Which task is most appropriate to delegate to an LPN /LVN?

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.

Correct Answer: A

Rationale: In the context of a 65-year-old patient being transferred into the Post-Anesthesia Care Unit (PACU) from the Operating Room (OR), the initial assessment should prioritize addressing immediate life-threatening issues. Option A, focusing on airway, breathing, circulation, and wound site, is the correct choice. This approach aligns with the ABCs of emergency care - ensuring a patent airway, adequate breathing, and optimal circulation, while also assessing the surgical wound for any signs of bleeding, infection, or complications. Options B, C, and D are incorrect for several reasons. Option B, which mentions intake, output, and intravenous access, is more relevant to ongoing monitoring and management in the PACU rather than the immediate postoperative assessment. Option C, involving abdominal sounds, oxygen setting, and level of consciousness, is important but should come after the ABC assessment to ensure the patient's physiological stability. Option D, focusing on pulse oximeter, pupil responses, and deep tendon reflexes, is more indicative of a neurological assessment and would not address the immediate concerns of airway, breathing, and circulation. Educationally, understanding the prioritization of assessments in the PACU is crucial for nursing students and healthcare providers. Emphasizing the ABC approach ensures that critical issues are addressed promptly, potentially preventing adverse outcomes in postoperative patients. By explaining the rationale behind the correct choice and why the other options are less appropriate, learners can develop a solid foundation in perioperative care.

Correct Answer: A

Rationale: The correct answer is A) laboratory tests and perioperative medications. Performing surgery at an ambulatory day-surgery center offers the advantage of decreased need for extensive preoperative preparations such as laboratory tests and perioperative medications. This is because ambulatory centers are designed for same-day surgeries and aim to streamline the process, avoiding unnecessary tests and medications that may be required for inpatient procedures. Option B) preoperative and postoperative teaching by the nurse is incorrect because education and teaching by healthcare professionals are essential regardless of the surgical setting. Patients need to be well-informed about the procedure, postoperative care, and expectations for a successful recovery. Option C) psychologic support to alleviate fears of pain and discomfort is incorrect because emotional support is crucial for all patients undergoing surgery, whether in an ambulatory or inpatient setting. Addressing fears and providing psychological support are integral parts of holistic patient care. Option D) preoperative nursing assessment related to possible risks and complications is incorrect because thorough preoperative assessments are necessary in all surgical settings to ensure patient safety and identify any potential risks or complications that may arise during or after the procedure. In an educational context, understanding the advantages of different surgical settings like ambulatory day-surgery centers helps nurses and healthcare providers deliver optimal care to their patients. It also highlights the importance of tailoring preoperative preparations to the specific needs of patients undergoing same-day surgeries.

Correct Answer: D

Rationale: In preparation for ambulatory surgery, providing procedural information to patients is crucial for ensuring their understanding, cooperation, and overall positive outcomes. Option D, which includes information about what odors and sensations may be experienced, as well as techniques for coughing and deep breathing if appropriate, is the correct choice. Explaining potential odors and sensations helps to prevent anxiety or confusion during the surgery, while teaching coughing and deep breathing techniques can aid in postoperative recovery by preventing complications like atelectasis and pneumonia. Option A, while important, only addresses pain management, which is just one aspect of the preoperative education. Option B, fluid and food restrictions, is essential but primarily pertains to preoperative fasting guidelines rather than procedural information. Option C, characteristics of monitoring equipment, is more relevant to intraoperative or postoperative care and may not directly impact the patient's preparation for surgery. Educationally, understanding the rationale behind providing detailed procedural information to patients emphasizes the importance of holistic patient care, informed decision-making, and active patient engagement in their own health management. By empowering patients with knowledge, healthcare providers can enhance patient satisfaction, compliance, and outcomes in the perioperative setting.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D, which is a White Blood Cell (WBC) count of 18,500/µL. An elevated WBC count indicates a potential infection or inflammation in the body, which is crucial information for the surgeon to be aware of before proceeding with surgery. This result should be brought to the surgeon's attention immediately to assess the patient's condition and consider appropriate interventions. Option A, a Serum K+ of 3.8 mEq/L, is within the normal range and does not pose an immediate threat to the patient's preoperative status. Similarly, option B, a Hemoglobin of 15 g/dL, and option C, a Blood glucose of 100 mg/dL, are also within normal limits and do not require immediate attention in this context. From an educational perspective, understanding the significance of abnormal laboratory values in preoperative patients is critical for nurses to provide safe and effective care. This question highlights the importance of recognizing abnormal findings and prioritizing communication with the healthcare team to ensure patient safety and optimal outcomes. Nurses must be vigilant in monitoring and interpreting laboratory results to advocate for their patients' well-being during the perioperative period.