,Chapter 01 — Pharmacology and the
Nursing Process in LPN Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem
An LPN is admitting a patient who reports a new prescription
for warfarin from a different provider. Which action should
the LPN perform first as part of the nursing process?
Options
A. Administer the first dose as ordered to start therapy
promptly.
B. Verify the patient’s current medication list and recent INR
results.
C. Teach the patient about dietary vitamin K interactions.
D. Schedule follow-up INR testing in 1 week.
Correct Answer
B
Rationales
Correct: Verifying the current medication list and recent INR
is the highest-priority assessment step to identify
duplications, interactions, and baseline lab values before
starting anticoagulation. This aligns with the nursing process’s
initial data-collection phase.
A: Premature administration risks harm if INR is already
,therapeutic or if there are interactions; assessment must
precede giving meds.
C: Patient education is important but follows assessment and
confirmation of therapy appropriateness.
D: Scheduling follow-up is appropriate but secondary to
confirming current status before initiation.
Teaching Point
Always complete assessment (med list, labs) before
administering high-risk medications.
2.
Chapter 1 — Pharmacology and the Nursing Process in LPN
Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem
A licensed vocational nurse (LVN) uses Tanner’s clinical
judgment steps when a patient develops shortness of breath
after morphine. Which step involves recognizing and naming
the problem?
Options
A. Interpreting
B. Noticing
C. Responding
D. Reflecting
, Correct Answer
B
Rationales
Correct: "Noticing" is the initial recognition of clinical cues
(e.g., shortness of breath) in Tanner’s model; it precedes
interpretation and action.
A: Interpreting is the step of analyzing cues and forming
hypotheses, not the initial recognition.
C: Responding is selecting and implementing actions based
on interpretation.
D: Reflecting occurs after action to evaluate outcomes.
Teaching Point
Clinical judgment begins with noticing patient cues before
interpretation and response.
3.
Chapter 1 — Pharmacology and the Nursing Process in LPN
Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem
While preparing medications, an LPN notes the prescription
reads “levothyroxine 0.125 mg orally daily,” but the patient’s
prior record lists 0.05 mg. What is the most appropriate
immediate action?
Nursing Process in LPN Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem
An LPN is admitting a patient who reports a new prescription
for warfarin from a different provider. Which action should
the LPN perform first as part of the nursing process?
Options
A. Administer the first dose as ordered to start therapy
promptly.
B. Verify the patient’s current medication list and recent INR
results.
C. Teach the patient about dietary vitamin K interactions.
D. Schedule follow-up INR testing in 1 week.
Correct Answer
B
Rationales
Correct: Verifying the current medication list and recent INR
is the highest-priority assessment step to identify
duplications, interactions, and baseline lab values before
starting anticoagulation. This aligns with the nursing process’s
initial data-collection phase.
A: Premature administration risks harm if INR is already
,therapeutic or if there are interactions; assessment must
precede giving meds.
C: Patient education is important but follows assessment and
confirmation of therapy appropriateness.
D: Scheduling follow-up is appropriate but secondary to
confirming current status before initiation.
Teaching Point
Always complete assessment (med list, labs) before
administering high-risk medications.
2.
Chapter 1 — Pharmacology and the Nursing Process in LPN
Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem
A licensed vocational nurse (LVN) uses Tanner’s clinical
judgment steps when a patient develops shortness of breath
after morphine. Which step involves recognizing and naming
the problem?
Options
A. Interpreting
B. Noticing
C. Responding
D. Reflecting
, Correct Answer
B
Rationales
Correct: "Noticing" is the initial recognition of clinical cues
(e.g., shortness of breath) in Tanner’s model; it precedes
interpretation and action.
A: Interpreting is the step of analyzing cues and forming
hypotheses, not the initial recognition.
C: Responding is selecting and implementing actions based
on interpretation.
D: Reflecting occurs after action to evaluate outcomes.
Teaching Point
Clinical judgment begins with noticing patient cues before
interpretation and response.
3.
Chapter 1 — Pharmacology and the Nursing Process in LPN
Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem
While preparing medications, an LPN notes the prescription
reads “levothyroxine 0.125 mg orally daily,” but the patient’s
prior record lists 0.05 mg. What is the most appropriate
immediate action?
