Author Question: A new graduate licensed practical/vocational nurse is working in a rehabilitation center and is ... (Read 32 times)

joesmith1212 · **on:** Jul 17, 2018

A new graduate licensed practical/vocational nurse is working in a rehabilitation center and is caring for an older adult client who is recovering from a stroke.

The health care team consists of the licensed practical/vocational nurse, a clinical nurse specialist in geriatrics, a social worker, a physical therapist, and occupational therapist, a speech pathologist, a psychologist, and a rehabilitation physician. The nurse notes that the client stated she feels a little blue and wanted the drapes pulled and to be left alone. The client refuses to participate in rehab activities today. The client's family shared that they are worried about the costs of the rehab because the Medicare limit has been met. Which action is best?
A) Contact the rehab physician about the recent changes and receive orders to help the client with her problems.
B) Discuss all of the findings during the daily rounds with the entire team for a multidisciplinary approach.
C) Discuss the financial concerns that the family has with the social worker, so the client and family can focus on rehab.
D) Discuss the findings with the clinical nurse specialist and the psychologist because the client is exhibiting signs of depression, and intervention is needed right away.

Question 2

A licensed practical/vocational nurse who is in her second year of an Associate's Degree in Nursing on a path to become a registered nurse has recently

begun working in an oncology unit and has been assigned by the RN on her team to access the client's port-a-cath and administer intravenous chemotherapy. The RN had attended the same nursing school to become an RN and knew that the licensed practical/vocational nurse was taught how to access a port-a-cath and had learned about chemotherapy. How should the nurse respond to the RN's directive?
A) Perform the assigned task and administer the medication to the best of her ability since it is within her recent training
B) Perform the assigned task and administer the medication with the RN present and have the RN chart the task
C) Inform the RN that she is only going to perform the task and administer the medication because the RN delegated it
D) Inform the RN that although she has the training, the task is not covered by her current license

ju · **Reply #1 on:** Jul 17, 2018

Answer to Question 1

Ans: B
Feedback:
The main purpose of a multidisciplinary health care team is to provide the client with the best possible care using a team approach, so daily rounds are a means to discuss assessment findings and explore the best interventions to provide. The team meeting is the most efficient way to tackle any problems. The client is exhibiting symptoms of depression, which is common after a stroke, or a chronic illness, but there is no immediate threat of suicide present, so contacting the psychologist and clinical nurse specialist for immediate measures is not necessary.

Answer to Question 2

Ans: D
Feedback:
The RN delegated an inappropriate task for the licensed practical/vocational nurse (LPN/LVN) since the task is not covered by the LPN/LVN license. It is the responsibility of both the person delegating the task and the person receiving the delegation to determine if the task is appropriate or not and to communicate with each other if there is a discrepancy. While attending the registered nurse program, the LPN/LVN may not perform the duties of the licensed RN. It is not appropriate for the LPN/LVN to perform the task and administer the medication in the presence of the RN and have the RN chart it; such an action jeopardizes both licensed individuals. Most of all, such actions would risk the safety of the client.