A nurse manager is facilitating a seminar for newly licensed registered nurses. The focus of the seminar is to assist the nurses in understanding their legal scope of practice. Which of the following information should the nurse manager include in the seminar?
An assistive personnel can evaluate a client's response to medication.
An RN can initiate the plan of care for a client on admission.
An RN can delegate blood administration to a licensed practical nurse.
A licensed practical nurse can provide initial discharge instructions.
The Correct Answer is B
A. An assistive personnel can evaluate a client's response to medication: Assistive personnel do not have the education or licensure to evaluate medication effects. They can perform delegated tasks such as vital signs or basic care, but assessment and evaluation of clinical responses remain within the RN’s scope of practice.
B. An RN can initiate the plan of care for a client on admission: Registered nurses are responsible for performing assessments, identifying nursing diagnoses, and developing an individualized plan of care upon admission. This is a core component of the RN’s legal scope of practice and requires professional judgment.
C. An RN can delegate blood administration to a licensed practical nurse: Blood administration is a high-risk procedure that generally cannot be delegated to an LPN in many states due to its complexity and potential for adverse reactions. The RN retains responsibility for administration and monitoring.
D. A licensed practical nurse can provide initial discharge instructions: Providing initial discharge instructions requires comprehensive assessment, education, and evaluation, which are within the RN’s scope of practice. LPNs may reinforce education but cannot independently provide initial instructions.
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Related Questions
Correct Answer is ["B","D"]
Explanation
A. "Attempt to gag": Gagging stimulates the vagus nerve and can worsen bradycardia. Clients should be instructed to avoid actions that trigger the gag reflex, so this instruction is not recommended.
B. "Take an antiemetic when feeling nauseated.": Nausea and vomiting can increase vagal stimulation. Taking an antiemetic as prescribed helps prevent excessive vagal nerve activation, which can reduce the risk of further slowing the heart rate.
C. "Apply firm pressure to the eyes": Applying pressure to the eyes can stimulate the vagus nerve, potentially exacerbating bradycardia. Clients should avoid eye rubbing or pressure.
D. "Eat a high-fiber diet to keep stools soft": Straining during defecation stimulates the vagus nerve and can worsen bradycardia. A high-fiber diet promotes regular, soft stools and helps prevent straining, thereby reducing vagal stimulation.
E. "Bear down to slow the pulse rate": Bearing down (Valsalva maneuver) directly increases vagal stimulation, which can dangerously slow the heart rate in clients with bradycardia. This action should be avoided.
Correct Answer is ["B","C","D"]
Explanation
A. Osteoarthritis: Osteoarthritis affects joint function and mobility but does not directly increase the risk for heart failure. While it can limit physical activity, it is not a primary cardiovascular risk factor.
B. Alcohol use disorder: Chronic excessive alcohol consumption can lead to cardiomyopathy, hypertension, and arrhythmias, all of which increase the risk for heart failure. Alcohol use disorder is a well-established modifiable risk factor for cardiac dysfunction.
C. Sleep apnea: Obstructive sleep apnea contributes to intermittent hypoxia, sympathetic nervous system activation, and increased blood pressure, all of which can promote the development of heart failure. Screening and management of sleep apnea are important preventive measures.
D. Diabetes mellitus: Diabetes increases the risk of heart failure through mechanisms such as accelerated atherosclerosis, microvascular damage, and diabetic cardiomyopathy. Poor glycemic control further elevates cardiovascular risk.
E. Hypotension: Hypotension, or low blood pressure, does not increase the risk of heart failure; in fact, hypertension is a more significant risk factor. Chronic hypotension can cause other issues, but it is not directly linked to heart failure development.
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