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Difficulty: MediumAssignment, Delegation and Supervision

During a mid-day interdisciplinary round on a general medical floor, a registered nurse receives updated orders for several assigned clients. The nursing team consists of the registered nurse, a licensed practical nurse, and an unlicensed assistive personnel. Which task delegation represents the safest and most appropriate use of team resources?

  1. Directing the licensed practical nurse to administer scheduled oral antiepileptic medication to a client with a documented history of chronic seizuresAnswer
  2. B
    Asking the unlicensed assistive personnel to assist a client with right-sided hemiplegia during their first oral meal after an ischemic stroke
  3. C
    Assigning the licensed practical nurse to complete the comprehensive admission assessment for a client arriving from the emergency department with sudden altered mental status
  4. D
    Instructing the unlicensed assistive personnel to evaluate a client's understanding of newly prescribed safety precautions for fall prevention

Answer

Directing the licensed practical nurse to administer scheduled oral antiepileptic medication to a client with a documented history of chronic seizures
The correct answer appropriately assigns the administration of a routine, scheduled oral medication to a stable client to the licensed practical nurse. This task is entirely within the licensed practical nurse's scope of practice, which includes medication administration for predictable, stable clients.

Step-by-Step Solution

1
Analyze each delegated task and determine the clinical stability of the client involved.
The client receiving chronic seizure medication is stable, whereas the new admission and the stroke client having their first meal are unstable or require assessment.
Delegation decisions must prioritize client stability and predictability of outcomes.
2
Evaluate the scope of practice required for each task against the National Council of State Boards of Nursing (NCSBN) delegation guidelines.
Tasks involving initial assessment, clinical judgment, and evaluation (such as first feedings, admission assessments, and evaluating teaching) must be retained by the registered nurse.
The registered nurse cannot delegate tasks involving the nursing process (assess, diagnose, plan, evaluate, or teach).
3
Identify the task that aligns correctly with the delegatee's scope of practice.
Administering routine oral medications to a stable client is a standard, safe skill for a licensed practical nurse.
This task does not require independent nursing judgment beyond the licensed practical nurse's training.

Key Concept

Scope of Practice and Safe Delegation Principles
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Topics

Assignment, Delegation and Supervision

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