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Difficulty: MediumClient Care Assignments and Collaboration

A practical nurse (PN) is providing care on a respiratory medical unit alongside a registered nurse (RN) and an assistive personnel (AP). Which action planned by the PN demonstrates an appropriate understanding of the legal scope of practice and safe delegation?

  1. A
    Directing the AP to check the vital signs of a client who just reported sudden, severe chest pain
  2. B
    Explaining the potential risks and complications of an upcoming bronchoscopy to an anxious client
  3. C
    Discussing a client's positive tuberculosis test result with the AP in the facility cafeteria to plan care
  4. Administering a scheduled oral corticosteroid to a client with chronic asthma who has a stable respiratory rateAnswer

Answer

Administering a scheduled oral corticosteroid to a client with chronic asthma who has a stable respiratory rate
The correct answer involves administering a routine medication to a stable client, which is a fundamental and safe component of the PN's scope of practice. The client's condition is chronic and currently stable, requiring no immediate complex assessment or intervention beyond standard care.

Step-by-Step Solution

1
Analyze each proposed action against the legal scope of practice for the Practical Nurse (PN).
Identify which actions fall within safe boundaries for medication administration, delegation, confidentiality, and informed consent.
The PN must practice within established legal and ethical guidelines to ensure client safety.
2
Evaluate the stability of the clients and the appropriateness of delegated tasks.
Sudden chest pain indicates an unstable client requiring RN assessment, making delegation to an AP inappropriate. The client with stable chronic asthma is appropriate for routine PN care.
Delegation decisions must be based on client stability and the competence of the personnel receiving the assignment.
3
Review ethical and legal constraints regarding consent and confidentiality.
Explaining procedure risks is the provider's duty, and discussing health information in public violates confidentiality.
Nurses must protect client privacy and operate strictly within their designated role during the informed consent process.

Key Concept

Scope of Practice, Safe Delegation, and Legal/Ethical Responsibilities
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Topics

Client Care Assignments and Collaboration

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