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Difficulty: Very hardClient Care Assignments and Collaboration

A licensed practical nurse (LPN) is collaborating with the interprofessional healthcare team on a busy medical-surgical unit. The LPN receives a list of client care assignments and delegated tasks for the shift. Which of the following actions by the LPN represent safe and legally appropriate practice? (Select all that apply)

  1. Reinforcing education regarding proper incentive spirometer use for a client who is two days postoperative.Answer
  2. B
    Evaluating the therapeutic effectiveness of an intravenous diuretic administered by the registered nurse to a client with acute heart failure.
  3. C
    Explaining potential surgical complications to a client who requests further clarification prior to signing an informed consent document.
  4. Performing a prescribed sterile dressing change on a client's healing, chronic stage 3 sacral pressure injury.Answer
  5. E
    Discussing a client's discharge placement needs with the unit case manager while seated in the hospital's public cafeteria.
  6. Administering a scheduled subcutaneous dose of insulin glargine to a clinically stable client with type 2 diabetes mellitus.Answer

Answer

The LPN safely practices by reinforcing education for a postoperative client, performing a sterile dressing change on a chronic pressure injury, and administering scheduled subcutaneous insulin to a stable client.
The correct selections represent safe practice within the LPN's legal scope. Reinforcing previously established education plans, performing routine sterile wound care on chronic injuries, and administering subcutaneous medications to stable clients do not require RN-level comprehensive assessment, initial teaching, or complex evaluation.

Step-by-Step Solution

1
Analyze each option to determine if it falls within the LPN/VN legal scope of practice and adheres to ethical principles.
Identify tasks that represent data collection, routine procedures, or reinforcement of teaching versus tasks requiring RN-level judgment or violating client rights.
The National Council of State Boards of Nursing (NCSBN) delineates specific boundaries for LPNs, explicitly excluding comprehensive assessment, initial evaluation, and provider-level consent explanation.
2
Evaluate the clinical tasks for client acuity and complexity.
Routine insulin administration, chronic wound care, and education reinforcement are acceptable. Evaluating acute IV diuretic therapy exceeds LPN scope.
LPNs are assigned to clients with predictable outcomes. Unstable clients or interventions requiring complex evaluation must be managed by the RN.
3
Assess the ethical and legal scenarios presented in the remaining options.
Explaining surgical complications is the provider's duty, and discussing cases in a cafeteria violates confidentiality.
LPNs must protect client privacy at all times and adhere to strict professional roles during the informed consent process.

Key Concept

Delegation, Scope of Practice, and Client Rights
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Topics

Client Care Assignments and Collaboration

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