Question 1

The 3 to 11 shift LPN/LVN charge nurse on a 20-bed nursing home unit is asked by the only other staff member on duty,a nursing assistant,"Will it be all right if I go home tonight while you are giving report to the night shift? My husband needs the car so he can go to work." The best response by the charge nurse is

Accepted Answer

The LPN/LVN is not responsible for the problems the nursing assistant (NA)has at home and must uphold institutional policies.This response sets limits and explains the reason the NA is needed on the unit.Responding not to make a habit of it and stating that it is permissible because the residents will be sound asleep by 11 PM create an unsafe environment for residents.The remaining option does not explain the major reason the NA is needed on the unit.

Question 2

A resident has not voided in 6 hours.Which instruction to a nursing assistant would likely ensure getting the information needed by the LPN/LVN charge nurse?

Accepted Answer

This is an example of specific,complete communication.It should be followed by giving the nursing assistant an opportunity to repeat what is expected.The other instructions are vague and could leave the nursing assistant wondering what to do.

Question 3

When the LPN/LVN charge nurse makes rounds with the physician,which information should be called to the physician's attention?

Accepted Answer

A reduced level of consciousness is a significant change.The other options are not considered significant.

Question 4

Which principles of delegation should the LPN/LVN charge nurse follow when delegating a duty to a nursing assistant?

Accepted Answer

Choosing a nursing assistant who is competent to perform the delegated duty fulfills the Right Person criteria.Delegation is complete only when the nursing assistant accepts the delegated duty.Responsibility for a delegated duty cannot be trAnswerferred.The LPN/LVN charge nurse is responsible for supervision and evaluation.Delegated duties should not necessarily be those that the nurse does not enjoy.

Question 5

The LPN/LVN charge nurse at the long-term care facility has assigned a newly licensed LPN/LVN to care for a resident needing a colostomy irrigation.The new LPN/LVN voices concern,because he has never performed a colostomy irrigation.What would be the best course of action for the LPN/LVN charge nurse?

Accepted Answer

This action provides the supervision the new employee needs,and the new LPN/LVN probably will be capable of performing the task independently in the future.Stating,"A colostomy irrigation is just like giving an enema.You'll be fine" does not recognize the need for supervision.Telling the new employee that the charge nurse will do the irrigation while the LPN/LVN cares for other assigned residents increases the workload of the charge nurse with no change in the employee's capabilities.Delegating the procedure to a willing nursing assistant would be inappropriate.The delegate should be competent,and the delegation should be acceptable according to state and agency policy.

Question 6

To which goal should the LPN/LVN give priority?

Accepted Answer

The goal for the resident who has been experiencing a medication reaction that states he will have no rash and uncompromised respirations reflects a level 1 priority,a life-threatening situation.The goal for an obese resident who has had a recent knee replacement that states she will ambulate using a walker with the assistance of a staff member is level 2,essential to safety.The remaining options are level 3 priorities,essential to the medical/nursing plan of care.

Question 7

Which information can be omitted when the LPN/LVN charge nurse gives the change-of-shift report?

Accepted Answer

Routine care should not be included in the change-of-shift report.It is recorded on the resident's Kardex and care plan and documented in the medical record and flow sheets.The change-of-shift report should focus on new information about residents.

Question 8

The LPN/LVN charge nurse has assigned tasks to the nursing assistant staff and the LPN/LVN orienting to the unit.On which statement about responsibility for outcomes should the LPN/LVN charge nurse base her or his actions?

Accepted Answer

The LPN/LVN charge nurse is responsible for ensuring that all assigned tasks and delegated duties have been performed and for noting the outcomes.

Question 9

The new nursing assistant arrived 1 hour late for duty on the second day of employment,giving the excuse of car trouble.The LPN/LVN charge nurse should

Accepted Answer

Documenting the incident in the charge nurse's personal file will allow the charge nurse to later determine whether a pattern develops.If no pattern develops,no harm has been done to the employee's work record.A first instance of tardiness does not require reprimand or termination,but rather an explanation that the expectation for all employees is to be at work on time.

Question 10

When a resident's family complains that their mother is receiving inferior care in the extended care facility,which action should the LPN/LVN charge nurse initially take?

Accepted Answer

Data collection is necessary to clarify the problem needing to be resolved.The other options display various levels of defensiveness.

Question 11

Assuming all the following are staff members on the unit,to whom should the LPN/LVN charge nurse assign a newly admitted 65-year-old resident with left hemiplegia and a large sacral decubitus requiring a sterile dressing change?

