RN vs LPN/LVN Scope of Practice

The RN and LPN operate under different legal scopes defined by state nurse practice acts, but NCLEX tests a national baseline. The RN owns the nursing process in its entirety: assessment (initial and ongoing requiring clinical judgment), nursing diagnosis, care plan development, evaluation of outcomes, and patient teaching that requires interpretation or adaptation. The LPN performs focused, task-oriented care within an established plan: collecting routine data (vital signs, intake/output), reinforcing teaching the RN has already initiated, performing straightforward skills (wound care, urinary catheterization, oral/IM/SubQ medication administration), and providing stable, predictable patient care. The critical dividing line is clinical judgment under uncertainty. Any task requiring a new judgment call — triaging a change in condition, interpreting assessment data, initiating or modifying a care plan, administering IV push medications, or managing blood product transfusions — stays with the RN. The LPN can monitor an existing IV infusion in many jurisdictions but cannot initiate or titrate IV medications. When an LPN identifies a change in patient status, the correct action is to report findings to the RN, who then reassesses and decides the next step.