,Chapter 01 — Pharmacology and the
Nursing Process in LPN Practice
Stem: An LPN admits a 78-year-old patient who is to receive a
new antihypertensive. Which action by the LPN during the
initial assessment best demonstrates appropriate data
collection for safe medication administration?
A. Ask about current home medications and record the exact
dosing schedule.
B. Assume the patient’s current blood pressure history from the
referral note.
C. Administer the antihypertensive and monitor blood pressure
afterward.
D. Delegate the medication history to a nursing assistant.
Correct Answer: A
Rationales:
• Correct (A): Asking about current home medications and
exact dosing is essential to identify drug interactions,
duplicates, and adherence—key assessment data before
administering a new antihypertensive.
• Incorrect (B): Assuming prior BP history from a referral
note risks missing recent changes or omissions; current
patient-reported information is necessary.
, • Incorrect (C): Administering before collecting medication
history jeopardizes safety; assessment must precede
administration.
• Incorrect (D): Delegating a medication history to a nursing
assistant exceeds typical scope and risks incomplete or
inaccurate data.
Teaching Point: Always collect a complete medication history
before administering new drugs.
2.
Chapter 1 — Section: The LPN/VN’s Role and the Nursing
Process; Using the Clinical Judgment Model
Stem: Using the NCSBN clinical judgment steps, which cognitive
process is the LPN using when clustering abnormal heart rate,
dizziness, and a new prescription for digoxin?
A. Take action
B. Recognize cues
C. Evaluate outcomes
D. Generate solutions
Correct Answer: B
Rationales:
• Correct (B): Recognizing cues refers to identifying salient
clinical data (tachycardia, dizziness, new digoxin) that may
indicate an adverse effect or interaction.
, • Incorrect (A): Taking action is the implementation phase,
which comes after analysis and solution generation.
• Incorrect (C): Evaluating outcomes occurs after
interventions have been implemented.
• Incorrect (D): Generating solutions follows analysis of cues,
not initial recognition.
Teaching Point: First identify and recognize important clinical
cues before planning interventions.
3.
Chapter 1 — Section: The LPN/VN’s Role and the Nursing
Process; Using the Clinical Judgment Model
Stem: An LPN analyzes a patient’s cue set (low urine output,
serum creatinine trending up, and scheduled ACE inhibitor).
Which priority nursing action aligns with clinical judgment?
A. Hold the ACE inhibitor and notify the prescriber.
B. Encourage oral fluids and continue the ACE inhibitor.
C. Document findings and give the next dose as ordered.
D. Discharge the patient to outpatient follow-up.
Correct Answer: A
Rationales:
• Correct (A): Reduced urine output and rising creatinine
suggest renal impairment; holding the ACE inhibitor and
Nursing Process in LPN Practice
Stem: An LPN admits a 78-year-old patient who is to receive a
new antihypertensive. Which action by the LPN during the
initial assessment best demonstrates appropriate data
collection for safe medication administration?
A. Ask about current home medications and record the exact
dosing schedule.
B. Assume the patient’s current blood pressure history from the
referral note.
C. Administer the antihypertensive and monitor blood pressure
afterward.
D. Delegate the medication history to a nursing assistant.
Correct Answer: A
Rationales:
• Correct (A): Asking about current home medications and
exact dosing is essential to identify drug interactions,
duplicates, and adherence—key assessment data before
administering a new antihypertensive.
• Incorrect (B): Assuming prior BP history from a referral
note risks missing recent changes or omissions; current
patient-reported information is necessary.
, • Incorrect (C): Administering before collecting medication
history jeopardizes safety; assessment must precede
administration.
• Incorrect (D): Delegating a medication history to a nursing
assistant exceeds typical scope and risks incomplete or
inaccurate data.
Teaching Point: Always collect a complete medication history
before administering new drugs.
2.
Chapter 1 — Section: The LPN/VN’s Role and the Nursing
Process; Using the Clinical Judgment Model
Stem: Using the NCSBN clinical judgment steps, which cognitive
process is the LPN using when clustering abnormal heart rate,
dizziness, and a new prescription for digoxin?
A. Take action
B. Recognize cues
C. Evaluate outcomes
D. Generate solutions
Correct Answer: B
Rationales:
• Correct (B): Recognizing cues refers to identifying salient
clinical data (tachycardia, dizziness, new digoxin) that may
indicate an adverse effect or interaction.
, • Incorrect (A): Taking action is the implementation phase,
which comes after analysis and solution generation.
• Incorrect (C): Evaluating outcomes occurs after
interventions have been implemented.
• Incorrect (D): Generating solutions follows analysis of cues,
not initial recognition.
Teaching Point: First identify and recognize important clinical
cues before planning interventions.
3.
Chapter 1 — Section: The LPN/VN’s Role and the Nursing
Process; Using the Clinical Judgment Model
Stem: An LPN analyzes a patient’s cue set (low urine output,
serum creatinine trending up, and scheduled ACE inhibitor).
Which priority nursing action aligns with clinical judgment?
A. Hold the ACE inhibitor and notify the prescriber.
B. Encourage oral fluids and continue the ACE inhibitor.
C. Document findings and give the next dose as ordered.
D. Discharge the patient to outpatient follow-up.
Correct Answer: A
Rationales:
• Correct (A): Reduced urine output and rising creatinine
suggest renal impairment; holding the ACE inhibitor and
