,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: A new LPN receives a medication order for a patient with
impaired renal function. According to the nursing process and
the clinical judgment model, what is the FIRST action the LPN
should take?
A. Administer the medication as ordered and document
administration.
B. Verify the order and assess the patient’s most recent renal
function labs.
C. Refuse to give the medication because of renal impairment.
D. Delegate medication administration to nursing assistive
personnel.
Correct Answer: B
Rationale — Correct: Before administering medications, the LPN
must verify orders and gather relevant assessment data (e.g.,
renal labs) to identify contraindications or dose adjustments;
this is the “recognize cues/analyze” step in clinical judgment.
Rationale — A incorrect: Administering before assessment risks
harm if dosing or drug choice is contraindicated by renal
impairment.
Rationale — C incorrect: Refusal without verifying or consulting
,the prescriber is inappropriate; further assessment and
communication are required.
Rationale — D incorrect: Delegation of medication
administration to assistive personnel is outside their scope; LPN
must perform assessment and decision-making.
Teaching Point: Always verify orders and assess pertinent labs
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: While using the clinical judgment model, an LPN notes a
patient develops a new rash after starting an antibiotic. Which
action best reflects appropriate clinical judgment?
A. Document the rash and continue antibiotic therapy.
B. Stop the antibiotic immediately without notifying anyone.
C. Assess the rash, stop the antibiotic if severe, notify the
RN/physician, and monitor for systemic signs.
D. Give an antihistamine and continue the antibiotic without
reporting.
Correct Answer: C
, Rationale — Correct: Appropriate clinical judgment requires
assessment, recognition of severity, communication with the
RN/provider, and monitoring for progression to anaphylaxis.
Rationale — A incorrect: Documentation alone neglects need
for evaluation and possible treatment change; may delay
necessary intervention.
Rationale — B incorrect: Unilateral cessation without
communication may disrupt care; LPN should notify supervising
clinician.
Rationale — D incorrect: Treating symptomatically without
reporting risks missing progression and does not address
possible drug allergy.
Teaching Point: Assess, communicate, and monitor when new
adverse effects emerge.
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: An LPN is caring for multiple patients and must prioritize
medication administration. Which factor should guide
prioritization according to clinical judgment principles?
A. The order in which medications were written.
B. The severity of potential harm from missed or delayed
Nursing Process in LPN Practice
Section: The LPN/VN’s Role and the Nursing Process — Using
the Clinical Judgment Model
Stem: A new LPN receives a medication order for a patient with
impaired renal function. According to the nursing process and
the clinical judgment model, what is the FIRST action the LPN
should take?
A. Administer the medication as ordered and document
administration.
B. Verify the order and assess the patient’s most recent renal
function labs.
C. Refuse to give the medication because of renal impairment.
D. Delegate medication administration to nursing assistive
personnel.
Correct Answer: B
Rationale — Correct: Before administering medications, the LPN
must verify orders and gather relevant assessment data (e.g.,
renal labs) to identify contraindications or dose adjustments;
this is the “recognize cues/analyze” step in clinical judgment.
Rationale — A incorrect: Administering before assessment risks
harm if dosing or drug choice is contraindicated by renal
impairment.
Rationale — C incorrect: Refusal without verifying or consulting
,the prescriber is inappropriate; further assessment and
communication are required.
Rationale — D incorrect: Delegation of medication
administration to assistive personnel is outside their scope; LPN
must perform assessment and decision-making.
Teaching Point: Always verify orders and assess pertinent labs
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: While using the clinical judgment model, an LPN notes a
patient develops a new rash after starting an antibiotic. Which
action best reflects appropriate clinical judgment?
A. Document the rash and continue antibiotic therapy.
B. Stop the antibiotic immediately without notifying anyone.
C. Assess the rash, stop the antibiotic if severe, notify the
RN/physician, and monitor for systemic signs.
D. Give an antihistamine and continue the antibiotic without
reporting.
Correct Answer: C
, Rationale — Correct: Appropriate clinical judgment requires
assessment, recognition of severity, communication with the
RN/provider, and monitoring for progression to anaphylaxis.
Rationale — A incorrect: Documentation alone neglects need
for evaluation and possible treatment change; may delay
necessary intervention.
Rationale — B incorrect: Unilateral cessation without
communication may disrupt care; LPN should notify supervising
clinician.
Rationale — D incorrect: Treating symptomatically without
reporting risks missing progression and does not address
possible drug allergy.
Teaching Point: Assess, communicate, and monitor when new
adverse effects emerge.
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: An LPN is caring for multiple patients and must prioritize
medication administration. Which factor should guide
prioritization according to clinical judgment principles?
A. The order in which medications were written.
B. The severity of potential harm from missed or delayed
