties in a specific role? Correct1 Authority 2 Supervision 3 Responsibility 4 Accountability Correct Answer: Authority is the ability to perform duties in a specific role. Supervision is the provision of guidance and oversight of a delegated task. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability involves determining whether the actions are appropriate and providing a detailed explanation of what has occurred. While assigning a task, the registered nurse finds that one of the delegatees is not competent to hold the current position. Which strategy does the nurse follow for managing this issue during delegation? 1 Attacking the delegate verbally 2 Doing the task himself or herself Incorrect3 Adjusting the quality of client care Correct4 Lowering the expectations temporarily Correct Answer: When the delegatee is not competent to hold the current position, the registered nurse temporarily lowers expectations. Temporarily lowering the expectations helps the delegatee to build strengths, minimize weaknesses, and gain confidence. Verbal attacking does not help in the situation but will only undermine the relationship between the delegatee and the registered nurse. If the registered nurse does the task herself or himself, the delegatee will not improve. Delegation is a process meant to improve the quality of client care but it is not a strategy to overcome the situation. How should a student nurse be trained for implementing delegation in practice? always retained with the delegator. Delegation involves the delegator and the delegatee. Delegation is an important strategy for ensuring client safety and quality of client care. Delegation has five rights that are to be followed throughout the delegation process: right task, right person, right circumstance, right direction/communication, and right supervision. A healthcare team is caring for a client with food poisoning. Which task is most suitable to be delegated to licensed practical nurse (LPN)? 1 Collecting vital signs 2 Performing a stomach wash Correct3 Administering oral antiemetic medication 4 Administering intravenous replacement fluids Correct Answer: The licensed practical nurse (LPN) can perform activities such as administering oral medication for the client. Monitoring vital signs can also be performed by the LPN but since the condition of the client is acute, it will be performed by the registered nurse. Performing a stomach wash and administering intravenous replacement fluids are performed by the registered nurse. The nurse is caring for a pregnant client with hypertension. Which client care tasks are most suitable to be delegated to the patient care associate (PCA)? Correct1 Recording the vital signs 2 Monitoring the blood pressure 3 Administering intravenous fluids 4 Administering antihypertensive medications Correct Answer: A patient care associate (PCA) is an unlicensed assistive personnel whose scope of practice is very limited. A PCA can be delegated the task of recording the vital signs as communicated by the delegator even if the condition of the client is acute or unstable. In stable clients, the PCA may be instructed to monitor the blood pressure, but in this acute condition, only the registered nurse (RN) should monitor the blood pressure. Administration of intravenous fluids or medications is out of scope of practice of the PCA. A PCA is not suitable to be delegated the task of administering any medication to a client. The registered nurse (RN) is planning to provide feedback to the licensed practical nurse(LPN). Which questions asked by the RN help in eliciting the LPN's work quality? Select all that apply. 1 "Are you feeling well today?" Correct2 "How did the patient respond?" 3 "Has the task been completed?" 4 "Are you willing to perform the task?" Correct5 "What changes were observed in the client?" Correct Answer: Providing feedback is the best strategy for shaping the future behavior of the individual. To elicit feedback, a series of open- ended questions should be asked by the registered nurse (RN). This will help collect pertinent information from the individuals delegated a portion of client care, such as client's response and the task to be completed. Asking personal questions about the delegatee does not help in eliciting the work quality of the delegatee. Asking whether the task has been completed is not an open- ended question. Willingness to perform the task directly implies the work interest of the delegate, but not the quality of the delegatee's work. The registered nurse (RN) is teaching a newly hired nurse about delegating tasks to the healthcare team. When asked what the rights of delegation are, which right listed by the hired nurse indicates the need for further teaching? Select all that apply. 1 Right task Incorrect2 Right direction 3 Right person Correct4 Right drug name 5 Right circumstance Correct Answer: The 5 rights of delegation are right task, right circumstance, right person, right directions and communication, right supervision and evaluation. A nurse manager delegates the task of phlebotomy to the members of a healthcare team who are caring for a client with diabetes. Which individual on the team can be delegated to perform the task of phlebotomy? Incorrect1 Registered nurse Correct2 Cross-trained technician 3 Licensed vocational nurse 4 Unlicensed assistive personnel Correct Answer: A cross-trained technician can safely perform the task of phlebotomy when paired with a registered nurse (RN). The RN delegates tasks to other assistive personnel. A licensed vocational nurse is assigned to administer oral and intramuscular