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Question

Difficulty: EasyClient Care Assignments and Collaboration

A nursing supervisor at a long-term care facility delegates four client care tasks to a practical nurse (PN). Which assigned action exceeds the PN's legal scope of practice and requires intervention?

  1. Completing the comprehensive admission assessment for a newly admitted clientAnswer
  2. B
    Reinforcing the physical therapist's instructions regarding safe walker usage
  3. C
    Administering a scheduled enteral feeding via an established percutaneous endoscopic gastrostomy (PEG) tube
  4. D
    Performing a routine sterile dressing change on a healing stage 3 pressure injury

Answer

Completing the comprehensive admission assessment for a newly admitted client
The correct answer identifies a task that is outside the practical nurse's scope of practice. Performing a comprehensive admission assessment requires complex clinical judgment, advanced data synthesis, and the formulation of an initial care plan. These responsibilities are legally restricted to the registered nurse (RN) and cannot be delegated to a PN.

Step-by-Step Solution

1
Identify the standard scope of practice and delegation boundaries for a practical nurse (PN).
Recognize that PNs care for stable clients with predictable outcomes and gather data, but do not synthesize data for initial assessments.
Understanding the legal limitations of the PN role is necessary to ensure safe delegation.
2
Evaluate each assigned task against the National Council of State Boards of Nursing (NCSBN) guidelines for PN practice.
Reinforcing teaching, giving tube feedings, and performing sterile dressing changes are within the PN scope. Comprehensive assessments are not.
Comparing tasks to established guidelines isolates the task that must be reassigned.
3
Select the task that requires registered nurse (RN) level clinical judgment.
The comprehensive admission assessment is identified as the out-of-scope task.
Initial assessments form the basis of the nursing care plan and require advanced RN education and licensure.

Key Concept

LPN/VN Scope of Practice regarding Initial Assessment and Delegation
Estimated Time:1m 0s
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Topics

Client Care Assignments and Collaboration

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