An RN is counseled by the nurse manager regarding inappropriate delegation when the:
a. RN instructs the nursing assistant to greet ambulatory surgery patients and show them to their rooms.
b. nursing assistant informs the RN that she has not been trained to collect a sputum specimen and the RN states, "I will show you this time and you can show me the next time."
c. RN assigns the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube.
d. LPN/LVN who has demonstrated competence is asked to perform a dressing change for a patient before she is discharged home.
ANS: C
Correct: Only an RN can initiate and complete a new plan of care; this does not fall within the scope of practice of the LPN/LVN. The RN has violated one of the five rights of delegation.
Incorrect:
a. The RN should provide clear directions for assigned tasks, and this assignment falls within typical job duties for unlicensed assistive personnel.
b. The RN received appropriate feedback and is providing directions and is demonstrating a skill for which the nursing assistive personnel (NAP) has not shown competency.
d. Routine repetitive dressing changes are within the scope of practice for the LPN/LVN who has demonstrated competency for the skill.
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