,Chapter 01 — 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/LVN is preparing to administer a new oral
antihypertensive to an older adult. According to the nursing
process and clinical judgment model, which action should the
LPN perform first?
A. Teach the patient about orthostatic precautions.
B. Review the patient’s current blood pressure and medication
history.
C. Administer the medication as ordered to avoid delay.
D. Document administration and the patient’s response.
Correct Answer: B
Rationales (Correct + Incorrects)
Correct: Reviewing the patient’s current blood pressure and
medication history is assessment—the first step in the nursing
process and essential before drug administration. It identifies
cues that guide safe action.
A: Teaching is important but follows assessment and planning; it
is not the initial priority before ensuring safety.
C: Administering without assessment may cause harm if BP is
low or drug interactions exist.
D: Documentation is done after assessment and administration;
it is not the first action.
,Teaching Point: Always assess (vitals, meds) 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: A patient reports new onset dizziness 30 minutes after
receiving digoxin. Using the clinical judgment model, the LPN’s
next best action is to:
A. Reassure the patient that dizziness is expected and continue
routine care.
B. Measure the patient’s heart rate and rhythm and report
findings to the RN/physician.
C. Document the complaint and wait for the next scheduled
assessment.
D. Offer the patient water and encourage lying flat.
Correct Answer: B
Rationales (Correct + Incorrects)
Correct: Measuring heart rate/rhythm is focused assessment for
digoxin toxicity (bradyarrhythmias) and provides objective data
to inform escalation. Prompt reporting is required.
A: Reassurance without assessment ignores potential drug-
related adverse effects.
C: Waiting delays recognition and treatment of a possible
adverse effect.
, D: Offering water/positioning addresses symptoms but neglects
cardiac assessment and escalation.
Teaching Point: Assess cardiac parameters promptly with
suspected digoxin adverse effects.
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: While using the clinical judgment model, an LPN
recognizes conflicting cues: the medication administration
record shows a narcotic PRN was given 2 hours ago, yet the
patient reports severe pain now. The LPN should next:
A. Administer another PRN narcotic immediately per the
patient’s report.
B. Ask the patient to rate pain and check last-dose time and
vital signs.
C. Tell the patient to wait until the RN decides.
D. Document the patient’s pain and leave the room.
Correct Answer: B
Rationales (Correct + Incorrects)
Correct: Gathering additional data (pain rating, last-dose time,
vitals) is analysis of cues in the clinical judgment model to
determine appropriateness of further analgesia.
A: Administering without confirming last dose and assessment
risks overdose or inadequate assessment.
Nursing Process in LPN Practice
THE LPN/VN’S ROLE AND THE NURSING PROCESS; USING THE
CLINICAL JUDGMENT MODEL
Stem: An LPN/LVN is preparing to administer a new oral
antihypertensive to an older adult. According to the nursing
process and clinical judgment model, which action should the
LPN perform first?
A. Teach the patient about orthostatic precautions.
B. Review the patient’s current blood pressure and medication
history.
C. Administer the medication as ordered to avoid delay.
D. Document administration and the patient’s response.
Correct Answer: B
Rationales (Correct + Incorrects)
Correct: Reviewing the patient’s current blood pressure and
medication history is assessment—the first step in the nursing
process and essential before drug administration. It identifies
cues that guide safe action.
A: Teaching is important but follows assessment and planning; it
is not the initial priority before ensuring safety.
C: Administering without assessment may cause harm if BP is
low or drug interactions exist.
D: Documentation is done after assessment and administration;
it is not the first action.
,Teaching Point: Always assess (vitals, meds) 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: A patient reports new onset dizziness 30 minutes after
receiving digoxin. Using the clinical judgment model, the LPN’s
next best action is to:
A. Reassure the patient that dizziness is expected and continue
routine care.
B. Measure the patient’s heart rate and rhythm and report
findings to the RN/physician.
C. Document the complaint and wait for the next scheduled
assessment.
D. Offer the patient water and encourage lying flat.
Correct Answer: B
Rationales (Correct + Incorrects)
Correct: Measuring heart rate/rhythm is focused assessment for
digoxin toxicity (bradyarrhythmias) and provides objective data
to inform escalation. Prompt reporting is required.
A: Reassurance without assessment ignores potential drug-
related adverse effects.
C: Waiting delays recognition and treatment of a possible
adverse effect.
, D: Offering water/positioning addresses symptoms but neglects
cardiac assessment and escalation.
Teaching Point: Assess cardiac parameters promptly with
suspected digoxin adverse effects.
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: While using the clinical judgment model, an LPN
recognizes conflicting cues: the medication administration
record shows a narcotic PRN was given 2 hours ago, yet the
patient reports severe pain now. The LPN should next:
A. Administer another PRN narcotic immediately per the
patient’s report.
B. Ask the patient to rate pain and check last-dose time and
vital signs.
C. Tell the patient to wait until the RN decides.
D. Document the patient’s pain and leave the room.
Correct Answer: B
Rationales (Correct + Incorrects)
Correct: Gathering additional data (pain rating, last-dose time,
vitals) is analysis of cues in the clinical judgment model to
determine appropriateness of further analgesia.
A: Administering without confirming last dose and assessment
risks overdose or inadequate assessment.
