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

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

A) "It's all right tonight, but don't make a habit of it."
B) "Sure, our residents will be sound asleep by 11 PM."
C) "Have you lost your mind? What would happen if the owner dropped in for a surprise visit?"
D) "That won't be possible. You must be here to answer lights while I give report to the night staff."

Answer 1

"That won't be possible. You must be here to answer lights while I give report to the night staff."

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?

A) "Watch the resident's output closely today."
B) "I need to know if the resident is voiding sufficiently."
C) "The resident should void at least twice during the shift in quantities of 200 ml or more."
D) "Report to me immediately if the resident voids between now and 10 AM, and tell me the amount he voids. If he has not voided by 10 AM, please report this to me."

Answer 2

"Report to me immediately if the resident voids between now and 10 AM, and tell me the amount he voids. If he has not voided by 10 AM, please report this to me."

Question 3

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

A) The resident demonstrates a weight increase or decrease of 1 lb.
B) The resident demonstrates a temperature elevation over 99° F.
C) The resident demonstrates a reduced level of consciousness.
D) The resident demonstrates a blood pressure over 120/80.

Answer 3

The resident demonstrates a reduced level of consciousness.

Question 4

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

A) Choose a nursing assistant who is competent to perform the delegated duty.
B) Determine the nursing assistant's willingness to accept the delegated duty.
C) Transfer responsibility for the duty to the nursing assistant accepting the delegation.
D) Permit the nursing assistant to perform the duty without guidance or monitoring.
E) Plan to delegate duties the LPN/LVN charge nurse enjoys least.

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?

A) State, "A colostomy irrigation is just like giving an enema. You'll be fine."
B) Tell the new LPN/LVN, "I'll do the irrigation while you care for your other assigned residents."
C) Delegate the procedure to a willing nursing assistant.
D) Arrange to supervise the new LPN/LVN as he performs the irrigation.

Question 6

To which goal should the LPN/LVN give priority?

A) Resident X who has been experiencing a medication reaction will have no rash and uncompromised respirations.
B) Resident Y who is obese and has had a recent knee replacement will ambulate using a walker with the assistance of a staff member.
C) Resident Z will receive blood glucose monitoring and insulin as ordered.
D) All residents will be weighed before breakfast.

Question 7

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

A) Routine care for each resident
B) New problems for any resident
C) Prn medication administered
D) New medical orders

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?

A) The LPN/LVN charge nurse has no further responsibility, because the staff members have accepted the assignments and are responsible for completing all tasks.
B) The LPN/LVN charge nurse is responsible for checking the outcomes of care of the LPN/LVN orientee only because he is not an official member of the staff.
C) The LPN/LVN charge nurse is responsible for checking the outcomes of care of the nursing assistants only, because the nursing assistants are unlicensed, whereas the LPN/LVN orientee is a licensed employee.
D) The LPN/LVN charge nurse is legally responsible for checking the outcomes of all assignments made.

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

A) note the incident of tardiness in the charge nurse's personal file.
B) send a letter of reprimand to the nursing assistant.
C) give an oral reprimand to the nursing assistant.
D) arrange to terminate the nursing assistant before a pattern develops.

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?

A) Gently explain that Continuous Quality Improvement (CQI) would not permit giving inferior care.
B) Mention that the staff is overworked and would be glad for the family's assistance.
C) Ask the family to be specific and give examples of "inferior care" the mother has received.
D) Tell the family that their reaction is based on guilt because of their need to place their mother in an extended care facility.

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?

A) LPN/LVN orientee with 1 week of experience
B) LPN/LVN with 2 years of experience
C) Nursing assistant with 3 years of experience
D) Nursing assistant who is a nursing student at a local college

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?

A) Calling the physician when a resident's condition deteriorates
B) Providing a performance evaluation for another nursing assistant
C) Taking the vital signs of a resident whose condition is not critical
D) Handling a grievance brought by a nursing assistant

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

A) the nursing assistants.
B) the LPN/LVN charge nurse.
C) Jenny.
D) Jenny and the nursing assistants.
E) Jenny and the LPN/LVN charge nurse.
F) the entire staff.

Question 14

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

A) report this finding to the RN supervisor.
B) send the person to the locker room to shower and put on clean clothes.
C) terminate the nursing assistant.
D) meet with the person to inform her of the problem and reinforce agency expectations.

Question 15

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

A) licensure in the state of practice.
B) experience with resident assignment.
C) the ability to coordinate patient care services.
D) a knowledge of the principles of delegation.

Question 16

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

A) Assigning patient care
B) Independently developing written treatment protocols
C) Assisting physicians in diagnostic and therapeutic measures
D) Maintaining a safe and hazard-free environment

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

A) determine whether the other LPN/LVN is competent to perform the task to be delegated.
B) check the Nurse Practice Act of the state to learn whether an LPN/LVN charge nurse is allowed to delegate duties.
C) delegate both the task and the responsibility that goes with the task.
D) determine the directions that will be provided to the person to whom the task is delegated.

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?

A) Weighing a patient
B) Initial patient education
C) Assessing a patient's pain
D) Changing a sterile dressing

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

A) a good example of encouraging the nursing assistant to be accountable for learning.
B) too pushy on the part of the LPN/LVN charge nurse.
C) placing too much responsibility on the nursing assistant.
D) placing too much responsibility on the LPN/LVN charge nurse.
E) condescending to the nursing assistant.

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?

A) RN
B) LPN/LVN charge nurse
C) Nursing assistant
D) Physician

Question 21

Examples of tasks the LPN/LVN charge nurse of the extended care unit might assign to a nursing assistant (NA)include which of the following?

A) Bathing a resident who is in stable condition
B) Administering a nasogastric tube feeding
C) Assisting a resident with Parkinson disease to ambulate
D) Transferring a resident from bed to chair with the assistance of another NA

Question 22

Select the examples of LPN/LVN charge nurse directions that meet the criteria for Right Direction/Communication.

A) "Please bathe Mrs. Duffy today, cut her nails, and shampoo her hair. The beautician will set her hair at 11 AM."
B) "Mr. Hovde needs to have fluids pushed today. His skin seemed dry to me when I made rounds, and we certainly don't want him to become dehydrated."
C) "Mrs. Neidert needs to walk from her room to the nurses' station with the assistance of two this morning and again after lunch. Please report whether she does this easily or with difficulty."
D) "Offer Mr. Jones the urinal before breakfast and before his shower. Report to me immediately if he voids and the amount he voids. If he does not void by 10 AM, notify me, as I will need to catheterize him."
E) "Mrs. Snyder must be showered, dressed in street clothes, and groomed by 10 AM. Have her hat, coat, and mittens ready. The Medi-van is picking her up at 10:30 for a doctor's appointment."