Answers and Explanations

Chapter Quiz

  1. The Answer is 1, 3, 4, and 6

    The LPN/LVN is part of the care team in a medical-surgical unit. The LPN/LVN could expect to perform which of the following client-care activities? Select all that apply.

    Strategy: Think about the skill level involved in each client-care activity.

    Category: Implementation/Safe and Effective Care Environment/Coordinated Care

    1. CORRECT: The LPN/LVN can educate pre- and postsurgical clients about laboratory test sample collection procedures.
    2. Performing the initial assessment of a client following surgery is outside the scope of LPN/LVN practice. An RN would perform this task.
    3. CORRECT: LPN/LVNs are trained to observe stable clients for changes indicating complications. One day after a tonsillectomy, the client would be considered in stable condition.
    4. CORRECT: LPN/LVNs can call a code on an unresponsive client.
    5. The LPN/LVN can provide medication instruction, but only an RN can evaluate the effectiveness of the teaching.
    6. CORRECT: LPN/LVNs are qualified to examine a surgical incision for problems as part of their overall monitoring of stable postsurgical clients.
  2. The Answer is 4

    The LPN/LVN is caring for clients in the acute medical-surgical unit. The LPN/LVN should question which assignment?

    Strategy: Remember that LPN/LVNs perform activities concerning stable clients with predictable outcomes. LPN/LVNs can reinforce teaching after RN has done initial teaching. Be careful! You are looking for an incorrect action.

    Category: Evaluation/Safe and Effective Care Environment/Coordinated Care

    1. Monitoring urine output is within LPN/LVN scope of practice. LPN/LVNs can monitor urine output and report observations to the RN. Eliminate.
    2. Providing nasotracheal suctioning for this client is within LPN/LVN scope of practice. LPN/LVNs can do nasotracheal suctioning in stable clients with predictable outcomes. Eliminate.
    3. Providing tracheostomy care for this client is within LPN/LVN scope of practice. LPN/LVNs can do tracheostomy care in stable clients with predictable outcomes. Eliminate.
    4. CORRECT: Receiving hand-off report is not within LPN/LVN scope of practice. Also, a client that is being admitted to the client care area from the emergency department is unstable and requires assessment and evaluation by an RN. LPN/LVNs care for stable clients with predictable outcomes.
  3. The Answer is 4

    Which task is most appropriate for the unlicensed assistive personnel (UAP) to perform?

    Strategy: Remember that UAPs can assist clients with activities of daily living and perform standard, unchanging procedures.

    Category: Evaluation/Safe and Effective Care Environment/Coordinated Care

    1. Resetting a client’s IV infusion pump alarm requires assessment and evaluation; it is not within UAP scope of practice. Eliminate.
    2. Changing a peripheral IV catheter insertion site dressing is not within UAP scope of practice. Eliminate.
    3. Observing the pH of gastric secretions requires assessment and evaluation; it is not within UAP scope of practice. Eliminate.
    4. CORRECT: Assisting with the insertion of a small-bore enteral tube is within UAP scope of practice. UAPs may assist with procedures.
  4. The Answer is 3

    The LPN/LVN is caring for clients in a pediatric urgent care clinic. The supervisor indicates that the LPN/LVN will float to an adult postoperative care unit. Which is the most appropriate statement the LPN/LVN should make?

    Strategy: Remember that skills are transferable during the care of clients. Float nurses should know and be able to perform core competencies in the new unit to meet legal obligations as an LPN/LVN.

    Category: Implementation/Safe and Effective Care Environment/Coordinated Care

    1. Skills are transferable. The LPN/LVN should be familiar with and prepared to perform core competencies. Eliminate.
    2. Rules of delegation should be followed. The LPN/LVN should inform the supervisor of previous experience and request an orientation. Eliminate.
    3. CORRECT: The LPN/LVN should inform the supervisor of previous experience and request an orientation.
    4. Float nurses should know and be able to perform core competencies on the new unit to meet legal obligations as an LPN/LVN. Eliminate.
  5. The Answer is 3

    An LPN/LVN is floating to several units in the community hospital. Which of the following client-care activities is best for an LPN/LVN?

    Strategy: “Best” indicates that discrimination is required to answer the question.

