Question 1

During the first staff meeting, a newly promoted nurse manager says, "I would like a commitment from all the nurses to review and improve the way delegation is done on the unit." Why would the manager be interested in delegation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The manager may be able to delegate some tasks to nurses if the nurses are not overloaded with client care that could be completed by UAPs.
2. If delegation is done effectively, unit efficiency is increased.
3. If the manager can get more done because delegation is effective, there is a greater chance for career advancement.
4. There is no evidence that this is the case.
5. Development is stifled when the staff members are doing the wrong tasks.

Question 2

A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task?

Accepted Answer

1. Whether or not other nurses delegate similar tasks is not as important as another question.
2. Experience is important, but is not the most important question.
3. The nurse should not delegate tasks that involve nursing assessment or judgment.
4. The nurse should consider if the delegate has sufficient time to complete the task, but this is not the most important consideration.

Question 3

Which situations are examples of ineffective delegation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The purpose of delegating attendance to a staff nurse is so the manager will not need to attend the meeting. When the manager does attend, the staff nurse's position is diminished. This is an example of underdelegation.
2. When someone of lower rank, in this case the unit clerk, delegates a task to someone of higher rank, in this case the nurse manager, a situation of reverse delegation has occurred. This is ineffective delegation.
3. The nurse manager has asked someone of lower rank to complete a task that is within that person's capabilities. This is effective delegation.
4. Provision of education requires nursing knowledge and judgment and cannot be delegated to a UAP. This is an example of over-delegation.
5. Bathing clients can be delegated to staff of lower rank. If the nurse is giving the bath for assessment purposes, this lack of delegation would be appropriate. If the nurse is not delegating baths because "I like to give bed baths," the lack of delegation is inappropriate.

Question 4

Which situations are examples of the nurse directing rather than delegating? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. This is delegation.
2. This situation is a crisis, so this is direction.
3. This is a crisis situation, so this is direction.
4. This is a crisis situation, so this is direction.
5. Because this crisis is not occurring, this is delegation.

Question 5

A nurse manager is delegating a new, complex task to the unit secretary. Which strategies should the manager use? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The manager should use a more direct "I" statement such as, "I need for you to take the lead on this project."
2. Eye contact helps to ensure that the secretary is attending to the information presented.
3. Face-to-face communication will be necessary for explanation and questions.
4. It is important to have all the critical information available so that the delegate can make a logical decision about the task.
5. It is important to let the delegate know the importance of the task.

Question 6

The nursing supervisor would like to delegate an information-gathering task. All the people listed have the ability to perform the task. In general, whom should the supervisor ask to do this work?

Accepted Answer

1. The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.
2. The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.
3. The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.
4. The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.

Question 7

A staff nurse asks the nurse manager, "What assignment are you delegating to me today? I would like to begin to organize my day before shift report begins." What is the error inherent in this statement?

Accepted Answer

1. Organization takes many forms and is different for every nurse. Some nurses may use the time prior to shift report to organize.
2. Depending on the structure of the unit, assignments may be made by the charge nurse or the nurse manager.
3. Assignment is a bureaucratic function that reflects job descriptions and client or organizational needs. Daily work allotment from nurse manager to staff nurse is an assignment, not delegation.
4. Team assignments occur prior to shift report. In some institutions, all nurses working on the unit listen to shift report on all clients. In other institutions, the nurse receives report only on the assigned team.

Question 8

A nurse says, "I am always worried that I will be liable if someone I delegate a task to does something that hurts the client." What is the manager's best response to this concern?

Accepted Answer

1. The RN does have liability associated with job responsibilities, but if delegation is done correctly, liability is minimized. This response is not supportive of the RN's need to delegate.
2. Hospital support is never a given when liability situations occur. This is not a response that would be supportive of the nurse's need to delegate.
3. This is not necessarily an accurate statement.
4. The five rights of delegation outline accepted measures to take when delegating tasks. If these rights are followed, the nurse has fulfilled job responsibilities. The delegate is responsible for his or her own care.

Question 9

A healthcare organization has provided intensive education to staff regarding benefits and correct methods of delegation. Why has the organization spent the time and money to sponsor these sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. When delegation is appropriate, work gets done in a timely manner and overtime decreases.
2. Delegation helps get work done efficiently and effectively. Absences tend to decrease in this environment.
3. Delegation is permitted by state boards of nursing, but it is not required.
4. Delegation results in care that is efficient and effective. Efficient and effective care results in increased patient satisfaction.
5. Delegation results in each part of the team working at their designated skill level. Nurses are not doing tasks that could be done by assistants. This results in increased productivity.

Question 10

The RN plans to delegate responsibility of client care to a certified nursing assistant (CNA).

Accepted Answer

1. The CNA is permitted to help clients with activities of daily living.
2. The CNA is not permitted to start IVs.
3. The CNA is not permitted to administer oral medications.
4. The CNA is permitted to collect vital signs.
5. The CNA is not permitted to discontinue IV's. The tip of the catheter must be assessed by the RN.

Question 11

The nurse supervisor would like to delegate accreditation preparation activities to the nurse manager. The manager is unsure of what is expected and has no experience with accreditation. How should the manager respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The manager should not accept a task until it is clear.
2. The manager should be clear about not having the required skill set but should indicate willingness to take the job if education is provided.
3. The problem is that the manager is not confident of his or her skills, not that time is unavailable.
4. The manager should clarify the task before accepting or refusing it.
5. Working on accreditation would help this nurse manager in career advancement.

Question 12

An RN prepares for the day and makes a list of what should be delegated to the LPN. Which tasks should the nurse delegate to the LPN?

Accepted Answer

1. Assessment is a responsibility for the RN.
2. The LPN is permitted to turn and reposition the patient with an ulcer.
3. Although the LPN is permitted to change dressings, the RN is responsible for assessment.
4. Assessment is a responsibility for the RN.
5. The LPN is permitted to administer oral medications.

Quiz 11: Delegating Successfully