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A nurse is preparing to delegate tasks to an assistive personnel (AP). The nurse should identify which of the following as one of the five rights of delegation?
Right time
Right documentation
Right communication
Right room
Correct Answer: C. Right communication
Explanation:
The five rights of delegation are: right task, right circumstance, right person, right direction/communication, and right supervision/evaluation. Right communication ensures the nurse provides clear, specific instructions about the task, expected outcomes, and when to report back. This prevents errors and promotes accountability. The other options—right time, documentation, and room—are not part of the five rights of delegation and do not ensure safe, effective delegation in nursing practice.
Which of the following assessments is the nurse's priority for a client who is receiving intermittent enteral nutrition through a nasogastric tube
The client is reporting constipation.
The client reports being thirsty.
The client is regurgitating the enteral formula.
The client is experiencing abdominal cramping.
Correct Answer C: The client is regurgitating the enteral formula
Explanation:
Regurgitation of enteral formula is the nurse’s priority because it poses a serious risk of aspiration, which can lead to aspiration pneumonia. This complication affects the airway and breathing, which take precedence over other concerns in nursing assessment and care. Immediate action is needed to prevent further regurgitation and possible respiratory compromise.
Why the Other Options Are Incorrect:
A. The client is reporting constipation
Constipation is a common side effect of enteral feeding but is not immediately life-threatening. It can be managed later with dietary adjustments or medications.
B. The client reports being thirsty
Thirst may indicate dehydration, but it is not an urgent concern compared to the risk of aspiration from regurgitation.
D. The client is experiencing abdominal cramping
Cramping suggests feeding intolerance but does not carry the immediate risk of airway compromise like regurgitation does.
Which of the following concepts of cultural competence is demonstrated when a community health nurse reflects on unconscious feelings they may have toward some of the clients they care for
Explicit bias
Color discrimination
Stereotyping
Implicit bias
Correct Answer D: Implicit bias
Explanation:
Implicit bias refers to unconscious attitudes or stereotypes that affect a person's understanding, actions, and decisions in an unintentional manner. When a nurse reflects on these hidden biases, they are engaging in self-awareness, a key component of developing cultural competence. Recognizing implicit bias is crucial in reducing health disparities and delivering equitable care.
Why the Other Options Are Incorrect:
A. Explicit bias
Explicit bias involves conscious attitudes and beliefs that are deliberately held and expressed. The nurse in this scenario is reflecting on unconscious feelings, not openly held or stated beliefs.
B. Color discrimination
Color discrimination involves treating individuals differently based on skin color, often in a legal or systemic context. The scenario is about internal reflections, not actions or treatment based on skin color.
C. Stereotyping
Stereotyping is the generalization of characteristics about a group. While it may stem from bias, the nurse is not applying generalized traits to clients but rather examining internal feelings, making this an example of implicit bias.
Which of the following findings should the nurse expect in an older adult client who is experiencing age-related changes
Increased muscle mass
Increased balance
Increased calcification of bones
Increased joint stiffness
Correct Answer D: Increased joint stiffness
Explanation:
Aging commonly results in increased joint stiffness due to decreased synovial fluid production, cartilage degeneration, and reduced flexibility of ligaments and tendons. These musculoskeletal changes can limit mobility, contribute to discomfort, and increase the risk of falls. Joint stiffness is a typical, expected age-related physical change.
Why the Other Options Are Incorrect:
A. Increased muscle mass
Older adults typically experience decreased muscle mass and strength (a condition known as sarcopenia), not an increase. This decline affects mobility and function.
B. Increased balance
Balance usually declines with age due to changes in the vestibular system, vision, and proprioception, which increases the risk of falls. An increase in balance would not be expected.
C. Increased calcification of bones
Aging leads to bone demineralization, not increased calcification. Bones become less dense and more fragile, raising the risk of fractures, especially in postmenopausal women.
A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:
Which of the following findings should the nurse expect in a client who has iron deficiency
Tooth decay
Goiter
Fatigue
Tetan
Correct Answer C: Fatigue
Explanation:
Fatigue is a common and expected finding in clients with iron deficiency, particularly when it leads to iron deficiency anemia. Iron is essential for the production of hemoglobin, which transports oxygen in the blood. Low iron levels reduce oxygen delivery to tissues, resulting in fatigue, weakness, pallor, and decreased exercise tolerance.
Why the Other Options Are Incorrect:
A. Tooth decay
Tooth decay is more commonly associated with poor oral hygiene or high sugar intake, not iron deficiency.
B. Goiter
Goiter is an enlargement of the thyroid gland typically caused by iodine deficiency, not iron deficiency.
D. Tetany
Tetany is caused by hypocalcemia (low calcium levels), not low iron, and is characterized by muscle cramps, spasms, and tingling.
