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Difficulty: MediumClient Care Assignments and Collaboration

A practical nurse (PN) is reviewing their assigned client care tasks for a shift on a general medical unit. The interprofessional team consists of a registered nurse (RN), the PN, and an assistive personnel (AP). Which of the following delegated tasks are within the PN's legal scope of practice to accept? (Select all that apply.)

  1. Administering a scheduled intramuscular (IM) injection of pain medicationAnswer
  2. B
    Developing the initial plan of care for a client newly admitted with pneumonia
  3. Reinforcing previously provided dietary education for a client with hypertensionAnswer
  4. D
    Administering a prescribed intravenous (IV) push antiarrhythmic medication
  5. Performing a sterile wet-to-dry dressing change on a client's surgical woundAnswer
  6. F
    Explaining the risks and benefits of an upcoming procedure to obtain informed consent

Answer

The practical nurse should accept tasks that involve administering intramuscular injections, reinforcing established dietary education, and performing sterile dressing changes.
The correct selections represent actions that align with standard practical nursing competencies. Administering routine intramuscular medications, performing sterile procedures like dressing changes, and reinforcing previously established teaching plans do not require the comprehensive assessment, independent evaluation, or complex judgment reserved for the registered nurse.

Step-by-Step Solution

1
Analyze the role boundaries of the practical nurse (PN) versus the registered nurse (RN) and healthcare provider.
The RN is responsible for initial assessments, formulating care plans, initial teaching, and high-risk IV therapies. The provider handles obtaining informed consent.
Establishing professional boundaries is critical to safely accepting delegated tasks.
2
Evaluate each task option against the NCSBN delegation guidelines and standard PN scope of practice.
IM injections, sterile dressing changes, and reinforcement of prior teaching fall clearly within the data collection, execution, and reinforcement duties of a PN.
To ensure compliance with the legal and ethical standards of nursing practice.
3
Identify and exclude tasks requiring independent comprehensive assessment or provider intervention.
Developing care plans, giving IV push antiarrhythmics, and explaining procedural risks are excluded from the PN's assignment.
These actions exceed the PN's scope and present a significant safety or legal risk if accepted.

Key Concept

LPN/VN Scope of Practice and Safe Task Delegation
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Topics

Client Care Assignments and Collaboration

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