A nurse is teaching a class about providing care within the legal stope 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?

Changing the inner cannula on a tracheostomy

Administering a platelet transfusion

Irrigation of an external ear canal

Inserting a tunneled central venous catheter

Answer and Explanation

The Correct Answer is D

A. Changing the inner cannula on a tracheostomy: This procedure falls within the RN's scope of practice, as it involves basic tracheostomy care and maintenance, which nurses commonly perform.
B. Administering a platelet transfusion: Administering blood and blood products, including platelet transfusions, is within the RN's scope of practice, provided the nurse has appropriate training and competency.
C. Irrigation of an external ear canal: Irrigation of an external ear canal is a routine nursing procedure that falls within the RN's scope of practice, as long as it does not involve invasive procedures beyond irrigation.
D. Inserting a tunneled central venous catheter: Inserting tunneled central venous catheters is typically performed by advanced practice nurses or physicians with specific training and certification, such as nurse practitioners or interventional radiologists. This procedure is beyond the scope of practice for RNs and requires specialized skills and knowledge.

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Correct Answer is C

Explanation

A. Provide the client with a low-protein diet: Clients with severe preeclampsia may require dietary modifications, but a low-protein diet is not typically indicated. Instead, they may need a balanced diet with adequate protein intake to support maternal and fetal health.
B. Ambulate the client every 4 hr: Ambulation may not be suitable for a client with severe preeclampsia due to the risk of seizures and other complications associated with the condition. Bed rest or limited activity is often recommended to reduce the risk of adverse outcomes.
C. Ensure that the side rails are up on the client's bed: This action is crucial for the safety of the client with severe preeclampsia, as they are at risk of seizures, which can lead to injury from falls. Keeping the side rails up helps prevent falls and ensures the client's safety during periods of altered consciousness.
D. Check the fetal heart rate twice daily: Monitoring the fetal heart rate is essential in managing severe preeclampsia to assess fetal well-being and detect signs of fetal distress. However, the frequency of monitoring may vary depending on the severity of the condition and the healthcare provider's orders. More frequent monitoring may be necessary in some cases.

A. Hearing loss B. Insomnia C. Tachycardia D. Blurred vision

Correct Answer is D

Explanation

A. Hearing loss: While digoxin toxicity can affect various organ systems, including the auditory system, resulting in symptoms such as tinnitus (ringing in the ears), hearing loss is not a typical manifestation of digoxin toxicity.
B. Insomnia: Insomnia is not a common symptom of digoxin toxicity. Clients with digoxin toxicity are more likely to experience neurological symptoms such as confusion, visual disturbances, or changes in mental status.
C. Tachycardia: Digoxin toxicity can cause arrhythmias, but it typically presents with bradycardia rather than tachycardia. Bradycardia is a hallmark sign of digoxin toxicity due to its negative chronotropic effect on the heart.
D. Blurred vision: Blurred or yellow-tinted vision is a classic symptom of digoxin toxicity, often described as "yellow halos" around lights. Visual disturbances occur due to the drug's effects on the optic nerve and can progress to more severe manifestations, such as changes in color vision or photophobia. Therefore, blurred vision is a key indicator of digoxin toxicity and requires prompt assessment and intervention.

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A nurse is teaching a class about providing care within the legal stope 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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is at 32 weeks of gestation and has severe preeclampsia. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

A nurse is assessing a client who is taking digoxin to treat chronic heart failure. Which of the following findings should indicate to the nurse that the client is developing digoxin toxicity?

Correct Answer is D

Explanation

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