Which action requires the RN license rather than the LPN, given an adult patient with respiratory issues?

• A. Auscultating breath sounds
• B. Administering medications via MDI
• C. Completing an in-depth admission assessment
• D. Checking oxygen saturation using pulse oximetry

Answer: (C)

The key idea is who is trained to perform the initial, comprehensive assessment and create a plan based on that synthesis. An in-depth admission assessment goes beyond just collecting data; it requires integrating history, physical findings, and risk factors to identify nursing diagnoses and outline a care plan. This level of independent assessment and planning is within the RN’s scope and is essential at the start of care, especially with a patient who has respiratory issues, because it sets the baseline and channels subsequent interventions.

The other tasks are typically within the scope of practice for an LPN under supervision: listening to breath sounds is a focused data collection activity; checking oxygen saturation with a pulse oximeter is a straightforward measurement of vital information; administering medications via an inhaler involves following a prescribed regimen and technique, which many settings allow LPNs to perform with appropriate oversight. These tasks support ongoing care but do not establish the initial plan or require the same depth of clinical decision-making as a full admission assessment.