A charge nurse is reinforcing teaching with a newly hired licensed practical nurse about scope of practice. Which of the following responsibilities should the nurse include in the teaching?

Coordinating client care

Providing direct client care

Assessing a client's health status

Providing a client with discharge instructions

Answer and Explanation

The Correct Answer is B

A. Coordinating client care: Coordination of care involves synthesizing assessments, planning interventions, and collaborating with multiple disciplines, which requires independent clinical judgment. This responsibility falls within the registered nurse’s scope of practice, not the LPN’s.

B. Providing direct client care: LPNs are trained to provide hands-on care, including administering medications (excluding certain IV medications), monitoring vital signs, assisting with activities of daily living, and implementing established care plans. Direct client care is a primary LPN responsibility and aligns with their scope of practice under RN supervision.

C. Assessing a client's health status: Comprehensive assessment, interpretation of findings, and determining nursing diagnoses require independent critical thinking and clinical decision-making. These tasks are within the RN scope and exceed the LPN’s role, which focuses on collecting data and reporting changes.

D. Providing a client with discharge instructions: Teaching clients about medications, follow-up care, or lifestyle modifications involves patient education and clinical judgment. LPNs may reinforce previously taught instructions but do not independently initiate discharge teaching, which is an RN responsibility.

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Correct Answer is D

Explanation

A. Assist the client to cough and deep breathe: Encouraging coughing and deep breathing helps mobilize secretions and improve alveolar ventilation. While this is an important intervention for pneumonia, it does not immediately address the client’s current hypoxemia, which requires rapid intervention to improve oxygenation.

B. Administer scheduled antibiotic medication: Antibiotics are essential to treat the underlying infection, but their effect is not immediate. They do not correct acute hypoxemia or respiratory distress, so administering the antibiotic is not the first priority in this situation.

C. Discuss the pneumococcal vaccine with the provider: Vaccination is a preventive measure to reduce the risk of future infections. It does not address the acute hypoxemia or impaired gas exchange the client is experiencing during the current episode of pneumonia.

D. Position the client in high-Fowler's position: Elevating the client to a high-Fowler’s position promotes maximal lung expansion and improves ventilation-perfusion matching. This immediate intervention helps increase oxygen saturation and ease shortness of breath, making it the priority action in a client with SaO2 of 88% on room air.

A. Constipation B. Elevated skin patches C. Ringing in the ears D. Depression

Correct Answer is B

Explanation

A. Constipation: Constipation is not a common adverse effect of cefazolin. While gastrointestinal disturbances such as diarrhea or nausea can occur with antibiotics, constipation is typically unrelated and does not require immediate reporting.

B. Elevated skin patches: Skin eruptions, including hives or elevated erythematous patches, may indicate an allergic reaction to cefazolin. Early recognition and reporting are critical to prevent progression to severe hypersensitivity reactions such as anaphylaxis.

C. Ringing in the ears: Ototoxicity is more commonly associated with aminoglycoside antibiotics, not cefazolin, which is a cephalosporin. Tinnitus would not be an expected adverse effect requiring urgent reporting in this context.

D. Depression: Cefazolin is not linked to mood changes or psychiatric effects. Monitoring for depression is unnecessary in this case, as it is unrelated to the medication’s known adverse effects.

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A charge nurse is reinforcing teaching with a newly hired licensed practical nurse about scope of practice. Which of the following responsibilities should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has pneumonia and reports shortness of breath. The nurse notes the client has crackles auscultated in the lower lobes and an SaO2 of 88% on room air. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

A nurse is reinforcing teaching with an adolescent who has a new prescription for cefazolin. For which of the following findings should the nurse instruct the adolescent to monitor and report to the provider?

Correct Answer is B

Explanation

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