medications to clients. Unlicensed assistive personnel are delegated to perform basic hygiene for clients. The registered nurse oversees five unlicensed nursing personnel (UNP), and each UNP cares for five clients, so the registered nurse in effect has responsibility for five UNPs and 25 clients. What do these numbers of subordinate and clients indicate? Incorrect1 Supervision Correct2 Span of control 3 Passive delegation 4 Appropriate authority Correct Answer: Span of control is the number of individuals the supervisor or delegator is responsible for. In this instance, the RN is responsible for the delegatees as well as the clients they are caring for. Supervision involves ensuring that the appropriate oversight and guidance is provided for a delegated task. Passive delegation occurs when licensed members of an organization perform tasks that are essential to their normal practice. Appropriate authority is the specific ability to perform the work or task. The registered nurse is delegating work to four delegatees. Which delegatee has an established relationship with the delegator? 1 Delegatee A Correct2 Delegatee B 3 Delegatee C Incorrect4 Delegatee D Correct Answer: According to Hersey's model, if the relationship between the delegator and delegatee is established, the behavior of the delegator is "observing or monitoring." Telling delegate B that his or her method is correct and to continue doing it in the same way indicates that the delegator is monitoring the delegatee's actions, which indicates an established relationship. Recommending delegatee A do the procedure because it can easily be done indicates a persuading behavior, which is done when the relationship between the delegator and delegate is developing. According to Hersey's model, if the relationship between the delegator and delegate is limited, the behavior of the delegator is "telling." The delegator is simply telling delegatee C to check the client's blood sugar level every morning for 5 days, which indicates a limited relationship between them. Participating in the work of delegatee D by demonstration indicates a new relationship. A nurse delegator assigns work to a delegatee who has the ability and willingness to do the work but the relationship between the delegator and delegatee is relatively new. How is the delegator's behavior described according to Hersey's Model? 1 Selling 2 Telling 3 Delegating Correct4 delegated to unlicensed assistive personnel (UAP). Administration of oral medication can be done by the licensed practical nurse (LPN). Licensed vocational nurses (LVNs) can care for the clients in a hospice care setting. Administration of intravenous medication cannot be done by LPNs as they are not eligible. Diabetic clients cannot be cared by UAP as this group does not have sufficient knowledge about how to care for clients with diabetes. 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 Incorrect3 Delegating Correct4 Participating Correct Answer: When the LPN has the willingness and ability to perform a task, but the relationship is new, the RN will share his or her expectations and conditions with the LPN. This is a clinical example of participating. Participating is encouraging the delegatee to perform the task and taking an active part in problem solving, which may occur during the execution of a given task. If the LPN has limited knowledge and ability to perform a task, the RN will provide more guidance, which is an example of telling what is the task to be done and how it is to be performed. If the LPN is delegated a new task, it requires explanation from the RN. This is termed as selling in Hersey's model, which is the process of explaining and persuading; this happens if a situation involves a new task and the relationship is ongoing. If the LPN has an established relationship and experience, he or she requires a little guidance and this is called delegation. The registered nurse (RN) is caring for a client with epilepsy. Which tasks delegated by the registered nurse (RN) to the assistive personnel indicates active delegation? Select all that apply. 1 Instructing the licensed practical nurse (LPN) to administer diazepam Correct2 Instructing the licensed practical nurse (LPN) to monitor the vital signs 3 Instructing the licensed vocational nurse (LVN) to administer sedatives Correct4 Instructing the unlicensed assistive personnel (UAP) to reposition the client Correct5 Instructing the unlicensed assistive personnel (UAP) to place the oxygen mask Correct Answer: Passive delegation includes performing the tasks based on the position description such as physician or pharmacist. The individual functioning in this role performs these tasks through passive delegation. Instructing the LPN to administer diazepam, medication that was already prescribed by the primary healthcare provider, is passive delegation. Instructing the LVN to administer sedatives that were already prescribed by the primary healthcare provider is passive delegation. Instructing the LPN to monitor vital signs is active delegation as the RN directs assistive personnel to perform certain tasks and holds the individual accountable. Instructing the UAP to reposition the client is also an active delegation as the UAP is carrying out certain tasks that are directed by the RN. Instructing the UAP to place the oxygen mask is an active delegation as the RN directs assistive personnel to perform certain tasks. Which action by the nurse constitutes constructive feedback for the delegatee? 