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Question

Difficulty: HardClient Care Assignments and Collaboration

A practical nurse (PN) is participating in an interprofessional discharge planning conference for a client with newly diagnosed end-stage renal disease (ESRD). Which action demonstrates appropriate adherence to the PN's scope of practice during this collaborative process?

  1. Sharing direct observations regarding the client's expressed anxiety about managing a restricted renal diet at homeAnswer
  2. B
    Formulating the comprehensive educational plan for the client's transition to outpatient hemodialysis
  3. C
    Discussing the client's anticipated discharge needs with a physical therapist while riding in a public elevator
  4. D
    Explaining the physiological risks and benefits of an arteriovenous (AV) fistula placement to the client's family

Answer

The correct action is sharing direct observations regarding the client's expressed anxiety about managing a restricted renal diet at home.
The practical nurse's role centers on data collection, implementation of care, and reporting findings. Sharing direct observations about a client's anxiety during a multidisciplinary conference is a highly appropriate and safe collaborative action that directly supports the team's ability to plan effective care.

Step-by-Step Solution

1
Identify the core subject of the question.
The question asks to identify the action that is within the legal scope of practice for a Practical Nurse (PN) during interprofessional collaboration.
Establishing the scope of practice boundaries is necessary to evaluate each option.
2
Evaluate the option regarding formulating an educational plan.
Developing comprehensive care or educational plans is an RN responsibility, making this action out of scope for the PN.
The PN's role is to reinforce teaching, not to initiate or formulate the primary educational plan.
3
Evaluate the option regarding discussing needs in an elevator.
This action constitutes a HIPAA violation because a public elevator is not a secure environment for discussing Protected Health Information (PHI).
Client confidentiality must be maintained at all times, even when speaking with other healthcare professionals.
4
Evaluate the option regarding explaining surgical risks.
Explaining risks and benefits is the provider's responsibility during the informed consent process. The PN may only witness the signature.
Nurses cannot obtain informed consent by explaining procedural risks; this exceeds their legal authority.
5
Evaluate the option regarding sharing direct observations.
This action is correct as it accurately reflects the PN's responsibility to collect data and communicate findings to the interprofessional team.
Reporting client concerns allows the team to collaboratively address psychosocial and educational needs within legal boundaries.

Key Concept

Scope of Practice and Interprofessional Collaboration
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Topics

Client Care Assignments and Collaboration

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