A resident in a skilled nursing facility for a short-term rehabilitation following a hip replacement says to the nurse, "I don't want to have you draw any more blood for those useless tests." When the nurse fails to convince the patient to have the blood drawn, the most appropriate documentation would be:
"Blood not drawn because tests are no longer desired by patient."
"Refuses to have blood drawn; says tests are 'useless. Doctor notified."
"Doctor notified of failure to draw ordered blood work."
"Refuses to have blood drawn. Doctor notified."
The Correct Answer is B
A. "Blood not drawn because tests are no longer desired by patient."
This statement is vague and lacks specific details regarding the patient's exact refusal and the communication with the doctor.
B. "Refuses to have blood drawn; says tests are 'useless.' Doctor notified."
This response documents the patient's refusal with their exact words ("useless") and also notes that the doctor has been informed, which is essential for clear, complete documentation.
C. "Doctor notified of failure to draw ordered blood work."
This documentation lacks the reason for the blood draw failure (patient refusal) and omits the patient’s specific wording.
D. "Refuses to have blood drawn. Doctor notified."
Although this documents the refusal and the doctor’s notification, it omits the patient’s exact words, which can provide additional context for the healthcare team.
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Correct Answer is C
Explanation
A. Scheduling admissions, discharges, and nurse staffing to keep the unit at the best occupancy and utilization. Scheduling and unit staffing are typically tasks for administrative staff rather than the direct responsibilities of an LPN.
B. Educating patients on how to use hospital computers to access information such as discharge instructions or information relative to specific medications. LPNs may be involved in patient education, including showing patients how to access relevant health information, making this a potential area of proficiency.
C. Input of data such as requests for radiographs or laboratory services. LPNs may be responsible for entering basic patient care data and service requests, making this a relevant skill in many clinical settings.
D. Programming the computer to record data from primary care providers and other healthcare workers. Programming tasks are typically not within the scope of LPN duties, as these require advanced computer skills beyond general data input.
Correct Answer is D
Explanation
A. "I don't feel like walking today either."
This response shifts the focus from the patient to the nurse and does not encourage further discussion about the patient's reluctance or explore the reasons behind it.
B. "You have to walk today."
This statement sounds forceful and dismissive, and may make the patient feel pressured rather than supported. It does not invite dialogue or provide understanding.
C. "Why don't you want to walk today?"
This question can sound judgmental and may put the patient on the defensive. A more neutral response would help the nurse understand the patient's reluctance without pressure.
D. "You don't want to walk today?"
This response reflects the patient's own words back, validating their feelings and opening up the opportunity for the patient to explain their reasons. It is empathetic and nonjudgmental, which encourages therapeutic communication.