1 Providing verbal attacks on feedback Incorrect2 Providing feedback to individual delegatee 3 Providing nonspecific feedback about the behavior Correct4 Providing open feedback about specific strategies for change Correct Answer: The best strategy is to provide open, honest, and constructive feedback. The feedback should be about work- related performance and specific strategies for change in the quality of performance. A verbal attack on a delegatee does not produce effective change and could undermine any long-term working relationship. Providing feedback to an individual delegatee as satisfactory may diminish the credibility of the nurse. Creating a work environment in which specific feedback about performance is provided is the best strategy for shaping the future behavior of the delegatee. A healthcare team is caring for a 68-year-old client with diabetes insipidus. Which task is most suitable to be delegated to licensed practical nurse (LPN) to provide effective client care? Select all that apply. Incorrect1 Emptying the urinary drainage bag Correct2 Monitoring urine output 3 Feeding the client with food 4 Administration of intravenous fluids Correct5 Administering oral rehydration medication Correct Answer: The LPN scope of practice includes monitoring urine output. Administration of any type of oral medication can also be performed by the LPN. Activities related to a client's hygiene such as emptying the drainage is usually performed by unlicensed assistive personnel (UAP). Feeding the client is usually performed by a UAP. Administration of intravenous fluids is the responsibility of the registered nurse. Which among the Five Rights of Delegation is the cornerstone of delegation? 1 "Right person" 2 "Right supervision" 3 "Right circumstance" Correct4 "Right communication and direction" Correct Answer: Among the Five Rights of Delegation, "right communication and direction" is the most important right of delegation. It is the most useful in maintaining the quality and safety outcomes, as it involves communication and direction. "Right person" is useful for understanding which person has the appropriate skills to perform the task. "Right supervision" involves monitoring the tasks that are performed with the goal of improving outcomes. "Right circumstance" seeks to ensure that the appropriate equipment and resources are available for the delegatee. The registered nurse (RN) delegates the collection of respiratory rate data to a licensed practical nurse (LPN) for a client who is experiencing severe dehydration and whose condition is unstable. The LPN reports the data to the RN. The RN rechecks the data and finds that the report no longer reflects the patient's current condition. Which characteristic of communication has interfered with the delegation process? Correct1 Information decay 2 Information salience 3 Confidence in abilities 4 Synergy between team members Correct Answer: Information decay can occur in a rapidly changing situation when reported information is no longer relevant to a patient's condition. Information salience describes the different ways individuals from different backgrounds might assess the quality, meaning, and clarity of certain information. Trust is developed when there is confidence in the abilities and capabilities of the team members. Healthy relationships among members of the health care team promote synergy between the team members. The registered nurse (RN) is caring for a client with severe diarrhea. Which task of the client care plan can be safely delegated to the unlicensed assistive personnel (UAP) by the registered nurse? 1 Administration of oral antidiarrheal 2 Administration of intravenous antibiotics Correct3 Administration of oral replacement fluids 4 Administration of intravenous antiemetics Correct Answer: The scope of practice of the UAP is limited to perform basic care, feeding, and hygiene. Administering oral replacement fluids can be safely performed by the UAP, as it is a basic care that may also be included under feeding. Administering oral medications such as antidiarrheal drugs can be safely delegated to a licensed practical nurse (LPN) or a licensed vocational nurse (LVN) according to guidelines but not to the UAP. Administering intravenous medication such as antibiotics or antiemetics is the role of the registered nurse. to provide care to client D with cardiogenic shock, and acute condition which may require continuous monitoring of vital signs. The registered nurse is teaching a newly hired nurse about communicating with delegatees during delegation. Which statement made by the newly hired nurse indicates the need for further learning? 1 "I should identify priorities." Incorrect2 "I should specify deviations." Correct3 "I should provide examples of each delegation." 4 "I should specify any performance limitations to the delegatee." Correct Answer: The delegator should ask the delegatee to provide examples of each delegation in order to understand his or her knowledge level. The delegator should identify priorities before delegating the task to the delegatee. The delegator should specify deviations, such as when the delegatee must take an immediate action while performing the task. The delegator should specify the performance limitations to the delegatee, which can help in performing the task effectively. The registered nurse is caring for an elderly client who is admitted with severe asthma. Which task delegated by the nurse is most suitable to be performed by the client attendant? Incorrect1 Assessing the vital signs 2 Monitoring respiratory rate 3 Administering inhalational medications Correct4 Assisting the client during nebulization Correct Answer: The client attendant is the unlicensed assistive personnel whose scope of practice is limited to providing basic care and comfort to the client. Assisting the client during nebulization is considered basic care and comfort and can be safely carried out by the client attendant. Assessing vital signs should be performed by the registered nurse. Monitoring respiratory rate can be delegated to the client attendant if the client condition is stable; however, since this client's condition is not stable, this task should not be delegated. Administering inhalational medications is not performed by unlicensed personnel such as a client attendant. During the process of delegation, the delegator's behavior is noted to be observing and monitoring. How is the relationship between the delegator and delagatee in this situation? 