NACE Nursing Acceleration Challenge Exam I PN-RN Coordinated Care and Delegation 4 — Questions and Answers
Question 1: A charge nurse is reviewing assignments. Which task is MOST appropriate to delegate to an unlicensed assistive personnel (UAP)?
- Ambulating a stable post-op patient on day 2 (Correct answer)
- Assessing a patient's response to a new pain medication
- Changing a sterile wound dressing on a surgical incision
- Teaching a diabetic patient about foot care
Correct answer: Ambulating a stable post-op patient on day 2
Ambulating a stable post-operative patient is within the UAP's scope as it does not require assessment or clinical judgment.
Question 2: A PN is coordinating care for a patient being discharged to a skilled nursing facility. Which action is the PN's priority?
- Calling the receiving facility to confirm bed availability
- Ensuring transfer documentation and medication reconciliation are complete (Correct answer)
- Arranging transportation for the patient
- Notifying the patient's family of the discharge date
Correct answer: Ensuring transfer documentation and medication reconciliation are complete
Complete and accurate transfer documentation and medication reconciliation are essential to ensure continuity and patient safety during transitions of care.
Question 3: When using SBAR for a handoff report, what information is included in the 'Background' component?
- The nurse's recommended action or request
- Current vital signs and immediate concerns
- Relevant medical history, admitting diagnosis, and pertinent lab values (Correct answer)
- A brief description of the current situation
Correct answer: Relevant medical history, admitting diagnosis, and pertinent lab values
The Background section of SBAR includes the patient's relevant medical history, diagnosis, and pertinent clinical data that provide context for the current situation.
Question 4: A UAP reports that a patient who was ambulating independently yesterday now refuses to get out of bed and seems confused. What is the PN's best response?
- Document the UAP's report and reassess at the next scheduled time
- Tell the UAP to encourage the patient and try again in one hour
- Immediately assess the patient, as this change may indicate a new clinical problem (Correct answer)
- Inform the UAP that patient refusal must be respected
Correct answer: Immediately assess the patient, as this change may indicate a new clinical problem
A sudden change in cognition or functional status may signal an acute clinical deterioration such as infection or delirium, requiring immediate nursing assessment.
Question 5: Which principle BEST describes the nurse's legal accountability when delegating a task to a UAP?
- The nurse is fully relieved of responsibility once the task is delegated
- The UAP assumes full legal liability for any errors made during the task
- The nurse retains accountability for appropriate delegation and must supervise outcomes (Correct answer)
- Accountability transfers to the charge nurse when delegation occurs
Correct answer: The nurse retains accountability for appropriate delegation and must supervise outcomes
Delegation transfers the task but not the nurse's accountability; the delegating nurse remains responsible for appropriate delegation and oversight.
Question 6: A PN is caring for four patients. Which patient should the PN assess FIRST?
- A patient with type 2 diabetes requesting a snack
- A post-op cholecystectomy patient on day 1 rating pain as 3/10
- A patient with COPD whose oxygen saturation dropped from 94% to 88% (Correct answer)
- A patient waiting for discharge instructions
Correct answer: A patient with COPD whose oxygen saturation dropped from 94% to 88%
A drop in oxygen saturation in a COPD patient represents a potentially life-threatening change in respiratory status and requires immediate assessment.
Question 7: An interprofessional care conference is scheduled for a patient with complex needs. What is the PN's primary role in this conference?
- To lead the meeting and set the agenda
- To provide bedside nursing observations and advocate for the patient's expressed needs (Correct answer)
- To make all final care decisions on behalf of the team
- To defer entirely to the physician's plan without offering input
Correct answer: To provide bedside nursing observations and advocate for the patient's expressed needs
The PN contributes direct bedside observations and serves as a patient advocate within the interprofessional team, ensuring the patient's preferences are heard.
NACE Nursing Acceleration Challenge Exam I PN-RN Coordinated Care and Delegation 4
A charge nurse is reviewing assignments.
Which task is MOST appropriate to delegate to an unlicensed assistive personnel (UAP)?