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Question

Difficulty: MediumClient Care Assignments and Collaboration

At the beginning of a shift on a subacute telemetry unit, a licensed practical nurse (LPN) receives a delegated task list from the coordinating registered nurse (RN). The LPN must evaluate each assignment for safety and legal compliance. Identify the task the LPN must decline to perform.

  1. Creating the initial discharge education plan for a client going home with a newly placed continuous positive airway pressure (CPAP) machine.Answer
  2. B
    Witnessing the signature on a surgical consent form for a client scheduled for an elective cardiac catheterization later in the day.
  3. C
    Documenting wound characteristics and applying a new sterile dressing to a healing stage 2 pressure injury.
  4. D
    Obtaining a sterile urine specimen from an indwelling urinary catheter for a client suspected of having a mild urinary tract infection.

Answer

Creating the initial discharge education plan for a client going home with a newly placed continuous positive airway pressure (CPAP) machine.
According to the National Council of State Boards of Nursing (NCSBN) guidelines and standard state practice acts, initiating client education and developing teaching plans are strictly the responsibility of the Registered Nurse (RN). The LPN may reinforce teaching that has already been initiated and documented by the RN, but cannot independently create the initial plan.

Step-by-Step Solution

1
Analyze the scope of practice limitations for a Licensed Practical Nurse (LPN) regarding the nursing process.
LPNs cannot perform initial comprehensive assessments, develop care plans, or initiate initial client education.
These specific tasks require the comprehensive clinical judgment, synthesis of data, and evaluation skills that are exclusive to a Registered Nurse (RN).
2
Evaluate each delegated task against the established LPN scope boundaries.
Initial education planning is identified as an RN-only responsibility. Witnessing consent, performing sterile dressing changes, and collecting sterile specimens are within the standard LPN scope.
Identifying the task that falls outside the legal scope ensures safe delegation and protects both the client and the nurse's license.

Key Concept

Licensed Practical Nurse (LPN) Scope of Practice and Delegation Boundaries
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Topics

Client Care Assignments and Collaboration

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