,Chapter 1: Pharmacology and the Nursing Process in LPN
Practice
1. NGN-Style Question:
A nurse is preparing to administer a new scheduled medication
to a patient. The patient states, "I'm not sure what this pill is
for." Which action by the nurse best demonstrates
the recognizing cues step of the Clinical Judgment
Measurement Model (CJMM)?
A. Administering the medication as ordered and planning to
discuss it with the patient later.
B. Documenting the patient's question in the medical record.
C. Withholding the medication and notifying the charge nurse
immediately.
D. Pausing the administration process to provide patient
education about the drug's purpose.
Correct Answer: D
Rationale: D is correct. Recognizing cues involves identifying
significant data, such as a patient's lack of knowledge about
their medication, which is a cue that requires action before safe
administration. A is incorrect because it ignores a critical patient
safety cue. B is incorrect as documentation is important but is
not the primary action for recognizing a cue; it follows the
intervention. C is incorrect because the cue does not necessarily
indicate a reason to withhold the medication, but rather a need
for education.
,Teaching Point: A patient's lack of knowledge is a critical cue
requiring education before medication administration.
2. NGN-Style Question:
An LPN is reviewing a patient's chart before medication
administration. Which finding is the priority for the nurse to
report to the RN before giving the scheduled antibiotic
vancomycin?
A. The patient's weight has decreased by 1 kg since admission.
B. The patient's latest trough vancomycin level is 22 mcg/mL.
C. The patient reports a mild headache.
D. The patient's temperature is 37.8°C (100°F).
Correct Answer: B
Rationale: B is correct. A vancomycin trough level of 22 mcg/mL
is significantly above the therapeutic range (typically 10-20
mcg/mL), indicating a high risk for nephrotoxicity and requiring
immediate dose adjustment. This is the most urgent finding. A,
C, and D are all assessment findings that should be monitored
and reported, but they do not represent an immediate, direct
risk related to the specific medication's pharmacokinetics like a
toxic drug level does.
Teaching Point: Toxic drug levels are a high-priority cue
requiring immediate intervention to prevent patient harm.
3. NGN-Style Question:
An LPN is participating in the planning phase of the nursing
process for a patient starting on antihypertensive therapy. What
is the LPN's primary role in this phase?
, A. Independently establishing long-term goals for blood
pressure management.
B. Collecting initial vital signs to serve as a baseline.
C. Reinforcing and providing education on the plan of care
developed by the RN.
D. Evaluating the patient's response to the first dose of
medication.
Correct Answer: C
Rationale: C is correct. The LPN's role in planning is to assist the
RN and reinforce the established plan of care, including patient
education. A is incorrect because establishing the initial plan of
care and goals is within the scope of the RN. B is incorrect as it
describes the assessment phase. D is incorrect as it describes
the evaluation phase.
Teaching Point: The LPN reinforces the plan of care developed
by the RN, including patient education.
4. NGN-Style Question:
When administering a controlled substance, which action by the
LPN is essential for safe and legal practice?
A. Asking another nurse to witness the wasting of any unused
portion of the medication.
B. Documenting the administration 30 minutes after the drug is
given to assess for effects.
C. Having the patient sign a consent form before the first dose is
administered.
D. Counting the inventory of controlled substances at the end of
the shift.
Practice
1. NGN-Style Question:
A nurse is preparing to administer a new scheduled medication
to a patient. The patient states, "I'm not sure what this pill is
for." Which action by the nurse best demonstrates
the recognizing cues step of the Clinical Judgment
Measurement Model (CJMM)?
A. Administering the medication as ordered and planning to
discuss it with the patient later.
B. Documenting the patient's question in the medical record.
C. Withholding the medication and notifying the charge nurse
immediately.
D. Pausing the administration process to provide patient
education about the drug's purpose.
Correct Answer: D
Rationale: D is correct. Recognizing cues involves identifying
significant data, such as a patient's lack of knowledge about
their medication, which is a cue that requires action before safe
administration. A is incorrect because it ignores a critical patient
safety cue. B is incorrect as documentation is important but is
not the primary action for recognizing a cue; it follows the
intervention. C is incorrect because the cue does not necessarily
indicate a reason to withhold the medication, but rather a need
for education.
,Teaching Point: A patient's lack of knowledge is a critical cue
requiring education before medication administration.
2. NGN-Style Question:
An LPN is reviewing a patient's chart before medication
administration. Which finding is the priority for the nurse to
report to the RN before giving the scheduled antibiotic
vancomycin?
A. The patient's weight has decreased by 1 kg since admission.
B. The patient's latest trough vancomycin level is 22 mcg/mL.
C. The patient reports a mild headache.
D. The patient's temperature is 37.8°C (100°F).
Correct Answer: B
Rationale: B is correct. A vancomycin trough level of 22 mcg/mL
is significantly above the therapeutic range (typically 10-20
mcg/mL), indicating a high risk for nephrotoxicity and requiring
immediate dose adjustment. This is the most urgent finding. A,
C, and D are all assessment findings that should be monitored
and reported, but they do not represent an immediate, direct
risk related to the specific medication's pharmacokinetics like a
toxic drug level does.
Teaching Point: Toxic drug levels are a high-priority cue
requiring immediate intervention to prevent patient harm.
3. NGN-Style Question:
An LPN is participating in the planning phase of the nursing
process for a patient starting on antihypertensive therapy. What
is the LPN's primary role in this phase?
, A. Independently establishing long-term goals for blood
pressure management.
B. Collecting initial vital signs to serve as a baseline.
C. Reinforcing and providing education on the plan of care
developed by the RN.
D. Evaluating the patient's response to the first dose of
medication.
Correct Answer: C
Rationale: C is correct. The LPN's role in planning is to assist the
RN and reinforce the established plan of care, including patient
education. A is incorrect because establishing the initial plan of
care and goals is within the scope of the RN. B is incorrect as it
describes the assessment phase. D is incorrect as it describes
the evaluation phase.
Teaching Point: The LPN reinforces the plan of care developed
by the RN, including patient education.
4. NGN-Style Question:
When administering a controlled substance, which action by the
LPN is essential for safe and legal practice?
A. Asking another nurse to witness the wasting of any unused
portion of the medication.
B. Documenting the administration 30 minutes after the drug is
given to assess for effects.
C. Having the patient sign a consent form before the first dose is
administered.
D. Counting the inventory of controlled substances at the end of
the shift.
