Examkin

Question

Difficulty: MediumClient Care Assignments and Collaboration

Upon arriving for a shift on a medical-surgical unit, a practical nurse reviews the shift roster and discovers they have been assigned a client who is hemodynamically unstable and requires continuous titration of intravenous vasoactive medications. Arrange the actions the practical nurse should take in the correct chronological order to safely manage this assignment conflict.

  1. 1Identify that the client's acuity level and required interventions exceed the practical nursing scope of practice.
  2. 2Immediately verbalize the safety concern to the charge nurse who created the assignment.
  3. 3Collaborate with the charge nurse to reassign the unstable client to a registered nurse.
  4. 4Accept a modified assignment consisting of stable clients with predictable health outcomes.

Answer

The correct sequence of actions is: 1) Identify that the assignment exceeds the scope of practice, 2) Verbalize the concern to the charge nurse, 3) Collaborate to reassign the unstable client, and 4) Accept a modified, safe assignment.
A practical nurse is legally responsible for accepting only those assignments that align with their educational preparation, experience, and the state's Nurse Practice Act. When presented with an unsafe or out-of-scope assignment, the nurse must first recognize the limitation, then follow the chain of command by notifying the charge nurse immediately. Resolving the issue collaboratively ensures the unstable client receives appropriate care from a registered nurse, allowing the practical nurse to accept a modified, safe assignment and provide competent care.

Step-by-Step Solution

1
Analyze the assignment against the legal scope of practice.
The nurse determines that an unstable client needing continuous IV vasoactive medications requires registered nurse (RN) level assessment and intervention.
Nurses are legally obligated to refuse tasks or assignments that fall outside their licensure or competency.
2
Initiate the chain of command.
The nurse informs the charge nurse about the specific limitation and safety risk.
Communication with the assigner must happen immediately so alternative arrangements can be made before care is delayed.
3
Engage in collaborative problem-solving.
The unstable client is reallocated to an RN's assignment.
Client safety is the priority, requiring appropriate distribution of unit resources based on acuity.
4
Assume responsibility for a safe assignment.
The practical nurse takes on an assignment of stable clients.
Once the assignment aligns with the practical nurse's scope and abilities, care can safely commence.

Key Concept

Safe Assignment Acceptance and Delegation
Rate this question

Topics

Client Care Assignments and Collaboration

More questions from this topic