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Question

Difficulty: MediumLegal and Ethical Practice

Upon arriving at a rehabilitation center for the day shift, a practical nurse reviews the pending interventions for assigned clients. Which of the following activities must the practical nurse refuse to perform in order to maintain legal and ethical compliance?

  1. Administering a scheduled dose of an intravenous push (IVP) opioid analgesic to a client experiencing acute pain.Answer
  2. B
    Co-signing an informed consent document as a witness after the attending provider explains the procedural risks to the client.
  3. C
    Sharing specific details about a client's mobility limitations with the facility's physical therapist during a collaborative care conference.
  4. D
    Initiating a formal report to state authorities after observing unexplained, patterned bruising on an older adult client's inner arms.

Answer

The practical nurse must refuse to administer the intravenous push (IVP) medication, as this falls outside the legal scope of practice.
Administering intravenous push (IVP) medications requires the advanced assessment skills, clinical judgment, and rapid evaluation capabilities of a registered nurse (RN). Under standard nurse practice acts, this task is explicitly outside the scope of practice for a practical nurse. Accepting and performing this delegated task would be a severe violation of legal guidelines and client safety protocols.

Step-by-Step Solution

1
Analyze each proposed activity to determine if it falls within the legal scope of practice and ethical guidelines for a practical nurse.
Three activities represent legal and ethical duties; one represents a violation of scope of practice.
To identify the single action that the nurse is legally obligated to refuse.
2
Evaluate the administration of intravenous push (IVP) medications by a practical nurse.
IVP medication administration requires specialized RN-level assessment, clinical judgment, and rapid evaluation capabilities.
Standard nurse practice acts universally exclude IVP administration from the practical nursing scope of practice due to safety risks.
3
Evaluate the remaining options regarding informed consent, interdisciplinary communication, and mandated reporting.
Witnessing consent, sharing information with the direct care team, and reporting suspected abuse based on objective findings are all legally correct actions.
These actions align perfectly with the practical nurse's legal duties and do not violate ethical standards.

Key Concept

Legal and Ethical Practice
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Topics

Legal and Ethical Practice

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