Chapter 01: Pharmacology and the Nursing Process i.l i.l i.l i.l i.l i.l
in LPN Practice Visovsky: Introduction to Clinical
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Pharmacology, 10th Edition
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MULTIPLE CHOICE i.l
1. The LPN is collecting data for the initial assessment of a patient upon admission to a long-term care fa
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patient‘s prescribed drugs. Which action should the LPN consider to be the highest priority?
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a. Obtain any special equipment that will be needed to give the patient‘s drug. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
b. Monitor the patient for a response to the drug given. i.l i.l i.l i.l i.l i.l i.l i.l i.l
c. Collect data about the patient and the patient‘s health condition. i.l i.l i.l i.l i.l i.l i.l i.l i.l
d. Review the nursing care plan to verify that it is accurate. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
ANS: i . l C
Collecting and documenting data about the patient and the patient‘s health condition is a critical step b
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Information regarding the present illness, any signs and symptoms, review of medical records, drug hi
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needed before drugs are given. Deciding on special equipment that will be needed to give the patient‘s
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phase of the nursing process. Monitoring the patient for his response to given drug is part of the evalu
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process. Reviewing the nursing care plan to verify that it is being followed accurately is part of the im
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nursing process.
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DIF: Cognitive Level: Applying i.l i.l REF: i . l i . l p. 2 i.l
2. The LPN is working with a patient in the planning stage of the nursing process related to the patient‘s p
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action should the LPN take during this stage?
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a. Develop a nursing goal to plan the procedures needed to give drug. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
b. Develop a teaching plan for the patient regarding the drug‘s actions. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
c. Determine that the patient is experiencing the expected response to his drug. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
d. Determine how much the patient understands about his drug. i.l i.l i.l i.l i.l i.l i.l i.l
ANS: i . l D
Determining how much the patient understands about his drug is part of the diagnosis phase of the nur
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nursing goal to plan the procedures needed to give drug and developing a teaching plan for the patient
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are part of the planning phase of the nursing process.
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DIF: Cognitive Level: Applying i.l i.l REF: i . l i . l p. 2 i.l
3. You are teaching a patient with depression about the potential adverse effects of a prescribed drug. Wh
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related to drug therapy are you engaging in at this point of the teaching plan?
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a. Assessment
b. Implementation
c. Evaluation
d. Diagnosis
ANS: i . l C
In the evaluation phase of the nursing process, the LPN understands and teaches to the patient the drug
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expected side effects, and potential adverse effects.
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 2 i.l
4. Which of the following is an example of subjective data?
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,6. The LPN/VN is assessing a patient before giving a drug for blood pressure management. The nurse note
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90/50 mm Hg. What is the nurse‘s best action?
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a. Hold the drug and report the blood pressure to the RN. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
b. Give the patient a full glass of water before giving the drug. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
c. Come back in 30 minutes and recheck the blood pressure. i.l i.l i.l i.l i.l i.l i.l i.l i.l
d. Have the patient perform pursed lip breathing before giving the drug.
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ANS: i . l A
The best action is to hold the drug and contact the RN. The patient may need an adjustment to the dose
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or switching to another drug. Giving water with the drug is not contraindicated but does not recognize
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hypotension. Pursed lip breathing has no role in this situation.
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 4 i.l
7. The LPN is collecting objective data for inclusion in the nursing assessment. Which piece of informatio
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i.l a clear understanding of objective assessment data?
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a. A patient‘s rating of chest pain as 8 on a 1 to 10 scale.
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b. Family members report that patient has been experiencing pain for 1 month. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
c. Detailed history of the patient‘s current illness upon admission. i.l i.l i.l i.l i.l i.l i.l i.l
d. Compilation of past laboratory results and x-ray reports. i.l i.l i.l i.l i.l i.l i.l
ANS: i . l D
The patient‘s past laboratory and x-ray results are examples of objective data. A pain rating of 8/10, a fa
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of the patient‘s pain, and history of current illness are examples of subjective data.
