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Question

Difficulty: MediumClient Care Assignments and Collaboration

During a busy afternoon in a long-term care facility, a practical nurse (PN) must navigate multiple client needs and coordinate with the healthcare team. Which action by the PN demonstrates a safe and appropriate application of their scope of practice?

  1. Asking the registered nurse (RN) to complete the initial comprehensive assessment for a newly admitted resident.Answer
  2. B
    Explaining the potential risks and complications of an upcoming surgery to a resident before they sign the informed consent document.
  3. C
    Agreeing to independently administer an intravenous (IV) push diuretic to a resident experiencing sudden respiratory distress.
  4. D
    Providing detailed updates regarding a resident's deteriorating clinical condition to visiting relatives in the facility's main dining hall.

Answer

The correct action is asking the registered nurse (RN) to complete the initial comprehensive assessment for a newly admitted resident.
In the nursing process, the registered nurse (RN) is legally responsible for the initial comprehensive assessment of a newly admitted client and formulating the initial care plan. The practical nurse (PN) contributes to the ongoing assessment by collecting specific data, but cannot perform the initial evaluation. Requesting the RN to perform this task demonstrates a correct understanding of scope boundaries and safe team collaboration.

Step-by-Step Solution

1
Analyze each option against the legal scope of practice for a practical nurse (PN).
Identified that three of the actions violate scope boundaries or facility safety policies.
Safe delegation and assignment acceptance requires recognizing the limits of the PN license.
2
Evaluate the requirement for initial assessments on new admissions.
Determined that initial comprehensive assessments require independent clinical judgment and care planning.
National nursing standards mandate that an RN must perform the initial comprehensive assessment; the PN can only assist with subsequent data collection.
3
Select the action that correctly defers out-of-scope work to the appropriate team member.
Selected the option where the PN defers the initial admission assessment to the RN.
This demonstrates a thorough understanding of collaboration and scope of practice.

Key Concept

Scope of Practice and Safe Delegation
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Topics

Client Care Assignments and Collaboration

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