BSN Prioritization, Delegation, and Assignment 5 — Questions and Answers
Question 1: A nurse is floating to the ICU from a medical-surgical unit. Which assignment is most appropriate for this float nurse?
- A patient on a continuous insulin drip requiring titration every hour based on blood glucose
- A patient being weaned from mechanical ventilation requiring frequent ventilator adjustments
- A stable ICU patient post-cardiac catheterization on day 2 with routine monitoring (Correct answer)
- A newly admitted patient in septic shock requiring vasopressor management
Correct answer: A stable ICU patient post-cardiac catheterization on day 2 with routine monitoring
A stable post-procedure patient requiring routine monitoring is the most appropriate assignment for a float nurse who may lack critical care-specific competencies.
Question 2: Which scenario represents a violation of the delegation principle of 'right task'?
- Asking a UAP to transport a stable patient to radiology
- Asking a UAP to insert a urinary catheter on a newly admitted patient (Correct answer)
- Asking a UAP to empty a urinary drainage bag and document the output
- Asking a UAP to reposition a bedbound patient every 2 hours
Correct answer: Asking a UAP to insert a urinary catheter on a newly admitted patient
Urinary catheter insertion requires sterile technique and clinical judgment, making it outside the standard scope of UAP practice in most states.
Question 3: A nurse working in a long-term care facility is planning assignments for a 12-hour shift. Which nursing task must be performed by an RN, not an LPN?
- Administering routine scheduled medications
- Changing a stable wound dressing per established protocol
- Completing the comprehensive nursing assessment and updating the care plan (Correct answer)
- Providing basic wound care for a small stage I pressure injury
Correct answer: Completing the comprehensive nursing assessment and updating the care plan
Comprehensive nursing assessment and care plan development are RN-specific responsibilities that cannot be delegated to an LPN.
Question 4: A nurse is overwhelmed and asks a colleague to help with a task. The colleague is currently busy with their own assignment. What is the BEST approach?
- Demand that the colleague stop their work and help immediately
- Notify the charge nurse that the workload is unmanageable and request assistance or re-assignment (Correct answer)
- Try to complete all tasks alone even if it delays care
- Ask a family member of a patient to help with non-clinical tasks
Correct answer: Notify the charge nurse that the workload is unmanageable and request assistance or re-assignment
Notifying the charge nurse is the appropriate chain-of-command response to unsafe workload distribution, ensuring patient safety is maintained.
Question 5: During a busy shift, a nurse identifies that a patient's call light has been on for 20 minutes. The nurse is currently performing a complex dressing change on another patient. What is the most appropriate action?
- Finish the dressing change, then respond to the call light
- Ask a UAP or colleague to check on the patient immediately and report back (Correct answer)
- Interrupt the dressing change to respond to the call light regardless of infection risk
- Tell the patient via intercom to wait until the nurse is available
Correct answer: Ask a UAP or colleague to check on the patient immediately and report back
Delegating the response to a UAP or available colleague ensures the waiting patient's needs are assessed promptly without compromising ongoing care.
Question 6: A nurse is organizing care for a patient with multiple needs. Which task should the nurse complete using the principle of 'doing the most good for the most patients' (utilitarian triage)?
- Spending 45 minutes with one patient who requests extensive conversation for emotional support
- Completing all medication administrations on time for all six assigned patients (Correct answer)
- Performing a detailed non-urgent chart review during peak morning care hours
- Helping one patient with discharge planning while others wait for morning medications
Correct answer: Completing all medication administrations on time for all six assigned patients
Timely medication administration for all assigned patients benefits the greatest number of patients and prevents harm from missed or delayed doses.
Question 7: A UAP reports to the nurse that a patient's vital signs are: BP 150/92, HR 98, RR 22, SpO2 94%. Which finding is the priority for the nurse to address first?
- The elevated blood pressure of 150/92 mmHg
- The oxygen saturation of 94% with a respiratory rate of 22 (Correct answer)
- The heart rate of 98 bpm
- All findings are equally urgent and should be addressed simultaneously
Correct answer: The oxygen saturation of 94% with a respiratory rate of 22
SpO2 of 94% with tachypnea suggests compromised oxygenation, which must be assessed and treated before addressing elevated blood pressure or mild tachycardia.
BSN Prioritization, Delegation, and Assignment 5
A nurse is floating to the ICU from a medical-surgical unit.
Which assignment is most appropriate for this float nurse?