,Chapter 01 — Pharmacology and the
Nursing Process in LPN Practice
Stem: A licensed practical nurse (LPN) prepares to give a patient
a scheduled oral antihypertensive. The patient reports new
lightheadedness and dizziness after standing. What is the most
appropriate immediate action by the LPN?
A. Administer the medication and chart the patient's complaint.
B. Hold the medication and notify the supervising RN or
prescriber.
C. Ask the patient to ambulate to assess orthostatic change
before giving the drug.
D. Give half the dose and reassess in 30 minutes.
Correct Answer: B
Rationale (correct): Holding the antihypertensive and notifying
the RN/prescriber protects patient safety because new dizziness
may indicate hypotension or an adverse effect requiring
assessment or change of therapy. LPNs must report assessment
findings that alter medication safety.
Rationale (A): Administering despite symptoms risks causing
syncope or injury and ignores the need for further assessment.
Rationale (C): Ambulating may precipitate syncope and is
unsafe before resolving dizziness.
Rationale (D): Arbitrarily reducing dose without prescriber
guidance is unsafe and outside appropriate independent LPN
decision-making.
,Teaching Point: Always escalate new adverse patient
assessment findings before administering medications.
2. Chapter 1 — Pharmacology and the Nursing Process in
LPN Practice — THE LPN/VN’S ROLE AND THE NURSING
PROCESS — USING THE CLINICAL JUDGMENT MODEL
Stem: Using a clinical judgment model, which action best
represents the “recognize cues” phase when preparing to give a
prescribed antibiotic?
A. Evaluating the expected therapeutic effect of the antibiotic.
B. Noticing the patient has a fever of 38.9°C and purulent
drainage from a wound.
C. Documenting the antibiotic administration in the MAR after
giving it.
D. Contacting the prescriber to request a different antibiotic.
Correct Answer: B
Rationale (correct): “Recognize cues” involves noticing
pertinent clinical data (fever, purulence) that indicate infection
and support the rationale for antibiotic therapy. This is the
initial cue-gathering step in clinical judgment models.
Rationale (A): Evaluating therapeutic effects is part of later
analysis and evaluation, not initial cue recognition.
Rationale (C): Documentation is a nursing process action post-
intervention; it does not represent cue recognition.
, Rationale (D): Contacting a prescriber may be appropriate later,
after analyzing cues and forming a hypothesis.
Teaching Point: Recognizing relevant patient cues is the first
step in clinical judgment.
3. Chapter 1 — Pharmacology and the Nursing Process in
LPN Practice — THE LPN/VN’S ROLE AND THE NURSING
PROCESS — USING THE CLINICAL JUDGMENT MODEL
Stem: An LPN administering a new oral medication checks the
MAR and the patient’s allergy list; the medication is not on the
allergy list, but the patient says they had a “bad reaction” to a
similar drug years ago. What is the best next step?
A. Administer and observe closely since the current MAR shows
no allergy.
B. Administer a reduced dose now, then the full dose later.
C. Withhold and clarify details with the supervising RN or
prescriber before administering.
D. Ask the patient to sign a waiver and then administer.
Correct Answer: C
Rationale (correct): The LPN must clarify ambiguous allergy
history because past reactions to similar drugs may indicate
cross-sensitivity; withholding and reporting to RN/prescriber
prevents harm.
Rationale (A): Ignoring patient history risks serious adverse
events if cross-reactivity exists.
Nursing Process in LPN Practice
Stem: A licensed practical nurse (LPN) prepares to give a patient
a scheduled oral antihypertensive. The patient reports new
lightheadedness and dizziness after standing. What is the most
appropriate immediate action by the LPN?
A. Administer the medication and chart the patient's complaint.
B. Hold the medication and notify the supervising RN or
prescriber.
C. Ask the patient to ambulate to assess orthostatic change
before giving the drug.
D. Give half the dose and reassess in 30 minutes.
Correct Answer: B
Rationale (correct): Holding the antihypertensive and notifying
the RN/prescriber protects patient safety because new dizziness
may indicate hypotension or an adverse effect requiring
assessment or change of therapy. LPNs must report assessment
findings that alter medication safety.
Rationale (A): Administering despite symptoms risks causing
syncope or injury and ignores the need for further assessment.
Rationale (C): Ambulating may precipitate syncope and is
unsafe before resolving dizziness.
Rationale (D): Arbitrarily reducing dose without prescriber
guidance is unsafe and outside appropriate independent LPN
decision-making.
,Teaching Point: Always escalate new adverse patient
assessment findings before administering medications.
2. Chapter 1 — Pharmacology and the Nursing Process in
LPN Practice — THE LPN/VN’S ROLE AND THE NURSING
PROCESS — USING THE CLINICAL JUDGMENT MODEL
Stem: Using a clinical judgment model, which action best
represents the “recognize cues” phase when preparing to give a
prescribed antibiotic?
A. Evaluating the expected therapeutic effect of the antibiotic.
B. Noticing the patient has a fever of 38.9°C and purulent
drainage from a wound.
C. Documenting the antibiotic administration in the MAR after
giving it.
D. Contacting the prescriber to request a different antibiotic.
Correct Answer: B
Rationale (correct): “Recognize cues” involves noticing
pertinent clinical data (fever, purulence) that indicate infection
and support the rationale for antibiotic therapy. This is the
initial cue-gathering step in clinical judgment models.
Rationale (A): Evaluating therapeutic effects is part of later
analysis and evaluation, not initial cue recognition.
Rationale (C): Documentation is a nursing process action post-
intervention; it does not represent cue recognition.
, Rationale (D): Contacting a prescriber may be appropriate later,
after analyzing cues and forming a hypothesis.
Teaching Point: Recognizing relevant patient cues is the first
step in clinical judgment.
3. Chapter 1 — Pharmacology and the Nursing Process in
LPN Practice — THE LPN/VN’S ROLE AND THE NURSING
PROCESS — USING THE CLINICAL JUDGMENT MODEL
Stem: An LPN administering a new oral medication checks the
MAR and the patient’s allergy list; the medication is not on the
allergy list, but the patient says they had a “bad reaction” to a
similar drug years ago. What is the best next step?
A. Administer and observe closely since the current MAR shows
no allergy.
B. Administer a reduced dose now, then the full dose later.
C. Withhold and clarify details with the supervising RN or
prescriber before administering.
D. Ask the patient to sign a waiver and then administer.
Correct Answer: C
Rationale (correct): The LPN must clarify ambiguous allergy
history because past reactions to similar drugs may indicate
cross-sensitivity; withholding and reporting to RN/prescriber
prevents harm.
Rationale (A): Ignoring patient history risks serious adverse
events if cross-reactivity exists.
