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Difficulty: MediumClient Care Assignments and Collaboration

An interdisciplinary team is managing client care on a cardiovascular step-down unit. Which action performed by the practical nurse (PN) demonstrates a correct understanding of their legal scope of practice and safe assignment principles?

  1. Administering scheduled oral antihypertensive medications to a clinically stable client who is two days post-myocardial infarction.Answer
  2. B
    Formulating the initial discharge teaching plan for a client who is preparing to return home with a newly implanted permanent pacemaker.
  3. C
    Describing the potential complications of an upcoming cardiac catheterization to a client before witnessing the informed consent signature.
  4. D
    Filing a laboratory report showing a serum potassium level of 2.8 mEq/L2.8 \text{ mEq/L} (2.8 mmol/L2.8 \text{ mmol/L}) for review during the upcoming shift handoff.

Answer

Administering scheduled oral antihypertensive medications to a clinically stable client who is two days post-myocardial infarction.
The correct answer involves providing routine care to a clinically stable client. Administering scheduled oral medications to a client who is two days post-myocardial infarction and stable is entirely within the recognized legal scope of practice for a practical nurse.

Step-by-Step Solution

1
Analyze each proposed action to determine if it falls within the legal and safe scope of practice for a practical nurse.
Three actions are identified as unsafe or outside the PN scope, while one is a standard PN task.
Safe delegation and assignment require adherence to legal practice boundaries and prompt recognition of critical client changes.
2
Evaluate the educational and consent-related tasks.
Formulating an initial teaching plan is an RN responsibility, and explaining procedural risks is a provider responsibility.
The PN scope allows for reinforcement of teaching and witnessing consent signatures, but not initial complex education or obtaining informed consent.
3
Evaluate the clinical data task.
A potassium level of 2.8 mEq/L2.8 \text{ mEq/L} is identified as a critical laboratory value.
Normal potassium is 3.53.5 to 5.0 mEq/L5.0 \text{ mEq/L}. Hypokalemia can cause severe arrhythmias, necessitating immediate escalation rather than delaying for shift handoff.
4
Verify the remaining action.
Administering routine oral medications to a stable client is confirmed as the correct action.
This task does not require complex initial assessment or intervention, making it perfectly suited for the PN scope of practice.

Key Concept

Practical Nurse Scope of Practice and Task Delegation
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Topics

Client Care Assignments and Collaboration

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