Leadership

Based on ATI focus review

Delegating
Even though a task may be delegated to
someone, the nurse who delegates maintains
accountability for the task
5 rights of delegation

Right
Right
Right
Right
Right

task
circumstances
person
direction/communication
supervision/evaluation

Assigning
Always ensure client safety
Provide directions that are clear, concise,
accurate, and complete
Make sure the person understands the given
task, and set a deadline for completion of
the task

UAP
Noninvasive interventions: (ADLS) skin care,
range-of-motion exercises, ambulation, bathing,
grooming, and hygiene measures, feeding
(without swallowing precautions), positioning,
specimen collection, I &O Vital signs (stable)

LPN
Tasks of a AP and invasive tasks: dressing
change, suctioning, urinary catheterization,
trach care, checking NG tube patency,
administration of enteral feedings, and
medication administration (oral, SubQ, IM,
and selected piggyback meds excluding IV
meds in several states) they can also review
teaching plans with clients that were
initiated by RN

priority
Client needs that are life-threatening or that could
result in harm to the client if left untreated are high
priority
Nonemergency and non-life threatening client needs
are intermediate priorities
Client needs that are not related directly to the
clients illness are low priority
Clients who have limited likelihood of survival are
assigned lowest priority
Listen to the client and dont assume

Prioritizing
First
Airway (obstruction, stridor, establish a patent airway)

Second
Breathing (apnea, depressed, respiratory rate)

Third
Circulation (hypotension, dysrhythmia, inadequate CO,
compartment syndrome)

Fourth
Disability (neurological deficits, strokes)

 Client who has an acute problem take priority

over chronic problem
Urgent over non-urgent needs
Unstable finding over stable findings
Systemic before local
Medical emergencies vs expected findings
Apply clinical knowledge to procedural
standards (anti-diabetic and antimicrobial more
important)

questions
The nurse is assigned to care for four clients.
In planning client rounds, which client should
the nurse assess first?
a) client scheduled for a chest x-ray
b) client requiring daily dressing changes
c) a postoperative client preparing for
discharge
d) a client receiving nasal oxygen who had
difficulty breathing during previous shift

 The registered nurse is planning the client

assignments for the day. Which is the most
appropriate assignment for an unlicensed
assistive personnel (UAP)
A) A client requiring a colostomy irrigation
B) A client receiving continuous tube feeding
C) A client who requires urine specimen
collections
D) A client with difficulty swallowing food and
fluid

 The nurse is giving a bed bath to an assigned client

when an unlicensed assistive personnel enters the
clients room and tells the nurse that another assigned
client is in pain and needs pain medication. Which is the
most appropriate nursing action?
A) finish the bed bath and then administer the pain
medication to the other client
B) ask the UAP to find out when the last pain medication
was given to the client
C) ask the UAP to tell the client in pain that medication
will be administered as soon as the bed bath is complete
D) cover the client, raise the side rails, tell the client that
you will return shortly, and administer the pain med

 The nurse employed in an emergency department is

assigned to triage clients coming to the emergency
department for treatment on the evening shift. The
nurse should assign priority to which client?
A) a client complaining of muscle aches, a
headache, and malaise
B) a client who twisted her ankle when she fell while
rollerblading
C) a client with a minor laceration on the index
finger
sustained while cutting an eggplant
D) a client with chest pain who states that he just
ate pizza that was made with a very spicy sauce

 The nurse employed in a long-term care facility

is planning assignments for the clients on a
nursing unit. The nurse needs to assign four
clients and has a licensed practical (vocational)
nurse and three unlicensed assistive personnel
(UAP) on a nursing team. Which client would the
nurse most appropriately assign to the licensed
practical nurse?
A) a client who requires a bed bath
B) An older client requiring frequent ambulation
C) a client who requires hourly vital sign
measurement
D) a client requiring abdominal wound
irrigations and dressing changes every 3 hours