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 3 i.l
8. A patient recently began a taking blood pressure drug and presents for a follow-up appointment. The of
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patient‘s daily blood pressure recordings. Which stage of the nursing process corresponds to this revie
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a. Assessment
b. Planning
c. Diagnosis
d. Evaluation
ANS: i . l D
The evaluation phase involves examining the results that occur when the plan is implemented. Review
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pressure recording examines the patient‘s response to the drug. The assessment phase provides initial in
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the problem, and anything that may change the choice of treatment. The planning phase involves usin
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and diagnoses to set goals and write care plans. The diagnosis phase involves decision-making about t
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including medical diagnoses made by the healthcare provider and nursing diagnoses developed throug
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Nursing Diagnosis Association (NANDA).
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 2 i.l
9. After receiving report, the LPN gives drugs to her assigned patients on the evening shift. With which st
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does this activity correspond?
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a. Implementation
b. Assessment
c. Planning
d. Diagnosis
ANS: i . l A
The implementation phase involves actively following the plan of care and accurately giving ordered d
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assessment phase involves obtaining initial information about the patient, the problem, and anything t
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treatment. The planning phase involves using patient assessment data and diagnoses to set goals and wr
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phase involves decision-making about the patient‘s problems, including medical diagnoses made by th
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nursing diagnoses developed through the North American Nursing Diagnosis Association (NANDA).
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 5 i.l
,11. A patient is receiving an antibiotic for pneumonia. On the third day of the treatment regimen, a rash app
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reports itching and shortness of breath. Which term describes the effect that has occurred?
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a. Therapeutic effect i.l
b. Adverse effect i.l
c. Side effect i.l
d. Overdose effect i.l
ANS: i . l B
An itchy rash with shortness of breath that develops in response to drug is an example of an allergic rea
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the antibiotic. Therapeutic effects occur when an antibiotic fights infection without causing any adver
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drugs are known potential effects of the antibiotic that range from mild to moderate. An overdose occu
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much of a drug.
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DIF: Cognitive Level: Understanding i.l i.l REF: i . l i . l p. 9 i.l
12. An LPN enters a patient‘s room to give a scheduled drug. Before administration, the patient states, ―I c
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allergic to it.‖ What should the nurse do first?
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a. Reassure the patient that the drug is needed and observations regarding possible i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
allergic symptoms will be made.
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b. Review the patient record and encourage the patient to take the drug if no i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
allergies have been documented.
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c. Assess the patient‘s allergic history and notify the healthcare provider to i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
determine a course of action.
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d. Document patient refusal and leave a note on the patient chart for the healthcare i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
provider. i.l
ANS: i . l C
The patient has shared information that indicates the potential for the ordered drug to cause adverse effe
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the nurse should investigate further by obtaining a more detailed drug history and notifying the health
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order. Although the order may be accurately written, determining whether the drug‘s benefits outweig
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within the legal scope of the nurse‘s practice. The nurse should not offer false reassurance and as an a
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should investigate further before giving the drug. The patient has raised concerns regarding the drug t
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brought to the provider‘s attention. A note on the chart leaves potential for information to be missed.
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DIF: Cognitive Level: Applying i.l i.l REF: i . l i . l p. 4 i.l
13. The LPN is preparing to give the initial dose of an antibiotic to a patient diagnosed with an infection. T
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in a rash the last time I took that pill.‖ What action should the LPN take next?