Which of the following statements by a school-age child with a new diagnosis of type 1 diabetes mellitus indicates an understanding of the teaching
I can store unopened bottles of insulin in the freezer.
I should not take my regular insulin when I am sick.
I should eat a snack half an hour before playing soccer.
My morning blood glucose should be between 90 and 130
Correct Answer C: I should eat a snack half an hour before playing soccer.
Explanation:
This statement shows correct understanding. Physical activity like soccer can lower blood glucose levels, increasing the risk of hypoglycemia. Eating a carbohydrate-containing snack before exercise helps maintain stable glucose levels and prevents hypoglycemia during or after physical activity. Children with type 1 diabetes are often taught to plan snacks around exercise to manage their energy and insulin needs.
Why the Other Options Are Incorrect:
A. I can store unopened bottles of insulin in the freezer.
This is incorrect. Insulin should never be frozen. Unopened insulin should be stored in the refrigerator, not the freezer, as freezing can damage its effectiveness.
B. I should not take my regular insulin when I am sick.
This is incorrect. Children with type 1 diabetes should usually continue taking insulin even when they are sick because illness can raise blood glucose levels. They may even need more frequent monitoring and insulin adjustments during illness.
D. My morning blood glucose should be between 90 and 130.
This range is more appropriate for adults. The target fasting blood glucose for school-age children with type 1 diabetes is typically 90 to 180 mg/dL, depending on their individual care plan. This response reflects a misunderstanding of the appropriate target range.
Which of the following types of transmission-based precautions should the nurse plan to use for a client with a new diagnosis of methicillin-resistant Staphylococcus aureus (MRSA)
Airborne
Droplet
Contact
Protective
Correct Answer C: Contact
Explanation:
MRSA is primarily transmitted through direct contact with infected wounds, secretions, or contaminated surfaces. Therefore, contact precautions are required. This includes placing the client in a private room, wearing gloves and gowns when entering the room, and practicing strict hand hygiene to prevent the spread of infection to other patients or healthcare workers.
Why the Other Options Are Incorrect:
A. Airborne
Airborne precautions are used for infections transmitted via small particles suspended in the air, such as tuberculosis or measles. MRSA does not spread this way.
B. Droplet
Droplet precautions are used for pathogens spread through large respiratory droplets, such as influenza or meningitis. MRSA requires contact, not droplet, precautions.
D. Protective
Protective (reverse) precautions are used for immunocompromised clients to protect them from infections, not for clients with contagious infections like MRSA.
Which of the following client statements indicates that a client is living in a faulty built environment
The client reports a lack of community centers in their neighborhood.
The client reports there are no bike paths or running trails in their community.
The client reports contaminants in their drinking water at home.
The client reports that there is limited public parking on their street.
Correct Answer B: The client reports there are no bike paths or running trails in their community.
Explanation:
A faulty built environment refers to man-made surroundings that negatively affect health and well-being—such as poor infrastructure, inadequate housing, or lack of access to physical activity spaces. The absence of bike paths or running trails limits opportunities for exercise and promotes sedentary behavior, increasing the risk for chronic diseases. This reflects a flaw in the built environment affecting health.
Why the Other Options Are Incorrect:
A. The client reports a lack of community centers in their neighborhood
This reflects a social or community resource issue, not specifically a structural or environmental design flaw related to health-supportive infrastructure.
C. The client reports contaminants in their drinking water at home
This is an environmental hazard, but it relates to natural or chemical contamination, not the built environment.
D. The client reports that there is limited public parking on their street
While inconvenient, this is more of a transportation or urban planning issue and doesn't directly reflect a health-impacting flaw in the built environment like the absence of safe exercise areas does.
Which of the following tasks can the nurse delegate to an assistive personnel (AP)
Obtaining a blood pressure for a client who is to be discharged later in the day.
Providing tracheostomy care for a client.
Teaching a client who is preoperative how to use an incentive spirometer.
Assessing a client who just returned from surgery.
Correct Answer A: Obtaining a blood pressure for a client who is to be discharged later in the day.
Explanation:
Obtaining vital signs, including blood pressure, is within the scope of practice for assistive personnel (AP) and can be safely delegated as long as the client is stable. The nurse remains responsible for interpreting the findings and following up as needed.
Why the Other Options Are Incorrect:
B. Providing tracheostomy care for a client
Tracheostomy care is a sterile and complex procedure that requires nursing judgment and must be performed by a licensed nurse, not an AP.
C. Teaching a client who is preoperative how to use an incentive spirometer
Client teaching requires nursing knowledge and clinical judgment. It cannot be delegated to an AP.
D. Assessing a client who just returned from surgery
Client assessment is a nursing responsibility that requires critical thinking and must be done by a licensed nurse, especially after surgery when complications are possible.
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