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Question

Difficulty: HardClient Care Assignments and Collaboration

At the start of a shift in a busy skilled nursing facility, client assignments and tasks must be distributed among a registered nurse (RN), a licensed practical nurse (LPN/VN), and assistive personnel (AP). Which action taken by the LPN/VN reflects appropriate adherence to the legal scope of practice and safe delegation principles?

  1. Completing a sterile dressing change for a client with a healing diabetic foot ulcer and delegating the client's subsequent bed bath to the APAnswer
  2. B
    Elaborating on the surgical risks and alternative treatment options for a client who expresses hesitation just before signing an informed consent document
  3. C
    Accepting the transfer of a newly admitted client who presents with sudden onset shortness of breath and an oxygen saturation of 88% on room air
  4. D
    Providing a detailed update regarding a client's newly diagnosed condition to visiting family members while standing in the facility's main hallway

Answer

The correct action is completing a sterile dressing change for a client with a healing wound and delegating the client's subsequent bed bath to the AP.
A licensed practical nurse (LPN/VN) is legally permitted to perform sterile dressing changes on stable, healing wounds, as this task involves following established procedures with expected outcomes. Furthermore, delegating routine personal care, such as a bed bath, to assistive personnel (AP) represents a correct application of the five rights of delegation and ensures efficient interprofessional collaboration.

Step-by-Step Solution

1
Analyze the LPN/VN scope of practice regarding wound care and delegation to assistive personnel (AP).
Sterile dressing changes on established, stable wounds are within the LPN/VN scope. Basic hygiene tasks like bed baths are appropriate to delegate to APs.
To ensure tasks are appropriately matched with the team members' skill levels and legal boundaries.
2
Evaluate the action involving informed consent.
The LPN/VN can witness a signature but cannot legally explain surgical risks, benefits, or alternatives.
Identifying that answering detailed procedural questions is the sole responsibility of the healthcare provider performing the procedure.
3
Evaluate the appropriateness of the newly admitted client assignment.
A client with sudden shortness of breath and hypoxia is highly unstable and requires comprehensive initial assessment.
To recognize that unstable clients requiring advanced clinical judgment must be assigned to an RN.
4
Evaluate the communication scenario with family members.
Discussing client information in a public hallway risks exposing private health data to bystanders.
To maintain strict compliance with confidentiality standards and HIPAA regulations.

Key Concept

LPN/VN Scope of Practice, Delegation, and Interprofessional Collaboration
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Topics

Client Care Assignments and Collaboration

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