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Chapter 9: Delegation of Client Care

1. Mr. Reynolds is admitted through the emergency department after being involved in a

motor vehicle accident. His airbag failed to deploy, and he as hit in the abdomen ith the

steering heel. He has an !" of #.9$ %& ' 1## m()hr, *+ 9)-, and complains of ea/ness,fatigue, and abdominal pain. 0n assessment, the nurse discovers that Mr. Reynolds is nauseated

and ust vomited -2# m(. 3he nurse is 4uite busy and decides to delegate client care activities to

the nursing assistant. 0f the folloing activities, hich should the nurse /eep567 3a/ing and recording vital signs every 1- minutes

*7 Recording accurate inta/e and output

C7 0btain a baseline eight to guide therapyD7 !ncrease the !" rate to -# m()hr if the blood pressure drops to -)-#

. Mrs. Dillon, a client recovering from CH8, is being discharged this afternoon. &he needsteaching reinforced. 3he most appropriate caregiver to complete this activity is:

67 6n (+%)("%

*7 6 6+

C7 6 unit secretaryD7 6 ndyear nursing student or/ing as a nurse tech on the unit

;. 0f the folloing clients, hich one could be assigned to a 6+5

67 6 client ith a recent head inury*7 6 fresh postoperative laparoscopy client for the removal of an ovarian cyst

C7 6 client ith stable angina

D7 6 client ith a sepsis

<. 3he R% ho is the team leader gives assignments to all the team members. 3he decisionis based on:67 3he number of staff illing to or/ 

*7 3he age and desires of the team members

C7 3he R% needing to ta/e orders and rite client outcomesD7 3he condition and needs of each client

-. =ddie, an R%, is charge nurse and is setting up the day>s assignments. (indsey, a nelylicensed R%, has been floated to the unit. ?hen ma/ing an assignment for (indsey, =ddie must

consider:

67 (indsey>s age*7 (indsey>s /noledge of the institution>s standards of practice

C7 (indsey>s nursing degree

D7 (indsey>s /noledge base and level of s/ill

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Chapter 9: Delegation of Client Care

2. ?hen ma/ing assignments, to legal responsibilities the R% must ta/e into

consideration are:

67 @noing the ob re4uirements and evaluating the outcomes*7 6ssessing ho much supervisory time is necessary and assessing the competence of

each staff member 

C7 ?riting ob descriptions and communicating them to all staff membersD7 Ma/ing sure the supervisor>s and the employee>s strengths are matched and giving

ade4uate supervision

A. (uci, an R%, arrives at or/. 3he nurse manager tells her that the !C needs more help

and as (uci is the most eBperienced R% on this unit, she is being reassigned to or/ in the !C

for the day. (uci tells the nurse manager that although she is the most eBperienced, she has never or/ed in the !C. &he shares her concerns ith the nurse manager regarding the lac/ of

familiarity ith the technical e4uipment and protocols of the !C. 3he nurse manager states that

she understands (uci>s concern and reluctance hoever, (uci is to go to the !C. 3he most

appropriate action (uci should ta/e is to:67 Refuse to go to the !C

*7 o to the !C and tell the charge nurse that she is ill and needs to go homeC7 o to the !C and inform the charge nurse of the tas/s she is able to perform and

those tas/s ith hich she feels she needs assistance

D7 Call the nurse manager>s supervisor and report her for unsafe delegation

. 3he R% has delegated the care of a fresh postoperative client to the (+% on the team.

3he (+% notifies the R% that the client>s vital signs are elevated and that the client iscomplaining of pain and dyspnea. ?hich of the folloing is the most appropriate action to be

ta/en by the R%5

67 %o further action is necessary as the (+% is eBperienced*7 Re4uest that the (+% offer the client a narcotic analgesic that had been ordered for

the postoperative period

C7 +lace a call to the attending surgeon and report that the client is having painD7 6ssess the client and analyEe the preoperative and perioperative data before calling

the surgeon

9. Delegation is defined as:

67 Reassigning the responsibility of performing a ob from one person to another 

*7 =Bplaining ho you ant a ob doneC7 3elling other people hat to do

D7 Developing ays to classify people into ob categories to learn hat they are

capable of doing

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Chapter 9: Delegation of Client Care

1#. (orena has or/ed in (abor and Delivery for 1- years ith a total R% staff. &he is no

the associate nurse manager of a busy postpartum unit and has R%s and 6+s. &he realiEes that

she needs to ma/e assignments to members of the healthcare team based on each individual>s:67 (ength of service

*7 &cope of practice

C7 6bility to perform the tas/ D7 Fob title

11. @imberly has been a nurse for 1# years, and she is precepting (oren, a ne R%. (oren is

having difficulty prioritiEing client care. @imberly eBplains to her that prioritiEing client care is

 based on:

67 3he nursing process*7 "ircho>s triad

C7 Client re4uests

D7 Maslo>s hierarchy

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Chapter 9: Delegation of Client Care

Answer Key

1. D. 6

;. C

<. D-. D

2. *

A. C. D

9. 6

1#. C11. D

+age <