Podcast
Questions and Answers
A nurse is delegating a task to a certified nursing assistant (CNA). Which statement by the nurse best demonstrates appropriate delegation?
A nurse is delegating a task to a certified nursing assistant (CNA). Which statement by the nurse best demonstrates appropriate delegation?
- "I need you to assess the patient's pain level before ambulation."
- "Please take Mr. Smith’s blood pressure and report it to me." (correct)
- "You should evaluate the patient's response to the medication I just administered."
- "Complete the patient’s discharge teaching while I finish charting."
Which of the following tasks can an RN safely delegate to a UAP?
Which of the following tasks can an RN safely delegate to a UAP?
- Assisting with ambulation (correct)
- Teaching a patient about dietary restrictions
- Administering insulin
- Performing a sterile dressing change
A nurse is considering delegating a task to a UAP. According to the Five Rights of Delegation, which factor is most important to assess first?
A nurse is considering delegating a task to a UAP. According to the Five Rights of Delegation, which factor is most important to assess first?
- Whether the nurse will be nearby for supervision
- Whether the task is appropriate for the patient’s condition (correct)
- The UAP’s competency to perform the task
- The UAP’s willingness to accept the task
A registered nurse (RN) is delegating a task to a licensed practical nurse (LPN). Which task is most appropriate for delegation?
A registered nurse (RN) is delegating a task to a licensed practical nurse (LPN). Which task is most appropriate for delegation?
The charge nurse notices that a UAP has failed to reposition a bedridden patient every two hours as instructed. What should the charge nurse do first?
The charge nurse notices that a UAP has failed to reposition a bedridden patient every two hours as instructed. What should the charge nurse do first?
A nurse is working with a new CNA and is unsure about the CNA’s ability to perform blood glucose checks. What should the nurse do?
A nurse is working with a new CNA and is unsure about the CNA’s ability to perform blood glucose checks. What should the nurse do?
A patient with uncontrolled diabetes is admitted to the unit. Which task could the RN delegate to an experienced CNA?
A patient with uncontrolled diabetes is admitted to the unit. Which task could the RN delegate to an experienced CNA?
A UAP reports to the RN that a post-operative patient has a respiratory rate of 8 breaths per minute. What is the nurse’s best action?
A UAP reports to the RN that a post-operative patient has a respiratory rate of 8 breaths per minute. What is the nurse’s best action?
The nurse is reviewing delegation with a group of students. Which of the following are principles of delegation? (Select all that apply.)
The nurse is reviewing delegation with a group of students. Which of the following are principles of delegation? (Select all that apply.)
Which of the following tasks can a registered nurse delegate to a licensed practical nurse (LPN)? (Select all that apply.)
Which of the following tasks can a registered nurse delegate to a licensed practical nurse (LPN)? (Select all that apply.)
The nurse is supervising a UAP performing delegated tasks. Which situations require immediate intervention? (Select all that apply.)
The nurse is supervising a UAP performing delegated tasks. Which situations require immediate intervention? (Select all that apply.)
A nurse is assigning tasks to a UAP. Which task should the nurse not delegate?
A nurse is assigning tasks to a UAP. Which task should the nurse not delegate?
Which task is most appropriate for the RN to delegate to a UAP?
Which task is most appropriate for the RN to delegate to a UAP?
The nurse is preparing to delegate a task to an LPN. Which task is most appropriate for the LPN?
The nurse is preparing to delegate a task to an LPN. Which task is most appropriate for the LPN?
A nurse is working with a CNA and is considering delegation. What is the most critical factor in determining whether delegation is appropriate?
A nurse is working with a CNA and is considering delegation. What is the most critical factor in determining whether delegation is appropriate?
A new RN is uncertain about delegating to an experienced CNA. What should the RN do first?
A new RN is uncertain about delegating to an experienced CNA. What should the RN do first?
The RN is reviewing delegation principles. Which action demonstrates ineffective delegation?
The RN is reviewing delegation principles. Which action demonstrates ineffective delegation?
A charge nurse observes an RN improperly delegating a task. What should the charge nurse do first?
A charge nurse observes an RN improperly delegating a task. What should the charge nurse do first?
A nurse delegates a task but later finds it incomplete. What is the best action?
A nurse delegates a task but later finds it incomplete. What is the best action?
A CNA reports that a post-operative patient is complaining of severe pain. What is the RN’s best response?
A CNA reports that a post-operative patient is complaining of severe pain. What is the RN’s best response?