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a. Give the drug and check the patient in 30 minutes for a rash. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
b. Document that the patient refused the drug per agency policy. i.l i.l i.l i.l i.l i.l i.l i.l i.l
c. Leave the drug at the bedside while checking the chart for the patient‘s allergies. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
d. Notify the registered nurse or healthcare provider. i.l i.l i.l i.l i.l i.l
ANS: i . l D
This is a possible adverse reaction, and the RN or healthcare provider should be notified immediately. Y
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drug to see if it does cause a rash. Drug should never be left at the bedside. The patient did not refuse
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DIF: Cognitive Level: Applying i.l i.l REF: i . l i . l p. 9 i.l
14. Which priority assessment must you make before giving any patient a drug by mouth?
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a. Quiz the patient about the action of each drug. i.l i.l i.l i.l i.l i.l i.l i.l
b. Make sure the patient can swallow. i.l i.l i.l i.l i.l
c. Find out whether the patient prefers cold or room temperature liquids. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
d. Ask the patient to repeat his or her name and birthdate. i.l i.l i.l i.l i.l i.l i.l i.l i.l i.l
ANS: i . l B
Before the patient can take any drug by mouth, they must be able to swallow. Asking the patient to rep
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may be part of using two identifiers but this is important with all patients. Preferences are also importa
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patient be able to swallow the drug.
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, 2. A licensed practical/vocational nurse has a specific set of roles and responsibilities. Which responsibili
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i.l an LPN/LVN? (Select all that apply.)
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a. Writing medical orders i.l i.l
b. Assessment of admission vitals to report to the admitting RN i.l i.l i.l i.l i.l i.l i.l i.l i.l
c. Conducting a comprehensive admission assessment i.l i.l i.l i.l
d. Independent initiation of comprehensive plan of care i.l i.l i.l i.l i.l i.l
e. Management of patient care under RN supervision i.l i.l i.l i.l i.l i.l
ANS: i . l B, E i.l
Assisting the RN in gathering specific data such as vital signs is within the scope of LPN/LVN practic
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directly with the patient and manages care and assists the RN in data collection and care plan developm
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have the legal authority to write medical orders or carry out the admission assessment. LPNs/LVNs ar
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planning and evaluation phase of the nursing process. An LPN/LVN can collect data to assist the RN
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but is unable to initiate a comprehensive plan of care independently.
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 3 i.l
3. The LPN is collecting subjective data for inclusion in the nursing assessment. What information indicat
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understanding of the nature of subjective assessment data? (Select all that apply.)
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a. Pulse rate i.l
b. ECG brought in by the patient i.l i.l i.l i.l i.l
c. Chief complaint of chest pain in the patient‘s own words i.l i.l i.l i.l i.l i.l i.l i.l i.l
d. Auscultation of lung sounds i.l i.l i.l
e. The patient‘s statement of current over the counter and prescription drugs
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f. The patient‘s laboratory test results i.l i.l i.l i.l
ANS: i . l C, E i.l
Subjective data include information given by the patient or family, like concerns or symptoms felt by t
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statement of mediations. The pulse rate, recent ECG, laboratory test results, and lung auscultation obta
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examination are examples of objective data.
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DIF: Cognitive Level: Remembering i.l i.l REF: i . l i . l p. 3 i.l
4. A 72 year-old female patient has just been admitted to a rehabilitation center for extended physical ther
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i.l are obtaining the patient‘s drug history. Which information should you collect? (Select all that apply.)
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a. Drugs currently being taken i.l i.l i.l
b. Over-the-counter drugs being taken i.l i.l i.l
c. Referrals to specialists i.l i.l
d. Diseases or conditions requiring drugs i.l i.l i.l i.l
e. Use of herbal supplements i.l i.l i.l
f. Past medical history i.l i.l
g. Alcohol use i.l
h. Drug allergies i.l
ANS: i . l A, B, D, E, G, H i.l i.l i.l i.l i.l
Important information to gather from a patient‘s drug history are the current prescription drugs, OTC d
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denote the patient‘s need for a drug, alcohol use, drug allergies, and the use of nutritional or herbal sup
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choices are items in the history of present or past illnesses, and not concerned with drugs.
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DIF: Cognitive Level: Understanding i.l i.l REF: i . l i . l p. 3 i.l