ATI RN Fundamentals Proctored Focus

ATI RN Fundamentals Proctored Focus 1. Can an RN delegate to the LPN to provide tracheostomy care to a client with pneumonia? Yes 2. A nurse on a med-surg unit has received change-of-shift report & will care for 4 clients. Which of the following client's needs may the nurse assign to an assistive personnel (AP)? A. Feeding a client who was admitted 24 hrs ago w/aspiration pneumonia B. Reinforcing teaching w/a client who is learning to walk using a quad cane C. Reapplying a condom catheter for a client who has urinary incontinence D. Applying a sterile dressing to a pressure ulcer Rationale: The application of a condom catheter is a noninvasive, routine procedure that the nurse may delegate to the AP 3. A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? Select All. A. The roommate is up independently. B. The client ambulates w/his slippers on over his antiembolic stockings C. The client uses a front-wheeled walker when ambulating D. The client had pain medication 30 min ago E. The client is allergic to codeine F. The client ate 50% of his breakfast this morning Answer: B . and C . and D . Step-by-Step explanation The information which the nurse should share with the AP include; The client ambulates w/his slippers on over his antiembolic stockings. The client uses a front wheeled-walker when ambulating. The client had pain medication 30 minutes ago. Reference. National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14.Chicago 4. An RN is making assignments for client care to a LPN at the beginning of the shift. Which of the following assignments should the LPN question? A. Assisting a client who is 24hr postop to use an incentive spirometer B. Collecting a clean-catch urine specimen from a client who was admitted on the previous shift C. Providing nasopharyngeal suctioning for a client who has pneumonia D. Replacing the cartridge and tubing on a PCA pump Answer: D . Step-by-Step explanation The RN is responsible for maintaining the PCA pump. Therefore, the answer is D. Replacing the cartridge and tubing on a PCA pump. 5. A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation? Select all. A. Right client B. Rightsupervision/evaluation C. Right direction/communication D. Right time E. Right circumstances Answer: B . and C . and E . Step-by-Step explanation A. One of the essential components of delegation is the responsibility. Nurse have a professional duty to perform patient care tasks dependably and reliably. The right client is one of the rights of medication administration, not of delegation. Nurses take care the patient already inquired in the hospital by the administration. B. This is correct. The right supervision and evaluation is one of the five rights of delegation of nurses they also include the right task and the right person. Generally, registered nurses are responsible for assessment, planning, and evaluation within the nursing process. These actions should not be delegated to someone who is not a registered nurse and the registered nurse must know the delegatee's job description and previous training in order to choose the right person. C. This is correct. The right direction and communication is one of the five rights of delegation of a nurse. The delegator must give the right direction and communication to the delegatee. All delegators must communicate performance expectations precisely and directly in order to cosider whether the delegatee understood the assigned task, directions, patient limitations, and expected outcomes before the delegatee assumes responsibility for it. D. This is not included in the five rights of delegation of nurses but this is part of the rights of medication administration. Athough the delegatee needs to know whether there is a time frame or a specific time to perform the task they are not the one who will give the order and the exact time the patients will take the medication. E. This is correct. Nurses should considers the right circumstances of delegation. They need to check the appropriate equipment and resources available to perform the task and consider the patients health condition. Registered nurses who assign, delegate and/or provide nursing care to a patients must report all significant changes that occur in terms of patients and their condition. 6. A nurse manager of a med-surg unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign to this client? A. Charge nurse B. RN C. LPN D. AP 7. A nurse observes an AP reprimanding a client for not using the urinal properly. The AP tells him she will put a diaper on him if he does not use the urinal more carefully next time. Which of the following torts is the AP committing? A. Assault B. Battery C. False imprisonment D. Invasion of privacy Answer: A . Step-by-Step explanation AP is committing assault by threatening him 8. An adult client who is competent tells the nurse that he is thinking about leaving the hospital against medical advice. The nurse believes that this is not in the client's best interest, so she administers a PRN sedative med that the client has not requested along w/his usual meds. Which of the following tort has the nurse committed? A. Assault B. False imprisonment C. Negligence D. Breach of confidentiality