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Question

Difficulty: MediumClient Care Assignments and Collaboration

While providing care on an acute surgical unit, a practical nurse (PN) encounters several situations requiring collaboration and decision-making. Which action taken by the PN demonstrates a correct understanding of safe client care assignments and role boundaries?

  1. A
    Assuming primary responsibility for a newly postoperative client who requires continuous titration of intravenous vasoactive medications
  2. Requesting the registered nurse (RN) to take over the care of a client whose vital signs have suddenly become hemodynamically unstableAnswer
  3. C
    Explaining the specific risks and alternative options for a surgical procedure to a client prior to witnessing the consent signature
  4. D
    Discussing a client's sensitive diagnostic test results with the client's spouse in the facility hallway to offer emotional support

Answer

The correct action is requesting the registered nurse (RN) to take over the care of a client whose vital signs have suddenly become hemodynamically unstable.
The practical nurse scope of practice mandates that PNs care for clients with stable, predictable conditions. When a client becomes hemodynamically unstable, their care requirements elevate to need comprehensive assessment, continuous clinical judgment, and potentially advanced interventions. The PN correctly recognizes these legal boundaries by collaborating with and transferring care to the registered nurse (RN).

Step-by-Step Solution

1
Analyze the PN's scope of practice regarding client stability.
The PN scope of practice involves caring for clients with stable, predictable outcomes.
Establishing the baseline rules for PN client assignments is required to evaluate the options.
2
Evaluate the option involving continuous titration of IV medications.
This task requires advanced physiological monitoring and RN-level clinical judgment, making it inappropriate for a PN to accept.
Titration of vasoactive drips is highly complex and outside the legal boundaries of PN practice.
3
Differentiate interprofessional roles in the informed consent process.
The prescribing healthcare provider must explain risks and alternatives; the PN only witnesses the voluntary signature.
Nurses must not overstep into the provider's legal duty to inform.
4
Identify privacy violations in clinical communication.
Discussing sensitive results in a hallway violates HIPAA regulations, even if the spouse is authorized to receive the information.
Confidentiality must be maintained by communicating in private areas.
5
Determine the correct collaborative action for an unstable client.
Escalating the care of a newly unstable client to the RN is the legally and ethically correct action.
Unstable clients require the comprehensive assessment and critical thinking skills of a registered nurse.

Key Concept

Practical Nurse Scope of Practice, Delegation, and Role Boundaries
Estimated Time:1m 0s
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Topics

Client Care Assignments and Collaboration

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