Which assignment should not be performed by the registered nurse?

DHS Staff Nurse - 2018 (Shift-2nd)

Nursing Foundation

Easy

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

Inserting sutures and clips to close a surgical wound is a procedure performed by a surgeon, physician assistant, or a nurse with advanced training, such as an RN First Assistant (RNFA).
This task is considered part of the surgical procedure itself and is beyond the scope of practice for a general registered nurse.
The RN's role during wound closure is to assist the provider, manage the sterile field, and monitor the patient's stability.

Option A: Inserting a Foley catheter is a fundamental and common sterile procedure that is well within the scope of practice for a registered nurse.
Option B: Inserting a nasogastric (NG) tube for feeding, medication administration, or gastric decompression is a standard skill taught in nursing school and routinely performed by RNs.
Option C: While a physician or advanced practice provider inserts the central line, the RN is responsible for monitoring the Central Venous Pressure (CVP), interpreting the readings, and managing the line. This is a core competency, especially in critical care.

Clinical Relevance

Nursing practice connection: Knowing Scope of Practice for Registered Nurses helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Adhering to the legal scope of practice is a primary responsibility for a nurse to ensure patient safety and avoid professional misconduct charges.
Nurses must be aware of their state's Nurse Practice Act, which defines the legal boundaries for their practice.
What if the nurse has an RNFA (RN First Assistant) certification? In that case, with appropriate training and working under the direct supervision of the surgeon, they would be qualified to insert sutures and perform other advanced surgical tasks.

How to Approach the Question

First, identify the negative framing of the question with the keyword 'not'. This means you are looking for the task that an RN is NOT allowed to do.
Evaluate each option based on the standard scope of practice for a general Registered Nurse.
Option A (Foley catheter) is a basic nursing skill. Eliminate it.
Option B (NG tube) is a common nursing procedure. Eliminate it.
Option C (CVP monitoring) is a key nursing responsibility in critical care. Eliminate it.
Option D (Inserting sutures) is a surgical closure technique, typically performed by a surgeon or advanced practitioner, not a general RN. This is the task that does not fit within the standard scope.

Concept Tested & Keywords

Concept Tested: Scope of Practice for Registered Nurses
Stem keywords: assignment, registered nurse, perform
Lead-in keywords: not
Negative lead-in flag: This question uses negative framing ('NOT') to test knowledge of tasks outside the standard RN scope of practice.

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