LVN Safe and Effective Care Environment 3 — Questions and Answers
Question 1: An LVN is caring for a post-operative client at high risk for falls. Which intervention is the priority?
- Applying bilateral wrist restraints
- Keeping the bed in the lowest position with side rails up (Correct answer)
- Asking the client's family to watch them at all times
- Placing a 'fall risk' sign only on the chart
Correct answer: Keeping the bed in the lowest position with side rails up
Keeping the bed in the lowest position and raising side rails reduces fall risk by minimizing fall height and providing support.
Question 2: When a physical restraint is applied to a client, the LVN must reassess the client at minimum every:
- 30 minutes
- 1 hour
- 2 hours (Correct answer)
- 4 hours
Correct answer: 2 hours
CMS and The Joint Commission standards require restraint assessment, including circulation and skin integrity checks, at least every 2 hours.
Question 3: The LVN smells smoke in the hallway. Using the RACE mnemonic, which action comes first?
- Alarm — activate the fire alarm
- Rescue — move clients in immediate danger (Correct answer)
- Contain — close all doors
- Extinguish — attempt to put out the fire
Correct answer: Rescue — move clients in immediate danger
RACE stands for Rescue, Alarm, Contain, Extinguish — rescuing clients in immediate danger is always the first priority.
Question 4: A client who was given a sedative needs to use the restroom. The LVN's best action is to:
- Allow the client to ambulate independently since they requested to use the restroom
- Place a bedpan in the bed and leave the client alone
- Accompany and assist the client to the restroom (Correct answer)
- Apply a restraint to keep the client in bed
Correct answer: Accompany and assist the client to the restroom
Sedatives impair balance and judgment, so the LVN must accompany and assist the client to prevent falls.
Question 5: Which client requires the highest priority when assigning rooms in a medical-surgical unit?
- A stable post-op client recovering from hip replacement
- A newly admitted client with active tuberculosis (Correct answer)
- A client scheduled for discharge in 2 hours
- A client with a healed surgical wound awaiting physical therapy
Correct answer: A newly admitted client with active tuberculosis
A client with active TB requires immediate placement in a negative-pressure isolation room to protect other clients and staff.
Question 6: The LVN finds a sharps container that is three-quarters full. What is the appropriate action?
- Push the contents down to make more room
- Continue using the container until it is completely full
- Replace the container with a new one (Correct answer)
- Cap the needles before disposing to free up space
Correct answer: Replace the container with a new one
Sharps containers should be replaced when three-quarters full to prevent overfilling, which increases the risk of needlestick injury.
Question 7: A client in a wheelchair needs to be transferred to bed. To protect both the client and LVN, which is the correct body mechanic principle?
- Bend at the waist to get close to the client
- Keep feet close together while lifting
- Use a wide base of support and bend at the knees (Correct answer)
- Twist the torso to pivot the client into position
Correct answer: Use a wide base of support and bend at the knees
A wide base of support and bending at the knees (not the waist) reduces injury risk by using leg muscles instead of the back.
LVN Safe and Effective Care Environment 3
An LVN is caring for a post-operative client at high risk for falls.
Which intervention is the priority?