Fundamentals of Nursing Q 564
Which client would be appropriate to assign to a newly graduated RN, who has recently completed orientation?.
A. An anxious, chronic pain client who frequently uses the call button.
B. A client second-day post-op who needs pain medication prior to dressing changes.
C. A client with HIV who reports headache and abdominal and pleuritic chest pain.
D. A client who is being discharged with a surgically implanted catheter.
Correct Answer: B. A client second-day post-op who needs pain medication prior to dressing changes
A second-day postoperative client who needs medication prior to dressing changes has predictable and routine care that a new nurse can manage. Some staff members may possess greater expertise than others. Some, such as new graduates, may not possess the same levels of knowledge, past experiences, skills, abilities, and competencies that more experienced staff members possess.
Option A: Although clients with chronic pain can be relatively stable, the interaction with this client will be time-consuming and may cause the new nurse to fall behind. Time is finite and often the needs of the client are virtually infinite. Time management, organization, and priority setting skills, therefore, are essential to the complete and effective provision of care to an individual client and to a group of clients.
Option C: The client with HIV has complex complaints that require expert assessment skills. Staff members differ in terms of their knowledge, skills, abilities, and competencies. A staff member who has just graduated as a certified nursing assistant and a newly graduated registered nurse cannot be expected to perform patient care tasks at the same level of proficiency, skill, and competency as an experienced nursing assistant or registered nurse. It takes time for new graduates to refine the skills that they learned in school.
Option D: The client pending discharge will need special and detailed instructions. Validated and documented competencies must also be considered prior to assignment of patient care. No aspect of care can be assigned or delegated to another nursing staff member unless this staff member has documented evidence that they are deemed competent by a registered nurse to do so.