NR 465 Final Exam Questions And
Correct Answers.
Delegation - Answer · Reassigning of responsibility for the performance of a job from one
person to another
o Direct- usually is verbal direction, RN decides which staff member can perform a specific task
o Indirect- contained in approved listing of tasks established by an institution; permitted tasks
mat vary from institution to institution (ex: vital signs, blood sugar checks as an aid)
Delegation vs. Supervision - Answer - Supervision is usually more direct than delegation
- Requires directly overseeing the work and performance of others and includes checking in
with individuals during the day
- May entail delegation of tasks and activities (nursing manager performs both)
Vicarious Liability, Respondent Superior - Answer · Healthcare organizations are responsible
for the acts of its employees
· Failure to delegate/supervise within acceptable standards may be considered malpractice
Considerations for Delegation - Answer · Predictability of outcome= if patient's response to an
activity cannot be known with some certainty it should not be delegation
· Potential for harm= how much risk is involved to the patient due to this task
· Complexity of task= the greater the complexity of this task the less likely it should be delegated
· Need for assessment/problem solving= if the problem involves a high degree of problem
solving it should be done by the RN
· Level of patient interaction= don't delegate activities that will interfere with the nurse/patient
relationship
· Cannot delegate= nursing process (think ADPIE), education, tasks that require clinical
judgement/assessment
Understanding the Role of the LPN - Answer · Care for stable patients
· Collection of patient data and report to RN
· Reinforcement of RN education
, LPNs and IV medications - Answer · An LPN cannot administer or maintain blood or blood
components, solutions for total parenteral nutrition, cancer therapeutic medications,
medications administered through any other line that does not run through a peripheral vein
including a central venous line and arterial line, and an IV piggyback infusion
· An LPN is not able to discontinue medication running through any other line that does run
through the peripheral vein
· And LPN cannot begin or stop a peripherally inserted central catheter· An LPN cannot program
or set any function of a patient-controlled analgesic (PCA) pump
Priority Setting - Answer · A complex step in the decision-making process
· Used to rank patient needs, determine order of nursing activities, and manage resources
· "Critical thinking" supplies the logic within this process
What is priority? - Answer · Something that is more important than anything else at a given
time
· Could be related to a patient, team, or organization
· These are principles that assist in arranging activities based on urgency, importance,
significance, or preference
Principles of Prioritization- systemic before local - Answer o Something affecting the whole
body vs. something affecting a specific area of the body
Principles of Prioritization- acute before chronic - Answer o Something that develops very
suddenly vs. something that is chronic and life-long
Principles of Prioritization- actual before potential problems - Answer o Somebody who is
having chest pain with EKG changes vs. somebody who is having chest pain without EKG
changes
Principles of Prioritization- trending vs. transient - Answer o Dropping BP vs. BP that is all over
the place (drops then bounces back)
Principles of Prioritization- listen carefully (do not assume) - Answer o If a patient says they are
going to die today, then pay attention because patients often have a sense of feeling
Correct Answers.
Delegation - Answer · Reassigning of responsibility for the performance of a job from one
person to another
o Direct- usually is verbal direction, RN decides which staff member can perform a specific task
o Indirect- contained in approved listing of tasks established by an institution; permitted tasks
mat vary from institution to institution (ex: vital signs, blood sugar checks as an aid)
Delegation vs. Supervision - Answer - Supervision is usually more direct than delegation
- Requires directly overseeing the work and performance of others and includes checking in
with individuals during the day
- May entail delegation of tasks and activities (nursing manager performs both)
Vicarious Liability, Respondent Superior - Answer · Healthcare organizations are responsible
for the acts of its employees
· Failure to delegate/supervise within acceptable standards may be considered malpractice
Considerations for Delegation - Answer · Predictability of outcome= if patient's response to an
activity cannot be known with some certainty it should not be delegation
· Potential for harm= how much risk is involved to the patient due to this task
· Complexity of task= the greater the complexity of this task the less likely it should be delegated
· Need for assessment/problem solving= if the problem involves a high degree of problem
solving it should be done by the RN
· Level of patient interaction= don't delegate activities that will interfere with the nurse/patient
relationship
· Cannot delegate= nursing process (think ADPIE), education, tasks that require clinical
judgement/assessment
Understanding the Role of the LPN - Answer · Care for stable patients
· Collection of patient data and report to RN
· Reinforcement of RN education
, LPNs and IV medications - Answer · An LPN cannot administer or maintain blood or blood
components, solutions for total parenteral nutrition, cancer therapeutic medications,
medications administered through any other line that does not run through a peripheral vein
including a central venous line and arterial line, and an IV piggyback infusion
· An LPN is not able to discontinue medication running through any other line that does run
through the peripheral vein
· And LPN cannot begin or stop a peripherally inserted central catheter· An LPN cannot program
or set any function of a patient-controlled analgesic (PCA) pump
Priority Setting - Answer · A complex step in the decision-making process
· Used to rank patient needs, determine order of nursing activities, and manage resources
· "Critical thinking" supplies the logic within this process
What is priority? - Answer · Something that is more important than anything else at a given
time
· Could be related to a patient, team, or organization
· These are principles that assist in arranging activities based on urgency, importance,
significance, or preference
Principles of Prioritization- systemic before local - Answer o Something affecting the whole
body vs. something affecting a specific area of the body
Principles of Prioritization- acute before chronic - Answer o Something that develops very
suddenly vs. something that is chronic and life-long
Principles of Prioritization- actual before potential problems - Answer o Somebody who is
having chest pain with EKG changes vs. somebody who is having chest pain without EKG
changes
Principles of Prioritization- trending vs. transient - Answer o Dropping BP vs. BP that is all over
the place (drops then bounces back)
Principles of Prioritization- listen carefully (do not assume) - Answer o If a patient says they are
going to die today, then pay attention because patients often have a sense of feeling
