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CN 20 EXAM QUESTIONS AND ACCURATE ANSWERS
Which member of the health care team can be assigned the responsibility to complete and sign the initial assessment on a newly admitted client who will be receiving only minimally invasive procedures on an outpatient basis?
a. RN
b. LPN/LVN
c. UAP
d. Any level of staff because the information is in the past and cannot change -Answer A.
The RN has relocated to another part of the country and has accepted a job as a charge nurse shortly after arrival. While determining for whom to delegate the appropriate task, the RN understands that:
a. the LPN/LVN role does not differ from state to state.
b. the LPN/LVN may be oriented to perform all the tasks of the RN provided that it is not prohibited by the employer and as long as additional on-the-job training is provided.
c. he or she should review the state's nurse practice act for LPN/LVNs, since under federal law each state has defined specifically the role and scope of practice of the LPN/LVN.
d. The Joint Commission has certified and identified roles for the LPN/LVN. - Answer C.
For a state's practice act, which of the following actions would be most likely always appropriate to delegate to an LPN/LVN if the patient is stable and nurse has shown competence in performing the action?
a. A patient undergoing elective surgery is given an enema.
b. The cardiac monitor is used to interpret a patient's rhythm while an antiarrhythmic medication is being administered IV.
c. Develop a plan of care for a stable patient admitted for observation after a head injury.
d. Teach a patient about the instillation of eye drops for glaucoma. - Answer A.
The patient is admitted with hypotension, shortness of breath, flushing, and urticaria. All levels of staff have received training about assessing vital signs. Because of budget constraints and following appropriate guidelines for delegation of duties, the RN would delegate which care provider to obtain the patient's initial blood pressure?
a. RN
b. LPN/LVN
c. UAP
d. Use the blood pressure taken in the ambulance because it was assessed by electronic monitoring. - Answer A.
A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP) the task of providing oral hygiene, because the activity "does not require decisions based on the nursing process." The nurse is properly using which of the five rights of delegation?
a. Supervision
b. Communication
c. Person
d. Scenario - Answer D.
A nursing student is curious about the process of delegation and wonders why hospitals would employ UAP and LPN/LVNs. The student nursing researcher consults the National Council of State Boards of Nursing and discovers the purpose of these employees is to:
a. enhance the staffing pattern when a registered nurse is not available.
b. support the RN by providing simple routine care for the patient.
c. replace the RN when the health care facility provides long-term care.
d. provide patient teaching, allowing more direct care to be provided by the RN. - Answer B.
An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for:
for a patient before she is discharged home. -Answer C.
The RN delegates the assignment of administering oral medications to a group of patients to an experienced LPN/LVN. The LPN/LVN accepts the assignment and the RN knows that the LPN/LVN has received the training and has developed the skills necessary to perform the task. The RN observes the LPN/LVN document the administration of a patient's medication just prior to entering the patient's room. The priority intervention by the RN is to:
a. compare the medication packages administered by the patient to ensure proper medications were given.
b. stop the LPN/LVN immediately and discuss the potential consequences of his actions in a non-judgmental way
c. call the nurse manager and ask for suspension of license of the LPN/LVN.
d. call the pharmacy and request new medications for the patients. - Answer B.
What is a correct statement about delegation?
a. The role of UAP is defined under the nurse practice act. b. Nursing practice may be delegated only if the LPN/LVN and/or UAP have undergone proper training. c. When routine activities are assigned to a competent individual, then supervision is not necessary.
d. The RN should be familiar with those laws and regulations that guide the practice of nursing and also those that don't have clearly outlined parameters such as those for UAP. -Answer D.
A registered nurse is orienting to a facility and is being told that LPN/LVNs in the facility are given additional training for various skills including hanging continuously infusing intravenous fluids that don't contain additives. The RN should understand that:
a. The state practice act can be superseded by the health care facility requiring all LPN/LVNs and UAPs to undergo on-site training.
b. LPN/LVNs are licensed professionals and thus each LPN/LVN is accountable for his or her own practice.
c. It is not possible to hold a UAP responsible for his or her own actions or omissions.
d. The nurse practice act and state rules related to delegation supersede the organization's policies. -Answer D.
A nurse moves to Arkansas from California and, due to 20 years of registered nurse experience is placed in charge of the telemetry unit immediately. The staffing includes LPNs and two unlicensed assistive personnel. The RN is unsure what tasks the LPNs can legally perform and reads the nurse practice act for Arkansas and finds it vague for some tasks. The RN should:
a. call the state nursing association to identify their position on the role of LPNs.
b. request a list from LPNs on the unit of the activities they routinely performed
c. call the state board of nursing to identify legal scope of practice for LPNs
d. refer to California's nurse practice act because scope of LPNs/LVNs is uniform in the United States. -Answer C.
An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high risk delegation?
a. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin.
b. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound.
c. An unlicensed assistive personnel is delegated the responsibility to assist a patient with late stages of Huntington's disease to ambulate a short distance in the hallway.
d. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm3. - Answer C.
The RN instructs the LPN to "Provide an enema to the client in room 327 who is to be discharged but states that he is constipated. Afterward, remember to record this on the medication administration record when given." Which of the five rights is not present in the above scenario? The right of:
a. direction and communication.
b. task.
c. person.
d. circumstances. Answer A.
a. The RN administers all medications to all patients.
b. The LPN provides sterile dressings and IV tubing changes to all central lines.
c. The experienced UAP applies telemetry electrodes and connects to cardiac monitor.
d. The RN gives an enema to a stable client who has an order "administer fleet enema prn when no bowel movement in two days." - Answer C.
