Scope of Practice (Nursing)
Scope of practice defines what a healthcare professional is legally authorized to do. LPN/LVN practice depends on the jurisdiction's nursing laws, the setting, required supervision and the nurse's competence.
Exam Tip
Check the nurse practice act and board rules. LPNs/LVNs contribute to the care plan and administer authorized medications. Assessment, teaching, IV therapy and delegation authority depend on jurisdiction and setting. Routine assignments and nursing delegation are distinct.
What Is Scope of Practice?
Scope of practice refers to the activities that a healthcare professional is legally permitted to perform based on their education, training, licensure, and state regulations. Each state's Nurse Practice Act (NPA) defines the scope of practice for LPNs, RNs, and APRNs.
Scope of Practice Comparison
| Activity | CNA/UAP | LPN/LVN | RN | APRN |
|---|---|---|---|---|
| Vital signs | Yes | Yes | Yes | Yes |
| ADL assistance | Yes | Yes | Yes | Yes |
| Focused assessment/data collection | Authorized observations | Focused assessment within scope | Yes | Yes |
| Comprehensive assessment | No | No | Yes | Yes |
| Nursing diagnosis | No | No | Yes | Yes |
| Care plan development | No | Contributes data | Yes | Yes |
| Oral medication administration | Only with separate state-authorized training/delegation | Yes | Yes | Yes |
| IV medication administration | Outside routine CNA scope | Varies by law, training and policy | Within scope and competence | Within scope and competence |
| IV push medications | Outside routine CNA scope | Check the jurisdiction, medication and facility policy | Within scope and competence | Within scope and competence |
| Blood product administration | Outside routine CNA scope | Check legal authority and facility policy | Within scope and competence | Within scope and competence |
| Initial patient teaching | Not independent nursing education | Within state scope and competence | Yes | Yes |
| Delegation to CNAs | No nursing delegation authority | Only where law authorizes it | Where law authorizes it | Where law authorizes it |
| Prescriptive authority | Outside role | Outside role | An RN license alone does not confer prescriptive authority | Depends on role and jurisdiction |
Key Principles of Scope of Practice
| Principle | Explanation |
|---|---|
| State Nurse Practice Act | The primary legal document governing scope; varies by state |
| Facility policies | May be more restrictive than state law, but never less |
| Education and competency | Must have training for any task performed |
| Professional accountability | Responsible for knowing and staying within your scope |
| Delegation rules | Cannot delegate beyond your own scope |
Working Outside Scope of Practice
| Risk | Consequence |
|---|---|
| Performing unauthorized tasks | License suspension or revocation |
| Patient harm | Legal liability (malpractice/negligence) |
| Criminal charges | Practicing without a license (if scope exceeded significantly) |
| Employment termination | Violation of facility policies |
How to Determine Your Scope
- Review your state Nurse Practice Act
- Check facility policies and procedures
- Verify your education and training cover the task
- Consult with your charge nurse or supervisor if uncertain
- When in doubt, do NOT perform the task until clarified
Exam Alert
Scope of practice questions are heavily tested in the Coordinated Care category on the NCLEX-PN (18-24%). Know what LPNs can and cannot do compared to CNAs and RNs. Always follow the state Nurse Practice Act. Facility policies may be more restrictive but never less restrictive than the NPA. When in doubt, ask your supervisor.
The CNA credential alone does not authorize every nursing task. Separately authorized medication-aide roles and state delegation programs must not be confused with routine CNA scope. Tables summarize typical roles rather than overriding state law. Official guidance.
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Delegation (Nursing)
Delegation in nursing authorizes another qualified person to perform a specific activity. The delegating nurse remains accountable for the decision and oversight. The person accepting the activity is accountable for their own performance.
Licensed Practical Nurse (LPN)
An LPN is a licensed practical nurse. California and Texas use the title licensed vocational nurse (LVN). LPNs/LVNs provide nursing care under the direction and supervision required by their jurisdiction.
Nursing Process
The nursing process is a cyclical framework for planning, delivering and evaluating patient-centered care. ADPIE is a common way to remember assessment, diagnosis, planning, implementation and evaluation.
Care Plan (Nursing)
A nursing care plan records a patient's identified needs, measurable goals and nursing interventions. The RN leads nursing care planning, and the LPN/LVN contributes findings and helps develop, implement and update the plan within the applicable scope of practice.
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