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Difficulty: HardClient Care Assignments and Collaboration

A 68-year-old client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory care unit with acute bacterial pneumonia. The client is receiving supplemental oxygen, intravenous therapy, and continuous pulse oximetry monitoring. Which specific intervention is safely within the scope of practice for the practical nurse (PN) to perform for this client?

  1. A
    Providing a detailed explanation of the risks and benefits of an impending bronchoscopy before securing the client's signature on the consent form.
  2. Auscultating bilateral lung sounds to collect data on the effectiveness of a recently administered albuterol nebulizer treatment.Answer
  3. C
    Administering a prescribed dose of intravenous (IV) push methylprednisolone to rapidly address acute airway inflammation.
  4. D
    Sharing the client's recent arterial blood gas results with an anxious extended family member waiting in the facility lobby.

Answer

The practical nurse (PN) is safely permitted to auscultate bilateral lung sounds to collect data on the effectiveness of a recently administered albuterol nebulizer treatment.
Under the National Council of State Boards of Nursing (NCSBN) guidelines, the practical nurse (PN) functions under the direction of an RN or provider. While the RN is responsible for the initial, comprehensive assessment and the creation of the nursing care plan, the PN is legally permitted to perform focused data collection. Auscultating lung sounds after a respiratory treatment represents appropriate focused data collection to monitor the client's response to a routine, established intervention.

Step-by-Step Solution

1
Analyze the client's clinical presentation and the required nursing interventions.
The client has COPD and pneumonia, requiring respiratory monitoring, intravenous medications, and potential invasive procedures.
Understanding the acuity and complexity of the client's condition is essential for determining safe delegation and scope of practice boundaries.
2
Evaluate each provided option against the legal scope of practice for a practical nurse (PN) according to NCSBN standards.
Informed consent explanation, IV push medications, and unauthorized disclosure of health information are identified as illegal or out of scope for the PN. Focused data collection is identified as within scope.
The PN must recognize tasks that require the advanced clinical judgment of an RN or provider to ensure client safety, as well as adhere strictly to legal and ethical compliance.

Key Concept

The practical nurse (PN) may perform focused data collection on stable clients and evaluate responses to established interventions, but cannot perform comprehensive assessments, administer IV push medications, or provide the primary explanation for informed consent.
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Topics

Client Care Assignments and Collaboration

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