A 35-year-old client is admitted for elective tubal ligation. During the preoperative teaching, the client states, 'The anesthesiologist said she was going to give me balanced anesthesia. What exactly is that?' The best explanation by the nurse is that balanced anesthesia:

Correct Answer: D

Rationale: A regional anesthesia does not produce loss of consciousness and is indicated for excision of moles, cysts, and endoscopic surgeries. Varying amounts of anesthetic agents are used when employing balanced anesthesia. The amounts used depend on the age, weight, condition of the client and the surgical procedure. General anesthesia is a drug induced depression of the central nervous system, which produces loss of consciousness and decreased muscle activity. Balanced anesthesia is a combination of a number of anesthetic agents that produce a smooth induction, appropriate depth of anesthesia, and appropriate muscle relaxation with minimal complications.

Correct Answer: A

Rationale: In the context of nursing delegation, it is crucial to assign tasks to the appropriate personnel based on their competencies and scope of practice. In this scenario, option A, "Assist the child to remove outer clothing," is the most appropriate task to delegate to a nursing assistant. Nursing assistants are trained to provide basic care and assist with activities of daily living, such as helping patients dress or undress. This task does not require clinical judgment or specialized nursing knowledge, making it suitable for delegation to a nursing assistant. Options B, C, and D involve providing medical advice, explaining treatment rationale, and performing a nursing intervention requiring assessment and evaluation. These tasks fall within the scope of licensed nursing practice and should be performed by a registered nurse or other qualified healthcare provider. Delegating these responsibilities to a nursing assistant would be inappropriate and could compromise patient safety. Educationally, understanding the principles of delegation is essential for nursing students and practicing nurses to ensure safe and effective patient care delivery. By differentiating tasks based on complexity and required skill level, healthcare teams can optimize efficiency and promote patient well-being. It is critical for healthcare providers to adhere to established guidelines and standards when delegating tasks to support staff to uphold quality care standards.

Correct Answer: A

Rationale: In this scenario, the correct response is option A: "The ingested children's chewable vitamins contain iron." This information should be immediately reported to the physician because iron toxicity can be a serious and potentially life-threatening condition, especially in children. Iron overdose can lead to gastrointestinal symptoms, metabolic acidosis, cardiovascular collapse, and even death if not promptly treated. Therefore, notifying the physician about the ingestion of iron-containing vitamins is crucial for timely intervention and management. Option B, "The child has been treated several times for ingestion of toxic substances," while concerning, is not as immediately critical as ingesting iron. Option C, "The child has been treated several times for accidental injuries," does not pertain to the current situation of potential toxicity. Option D, "The child was nauseated and vomited once at home," is a common symptom post-ingestion but does not provide crucial information about the specific substance ingested, unlike the iron in this case. In an educational context, understanding the significance of reporting specific information to healthcare providers is vital for healthcare professionals, especially in emergency situations. This question highlights the importance of thorough assessment and prompt communication to ensure appropriate interventions and patient safety. Nurses and other healthcare providers must be able to prioritize and communicate critical findings effectively to optimize patient outcomes.

Correct Answer: D

Rationale: The correct answer is option D: Administer IV fluid support with supplemental thiamine as ordered. In this scenario, the patient is likely presenting with symptoms of alcohol withdrawal syndrome, which can lead to severe complications like delirium tremens. Administering IV fluid support helps to prevent dehydration and maintain electrolyte balance, while thiamine supplementation is crucial in preventing Wernicke's encephalopathy, a common complication of alcohol withdrawal. Option A: Obtaining an order for a blood alcohol level may be important for assessing the patient's alcohol intoxication status but is not the priority in managing acute alcohol withdrawal. Option B: Contacting the family for additional history is valuable for holistic care but does not address the immediate physiological needs of a patient experiencing alcohol withdrawal. Option C: Administering naloxone (Narcan) is used to reverse opioid overdose, not alcohol withdrawal symptoms. It is not indicated in this situation. Educationally, understanding the priority actions in managing alcohol withdrawal is essential for nurses caring for patients in acute care settings. Recognizing the signs and symptoms of withdrawal, and knowing the appropriate interventions, can help prevent severe complications and improve patient outcomes. Learning to prioritize interventions based on patient needs is a crucial skill in nursing practice.

Correct Answer: C

Rationale: In the context of delegation in nursing, it is crucial to understand the scope of practice for different levels of nursing personnel. In this scenario, the most appropriate task to delegate to an LPN/LVN is option C) Remove wet clothing and cover the victim with a warm blanket. This task falls within the scope of practice for an LPN/LVN as it involves basic patient care and does not require advanced assessment or critical thinking skills. LPNs/LVNs are trained to provide direct patient care, such as assisting with activities of daily living and maintaining the comfort and safety of patients. Option A, talking to a community group about water safety issues, involves health education and promotion, which is typically beyond the scope of practice for an LPN/LVN. Option B, stabilizing the cervical spine for an unconscious drowning victim, requires specialized knowledge and skills that are within the scope of practice for a registered nurse or higher level of care provider. Option D, monitoring an asymptomatic near-drowning victim, involves ongoing assessment and potential for changes in the patient's condition that may require immediate intervention or critical thinking skills beyond the scope of practice for an LPN/LVN. Understanding the delegation of tasks based on scope of practice is essential for safe and efficient patient care delivery in the healthcare setting. Nurses must know their own scope of practice as well as the scope of practice for other members of the healthcare team to ensure appropriate delegation and collaboration for optimal patient outcomes.