Examkin

Question

Difficulty: HardClient Care Assignments and Collaboration

A licensed practical/vocational nurse (LPN/VN) and an unlicensed assistive personnel (UAP) are co-assigned to care for a group of clients on a medical-surgical unit. The registered nurse (RN) team leader is currently responding to a rapid response call on another hall. A healthcare provider has just finished speaking with a client who is about to undergo a bedside thoracentesis. Which action by the LPN/VN demonstrates appropriate scope of practice and safe delegation principles?

  1. Directing the UAP to assist the client into an upright position leaning over the overbed table, while the LPN/VN witnesses the client's signature on the consent form.Answer
  2. B
    Clarifying the client's specific questions regarding the risk of a pneumothorax to ensure full understanding before obtaining their signature on the consent form.
  3. C
    Performing an initial comprehensive respiratory assessment to establish a definitive clinical baseline prior to the start of the invasive procedure.
  4. D
    Reviewing the client's medical history and procedural details with the UAP in the unit's visitor waiting area to expedite care coordination.

Answer

Directing the UAP to assist the client into an upright position leaning over the overbed table, while the LPN/VN witnesses the client's signature on the consent form.
The correct answer demonstrates safe, legal practice. The LPN/VN is acting within their designated scope by serving exclusively as a witness to the informed consent signature. Concurrently, delegating the standard, routine task of positioning the client to the UAP adheres to the five rights of delegation, ensuring efficient and safe client care while the RN is unavailable.

Step-by-Step Solution

1
Evaluate the clinical situation and identify the scope of practice boundaries for the LPN/VN regarding informed consent.
The LPN/VN can act as a witness to the client's signature but cannot provide the initial education or explain the medical risks of the procedure.
Informed consent requires the healthcare provider performing the procedure to explain the risks, benefits, and alternatives.
2
Assess the tasks required to prepare the client for the thoracentesis and determine what can be safely delegated.
Positioning a stable client is a routine, standard task that does not require nursing judgment.
According to the five rights of delegation, routine physical care tasks can be safely delegated to trained UAP.
3
Review the remaining options for scope of practice violations or safety breaches.
Initial comprehensive assessments and discussing client data in public areas are identified as practice violations.
LPN/VNs perform focused, ongoing data collection, not initial comprehensive assessments. Furthermore, confidentiality must be maintained at all times.

Key Concept

LPN/VN Scope of Practice, Informed Consent, and Safe Delegation
Rate this question

Topics

Client Care Assignments and Collaboration

More questions from this topic