Illinois Nursing Home Administrators (NHA) Practice Exam

Under what circumstance can a LPN be designated as in charge of nursing services?

1. In a small SNF with fewer than 100 beds

2. Only when neither the DON nor administrator is present

3. When no RN is on duty during the shift

4. If the facility has an ADON or is a RN

The correct answer is: When no RN is on duty during the shift

A Licensed Practical Nurse (LPN) may be designated as in charge of nursing services primarily in a situation where no Registered Nurse (RN) is on duty during the shift. This guideline is rooted in the regulations that govern nursing practice and the hierarchy of nursing personnel. In the absence of an RN, an LPN can assume supervisory responsibilities to ensure continuity of care and management of nursing services, as there may be practical situations where an RN is not available. It is crucial that LPNs operate within their scope of practice, which allows them to perform certain duties, but they also must recognize the limitations of their role when it comes to clinical decision-making and overall patient management duties reserved for RNs. While other options may include conditions related to facility size or personnel arrangements, these do not necessarily align with the regulatory framework that specifies the need for an RN to oversee nursing services when they are present. The presence of an ADON or RN does not inherently validate the LPN's authority to manage nursing services, which solidifies the choice of having the LPN in charge only when there is no RN on duty. This distinction is vital for maintaining compliance with state regulations and ensuring patient safety and quality of care in nursing facilities.