An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high risk delegation?
a. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin.
b. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound.
c. An unlicensed assistive person is assigned the task of assisting a patient with late stages of Huntington's disease to ambulate a short distance in the hallway.
d. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm3.
ANS: C
Correct: Risk of falling is great in later stages of Huntington's disease due to chorea movements.
Incorrect:
a. Mixing regular and NPH insulin is within the scope of practice of an RN and all insulin should be checked by an RN prior to administration, reducing the risk of a medication error.
b. Simple dressing changes are within the scope of practice for an LPN/LVN.
d. An experienced nurse from an oncology unit would be familiar with care of immunocompromised patients.
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