The nurse is assigning tasks for the shift. Which task is appropriate for the UAP?
The nurse is assigning tasks for the shift. Which task is appropriate for the UAP?
Which factor is most important for a nurse to consider when delegating a task?
Which factor is most important for a nurse to consider when delegating a task?
Which of the following should not be delegated to a UAP?
Which of the following should not be delegated to a UAP?
A nurse is delegating to a UAP. Which tasks are appropriate? (Select all that apply.)
A nurse is delegating to a UAP. Which tasks are appropriate? (Select all that apply.)
The nurse is teaching about appropriate delegation. Which statements by the nurse are correct? (Select all that apply.)
The nurse is teaching about appropriate delegation. Which statements by the nurse are correct? (Select all that apply.)
Which tasks can the nurse delegate to an LPN? (Select all that apply.)
Which tasks can the nurse delegate to an LPN? (Select all that apply.)
The nurse is supervising a UAP. Which actions require intervention? (Select all that apply.)
The nurse is supervising a UAP. Which actions require intervention? (Select all that apply.)
The nurse is caring for multiple patients and needs to delegate tasks to a UAP. Which task is not appropriate for delegation?
The nurse is caring for multiple patients and needs to delegate tasks to a UAP. Which task is not appropriate for delegation?
The charge nurse is reviewing tasks that can be delegated to a UAP. Which statement indicates a need for further teaching?
The charge nurse is reviewing tasks that can be delegated to a UAP. Which statement indicates a need for further teaching?
A nurse is assigning tasks to a UAP and an LPN. Which task is most appropriate to assign to the LPN?
A nurse is assigning tasks to a UAP and an LPN. Which task is most appropriate to assign to the LPN?
The nurse delegates a task to a UAP and later finds the task was not completed. What should the nurse do first?
The nurse delegates a task to a UAP and later finds the task was not completed. What should the nurse do first?
A nurse is reviewing which tasks can be delegated to a UAP. Which task should not be delegated?
A nurse is reviewing which tasks can be delegated to a UAP. Which task should not be delegated?
The RN is supervising a UAP who is ambulating a patient post-operatively. The patient becomes dizzy. What should the nurse do first?
The RN is supervising a UAP who is ambulating a patient post-operatively. The patient becomes dizzy. What should the nurse do first?
The nurse delegates obtaining a blood glucose check to a UAP. Which situation requires the nurse to intervene?
The nurse delegates obtaining a blood glucose check to a UAP. Which situation requires the nurse to intervene?
Which factors must the nurse consider when delegating a task? (Select all that apply.)
Which factors must the nurse consider when delegating a task? (Select all that apply.)
The nurse is providing education on delegation. Which statements about the Five Rights of Delegation are correct? (Select all that apply.)
The nurse is providing education on delegation. Which statements about the Five Rights of Delegation are correct? (Select all that apply.)
The nurse is supervising a UAP. Which situations require immediate intervention? (Select all that apply.)
The nurse is supervising a UAP. Which situations require immediate intervention? (Select all that apply.)
Which of the following tasks can be delegated to a UAP? (Select all that apply.)
Which of the following tasks can be delegated to a UAP? (Select all that apply.)
Which task is appropriate for an LPN? (Select all that apply.)
Which task is appropriate for an LPN? (Select all that apply.)
Which tasks can a registered nurse delegate to a UAP? (Select all that apply.)
Which tasks can a registered nurse delegate to a UAP? (Select all that apply.)
A nurse is observing a new LPN. Which actions by the LPN require correction? (Select all that apply.)
A nurse is observing a new LPN. Which actions by the LPN require correction? (Select all that apply.)
A nurse is supervising a UAP who is providing morning care. Which actions require intervention? (Select all that apply.)
A nurse is supervising a UAP who is providing morning care. Which actions require intervention? (Select all that apply.)
A patient with a history of falls is being admitted. Which task is least appropriate for the RN to delegate to a UAP?
A patient with a history of falls is being admitted. Which task is least appropriate for the RN to delegate to a UAP?
A patient who underwent surgery 2 days ago now needs ambulation. What should the nurse consider first when delegating ambulation to a UAP?
A patient who underwent surgery 2 days ago now needs ambulation. What should the nurse consider first when delegating ambulation to a UAP?
The RN assigned a UAP to take a patient's blood pressure. The UAP reports a significantly elevated reading. What is the RN’s best next step?
The RN assigned a UAP to take a patient's blood pressure. The UAP reports a significantly elevated reading. What is the RN’s best next step?
