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Question

Difficulty: MediumClient Care Assignments and Collaboration

While managing care for assigned individuals on a telemetry step-down unit, a practical nurse encounters several situations requiring clinical decision-making. Which action by the practical nurse demonstrates appropriate scope of practice and interprofessional collaboration?

  1. Deferring the comprehensive admission assessment of a client newly transferred from critical care to the supervising registered nurse.Answer
  2. B
    Providing an initial intravenous push dose of an analgesic to a client reporting sudden, crushing substernal chest discomfort.
  3. C
    Explaining the potential procedural risks and alternative treatments to a client prior to witnessing the surgical consent form.
  4. D
    Reviewing a client's unexpected diagnostic findings with the assigned physical therapist while riding in a public visitor elevator.

Answer

Deferring the comprehensive admission assessment of a client newly transferred from critical care to the supervising registered nurse.
The scope of practice dictates that comprehensive initial assessments, particularly for clients transitioning from a critical care environment, require the advanced clinical judgment of a registered nurse. Deferring this task ensures the client receives appropriate, safe care and demonstrates excellent interprofessional collaboration.

Step-by-Step Solution

1
Analyze the role of the practical nurse regarding patient assessments.
The practical nurse is legally permitted to gather data and perform focused assessments on stable clients with predictable outcomes.
Recognizing foundational scope boundaries is essential for safe practice and legal compliance.
2
Evaluate the acuity and needs of a client transferring from critical care.
A newly transferred client from an intensive care environment requires a comprehensive admission assessment to establish a new clinical baseline.
Comprehensive assessments for complex or potentially unstable clients fall strictly within the registered nurse's scope of practice.
3
Determine the appropriate collaborative action for the practical nurse.
The practical nurse must hand off or defer this admission assessment to the registered nurse.
Delegation up the chain of command ensures the client receives the required level of care and maintains patient safety.

Key Concept

Practical Nurse Scope of Practice in Assessment and Delegation
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Topics

Client Care Assignments and Collaboration

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