Question

question 4
1 pts
the licensed practical/vocational nurse (lp/vn) delegates the insertion of urinary straight catheterization to a nursing assistant (na) without first assessing the clients situation and failed to read the clients history of previous urinary strictures (a narrowing of the urethra). the na had never performed the task before on a client but had practiced on a lab mannequin. the lp/vn did not provide any directions or when to ask the nurse for help. the na performed the task forcing the urinary catheter and traumatized the clients urethra resulting in bleeding. the lp/vn promptly cared for the client after the complication occurred. which of the five delegation rights did the lp/vn fail to consider resulting in an improper assignment? select all that apply.

right person
right circumstances
right task
right supervision/evaluation
right direction/communication

Explanation:

Analyze the clinical scenario

The scenario describes a licensed practical/vocational nurse (LP/VN) delegating a urinary catheterization to a nursing assistant (NA). We must evaluate this delegation against the Five Rights of Delegation: Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation.

Evaluate Right Person

The LP/VN delegated the task to an NA who had never performed the procedure on a live client before, only on a mannequin. This violates the Nursing Management principle of ensuring the delegatee has the appropriate clinical competence for the specific task and client. Thus, Right Person was violated.

Evaluate Right Circumstances

The LP/VN delegated the task without first assessing the client's clinical situation and failed to review the client's history of urinary strictures (which makes catheterization highly risky). This is a direct violation of delegating under the Right Circumstances, which requires assessing the health status of the individual client first. Thus, Right Circumstances was violated.

Evaluate Right Direction/Communication

The scenario states that the LP/VN did not provide any directions or instructions on when to ask the nurse for help. This is a clear failure to provide the Right Direction/Communication, which requires giving clear, concise descriptions of the task, objectives, limits, and expectations. Thus, Right Direction/Communication was violated.

Evaluate Right Task and Right Supervision

• Right Task: Straight catheterization is generally a task that can be delegated to unlicensed assistive personnel depending on state practice acts and institutional policy, provided the client is stable and there are no complications. The primary failures here lie in the assessment, person competence, and communication rather than the task itself being inherently undelegatable.
• Right Supervision/Evaluation: While the nurse failed to supervise during the task, the prompt specifically asks which rights the nurse failed to consider resulting in an improper assignment (the initial delegation decision). The failures in assessment (circumstances), competency verification (person), and instruction (direction) directly created the improper assignment.

Answer:

• Right person (Correct answer)
• Right circumstances (Correct answer)
• Right task
• Right supervision/evaluation
• Right direction/communication (Correct answer)