CSLB General Building (B) — All Questions

A charge nurse is assigning tasks on a medical unit. Which task is appropriate to delegate to the LPN/LVN?

• a.Administering an oral antibiotic to a stable client✓
• b.Developing the initial nursing care plan for a new admission
• c.Performing the admission assessment on an unstable client
• d.Providing discharge teaching about a new diagnosis

Administering routine oral medications to stable clients is within the LPN/LVN scope. Initial assessments, care-plan development, and client teaching about new content are RN responsibilities. The LPN/LVN reinforces teaching but does not perform the initial teaching.

The LPN/LVN receives a verbal order from a physician during an emergency. What is the most appropriate action?

• a.Refuse the order because verbal orders are never allowed
• b.Write down the order, read it back, and have the RN or provider co-sign per policy✓
• c.Carry out the order and document it several hours later
• d.Ask a family member to witness the order

During an emergency a verbal order may be accepted, but it must be written down and read back to the provider to confirm accuracy. It should be signed by the provider within the facility's required timeframe. Read-back reduces transcription and communication errors.

Which client care assignment is most appropriate to give to unlicensed assistive personnel (UAP)?

• a.Inserting an indwelling urinary catheter
• b.Evaluating a client's response to pain medication
• c.Assisting a stable client with a bath and recording oral intake✓
• d.Adjusting the flow rate of an IV infusion

UAP may perform basic hygiene and record intake and output for stable clients. Catheter insertion, evaluating medication response, and adjusting IV rates require nursing judgment and licensure. Assessment and evaluation cannot be delegated to UAP.

An LPN/LVN notices a coworker documenting care that was not provided. What is the priority action?

• a.Ignore it because it is not the LPN/LVN's responsibility
• b.Confront the coworker angrily in front of clients
• c.Alter the record to correct it personally
• d.Report the concern to the charge nurse or supervisor✓

Falsifying documentation is a serious ethical and legal violation that must be reported through the chain of command. The LPN/LVN should not alter another person's entry or handle it confrontationally. Reporting protects clients and maintains accurate records.

When using the SBAR communication tool during a hand-off report, the 'R' stands for which component?

• a.Recommendation✓
• b.Response
• c.Rationale
• d.Reassessment

SBAR stands for Situation, Background, Assessment, and Recommendation. The recommendation states what the nurse wants done or is requesting next. Standardized hand-off tools reduce omissions and improve safety.

The LPN/LVN is caring for four clients. Which client should be assessed first?

• a.A client scheduled for discharge this afternoon
• b.A client reporting new onset of shortness of breath✓
• c.A client requesting a second pillow
• d.A client asking about the lunch menu

Airway and breathing problems take priority using the ABC framework. New shortness of breath could signal a life-threatening change and must be assessed immediately. The other requests are non-urgent.

A client refuses a prescribed medication. What is the LPN/LVN's best response?

• a.Hide the medication in food without telling the client
• b.Tell the client they must take it or be discharged
• c.Respect the refusal, document it, and notify the RN or provider✓
• d.Insist repeatedly until the client agrees

Competent adults have the right to refuse treatment. The nurse should honor the refusal, document it, and inform the RN or provider so follow-up can occur. Concealing medication violates client autonomy and trust.

Which situation represents a breach of client confidentiality under HIPAA?

• a.Reporting a client's abuse suspicion to authorities
• b.Sharing information with the treating physician
• c.Giving a shift report to the oncoming nurse
• d.Discussing a client's diagnosis with a friend not involved in care✓

Sharing protected health information with someone not involved in the client's care violates confidentiality. Reporting mandated concerns, communicating with the care team, and giving hand-off report are permitted. Only those with a need to know may access information.

The LPN/LVN is documenting in the electronic health record. Which entry is written correctly?

• a."Client reports pain rated 7 of 10 in right lower abdomen at 0900."✓
• b."Client seems to be doing fine today."
• c."Client is being difficult and uncooperative."
• d."Client probably has appendicitis."

Documentation should be objective, specific, and factual, including measurable data and time. Subjective judgments and unauthorized diagnoses are inappropriate. Clear entries support continuity and legal accuracy.

An LPN/LVN is floated to an unfamiliar unit. Which action is most appropriate?

• a.Refuse the assignment and leave the facility
• b.Accept tasks within the LPN/LVN scope and ask for orientation to the unit✓
• c.Perform any task requested regardless of competence
• d.Care only for clients who require no medications

A floated nurse should accept assignments within their scope and competence while requesting orientation to unfamiliar equipment and routines. Refusing to work may be abandonment, but performing unsafe tasks is negligent. Communicating limitations protects clients.

Which task performed by UAP requires the LPN/LVN to intervene immediately?

• a.Feeding a client who has no swallowing difficulty
• b.Ambulating a stable client with a gait belt
• c.Repositioning a client's oxygen tubing and adjusting the liter flow✓
• d.Emptying and recording a urinary drainage bag

Adjusting oxygen flow rate is outside the UAP scope and requires nursing judgment. Feeding a client with no swallowing risk, ambulating with a gait belt, and recording drainage are acceptable UAP tasks. The nurse must correct the unsafe action.

The LPN/LVN is reinforcing discharge instructions. Which statement indicates the client understood teaching about a wound?

• a."I will remove the dressing and leave the wound open to air right away."
• b."I only need to call the clinic if the wound falls off completely."
• c."Redness and warmth spreading around the wound are normal for weeks."
• d."I will wash my hands before and after changing the dressing."✓

Hand hygiene before and after dressing changes prevents infection and reflects correct understanding. Spreading redness and warmth are signs of infection that should be reported. Dressings should be managed as ordered, not removed prematurely.

A client's family asks the LPN/LVN to explain the surgeon's plan for an upcoming operation. What is the best response?

• a."I will let the surgeon know you have questions about the plan."✓
• b."The surgery is simple, so there is nothing to worry about."
• c."I cannot discuss anything about the surgery with you."
• d."Let me describe the entire surgical procedure for you."

Explaining the surgical plan and obtaining informed consent are the provider's responsibility. The nurse should facilitate communication by notifying the surgeon of the family's questions. Reassurance or refusal without follow-up does not meet the family's needs.

Which principle guides prioritization when the LPN/LVN plans care for multiple clients?

• a.Complete tasks in the order rooms are numbered
• b.Address physiologic and safety needs before comfort or teaching needs✓
• c.Always perform the quickest tasks first
• d.Care for the client the family requests first

Maslow's hierarchy directs the nurse to meet physiologic and safety needs before higher-level needs like comfort and education. Room number, task length, and family preference are not valid prioritization frameworks. Life-threatening problems come first.

An advance directive states a client does not want cardiopulmonary resuscitation. The client stops breathing. What should the LPN/LVN do?

• a.Begin full CPR immediately
• b.Call the family to ask what to do
• c.Follow the do-not-resuscitate order and notify the RN and provider✓
• d.Wait to see if the client resumes breathing

A valid do-not-resuscitate order must be honored, so resuscitation is not initiated. The nurse provides comfort measures and notifies the RN and provider. Ignoring a legal directive violates the client's expressed wishes.

The LPN/LVN is part of an interdisciplinary care conference. What is the LPN/LVN's primary contribution?

• a.Ordering diagnostic laboratory tests
• b.Prescribing physical therapy
• c.Determining the medical diagnosis
• d.Reporting ongoing observations of the client's response to care✓

The LPN/LVN contributes bedside observations and data about how the client is responding to interventions. Ordering tests, prescribing therapies, and making medical diagnoses are outside the LPN/LVN scope. Collaboration relies on accurate frontline information.