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 A

Explanation

A. Measure the legs with a tape measure to determine stocking size: Antiembolic stockings should fit properly to provide therapeutic compression without causing discomfort or impairing circulation. Measuring the legs accurately with a tape measure ensures the stockings fit appropriately and exert the correct amount of pressure to prevent deep vein thrombosis (DVT) and promote venous return.
B. Remove the stockings every 24 hr: Antiembolic stockings are typically worn continuously, especially during periods of immobility, to maintain consistent compression and prevent blood clots. Removing the stockings every 24 hours would interrupt the therapeutic effect and increase the client's risk of developing DVT.
C. Massage the legs before applying the stockings: Massaging the legs before applying antiembolic stockings is contraindicated, as it can dislodge blood clots and increase the risk of embolism. Additionally, massaging may cause trauma to the skin and exacerbate any existing circulatory issues.
D. Fold the stockings at the top if they are too long: Folding the stockings at the top if they are too long can create pressure points and compromise circulation, leading to discomfort and potentially exacerbating vascular issues. It is essential to ensure the stockings fit properly by selecting the appropriate size rather than folding them.

A. "Eat a high-fat snack at bedtime." B. "Sip carbonated beverages throughout the day C. "Drink hot herbal tea to relieve symptoms. D. "Lie down for 30 min after meals."

Correct Answer is C

Explanation

A. "Eat a high-fat snack at bedtime": Consuming high-fat foods, especially close to bedtime, can exacerbate heartburn symptoms. Fatty foods delay gastric emptying and can contribute to increased acid production, leading to heartburn. Therefore, advising the client to avoid high-fat snacks before bedtime is essential for managing heartburn.
B. "Sip carbonated beverages throughout the day": Carbonated beverages, including soda and sparkling water, can exacerbate heartburn symptoms due to their acidic nature and carbonation. Therefore, advising the client to avoid or limit carbonated beverages is essential for managing heartburn.
C. "Drink hot herbal tea to relieve symptoms": Herbal teas such as chamomile or ginger tea can help alleviate heartburn symptoms by promoting digestion and soothing the gastrointestinal tract. Warm beverages can have a soothing effect on the esophagus and stomach, potentially providing relief from heartburn discomfort. Therefore, advising the client to drink hot herbal tea to relieve symptoms is an appropriate recommendation.
D. "Lie down for 30 min after meals": Remaining upright for at least 30 minutes after meals can help prevent acid reflux and reduce the risk of heartburn. However, lying down immediately after eating can worsen heartburn symptoms by allowing stomach acid to flow back into the esophagus. Therefore, advising the client to lie down for 30 minutes after meals is not an appropriate instruction for managing heartburn.

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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

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Explanation

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Explanation

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