LVN Exit

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Sample questions from LVN Exit

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 72-year-old client on a medical-surgical unit develops sudden dyspnea 2 days after hip replacement. The client is restless, with BP 94/58 mm Hg, pulse 124/min, respirations 30/min, and oxygen saturation 86% on room air. Which action should the LVN take first?

   • A.Assist the client to walk to improve ventilation.
   • B.Apply oxygen and activate the emergency response system.
   • C.Inspect both calves and measure their circumferences.
   • D.Administer the prescribed as-needed opioid for postoperative pain.

   Rationale: Sudden hypoxemia, tachycardia, and hypotension after surgery suggest a pulmonary embolism and require immediate oxygen and emergency assistance. Walking increases oxygen demand and is unsafe during instability. Calf measurements may provide information but delay treatment of a life-threatening breathing problem. An opioid does not treat the cause and may worsen respiratory compromise; prioritize breathing and circulation.

2. 2.An LVN in a long-term care facility is assigning tasks to experienced unlicensed assistive personnel (UAP). Four clients are awaiting care. Which task is appropriate to delegate?

   • A.Determine whether a 79-year-old client's new confusion represents a change from baseline.
   • B.Teach an 82-year-old client how to use a newly prescribed walker.
   • C.Measure and record urine output for a stable 76-year-old client with an indwelling catheter.
   • D.Evaluate swallowing safety for an 80-year-old client who coughs during breakfast.

   Rationale: Measuring and recording routine output for a stable client is a predictable task that can be delegated to trained UAP. Evaluating new confusion and swallowing safety requires licensed nursing judgment. Initial instruction in using a new device also requires a qualified licensed professional rather than independent UAP teaching. Delegate routine tasks, not assessment, teaching, or evaluation.

3. 3.A 64-year-old client on a rehabilitation unit has an apical pulse of 52/min before the scheduled digoxin dose. The client reports nausea and seeing yellow halos; potassium is 3.1 mEq/L. Which action should the LVN take?

   • A.Give digoxin with food to reduce nausea.
   • B.Hold digoxin and promptly report the findings to the RN or prescriber.
   • C.Give the dose and recheck the pulse in 1 hour.
   • D.Encourage extra fluids and administer the medication at bedtime.

   Rationale: Bradycardia, nausea, and visual changes suggest digoxin toxicity, and hypokalemia increases susceptibility. Giving the medication with food does not prevent its cardiac toxicity. Administering the dose before reassessment could worsen conduction disturbances. Fluids and a bedtime schedule do not address toxicity; withhold the medication and escalate concerning findings.

4. 4.A 58-year-old client with type 1 diabetes is awake on an outpatient clinic examination table and reports shakiness. Blood glucose is 54 mg/dL, pulse is 108/min, and the client can swallow safely. Which intervention is best?

   • A.Administer the scheduled rapid-acting insulin.
   • B.Give peanut butter crackers and recheck glucose in 1 hour.
   • C.Prepare intramuscular glucagon despite the client's ability to swallow.
   • D.Give 15 g of rapid-acting carbohydrate and recheck glucose in 15 minutes.

   Answer and rationale are in the full material.

5. 5.An 81-year-old client receiving antibiotics in a skilled nursing facility develops six watery stools in 12 hours. Temperature is 38.2 C, and testing for Clostridioides difficile is ordered. Which infection-control plan should the LVN implement?

   • A.Use contact precautions, dedicate equipment, and wash hands with soap and water after care.
   • B.Use droplet precautions and place a surgical mask on the client during all care.
   • C.Use standard precautions until the stool test is positive.
   • D.Use airborne precautions and require fit-tested respirators.

   Answer and rationale are in the full material.