The nurse needs to delegate tasks on a busy medical-surgical unit. Which patient is most appropriate to assign to a UAP for vital sign monitoring?
The nurse needs to delegate tasks on a busy medical-surgical unit. Which patient is most appropriate to assign to a UAP for vital sign monitoring?
A UAP informs the RN that a patient refuses to allow them to assist with a bath. Which of the following actions should the RN take first?
A UAP informs the RN that a patient refuses to allow them to assist with a bath. Which of the following actions should the RN take first?
Which scenario requires the most immediate intervention from the supervising RN after a task has been delegated to a UAP?
Which scenario requires the most immediate intervention from the supervising RN after a task has been delegated to a UAP?
The RN is delegating tasks for a patient on strict intake and output (I&O). Which instruction to the UAP is most important to ensure accurate I&O measurement?
The RN is delegating tasks for a patient on strict intake and output (I&O). Which instruction to the UAP is most important to ensure accurate I&O measurement?
Following a change-of-shift report, the nurse is prioritizing tasks and delegating to an LPN. Which patient should not be delegated to the LPN?
Following a change-of-shift report, the nurse is prioritizing tasks and delegating to an LPN. Which patient should not be delegated to the LPN?
A patient on a cardiac monitor suddenly develops a rapid heart rate of 150 bpm. Which action would not be appropriate to delegate to a UAP?
A patient on a cardiac monitor suddenly develops a rapid heart rate of 150 bpm. Which action would not be appropriate to delegate to a UAP?
A newly licensed nurse is unsure whether it is appropriate to delegate catheter care to a specific UAP. What is the best initial action by the charge nurse?
A newly licensed nurse is unsure whether it is appropriate to delegate catheter care to a specific UAP. What is the best initial action by the charge nurse?
Flashcards
CNA appropriate task
CNA appropriate task
Measuring and reporting vital signs.
UAP safe delegation
UAP safe delegation
Assisting with ambulation.
First delegation factor
First delegation factor
Consider the patient's condition and stability.
LPN appropriate task
LPN appropriate task
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First response: Incomplete task
First response: Incomplete task
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Unsure of CNA ability?
Unsure of CNA ability?
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CNA acceptable task
CNA acceptable task
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Post-op patient: RR of 8
Post-op patient: RR of 8
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Delegation principles
Delegation principles
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RN delegates to LPN
RN delegates to LPN
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UAP: Immediate intervention
UAP: Immediate intervention
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Task not to delegate
Task not to delegate
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RN delegates this often
RN delegates this often
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LPN best with
LPN best with
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Delegation: Critical Factor
Delegation: Critical Factor
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New RN/Experienced CNA
New RN/Experienced CNA
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Ineffective delegation?
Ineffective delegation?
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Charge nurse observes
Charge nurse observes
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Task incomplete: Best action
Task incomplete: Best action
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CNA reports: severe pain
CNA reports: severe pain
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UAP acceptable shift task
UAP acceptable shift task
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Important Delegation Factor
Important Delegation Factor
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Not delegate to UAP
Not delegate to UAP
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Tasks appropriate for UAP
Tasks appropriate for UAP
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Appropriate Delegation
Appropriate Delegation
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Nurse delegates to LPN
Nurse delegates to LPN
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UAP requires intervention
UAP requires intervention
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Delegate to UAP? No!
Delegate to UAP? No!
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UAP can teach?
UAP can teach?
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Assign to LPN
Assign to LPN
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Delegee fails task
Delegee fails task
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Not Delegate to UAP
Not Delegate to UAP
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Ambulating patient gets dizzy
Ambulating patient gets dizzy
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UAP adjusts patient insulin dosage based on result
UAP adjusts patient insulin dosage based on result
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Delegatee has
Delegatee has
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Five Rights? Delegation
Five Rights? Delegation
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Actions require intervention??
Actions require intervention??
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The delegatee is!
The delegatee is!
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Tasks for LPN
Tasks for LPN
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Delegation, What is not?
Delegation, What is not?
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New actions
New actions
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Supervision??
Supervision??
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Delegate!
Delegate!
