LVN Geriatric & Long-Term Care 2 — Questions and Answers
Question 1: An elderly resident in a long-term care facility refuses to take a prescribed medication. What is the LVN's first action?
- Administer the medication covertly in food
- Document the refusal and notify the charge nurse (Correct answer)
- Restrain the resident to administer the medication
- Discharge the resident for non-compliance
Correct answer: Document the refusal and notify the charge nurse
Documenting the refusal and notifying the charge nurse respects patient autonomy while ensuring proper communication and follow-up.
Question 2: Which assessment finding in an older adult most warrants immediate reporting to the RN?
- Mild joint stiffness in the morning
- Sudden onset confusion in a previously alert resident (Correct answer)
- Decreased appetite at one meal
- Mild skin dryness on the arms
Correct answer: Sudden onset confusion in a previously alert resident
Sudden onset confusion (acute delirium) in an older adult can indicate a serious underlying condition such as infection, medication toxicity, or stroke.
Question 3: A long-term care resident develops a stage 2 pressure injury. Which intervention is the priority?
- Apply a tight pressure bandage
- Reposition the resident every 2 hours and apply an appropriate dressing (Correct answer)
- Limit the resident's fluid intake
- Restrict ambulation entirely
Correct answer: Reposition the resident every 2 hours and apply an appropriate dressing
Repositioning every 2 hours relieves pressure and promotes circulation, while proper wound dressing supports healing of a stage 2 pressure injury.
Question 4: Which medication class is most commonly associated with fall risk in elderly patients?
- Antacids
- Benzodiazepines (Correct answer)
- Stool softeners
- Vitamin supplements
Correct answer: Benzodiazepines
Benzodiazepines cause sedation, muscle relaxation, and impaired coordination, significantly increasing fall risk in older adults.
Question 5: An LVN is caring for a resident with dementia who is agitated. Which non-pharmacologic intervention should be tried first?
- Apply physical restraints
- Administer a PRN sedative
- Redirect the resident with a calm voice and familiar activity (Correct answer)
- Isolate the resident in their room
Correct answer: Redirect the resident with a calm voice and familiar activity
Redirection with a calm voice and familiar activity is the first-line non-pharmacologic approach to managing agitation in dementia patients.
Question 6: What is the purpose of a Minimum Data Set (MDS) in long-term care facilities?
- To determine staff-to-patient ratios
- To standardize comprehensive assessment and care planning for residents (Correct answer)
- To calculate Medicare reimbursement for physicians only
- To document shift-change reports
Correct answer: To standardize comprehensive assessment and care planning for residents
The MDS is a federally mandated comprehensive assessment tool used in long-term care to guide care planning and support reimbursement decisions.
Question 7: Which action by a nursing assistant requires the LVN to intervene immediately?
- Offering a resident a choice of clothing
- Placing a resident in a semi-Fowler's position after eating
- Leaving the side rails down on a fall-risk resident's bed (Correct answer)
- Encouraging a resident to perform self-care
Correct answer: Leaving the side rails down on a fall-risk resident's bed
Leaving side rails down on a fall-risk resident poses an immediate safety hazard and requires prompt correction by the LVN.
LVN Geriatric & Long-Term Care 2
An elderly resident in a long-term care facility refuses to take a prescribed medication.
What is the LVN's first action?