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Question

Difficulty: MediumLegal and Ethical Practice

A practical nurse (PN) is working a shift at an outpatient community clinic and encounters multiple situations requiring clinical judgment. Which of the following actions by the PN demonstrate adherence to legal and ethical practice standards? Select all that apply.

  1. Witnessing a client's signature on an informed consent document after the healthcare provider has fully explained the procedureAnswer
  2. B
    Explaining surgical risks and alternative treatments to a client before obtaining their signature on a consent form
  3. Refusing a provider's directive to administer an intravenous push (IVP) medication that falls outside the practical nursing scope of practiceAnswer
  4. D
    Disclosing a client's diagnostic laboratory results to their spouse without verifying a signed release of information
  5. Reporting suspected elder abuse to the appropriate state protective agency immediately, even without definitive proofAnswer
  6. F
    Accepting a delegation to perform the initial, comprehensive clinical assessment on a newly admitted client

Answer

The correct actions include witnessing the consent signature after the provider's explanation, refusing to administer IV push medications outside the scope of practice, and reporting suspected abuse even without definitive proof.
The practical nurse operates within legal and ethical boundaries by acting solely as a witness to informed consent, declining tasks that require registered nurse (RN) qualifications such as IV push medications, and fulfilling the legal duty as a mandated reporter of suspected abuse based on clinical suspicion.

Step-by-Step Solution

1
Evaluate the nurse's role in informed consent.
The nurse acts only as a witness to the signature, while the provider must explain risks and alternatives.
This establishes clear boundaries of legal responsibility during procedural consent.
2
Determine the appropriate response to out-of-scope directives and initial assessments.
The nurse must refuse IV push medications and initial comprehensive assessments.
These tasks fall outside the legal scope of practice for practical nursing, and accepting them jeopardizes client safety and the nurse's license.
3
Assess the requirements for confidentiality and mandated reporting.
The nurse must have written authorization to share results with a spouse, but must report abuse immediately based on suspicion alone.
HIPAA strictly protects client information, whereas mandated reporting laws prioritize the immediate safety of vulnerable populations over the need for concrete proof.

Key Concept

Legal and Ethical Practice Boundaries for the Practical Nurse
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Topics

Legal and Ethical Practice

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