Practice
1. Chapter 1: The LPN/VN’s Role and the Nursing Process
A patient is prescribed a new antihypertensive medication. The
LPN/VN reviews the patient’s chart, prepares the correct dose,
and administers it. Which step of the nursing process is the
LPN/VN primarily demonstrating?
A) Assessment
B) Diagnosis
C) Planning
D) Implementation
Correct Answer: D
Rationale: Implementation is the step where nursing care is
provided, including the direct administration of medications.
Assessment involves data collection, diagnosis involves
identifying the problem, and planning involves setting goals and
outcomes.
Teaching Point: Medication administration is a key
implementation activity in the nursing process.
2. Chapter 1: Using the Clinical Judgment Model
An LPN/VN is assigned to administer digoxin to a patient. The
,patient reports nausea, fatigue, and "seeing yellow halos
around the lights." The LPN/VN withholds the dose and notifies
the charge RN. Which component of the Clinical Judgment
Measurement Model (CJMM) does this action best represent?
A) Recognize Cues
B) Analyze Cues
C) Prioritize Hypotheses
D) Take Action
Correct Answer: A
Rationale: The LPN/VN has recognized subjective and objective
cues (nausea, fatigue, visual changes) that are classic signs of
digoxin toxicity. The other steps involve interpreting these cues
or implementing a plan, which follows recognition.
Teaching Point: Recognizing cues of toxicity is a critical safety
step before administering any medication.
3. Chapter 1: The LPN/VN’s Role and the Nursing Process
When applying the nursing process to pharmacology, which
action is an LPN/VN’s primary responsibility during the
assessment phase for a newly prescribed drug?
A) Developing the plan of care with outcomes
B) Evaluating the patient’s response to the medication
C) Collecting data on the patient’s allergies and medical history
D) Formulating a nursing diagnosis related to drug therapy
Correct Answer: C
Rationale: Assessment involves gathering data. For a new
, medication, this includes a thorough history, allergy status, and
baseline vital signs. Developing plans (A), formulating diagnoses
(D), and evaluation (B) are steps typically led by or performed in
collaboration with the RN.
Teaching Point: A thorough assessment is the foundation for
safe and effective medication administration.
4. Chapter 1: The LPN/VN’s Role and the Nursing Process
An LPN/VN is reviewing medication orders during morning care.
Which action is within the scope of practice for an LPN/VN
regarding the planning phase of the nursing process?
A) Establishing a new nursing diagnosis of "Noncompliance"
B) Collaborating with the RN to identify goals for pain
management
C) Independently creating a teaching plan for a complex
anticoagulant regimen
D) Discontinuing a medication that is no longer effective
Correct Answer: B
Rationale: LPN/VNs contribute to the planning phase by
collaborating with the RN and other team members to establish
patient-centered goals and outcomes. Establishing diagnoses
(A), creating independent complex plans (C), and discontinuing
medications (D) are outside the standard LPN/VN scope.
Teaching Point: LPN/VNs collaborate with the RN to develop
realistic and measurable patient goals.