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Question

Difficulty: MediumLegal and Ethical Practice

During shift planning on an acute medical-surgical unit, a practical nurse (PN) reviews the assigned client interventions. Which of the following delegated activities should the PN decline because it exceeds the legal scope of practice?

  1. Administering a prescribed dose of intravenous (IV) push morphine for a client with acute painAnswer
  2. B
    Serving as a witness to a client's signature on a surgical informed consent document
  3. C
    Initiating a mandatory report to state authorities regarding suspected elder abuse based only on observation
  4. D
    Withholding diagnostic test results from a client's spouse who is unable to provide the designated privacy passcode

Answer

Administering a prescribed dose of intravenous (IV) push morphine for a client with acute pain
Intravenous (IV) push medications require advanced clinical assessment, continuous monitoring for rapid physiological changes, and independent clinical judgment. These responsibilities fall exclusively under the registered nurse (RN) scope of practice. The PN must recognize this limitation and decline the assignment to ensure client safety and legal compliance.

Step-by-Step Solution

1
Analyze the activity regarding IV push medication administration.
Identified that IV push medications require advanced assessment skills and are outside the PN scope of practice.
To determine if the medication route and acuity match PN licensure limits.
2
Evaluate the PN role in witnessing informed consent.
Recognized that acting as a signature witness is a standard, legal PN responsibility.
To rule out the option as being out of scope.
3
Assess the legal requirements for mandatory abuse reporting.
Confirmed that reasonable suspicion, not concrete proof, is all that is legally required to report suspected abuse.
To verify compliance with state mandated reporting laws.
4
Review confidentiality requirements under HIPAA.
Determined that withholding information without the correct privacy code is legally required to protect client confidentiality.
To verify proper adherence to health information privacy laws.

Key Concept

Scope of Practice and Legal Responsibilities of the Practical Nurse
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Topics

Legal and Ethical Practice

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