Which of the following is not a physician-prescribed intervention?

DSSSB Public Health Nurse - 2015

Fundamental of Nursing

Medium

Appeared in: DSSSB Public Health Nurse - 2015

Explanation

Elevating an edematous limb is an independent nursing intervention that a nurse can perform based on their clinical judgment without a physician's order.
This action falls under promoting comfort and managing physiological symptoms, which is within the autonomous scope of nursing practice.
The goal is to use gravity to help reduce swelling (edema) by promoting the return of venous blood and lymphatic fluid from the extremity.
Unlike administering drugs or ordering tests, limb elevation is a non-invasive, low-risk comfort measure that does not require a prescription.

Option A: Performing wound care is often a dependent or interdependent intervention. While the nurse physically performs the care, the specific type of dressing, cleaning solution, and frequency of changes are typically prescribed by a physician, especially for complex or surgical wounds.
Option B: Ordering diagnostic tests, such as lab work, X-rays, or CT scans, is a classic example of a physician-initiated intervention. Nurses are not licensed to order such tests independently.
Option D: Drug administration is a core dependent nursing intervention. Nurses can only administer medications after receiving a valid and legal prescription or order from a licensed provider like a physician.

Clinical Relevance

Nursing practice connection: Knowing Types of Nursing Interventions (Independent vs. Dependent) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding the scope of practice is crucial for patient safety and legal accountability. Nurses must know which actions they can perform independently and which require a physician's order.
Independent nursing interventions empower nurses to respond promptly to patient needs, such as managing pain with non-pharmacological measures or preventing complications like pressure injuries through positioning.
In an emergency, a nurse might initiate certain actions under standing orders or protocols, which are pre-approved by physicians, blurring the line but still operating under physician authority.

How to Approach the Question

First, analyze the question's lead-in. The word 'not' is critical; you are looking for the option that is an exception.
The core concept is 'physician-prescribed intervention'. This is another term for a 'dependent' nursing intervention.
Therefore, the question is asking you to identify which of the four options is an 'independent' nursing intervention.
Evaluate each option against the definition of independent vs. dependent actions.
Ask yourself for each option: 'Can a nurse do this on their own initiative without a doctor's order?'
The action that a nurse can and should do based on their own assessment (elevating a swollen leg) is the correct answer.

Concept Tested & Keywords

Concept Tested: Types of Nursing Interventions (Independent vs. Dependent)
Stem keywords: physician-prescribed intervention, nursing interventions
Lead-in keywords: not
Negative lead-in flag: The question uses the word 'not', asking for the exception among the options.

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