Accepted Answer

The resident will require data collection by an experienced person to assist the RN with care planning.The assigned caregiver will need to be able to implement relatively complex care,including use of surgical aseptic technique and nursing judgment.The care required might be more than the orientee can provide.A nursing assistant should not be assigned to care for a new resident requiring careful data collection and use of nursing judgment.

Question 12

When the Nurse Practice Act of the state permits delegation as part of the LPN/LVN charge nurse duties,which task could be delegated to experienced,unlicensed assistive personnel who have been trained to perform the task?

Accepted Answer

This duty is one that can be safely and appropriately delegated.The other options are duties that are reserved for charge nurses or higher level management.Duties that may be delegated to nursing assistants usually involve identified resident goals rather than goals relating to personnel management.

Question 13

In the following scenario,who owns the problem?
Before the shift starts,the nursing assistants sympathetically tell the LPN/LVN charge nurse about nursing assistant Jenny's latest child care and car problems,which make it difficult for Jenny to get to work on time.
The problem is owned by

Accepted Answer

The individual with the problem is Jenny.She must take responsibility for it (own it)and resolve it.The other options suggest that team members should solve problems for peers,which is an incorrect idea.

Question 14

The LPN/LVN charge nurse notices that a new nursing assistant has offensive body odor.The LPN/LVN charge nurse should

Accepted Answer

This action encourages the nursing assistant to take personal responsibility for her hygiene and appearance.The other actions do not permit the nursing assistant the opportunity to take personal responsibility.

Question 15

The most fundamental requirement for assuming the practice role of LPN/LVN charge nurse is

Accepted Answer

The LPN/LVN practice role requires that the individual be licensed as an LPN/LVN in the state in which he or she is practicing.The other qualifications are important but are not the most basic.

Question 16

Which duty would exceed the LPN/LVN scope of practice if included in the job description for an LPN/LVN charge nurse?

Accepted Answer

Treatment protocols are written by members of the treatment team who are professionals,often with input from the LPN/LVN.The other options are within the scope of practice of the LPN/LVN.

Question 17

The priority step the LPN/LVN charge nurse should take before delegating one of the charges to another LPN/LVN on staff is to

Accepted Answer

Charge nurse duties are part of an expanded LPN/LVN role.The charge nurse can delegate duties that are part of the ordinary role of the LPN/LVN to another LPN/LVN but may not be able to delegate duties that are part of the expanded role unless specifically permitted to do so by the Nurse Practice Act of the state.Determining whether the other LPN/LVN is competent to perform the task to be delegated is relevant but not the priority step to take.Delegating both the task and the responsibility that goes with the task is not the priority step to take.Determining the directions that will be provided to the person to whom the task is delegated is relevant but not the priority step to take.

Question 18

An LPN/LVN is working in a health care facility that allows delegation of nursing duties to nursing assistants by the LPN/LVN.Which of the following duties could be delegated to the nursing assistant?

Accepted Answer

Weighing a patient is within a nursing assistant's scope of practice.The remaining options are not within a nursing assistant's scope of practice.Examples of duties not to delegate to a nursing assistant include sterile technique procedures,crisis situations,initial patient education,and interpretation of data.

Question 19

How should the following scenario be evaluated with respect to the goal of encouraging the nursing assistant to be accountable for learning skills?
Nursing assistant: "I do not know how to use the new lifting device to get Mrs.Jackson out of bed.I missed the demonstration the other day."
LPN/LVN charge nurse: "I will ask Kay if she has time to get Mrs.Jackson out of bed with the new device while you assist.How can you prepare yourself to use the new device?"
Nursing assistant: "I could watch closely when I assist Kay and ask questions.Then,I guess I could watch the videotape that came from the company and practice with a couple of the aides when they have time."
LPN/LVN charge nurse: "Good plan.I will plan to observe and evaluate your competency tomorrow afternoon."
The scenario should be evaluated as

Accepted Answer

When nursing assistants can't perform tasks that are in their job description,it is their responsibility to learn the skill.This option reminds the nursing assistant of that fact and asks for a plan for remediation,which the nursing assistant provides.

Question 20

The plan of care for a resident in the rehabilitation unit requires the resident to receive teaching about how to monitor blood glucose as part of discharge teaching.The RN is working with a resident whose condition is deteriorating.The LPN/LVN charge nurse has performed blood glucose monitoring many times but is new and has not received facility certification.The nursing assistant assigned to the patient is a diabetic and monitors blood glucose several times a day.Who should perform the teaching?

Accepted Answer

The RN is required to initiate teaching.The LPN/LVN can follow up,review,and reinforce.

Quiz 21: LPN/LVN Charge Nurse Skills: Management, Including Assignment and Delegation