The charge nurse prepares for client care by making assignments. They have two RN's and one LVN on the shift. Which client should the charge nurse assign to the LVN?
A client who is having difficulty breathing with a diagnosis of a fractured femur.
A client with a total knee replacement and will be discharged tomorrow.
A new admission with a diagnoses of Congestive Heart Failure.
A transfer client from the ICU with a diagnoses of End-stage Renal Failure.
The Correct Answer is B
A. A client who is having difficulty breathing with a diagnosis of a fractured femur: Clients experiencing respiratory difficulty require continuous assessment, rapid intervention, and potential critical thinking for changes in status. These responsibilities fall within the RN scope of practice, making this client inappropriate for LVN assignment.
B. A client with a total knee replacement and will be discharged tomorrow: This client is stable, has predictable care needs, and requires routine postoperative tasks such as vitals, dressing checks, and ambulation assistance. These responsibilities are within the LVN’s scope of practice, making this the most appropriate assignment.
C. A new admission with a diagnosis of Congestive Heart Failure: New admissions require comprehensive assessment, identification of acute changes, and nursing judgment for prioritizing care, which are RN responsibilities. LVNs should not manage new admissions independently due to these complex requirements.
D. A transfer client from the ICU with a diagnosis of End-stage Renal Failure: ICU transfers are high-risk and require ongoing assessment, titration of medications, and recognition of rapid deterioration. These responsibilities require RN-level critical thinking and are not appropriate for LVN assignment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. allows oxygen to reach lower into the lungs: While oxygen delivery devices aim to increase alveolar oxygenation, the Venturi mask does not specifically direct oxygen deeper into the lungs. Oxygen distribution depends on tidal volume and patient effort rather than the mask type itself, so this is not the distinguishing feature of a Venturi mask.
B. contains an oxygen reservoir bag: Oxygen reservoir bags are characteristic of non-rebreather and partial rebreather masks, not Venturi masks. These bags store a high concentration of oxygen for inhalation, whereas the Venturi mask relies on precise air-entrainment to deliver a controlled FiO₂.
C. administers the highest percentage of oxygen: Non-rebreather masks deliver the highest concentration of oxygen (up to ~100%), whereas Venturi masks are designed to deliver precise, lower concentrations (e.g., 24–50%) for patients requiring controlled oxygen therapy.
D. has a flow control meter attached: The Venturi mask uses an air-entrainment system with a flow control adapter to deliver a precise and predictable fraction of inspired oxygen (FiO₂). This allows clinicians to carefully titrate oxygen for patients with chronic respiratory conditions, such as COPD, minimizing the risk of hypercapnia from excessive oxygen administration.
Correct Answer is D
Explanation
A. Client who urinates frequently due to diuretic therapy: Increased urination may lead to fluid loss and potential dehydration if not managed, which can affect skin turgor and perfusion. However, with adequate fluid replacement, this factor alone does not significantly impair the physiological processes required for wound healing.
B. Client with limited mobility recovering from knee surgery: Limited mobility can increase the risk of pressure injuries due to prolonged pressure over bony prominences and reduced circulation. While this may contribute to delayed healing if a wound develops, it does not inherently impair systemic healing processes as chronic metabolic and vascular conditions.
C. Client who is NPO one day before abdominal surgery: Short-term NPO status typically does not result in significant nutritional deficiency or impair wound healing. The body’s nutrient stores and perioperative management generally compensate for this brief period without oral intake, making it a minimal risk factor.
D. Client with diabetes, obesity and current cigarette smoker: Diabetes impairs wound healing through microvascular damage, reduced tissue perfusion, and impaired leukocyte function, increasing infection risk. Obesity decreases vascularity of adipose tissue and places mechanical stress on wounds, while smoking causes vasoconstriction and reduces oxygen delivery due to carbon monoxide exposure. These factors significantly disrupt all phases of wound healing.
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