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Study Notes
- These notes cover fundamental concepts and application of delegation in nursing practice, with NCLEX-style questions and rationales
Fundamental Concepts of Delegation
- Appropriate delegation involves assigning tasks that are within the scope of practice of the delegatee
- Tasks such as assessment, evaluation, and patient teaching are RN responsibilities and cannot be delegated
- Assisting with ambulation is within the scope of practice for Unlicensed Assistive Personnel (UAP)
- Medication administration, sterile procedures, and patient education are RN responsibilities
The Five Rights of Delegation
- The most important factor to assess is the "right circumstance"
- If a patient's condition is unstable or requires nursing judgment, the task should not be delegated
Delegation to Licensed Practical Nurses (LPNs)
- LPNs can provide wound care for stable patients
- Administering IV push medications, evaluating patient responses, and developing care plans require RN-level judgment
Application of Concepts in Delegation
- Effective delegation includes supervision and evaluation of the task being delegated.
- If a UAP fails to complete a task, the nurse should first ask why the task was not completed, and evaluate the situation prior to taking any action.
- Competency must be verified by the nurse before allowing independent performance of the task
- Checking blood glucose is something that can be performed by CNAs
- CNAs can perform blood glucose checks but cannot assess, educate, or adjust medications
- In an emergency, the RN must assess and intervene immediately.
Principles of Delegation
- The nurse retains accountability for delegated tasks
- The delegated task has to be within the scope of practice of the delegatee
- The nurse has to supervise and evaluate the delegated task
Appropriate Tasks for LPNs
- LPN's can administer oral medications
- LPN's can monitor wounds
- LPN's can reinforce education
- LPN's cannot provide initial teaching or administer chemotherapy.
Situations Requiring Immediate Intervention
- Situations include a UAP assisting a patient with ambulation who has an unstable gait
- Another concerning situations happens when a UAP feeding a patient with difficulty swallowing without supervison,
- A final situation requiring immediate intervention involves pain management for a UAP documenting a patients paint level as "0/10"
Tasks Not to Delegate
- Tasks that require assessment of swallowing ability and aspiration risk, which is beyond a UAP’s scope, should not be delegated
- Personal hygiene tasks for a stable patient, can be delegated to a UAP, but medication administration, assessment, and patient education are the RN’s responsibilities
LPN Tasks
- LPN's can reinforce education, but they do not initiate care plans, push IV meds, or perform comprehensive assessments
Critical Delegation Factors
- Patient stability is the primary consideration when delegating tasks
- Nurses should verify competency before allowing independent performance
- Ineffective delegation consists of monitoring patient response to medications
Delegation and Patient Safety
- If patient safety is at risk, immediate intervention is necessary
- Pain assessment and medication administration require RN involvement
Delegation Considerations
- Task complexity determines whether it can be safely delegated
- Neurological assessments require nursing expertise, therefore should not be delegated
Appropriate Delegation to UAPs
- UAP's can transport stable patients
- UAP's can assist with ambulation
- UAP's can take vital signs
- CNAs are not able to administer oxygen or assess fall risk
Key Statements About Delegation
- Nurses retain accountability for delegated tasks
- Tasks should match the delegatee's competency level
- Supervision and feedback are important aspects of delegation
Supervision and Intervention
- Feeding patients post-stroke, catheterization, and Oxygen adjustments require RN involvement
- Sterile procedures require nursing knowledge and should not be delegated to UAPs
- Patient education is an RN responsibility and can not be delegated to a UAP
- Reinforcing patient education, is something that LPN's are able to carry out
- Assessing a patients pain, cannot be delegated to a UAP
Delegation and UAPs
- If patient becomes dizzy, sit the patient down and call for help
Blood Glucose Monitoring
- Medication administration and dosage adjustments are nursing responsibilities and cannot be delegated to UAPs
Delegation Factors
- Experience of the caregiver should be taken into account
- Complexity of the task also determines delegation
- Patient condition and stability is of most importance
- Availability of supervision is also important
- The right person must be assigned the task
- The nurse has to supervise the tasks performed
Medication Administration
- If oral care to an unconscious patient without suction risks aspiration, this requires intervention
- Medication administration requires a license
- Pain assessment is an RN responsibility
- The nurse does not delegate decision-making regarding care plans
The Nurse Overseeing
- UAPs can assist with ADLs and vital signs
- UAPs cannot provide education or perform wound care.
- LPNs do not initiate care plans or perform initial assessments.
The Nurse and LPNs
- LPN's can perform wound care and focused assessments
- LPN's do not evaluate medication responses or give IV push meds
- LPN's are not responsible for post-op assessments
Considerations When Working with New Staff
- Applying SCDs and cutting diabetic toenails require nursing supervision and knowledge.
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Description
Explore the core principles and real-world applications of delegation in nursing. Learn about appropriate delegation, the five rights, and delegation to LPNs. Includes NCLEX-style questions and rationales.