    Category: Implementation/Safe and Effective Care Environment/Coordinated Care

    1. An unlicensed assistive personnel (UAP) would be an appropriate member of staff to assist a postsurgical client to the bathroom.
    2. Evaluating the effectiveness of discharge teaching is within the scope of RN practice, not LPN/LVN duties.
    3. CORRECT: LPN/LVNs are trained to provide client education and physical preparation for diagnostic tests.
    4. LPN/LVNs are qualified to change dressings in stable clients. A client with a stage 4 pressure injury is not considered stable.
  6. The Answer is 2, 3, 4, and 5

    A rehabilitation unit is staffed by an RN, 2 LPN/LVNs, and a UAP. The UAP has just called in sick. Which of the following client-care assignments would be appropriate for the LPN/LVNs? Select all that apply.

    Strategy: For each answer choice, determine the skill level involved in completing the specific task.

    Category: Planning/Safe and Effective Care Environment/Coordinated Care

    1. RNs undertake clinical assessment of newly admitted clients.
    2. CORRECT: An LPN/LVN could appropriately perform this task, more often assigned to a UAP, in the absence of this member of staff.
    3. CORRECT: An LPN/LVN is trained to take accurate vital signs and report significant deviations from normal.
    4. CORRECT: An LPN/LVN can listen for breath sounds and report the findings to the RN.
    5. CORRECT: An LPN/LVN could appropriately perform this task, more often assigned to a UAP, in the absence of this member of staff.
    6. An RN performs this type of teaching, which is outside the scope of LPN/LVN practice.
  7. The Answer is 3

    The LPN/LVN is caring for clients in the medical-surgical unit of the acute care facility. Which assignment is most appropriate for the LPN/LVN?

    Strategy: Remember that LPN/LVNs perform activities concerning stable clients with predictable outcomes. LPN/LVNs can reinforce teaching after an RN has done the initial teaching.

    Category: Planning/Safe and Effective Care Environment/Coordinated Care

    1. This client is not stable and requires assessment and evaluation by an RN.
    2. The LPN/LVN can reinforce initial teaching done by an RN.
    3. CORRECT: The LPN/LVN can administer prescribed therapies such as dressings.
    4. The LPN/LVN can reinforce initial teaching done by an RN.
  8. The Answer is 1

    The LPN/LVN is working in the oncology unit at the pediatric hospital. Which of the following assignments, if made by the team leader, should be questioned by the LPN/LVN?

    Strategy: “Should be questioned” signals you to look for an outlier. Identify the assignment that is beyond the scope of practice of the LPN/LVN.

    Category: Planning/Safe and Effective Care Environment/Coordinated Care

    1. CORRECT: The RN is the team member who would communicate information about chemotherapy.
    2. Although transportation is often assigned to unlicensed assistive personnel (UAPs), an LPN/LVN would not need to question this task.
    3. LPN/LVNs are knowledgeable about positioning options.
    4. LPN/LVNs routinely answer call lights.
  9. The Answer is 4

    The LPN/LVN is working the night shift in the urgent care clinic. Which of the following assignments, if made by the team leader, should be questioned by the LPN/LVN?

    Strategy: “Should be questioned” signals you to look for an outlier. Identify the assignment that is beyond the scope of practice of the LPN/LVN.

    Category: Planning/Safe and Effective Care Environment/Coordinated Care

    1. An LPN/LVN can instruct a client about obtaining stool samples.
    2. An LPN/LVN can collect a sputum sample.
    3. An LPN/LVN can administer a tetanus vaccination.
    4. CORRECT: Fever and rash in a newborn indicate the newborn’s condition is unstable and could deteriorate. The monitoring should be performed by an RN.
  10. The Answer is 3

    The LPN/LVN is working in the endocrinology clinic. The LPN/LVN knows that which of the following client-care activities should be performed only by an RN?

    Strategy: Look at each answer choice in terms of the appropriate scope of practice. You are looking for an answer that is outside that scope.

    Category: Implementation/Safe and Effective Care Environment/Coordinated Care

    1. LPN/LVNs are trained to take medical histories.
    2. LPN/LVNs are trained to use glucometers to obtain accurate blood glucose readings.
    3. CORRECT: Teaching a newly diagnosed diabetic to perform insulin injections is not within the scope of LPN/LVN practice. An RN performs this type of teaching.
    4. LPN/LVNs are trained in insulin injection techniques.