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Difficulty: MediumLegal and Ethical Practice

A practical nurse (PN) is providing care for a group of clients on an inpatient rehabilitation unit. Which of the following actions by the PN demonstrate adherence to legal and ethical standards of practice? (Select all that apply.)

  1. Refusing an assignment to administer intravenous (IV) push pain medication to a newly admitted client.Answer
  2. Signing a surgical consent form to verify that the client voluntarily signed the document.Answer
  3. C
    Discussing a client's physical therapy progress with an adult child who is not listed on the information release form.
  4. D
    Waiting for definitive photographic proof of neglect before reporting suspected elder abuse to adult protective services.
  5. E
    Accepting a transfer client from the intensive care unit who requires continuous invasive hemodynamic monitoring.
  6. Documenting the failure of less restrictive alternative interventions before applying a prescribed physical restraint.Answer

Answer

The correct actions include refusing the IV push medication assignment, acting as a witness for the informed consent signature, and documenting less restrictive alternatives prior to restraint application.
The correct actions demonstrate a clear understanding of the practical nurse's scope of practice and legal responsibilities. The PN correctly refuses to administer IV push medications, as this requires RN-level clinical judgment and is outside standard practice. When participating in informed consent, the PN acts appropriately by solely witnessing the client's voluntary signature, leaving the procedural explanation to the provider. Additionally, documenting the failure of less restrictive interventions before applying restraints complies with legal and ethical standards to prevent false imprisonment and protect client autonomy.

Step-by-Step Solution

1
Evaluate each option against the established practical nurse (PN) scope of practice.
Refusing IV push medications and rejecting the assignment of a hemodynamically unstable client are both correct applications of the PN scope of practice.
PNs care for stable clients with predictable outcomes and typically do not administer IV push medications.
2
Analyze each action involving client rights, confidentiality, and consent.
Witnessing the voluntary signature on a consent form is appropriate. Disclosing information to an unauthorized adult child is an inappropriate breach of confidentiality.
HIPAA strictly prohibits sharing information without consent, while the nurse's role in procedures is merely to witness the client's signature.
3
Assess actions related to legal mandates and safety protocols.
Waiting for definitive proof of abuse before reporting is incorrect. Documenting the failure of less restrictive alternatives before using restraints is legally required.
Mandatory reporting requires only a reasonable suspicion, and restraint laws mandate exhausting alternative measures to prevent false imprisonment.

Key Concept

Legal and Ethical Practice Boundaries
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Topics

Legal and Ethical Practice

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