Professional Nursing Practice and Scope of Practice
Scope of practice defines what a nurse may legally do, and it is set by state nurse practice acts, not by employer policy or personal comfort. A candidate must understand the distinction between the RN scope, the LPN/LVN scope, and the APRN scope, and must recognize that scope varies by jurisdiction. Core RN functions include assessment, nursing diagnosis, care planning, implementation, and evaluation; teaching and delegation are also RN responsibilities.
Traps in questions:
- "Can the nurse do X?" vs. "Should the nurse do X first?" Scope questions ask legality; priority questions ask sequencing. Read the stem carefully.
- Employer policy cannot expand scope. A hospital may permit a task, but if the state act prohibits it, the nurse is still outside scope.
- Assessment is never delegated. The RN may not hand off the initial assessment or the evaluation of care.
- The nursing process is iterative. A question describing a change in condition usually points to reassessment, not to continuing the old plan.
Worked rule of thumb: If the task requires nursing judgment about a patient's condition, it belongs to the RN. If it is a fixed, predictable procedure with a stable patient, it may be within a delegated or assistive scope. When a stem describes an unstable patient, the answer is almost always to keep the task with the RN and notify the provider as needed.
Also know the difference between independent nursing functions (done on nursing judgment) and dependent functions (performed under a provider's order, such as administering a prescription). Understanding this split helps you eliminate options that blur legal authority with clinical preference.