Chapter 14: Delegating Effectively

MULTIPLE CHOICE

1. Which statement best reflects a difference between patient assignment and patient supervision?

1. Assignment can be handled at the patient level, whereas supervision is handled at the management level.

2. Assignment refers to how work is distributed among staff, whereas supervision refers to evaluating complexity of care.

3. Assignment focuses on complexity of care, whereas supervision focuses on delivery of care.

4. Assignment is based on care delivered by participant members, whereas supervision is based on monitoring and follow-through of all provided care to patients.

ANS:

2. A nurse manager is educating a staff nurse with regard to the five rights of delegation. Which statement by the staff nurse indicates that additional training is needed?

1. Environmental issues should be taken into consideration before delegating tasks.

2. Client assessment does not affect the ability to delegate tasks.

3. The focus is on maintaining competency throughout the delegation process.

4. Delegation should never be done in the presence of an unsafe observation.

ANS:

3. A registered staff nurse is working with an experienced registered nurse who has transferred from an ambulatory surgical care unit to a medical-surgical unit as a preceptor. Which activity is not appropriate to be delegated by the preceptor?

1. Admitting a new patient to the unit who is scheduled for elective surgery in the morning

2. Titrating anticoagulant therapy for a patient who is being treated for thrombosis

3. Inserting a Foley catheter

4. Performing a pain assessment in order to administer prn pain medication

ANS:

4. The nurse manager is having a staff meeting to improve patient outcomes in terms of delegation of care. Staffing includes four registered nurses (RNs), three licensed vocational nurses (LVNs), two certified nurse’s aides (CNAs), and two unit secretaries. Which observation if noted by the nurse manager would indicate a concern relative to effective delegation?

1. Staff is openly discussing frustrations about occasional staffing issues on the unit.

2. Delivery of quality care is a major focus of staff members.

3. Nursing staff and CNAs have a different view of what needs to be done and by whom.

4. Understanding of policies and procedures should be consistent among all staff members.

ANS:

5. Which factor would be considered to be most critical for its potential impact on leadership- and management-related barriers on delegation in the clinical setting?

1. Policies and procedures manual is up to date on unit.

2. Job description was updated 2 years ago.

3. Credentials of nurses on unit are verified.

4. All nursing positions are currently filled on the unit.

ANS:

6. Which task could be delegated to a licensed vocational nurse (LVN) by a registered nurse (RN) who is working with an LVN and unlicensed assistive personal (UAP) as part of the team?

1. Performing oral hygiene

2. Feeding a patient with dysphagia

3. Collecting a urine specimen

4. Obtaining daily weight

ANS:

7. Which activity should only be performed by a registered nurse (RN) even if there are additional staff members present on a medical-surgical unit, such as licensed practical nurses (LPNs) and unlicensed assistive personnel (UAP)?

1. Initiation of blood transfusions
2. Tracheostomy care
3. Vital signs on a new patient to be admitted to the unit
4. Insertion of a Foley catheter

ANS:

MULTIPLE RESPONSE

8. Which elements are critical for a nurse to consider with regard to using delegation in the clinical setting on a medical-surgical unit? Select all that apply.

1. Knowledge of state’s practice act

2. Number of patient beds in the clinical facility

3. Assessment of patient acuity

4. Whether or not the health-care providers belong to a health maintenance organization (HMO)

5. Number and type of staff scheduled to work on the unit for that shift

ANS:

9. Which actions are not appropriate to be delegated by a registered nurse (RN) to unlicensed assistive personnel (UAP) on a medical unit in a hospital setting? Select all that apply.

1. Taking a patient to the bathroom who has no activity restrictions

2. Administering pain medication

3. Assisting the registered nurse in performing a dressing change for a postoperative patient

4. Asking the physician for a new order for the patient who needs a change in diet

5. Monitoring postoperative dressing for bleeding

ANS:

10. Which statements illustrate the “right person” in the context of the five rights of delegation? Select all that apply.

1. Assessing the patient population

2. Being aware of competence standards

3. Reporting and documenting

4. Having knowledge of educational requirements

5. Conducting performance evaluations

ANS: