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Continuity of Care and Handoff

1. At the beginning of her evening shift, an LPN receives the handoff report from the outgoing nurse. One of her assigned patients, Mr. Cloutier, was admitted earlier for pneumonia and has been receiving IV antibiotics. The report includes his vital signs, oxygen therapy, and antibiotic schedule, but no mention of the IV site condition. During the first assessment, the LPN notices that the IV insertion site is red and swollen. Which of the following best describes the nurse’s next step to ensure continuity of care? *
2. Mr. Boucher, age 82, is being transferred from the surgical unit to a rehabilitation center after hip surgery. The LPN must prepare a transfer report for the receiving team. Mr. Boucher still has a surgical dressing, uses a walker, and is on anticoagulant therapy. The LPN notes that he occasionally becomes disoriented and tries to stand up alone. Which information is most important to include in the transfer report? *
3. During handoff between the evening and night shifts, an LPN learns that a patient, Mrs. Desrochers, who has COPD, has been increasingly short of breath during the day. No new oxygen order was received. When the LPN checks on the patient, she finds her breathing rapidly, with oxygen saturation at 86%. What should the LPN do first to ensure effective communication and continuity of care? *
4. An LPN working on the medical floor prepares to transfer Mrs. Nguyen, age 73, to another hospital for specialized cardiac care. The ambulance team arrives early. The LPN rushes to finish the paperwork and forgets to include the last ECG result and the physician’s latest orders in the transfer file. What is the main risk associated with this omission? *
5. At the end of her night shift, an LPN prepares to give a handoff to the morning nurse. One of her patients, Mr. Bélanger, who has diabetes, experienced hypoglycemia during the night. The LPN treated him with juice and crackers, and his blood glucose returned to normal. However, she is in a hurry and considers skipping that detail in the verbal report because she already wrote it in the chart. What should the LPN do? *
6. At the beginning of her evening shift, an LPN receives a handoff report on Mr. Raymond, age 59, who underwent an appendectomy this morning. The outgoing nurse mentions that his incision is clean and dry, but the LPN notices during her assessment that the dressing is slightly soaked with serosanguinous fluid. The nurse also observes that Mr. Raymond reports increased abdominal pain rated 8/10 and a low-grade fever of 38.1°C. What is the most appropriate action to ensure continuity of care? *
7. Mrs. Tremblay, age 81, admitted for a urinary tract infection, becomes confused and agitated during the night. She repeatedly tries to get out of bed, pulling at her IV line. The LPN documents the episode and reorients the patient, but does not mention the event in the morning handoff. During the next shift, Mrs. Tremblay falls while attempting to go to the washroom unassisted. What error compromised continuity of care? *
8. An LPN is caring for Mr. Diallo, age 72, with worsening shortness of breath due to heart failure. The physician orders an emergency transfer to the ICU. The LPN gathers the chart and helps prepare the patient. The receiving ICU nurse asks about the patient’s last medication and vital signs, but the LPN is unsure because the report was incomplete. Which action ensures the best continuity of care? *
9. During shift change, an outgoing LPN forgets to mention that a patient, Ms. Roberge, did not receive her scheduled 9 a.m. antibiotic dose due to a missing order renewal. The incoming nurse assumes the medication was administered and documents it as complete. Later, the physician notices the missed dose and questions the team. What is the main issue that occurred? *
10. Mr. Lévesque, age 70, is being transferred from the emergency department to the medical unit after being treated for dehydration. The LPN in the emergency department provides a verbal report but omits to mention that the patient had an episode of low blood pressure after IV fluids were started. The receiving nurse later finds the patient dizzy and pale. What is the best way to prevent this type of incident? *
Continuity of Care and HandoffDownload