Management Principles Exam
Questions and Answers
The nurse in the emergency department (ED) has several tasks that can be
delegated to unlicensed assistive personnel (UAP). One of these tasks involves
sitting with an older adult client who has dementia. The client was found wandering
out of doors, and law enforcement transported him to the ED for a medical
evaluation while they located his family, who are on their way to pick up the client. To
which employee should the nurse delegate this assignment? - Answer- Nursing
assistant with a good safety record
The nurse needs to determine the right person to whom to delegate this task. If an
assistant has a good safety record, then the nurse knows the individual is capable of
the task. An assistant whose own father recently died might find sitting with this client
emotionally draining if she has not yet processed her own grief. An assistant who
normally works with young children may not have experience working with clients
who have dementia. The nursing assistant who is completing morning care does not
have time to take on the assigned task.
The registered nurse is determining tasks to delegate to a licensed practical nurse
(LPN) and nursing assistant (NA). Which tasks should the nurse delegate to the
nursing assistant? - Answer- Feeding a client with expressive aphasia after a stroke
Measuring output on a client with heart failure
When delegating to other staff, the registered nurse retains responsibility for
ensuring that the tasks are completed correctly and appropriately and are within the
individual's scope of practice. Measuring output and client feeding are within the
nursing assistant's scope of practice. Nasotracheal suctioning and bladder irrigation
are within the licensed nurse's scope of practice. Administering intravenous
medication on an immediate post-operative client and client teaching are within the
registered nurse's scope of practice.
The director of nursing is reviewing the impact of increased delegation within the
organization. Which observations indicate that delegation is benefiting nurses? -
Answer- Applications to the organization's open double quote"nurse as leader
program have increased by 20%.
Requests from nurses to transfer units have decreased by 20%.
Client satisfaction with services as reflected on post discharge surveys has
increased by 18%.
Safety errors have decreased by 8%.
An increase in applications for a nurse leadership program indicates nurses are
experiencing greater job satisfaction and taking an interest in the success of the
organization. A decrease in transfer requests indicates that nurses are experiencing
greater satisfaction working on their units. A reduction in safety errors indicates
, improvements in client care. All of these suggest that delegation is benefiting nurses.
A decrease in expenses may or may not relate to the changes made in delegation.
Client perceptions of services benefit the organization.
The nurse manager is planning to implement partnering in the medical-surgical care
area. Which actions should the manager perform to support this approach to
delegation? - Answer- Schedule nurses and assistants to work the same shifts
Assign a designated group of nurses and assistants to attend a training session
together
Partnering is an approach to delegation in which teams of workers, such as an RN,
LPN, and UAP, work together consistently. Scheduling the same staff to work the
same shifts and sending them to training sessions together supports partnering as a
delegation strategy. Preparing a task list is a unit-based approach to delegation.
Assigning a nurse to an assistant for each shift exemplifies the pairing approach to
delegation. Nurses should always ask for help when necessary.
The primary nurse is reviewing a list of tasks to delegate to a nursing assistant.
Which tasks should the nurse avoid delegating to this level of personnel? - Answer-
Discussing a care error made by another nursing assistant
Suctioning a client recovering from radical neck surgery
Assessing limb pulses on a client recovering from a cardiac catheterization
When assigning tasks to delegate, the nurse needs to determine if the task involves
technical skills or cognitive abilities, specific qualifications, licensure, scope of
practice, job description, complexity, education, or training. Tasks that should never
be delegated include disciplining other employees, highly technical tasks, complex
client care tasks that require specific levels of licensure, certification, or training, and
any situation that involves confidentiality or controversy. Assessing limb pulses is a
complex task that requires nursing licensure. Discussing errors made by another
employee is likely to violate the organization's personnel policies related to employee
confidentiality. The other tasks are within the scope of practice for unlicensed
assistive personnel.
A client scheduled for emergency surgery needs a bowel preparation. The assistant
with the necessary experience to complete this task is currently working with another
client. Which nursing action is the most appropriate? - Answer- Ask if other
assistants have experience in the bowel preparation
When delegating a task, the nurse should match the task to the individual. To decide
on the delegate, the nurse needs to analyze skill levels and abilities in order to
determine if a person is able to complete a task. Availability of the delegate is
another consideration. In this situation, the nurse will need to find another qualified
individual to serve as delegate. The client is being prepared for emergency surgery,
so the task needs to be completed quickly. Waiting on an assistant to complete
another task or informing the surgical suite of a delay are not appropriate. The nurse
should not reassign a task that another nurse has delegated.