A nurse is teaching a class about providing care within the legal scope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN?

Choice A reason: The Weber test involves placing a vibrating tuning fork on the head’s midline to assess hearing symmetry, detecting conductive or sensorineural loss. This correct technique ensures accurate hearing evaluation, critical for identifying hearing deficits in children, guiding referrals, and supporting academic performance and communication.

Choice B reason: Holding a tuning fork near the ears is part of the Rinne test, not Weber, which uses midline placement. This error risks incorrect hearing assessment, potentially missing unilateral hearing loss, delaying diagnosis, and affecting interventions, critical for addressing hearing issues in school-age children.

Choice C reason: Measuring sound duration is not part of the Weber test, which assesses sound lateralization, not duration. This action risks misinterpreting hearing acuity, potentially overlooking conductive or sensorineural deficits, delaying audiology referrals, critical for ensuring proper hearing evaluation and support in school-age children.

Choice D reason: Obtaining a tympanogram assesses middle ear function, not hearing acuity like the Weber test, which uses a tuning fork. Assuming a tympanogram is needed risks unnecessary testing, delaying direct hearing assessment, critical for identifying hearing loss and guiding interventions in children’s auditory health.

Choice A reason: Increased urine output is not a therapeutic effect of methylphenidate, a stimulant used for ADHD to improve focus and reduce impulsivity. It does not affect renal function or urine production, making this finding irrelevant to evaluating the medication’s effectiveness in a school-age child.

Choice B reason: Increased appetite is not expected with methylphenidate, which commonly suppresses appetite as a side effect. Effective ADHD treatment improves behavior, not appetite, so this finding does not indicate the medication’s success in managing the child’s ADHD symptoms.

Choice C reason: Decreased abdominal pain is unrelated to methylphenidate’s therapeutic effects, which target ADHD symptoms like impulsivity and inattention. While gastrointestinal side effects may occur, pain reduction is not a primary indicator of efficacy, making this an incorrect measure of effectiveness.

Choice D reason: Decreased impulsiveness is a primary indicator of methylphenidate’s effectiveness, as it stimulates the central nervous system to enhance focus and reduce hyperactive-impulsive behaviors in ADHD. This behavioral improvement aligns with therapeutic goals, making it the correct finding to evaluate progress.