A nurse is reviewing client care assignments prior to the beginning of a shift. Which of the following client assignments should the nurse identify as being outside the scope of practice for an LPN?

A. A client who has a new onset of chest pain: New-onset chest pain represents a potentially unstable and life-threatening condition that requires immediate comprehensive assessment, clinical judgment, and rapid intervention. Evaluation may involve interpretation of cardiac rhythms, hemodynamic monitoring. These responsibilities fall within the RN’s scope. B. A client who has a tracheostomy: Clients with established tracheostomies are often considered stable if no acute complications are present. LPNs are generally trained to provide routine tracheostomy care, including suctioning and site care. Management focuses on maintaining airway patency and preventing infection rather than performing complex assessments. C. A client who is receiving enteral feedings: Administration and monitoring of enteral feedings for stable clients are typically within the LPN scope of practice. Responsibilities include verifying tube placement per facility policy, maintaining feeding schedules, and monitoring for complications such as aspiration or intolerance. D. A client who has urinary retention: Urinary retention in a stable client may require bladder assessment, catheterization, and monitoring of output. LPNs are commonly authorized to perform catheter insertion and provide routine urinary care under supervision. This assignment does not inherently involve complex clinical judgment unless accompanied by acute instability.