,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 preparing to give a new oral antihypertensive to
a stable patient. Which step of the nursing process should the
LPN perform first to ensure safe medication administration?
A. Implement the medication administration as ordered.
B. Assess the patient’s current blood pressure and heart rate.
C. Teach the patient about potential side effects.
D. Evaluate the patient’s response 1 hour after administration.
Correct Answer: B
Rationales:
• Correct: Assessing vital signs (blood pressure and heart
rate) is the first step because baseline data determine
appropriateness and safety of antihypertensive
administration; it prevents harm from hypotension or
bradycardia.
• A: Implementation before assessment risks giving
medication when contraindicated.
• C: Teaching is important but follows assessment and
initiating therapy as appropriate.
, • D: Evaluation is necessary later but cannot replace the
initial assessment.
Teaching Point: Always assess relevant baseline parameters
before medication administration.
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 patient’s medication order reads “Digoxin 0.25 mg PO
daily.” The LPN notes the patient’s apical pulse is 48 bpm.
According to the clinical judgment model, what is the most
appropriate LPN action?
A. Administer the dose and document the pulse.
B. Hold the dose and notify the supervising nurse or prescriber.
C. Give half the dose to avoid toxicity.
D. Reassess the pulse in 60 minutes and then decide.
Correct Answer: B
Rationales:
• Correct: Holding a cardiac glycoside when bradycardia (<60
bpm) is present and notifying the RN or prescriber follows
safe practice and the clinical judgment model (notice,
interpret, respond).
, • A: Administering despite bradycardia risks worsening heart
rate and toxicity.
• C: Splitting prescribed doses without an order is unsafe
and unauthorized.
• D: Waiting 60 minutes before communicating delays
necessary action and risks harm.
Teaching Point: Hold digoxin for bradycardia and promptly
report to RN/prescriber.
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: During medication reconciliation, the LPN discovers the
patient takes an over-the-counter herbal supplement that may
interact with warfarin. Which part of the nursing process does
this activity represent?
A. Implementation
B. Evaluation
C. Assessment
D. Planning
Correct Answer: C
Rationales:
Nursing Process in LPN Practice
Section: THE LPN/VN’S ROLE AND THE NURSING PROCESS /
USING THE CLINICAL JUDGMENT MODEL
Stem: An LPN is preparing to give a new oral antihypertensive to
a stable patient. Which step of the nursing process should the
LPN perform first to ensure safe medication administration?
A. Implement the medication administration as ordered.
B. Assess the patient’s current blood pressure and heart rate.
C. Teach the patient about potential side effects.
D. Evaluate the patient’s response 1 hour after administration.
Correct Answer: B
Rationales:
• Correct: Assessing vital signs (blood pressure and heart
rate) is the first step because baseline data determine
appropriateness and safety of antihypertensive
administration; it prevents harm from hypotension or
bradycardia.
• A: Implementation before assessment risks giving
medication when contraindicated.
• C: Teaching is important but follows assessment and
initiating therapy as appropriate.
, • D: Evaluation is necessary later but cannot replace the
initial assessment.
Teaching Point: Always assess relevant baseline parameters
before medication administration.
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 patient’s medication order reads “Digoxin 0.25 mg PO
daily.” The LPN notes the patient’s apical pulse is 48 bpm.
According to the clinical judgment model, what is the most
appropriate LPN action?
A. Administer the dose and document the pulse.
B. Hold the dose and notify the supervising nurse or prescriber.
C. Give half the dose to avoid toxicity.
D. Reassess the pulse in 60 minutes and then decide.
Correct Answer: B
Rationales:
• Correct: Holding a cardiac glycoside when bradycardia (<60
bpm) is present and notifying the RN or prescriber follows
safe practice and the clinical judgment model (notice,
interpret, respond).
, • A: Administering despite bradycardia risks worsening heart
rate and toxicity.
• C: Splitting prescribed doses without an order is unsafe
and unauthorized.
• D: Waiting 60 minutes before communicating delays
necessary action and risks harm.
Teaching Point: Hold digoxin for bradycardia and promptly
report to RN/prescriber.
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: During medication reconciliation, the LPN discovers the
patient takes an over-the-counter herbal supplement that may
interact with warfarin. Which part of the nursing process does
this activity represent?
A. Implementation
B. Evaluation
C. Assessment
D. Planning
Correct Answer: C
Rationales:
