LVN Geriatric & Long-Term Care 4 — Questions and Answers
Question 1: Which sign or symptom is most indicative of a urinary tract infection (UTI) in an elderly resident with dementia?
- Complaint of burning on urination
- Sudden increase in confusion or behavioral changes (Correct answer)
- Elevated blood pressure
- Skin rash on the abdomen
Correct answer: Sudden increase in confusion or behavioral changes
Elderly patients with dementia often cannot verbalize UTI symptoms; instead, a sudden change in behavior or increased confusion is a common atypical presentation.
Question 2: A resident's family member asks to see their loved one's medical record. What is the LVN's best response?
- Provide the record immediately as family members have automatic access
- Explain that HIPAA requires a signed authorization from the resident unless the resident lacks decision-making capacity (Correct answer)
- Refuse all access without consulting an attorney
- Allow access only if a physician is present
Correct answer: Explain that HIPAA requires a signed authorization from the resident unless the resident lacks decision-making capacity
HIPAA protects patient privacy; family members need the resident's authorization to access records unless the resident lacks decision-making capacity or has designated them as a representative.
Question 3: Which intervention is most appropriate for a resident at high risk for aspiration pneumonia?
- Administer all medications in tablet form
- Position the resident supine during and after meals
- Elevate the head of the bed to 90 degrees during meals and 30 minutes after (Correct answer)
- Encourage the resident to eat quickly to reduce fatigue
Correct answer: Elevate the head of the bed to 90 degrees during meals and 30 minutes after
Keeping the head of the bed elevated at 90 degrees during meals and for 30 minutes after significantly reduces the risk of aspiration.
Question 4: Which behavior by a long-term care staff member constitutes elder abuse?
- Assisting a resident with ambulation using a gait belt
- Yelling at a resident to hurry up during morning care (Correct answer)
- Offering a resident a choice between two meal options
- Documenting a resident's refusal of care
Correct answer: Yelling at a resident to hurry up during morning care
Yelling at a resident is psychological/emotional abuse, which is a form of elder abuse and violates residents' rights.
Question 5: A resident taking warfarin in a long-term care facility has a PT/INR of 4.5. What is the LVN's priority action?
- Administer the next scheduled dose as ordered
- Withhold the dose and notify the charge nurse or physician immediately (Correct answer)
- Encourage the resident to eat more leafy green vegetables
- Document the result and continue monitoring
Correct answer: Withhold the dose and notify the charge nurse or physician immediately
An INR of 4.5 is supratherapeutic and indicates excessive anticoagulation, creating a serious bleeding risk that requires immediate notification and dose withholding.
Question 6: Which approach is most effective in managing chronic pain in elderly long-term care residents?
- Reserve pain medication only for severe pain complaints
- Use a multimodal approach combining pharmacologic and non-pharmacologic methods (Correct answer)
- Avoid opioids entirely in elderly patients
- Administer the maximum available dose of analgesics at all times
Correct answer: Use a multimodal approach combining pharmacologic and non-pharmacologic methods
A multimodal approach combining medications, positioning, heat/cold therapy, and distraction techniques provides the most effective chronic pain management in older adults.
Question 7: A resident in a long-term care facility expresses a wish to die and asks the staff not to resuscitate them. What should the LVN do first?
- Dismiss the statement as part of normal aging
- Assess the resident's mental status and notify the charge nurse to follow advance directive protocols (Correct answer)
- Immediately call 911
- Document the statement and take no further action
Correct answer: Assess the resident's mental status and notify the charge nurse to follow advance directive protocols
The LVN must assess the resident's mental status, take the statement seriously, and notify the charge nurse so proper advance directive and DNR processes can be initiated.
LVN Geriatric & Long-Term Care 4
Which sign or symptom is most indicative of a urinary tract infection (UTI) in an elderly resident with dementia?