1 Limited Correct2 Established 3 New or developing Incorrect4 Developing or ongoing Correct Answer: Observing and monitoring behavior of the delegator indicates delegating, which is done when the relationship between the delegator and delegatee is established. The delegator's behavior is guiding or directing when the relationship between the delegator and delegatee is limited. The delegator's behavior is encouraging or problem solving when the relationship between the delegator and delegatee is new or developing. The delegator's behavior is explaining or persuading when the relationship between the delegator and delegatee is developing or ongoing. Which intervention should the charge nurse perform to manage a task when the unlicensed nursing personal (UNP) is lacking competence? 1 Provide constructive feedback and assign another task. 2 Provide open vocal feedback and withdraw the UNP from task. Correct3 Provide additional support and temporarily lower expectations. Incorrect4 Provide accountability to the organization and undergo training again. Correct Answer: The charge nurse should manage a task by temporarily lowering expectations and providing additional support to an unlicensed nursing personal (UNP) who is lacking competence. This strategy allows the UNP to build on strengths, minimize weaknesses, and gain confidence. Providing constructive feedback and assigning another task may not improve the strategy of the UNP and may affect the productivity of the new task. Withdrawing the UNP from the task and providing open vocal feedback may weaken the working relationship and the UNP may lose confidence or become frustrated. The charge nurse should be aware of accountability to the organization in case of a failure of the delegation, but assigning the UNP for further training may lead to high risk for legal liability. Which quality of the nursing assistant should be known by the delegator when assigning a task? Correct1 Ability 2 Willingness 3 Interaction 4 Relationship Correct Answer: The ability of the nursing assistant to perform a task should be known by the delegator before assigning a task. The willingness of the delegatee to work on a task can be understood by the delegator while communicating with the delegatee. Interaction is the quality of a delegatee, which can determine the effectiveness of the delegatee to perform a task. Relationship between the delegator and delegatee is not an aspect that should be known by the delegator before assigning a task. What are the three strategies that the nurse can perform while assisting other nurses in making delegation decisions? Select all that apply. Correct1 Doing 2 Telling Correct3 Asking Correct4 Offering 5 Participating Correct Answer: The nurse can assist other registered nurses with delegation decisions by using three strategies: asking, offering, and doing. Telling and participating are the strategies used by the nurse to communicate with the delegatee. Who functions as a liaison between team leaders and other healthcare providers? Correct1 Charge nurse 2 Registered nurse 3 Nursing manager 4 Chief nursing officer Correct Answer: The charge nurse functions as a liaison between team leaders and other healthcare providers. Registered nurses function as accountable and responsible people for delegated tasks. Nursing managers are responsible for more than one unit and have other managerial responsibilities. Chief nursing officers are accountable for establishing systems to assess, monitor, verify, and communicate competency requirements related to delegation. The registered nurse (RN) is caring for a client who underwent a hysterectomy. Which tasks can be delegated to the unlicensed assistive personnel (UAP) to provide quality care to the client? Select all that apply. Correct1 Recording vital signs Correct2 Assisting the client with bathing 3 Administering oral medications 4 Preparing the care plan for the client 5 Administering intravenous antibiotics Correct Answer: The tasks within the scope of unlicensed assistive personnel (UAP) include recording vital signs and providing basic hygiene, such as assisting the client with activities of daily life such as bathing. Administering oral medications is under the scope of licensed practical nurse (LPN) or licensed vocational nurse (LVN), but not the UAP. Depending on the state, administering intravenous antibiotics can be performed by either the RN or an LPN/LVN. Preparing the care plan for the client should be performed by the registered nurse only. Licensed practical nurse Correct Answer: Charge nurses act as delegators as they also have knowledge and expertise in the clinical setting. In cases where there are a limited number of unlicensed nursing personnel, the registered nurse does not delegate tasks. In this instance the charge nurse usually becomes a delegator and delegates the tasks. The chief nursing officer is not the immediate person to delegate the tasks in such instances. Patient care associates and licensed practical nurses act as delegatees. Which task can be delegated to the licensed vocational nurse (LVN)? Select all that apply. 