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Difficulty: MediumAssignment, Delegation and Supervision

Midway through an evening shift on a neurology step-down unit, a registered nurse (RN) is reviewing pending interventions for a group of assigned clients. The care team includes the RN, a licensed practical/vocational nurse (LPN/VN), and an unlicensed assistive personnel (UAP). Which of the following tasks is most appropriate to delegate to the LPN/VN?

  1. A
    Performing a baseline neurological assessment on a client just transferred from the emergency department.
  2. Inserting a straight urinary catheter for a clinically stable client with a neurogenic bladder.Answer
  3. C
    Formulating a home safety education plan for a client preparing for discharge after a mild ischemic stroke.
  4. D
    Administering scheduled oral analgesics to a client who suddenly reports an intense, new-onset headache and photophobia.

Answer

Inserting a straight urinary catheter for a clinically stable client with a neurogenic bladder.
The correct answer describes a standardized, sterile procedure (urinary catheterization) for a client whose condition is stable. This falls perfectly within the defined scope of practice for an LPN/VN, as it does not require initial assessment, care planning, or independent clinical judgment regarding a change in status.

Step-by-Step Solution

1
Analyze each proposed task against the established scope of practice for an LPN/VN.
Identify tasks involving initial assessment, planning, or unstable clients as inappropriate for delegation.
The National Council of State Boards of Nursing (NCSBN) dictates that the RN retains accountability for assessment, clinical judgment, and evaluation.
2
Evaluate the clinical stability of the clients associated with each task.
The client requiring an initial assessment, the client needing a discharge plan, and the client with a new-onset severe headache require RN-level intervention.
Delegation to an LPN/VN must involve clients whose conditions are stable and predictable.
3
Select the task that falls safely within the LPN/VN scope of practice.
Inserting a straight catheter in a stable client is identified as the correct choice.
This is a standardized sterile procedure with a predictable outcome that an experienced LPN/VN is trained to execute.

Key Concept

Delegation of tasks based on scope of practice and client stability.
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Topics

Assignment, Delegation and Supervision

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