LVN Exit Study Guide

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Sample questions from LVN Exit Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.An LVN is preparing to witness a patient's signature on a surgical consent form. The patient states, "I signed because my family wants this surgery, but I do not understand what the surgeon will do." What should the LVN do next?

   • A.Explain the surgical risks and benefits, then witness the signature.
   • B.Pause the consent process and notify the RN and surgeon of the patient's statement.
   • C.Witness the signature because the patient has already signed the form.
   • D.Ask the family to explain the procedure before sending the patient to surgery.

   Rationale: The patient's statement indicates that informed, voluntary consent needs clarification by the surgeon before proceeding. The LVN should pause and communicate the concern. Explaining surgical risks and benefits does not replace the surgeon's responsibility. A signature alone does not establish informed consent. Family explanations cannot substitute for the patient's understanding and voluntary decision.

2. 2.An older adult hospitalized with frequent watery stools has a confirmed Clostridioides difficile infection. Which action should the LVN take to reduce transmission?

   • A.Use alcohol-based hand rub as the only hand hygiene method after providing perineal care.
   • B.Place the patient in a negative-pressure room and wear an N95 respirator.
   • C.Wear a surgical mask for all care without using a gown or gloves.
   • D.Use contact precautions and wash hands with soap and water after removing gloves.

   Rationale: Contact precautions reduce spread through contaminated hands and surfaces, and soap and water help physically remove C. difficile spores. Alcohol-based hand rub does not reliably eliminate spores. Negative-pressure rooms and N95 respirators are used for airborne precautions, not routine C. difficile care. A surgical mask does not replace the gown and gloves needed for contact precautions.

3. 3.A patient with heart failure takes furosemide and digoxin. Before administering the morning medications, the LVN notes new nausea, an apical pulse of 52 beats/min, and a potassium level of 2.9 mEq/L. Which action is most appropriate?

   • A.Withhold digoxin and promptly notify the RN or prescribing clinician of the findings.
   • B.Administer digoxin because a slower pulse reduces the heart's workload.
   • C.Administer digoxin with food to reduce nausea and reassess in one hour.
   • D.Give an additional dose of furosemide to improve digoxin elimination.

   Rationale: Bradycardia and nausea can indicate digoxin toxicity, and hypokalemia increases susceptibility to toxicity. Withholding digoxin and promptly reporting all findings protects the patient. Giving digoxin despite these findings can worsen bradycardia or dysrhythmias. Food does not correct toxicity. An extra, unprescribed furosemide dose is unsafe and may worsen potassium loss.

4. 4.An adult with diabetes is awake, follows directions, and can swallow safely. The patient is shaky and diaphoretic, and the blood glucose is 54 mg/dL. According to the facility's hypoglycemia protocol, what should the LVN do first?

   • A.Administer the scheduled rapid-acting insulin dose.
   • B.Give a snack containing only cheese and nuts.
   • C.Give 4 ounces of regular fruit juice and recheck glucose in 15 minutes.
   • D.Withhold oral intake and recheck glucose in one hour.

   Answer and rationale are in the full material.

5. 5.One hour after a vaginal birth, a patient reports dizziness. The LVN observes heavy vaginal bleeding and finds the uterine fundus boggy and above the umbilicus. What is the priority action?

   • A.Assist the patient to walk to the bathroom before reassessing the bleeding.
   • B.Immediately summon assistance and begin fundal massage according to protocol.
   • C.Document the findings as expected postpartum changes and reassess in 30 minutes.
   • D.Provide oral fluids and place a warm compress over the lower abdomen.

   Answer and rationale are in the full material.