1 Analyzing vital signs 2 Maintaining oral hygiene 3 Administering intravenous drugs Correct4 Administering oral hypoglycemic agents Correct5 Administering intramuscular medications Correct Answer: Licensed vocational nurses and licensed practical nurses are authorized to administer drugs through oral and intramuscular routes. Analyzing vital signs should be performed by the registered nurse. Hygiene maintenance can be delegated to unlicensed nursing practitioners (UNP). Administering intravenous drugs should be done by the registered nurse. Which work is automatically increased for the delegator when there is a decrease in direct client care? 1 Leadership Correct2 Supervision 3 Delegation 4 Assignment Correct Answer: After delegating tasks to other members of the health care team, the delegator's care towards the client in a direct way decreases, and the supervisory work of the delegator increases. Leadership work does not necessarily increase when there is a decrease in direct client care. Delegation and assignment of work does not increase, because the work has already been delegated to another health care team member. A healthcare team is caring for a client with dental pain. Which task is most suitable to be delegated to unlicensed assistive personnel (UAP) to provide effective client care? 1 Administering analgesics 2 Administering intravenous antibiotics 3 Administering nerve block anesthesia Correct4 Administering mouth wash for oral hygiene Correct Answer: The UAP scope of practice includes administering mouth wash to the client. Instructing the UAP to administer medications such as antibiotics and anesthetics is inappropriate because the UAP is not eligible to do so and may not have the knowledge to administer medications. Administering nerve block anesthesia should be performed by the anesthesiologist. Which nursing model includes a registered nurse (RN) paired with technical assistance? 1 Team nursing model Correct2 Co-primary nursing model 3 Patient-focused care model 4 Functional model of nursing Correct Answer: In the co-primary nursing model or practice partnership model, the registered nurse (RN) is paired with technical assistance. The team nursing model is a modification of the functional nursing model. The focused care model is the care delivered in patient-focused care. The functional model of nursing is a method of providing care by each licensed and unlicensed staff member who performs specific tasks for a large group of clients. During the delegation process, which healthcare professional acts as a liaison between the team leader and healthcare provider? Correct1 Charge nurse 2 Nurse manager 3 Nursing supervisor 4 Chief nursing officer Correct Answer: The charge nurse is responsible for acting as a liaison between the team leaders and healthcare providers. Nurse managers cannot act as a liaison between the team leader and other healthcare providers because they are often responsible for more than one unit and have other managerial responsibilities. The nursing supervisor will be delegated to supervise and ensure effective outcomes for the tasks delegated to the delegatees. The chief nursing officer is responsible for establishing the systems for assessment. The registered nurse is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for being delegated the task of administering vaccinations? 1 Nursing aide 2 Certified technician 3 Patient care associate Correct4 Licensed practical nurse Correct Answer: Tetanus vaccination is administered through the intramuscular route. The licensed practical nurse can administer oral, topical, and intramuscular medications, except for intravenous. The nursing aide, certified technician, and patient care associate are unlicensed assistive personnel whose scope of practice is limited for administering medications. Who is most accountable for an initial assessment and the ongoing evaluation of client care? 1 Client Correct2 Registered nurse 3 Licensed practical nurse 4 Unlicensed nursing personnel Correct Answer: Registered nurses are accountable for initial assessment and the ongoing evaluation of client care. The client is not responsible for assessment and evaluation. The licensed practical nurse has a responsibility to assess and report client care. Unlicensed nursing personnel perform tasks as delegated by the registered nurse. The nurse is caring for a client who underwent a hysterectomy and who is admitted to a general medical-surgical unit. Which tasks can be delegated to the unlicensed assistive personnel (UAP)? Select all that apply. Correct1 Oral hygiene Correct2 Assistance with bathing 3 Oral medication administration 4 Intravenous fluid administration 5 Providing treatments with supervision Correct Answer: The UAP is eligible to carry out hygiene tasks such as providing oral hygiene and assisting with bathing. The licensed practical nurse and licensed vocational nurse may provide oral medications and treatments under the supervision of an RN. While treating clients, tasks such as intravenous administration of fluids should be carried out by the RN, as they are associated with potential risk if improperly infused. Which of these clients can be provided care safely by unlicensed nursing personnel? Select all that apply. 1 A client with pain 2 A client who is upset Correct3