An LPN, under the supervision of the charge RN, is providing nursing care for a patient with an upper respiratory infection. Which action is NOT appropriate for the scope of practice of an LPN?
Auscultate breath sounds for a patient with respiratory issues
Give the patient a dose of Solumedrol (a steroid medication) 125 mg IV push
Draw a CBC lab for a patient with a suspected infection
Communicate findings with physician regarding a client’s x-ray
The Correct Answer is B
Choice A reason: Auscultating breath sounds is within the scope of practice for LPNs. They are trained to perform focused assessments, including listening to lung sounds, and then report abnormal findings to the RN or physician. This helps identify issues such as wheezing, crackles, or diminished breath sounds, which are critical in respiratory infections.
Choice B reason: Administering IV push medications, especially high-risk drugs like Solumedrol, is outside the scope of practice for LPNs in most states. IV push requires advanced knowledge of pharmacodynamics, monitoring for immediate adverse reactions, and rapid intervention skills that fall under RN responsibilities. Allowing LPNs to perform this would pose safety risks and violate the Nurse Practice Act.
Choice C reason: Drawing blood for laboratory tests such as a CBC is within the LPN scope of practice. LPNs are trained in venipuncture and specimen collection, and this task supports diagnostic evaluation of infection by assessing white blood cell counts and other parameters.
Choice D reason: Communicating findings with the physician regarding a client’s x-ray is appropriate for LPNs. They can report objective data and observations to providers, ensuring continuity of care. While they do not interpret x-rays independently, they can relay results and patient status to the physician.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: “Rate plus 40” is not a valid method for determining systolic blood pressure. Blood pressure is measured using Korotkoff sounds, not arbitrary calculations.
Choice B reason: The systolic blood pressure is identified at the first Korotkoff sound, which represents the point at which blood begins to flow through the artery as the cuff pressure decreases. This is the correct clinical marker.
Choice C reason: The diastolic reading plus MAP is not a recognized method for determining systolic pressure. MAP is a separate calculation used to assess perfusion.
Choice D reason: The last Korotkoff sound represents diastolic pressure, not systolic. Recording this as systolic would be inaccurate.
Correct Answer is C
Explanation
Choice A reason: An open-ended question invites the patient to share feelings or elaborate on concerns, typically beginning with prompts like “Tell me more about…” or “How are you feeling?” The statement given by the LPN is not a question at all, and therefore does not encourage patient expression. Instead, it closes off dialogue.
Choice B reason: A therapeutic method involves validating feelings, offering empathy, and encouraging coping strategies. For example, saying “I understand this is difficult, let’s talk about what worries you most” would be therapeutic. The LPN’s statement dismisses the patient’s unique feelings by generalizing them, which is not therapeutic.
Choice C reason: This is a communication block because it minimizes the patient’s concerns and discourages further discussion. By saying “Everyone feels that way,” the nurse invalidates the patient’s individual experience, which can lead to mistrust and reluctance to share. Communication blocks interfere with therapeutic rapport and hinder patient-centered care.
Choice D reason: “Just Culture” refers to a system of accountability in healthcare organizations that balances learning from mistakes with appropriate responsibility. It is not a communication style used in patient interactions. Therefore, this option does not apply to the scenario.
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