,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: A 68-year-old patient is admitted with new-onset atrial
fibrillation and is started on warfarin. Which nursing action
best fits the LPN/VN role during the “assessment” phase of
the nursing process?
A. Teach the patient how to manage dietary vitamin K intake.
B. Obtain baseline INR and document current medications
and herbal supplements.
C. Adjust the warfarin dose per prescriber phone order.
D. Provide discharge teaching about bleeding precautions.
Correct Answer: B
Rationales:
Correct: B — Obtaining baseline INR and a complete
medication/herbal history is an assessment activity that
identifies factors affecting warfarin therapy and bleeding risk.
A: Teaching is part of implementation/education, not initial
assessment.
C: Dose adjustment is a prescriber’s order or a protocol
action; LPN/VNs typically report assessment data to the
RN/MD.
D: Discharge teaching is a later implementation/education
step, not assessment.
,Teaching Point: Gather baseline labs and med history before
anticoagulant therapy.
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: During medication administration, an LPN/VN notices a
patient’s newly documented allergy to penicillin that was not
on the MAR and the patient’s scheduled amoxicillin is at the
bedside. What is the best immediate action?
A. Hold the medication and notify the RN or prescriber.
B. Administer half the dose and observe for reaction.
C. Give the full dose because the allergy is newly
documented.
D. Ask the patient to sign a refusal.
Correct Answer: A
Rationales:
Correct: A — Holding the medication and promptly notifying
the RN/prescriber prevents a potential allergic reaction and
follows safety and legal responsibilities.
B: Administering any dose risks an allergic reaction; partial
dosing is unsafe and inappropriate.
C: Administering despite an allergy is dangerous and violates
, scope of practice.
D: Asking for a refusal is irrelevant and delays necessary
clarification from prescriber.
Teaching Point: Stop and report when allergy information
conflicts with orders.
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: An LPN/VN is using the Clinical Judgment Model to
prioritize actions for a patient on opioids with respiratory rate
of 8 breaths/min. Which action is most appropriate to
prioritize?
A. Document the respiratory rate and reassess in 30 minutes.
B. Stimulate the patient, assist with naloxone administration
per protocol, and notify the RN/MD.
C. Offer oxygen and continue routine monitoring.
D. Encourage the patient to take deep breaths.
Correct Answer: B
Rationales:
Correct: B — A respiratory rate of 8 indicates potential
opioid-induced respiratory depression; stimulating, initiating
naloxone per protocol, and notifying the RN/MD is urgent
Nursing Process in LPN Practice
Section: The LPN/VN’s Role and the Nursing Process — Using
the Clinical Judgment Model
Stem: A 68-year-old patient is admitted with new-onset atrial
fibrillation and is started on warfarin. Which nursing action
best fits the LPN/VN role during the “assessment” phase of
the nursing process?
A. Teach the patient how to manage dietary vitamin K intake.
B. Obtain baseline INR and document current medications
and herbal supplements.
C. Adjust the warfarin dose per prescriber phone order.
D. Provide discharge teaching about bleeding precautions.
Correct Answer: B
Rationales:
Correct: B — Obtaining baseline INR and a complete
medication/herbal history is an assessment activity that
identifies factors affecting warfarin therapy and bleeding risk.
A: Teaching is part of implementation/education, not initial
assessment.
C: Dose adjustment is a prescriber’s order or a protocol
action; LPN/VNs typically report assessment data to the
RN/MD.
D: Discharge teaching is a later implementation/education
step, not assessment.
,Teaching Point: Gather baseline labs and med history before
anticoagulant therapy.
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: During medication administration, an LPN/VN notices a
patient’s newly documented allergy to penicillin that was not
on the MAR and the patient’s scheduled amoxicillin is at the
bedside. What is the best immediate action?
A. Hold the medication and notify the RN or prescriber.
B. Administer half the dose and observe for reaction.
C. Give the full dose because the allergy is newly
documented.
D. Ask the patient to sign a refusal.
Correct Answer: A
Rationales:
Correct: A — Holding the medication and promptly notifying
the RN/prescriber prevents a potential allergic reaction and
follows safety and legal responsibilities.
B: Administering any dose risks an allergic reaction; partial
dosing is unsafe and inappropriate.
C: Administering despite an allergy is dangerous and violates
, scope of practice.
D: Asking for a refusal is irrelevant and delays necessary
clarification from prescriber.
Teaching Point: Stop and report when allergy information
conflicts with orders.
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: An LPN/VN is using the Clinical Judgment Model to
prioritize actions for a patient on opioids with respiratory rate
of 8 breaths/min. Which action is most appropriate to
prioritize?
A. Document the respiratory rate and reassess in 30 minutes.
B. Stimulate the patient, assist with naloxone administration
per protocol, and notify the RN/MD.
C. Offer oxygen and continue routine monitoring.
D. Encourage the patient to take deep breaths.
Correct Answer: B
Rationales:
Correct: B — A respiratory rate of 8 indicates potential
opioid-induced respiratory depression; stimulating, initiating
naloxone per protocol, and notifying the RN/MD is urgent
