NCLEX-PN® ExaminationPharmacological TherapiesMedium
An LPN is preparing to administer an oral medication to a client who is NPO for a surgical procedure scheduled in 4 hours. The medication is a routine morning antihypertensive. What is the most appropriate action by the LPN?
- AHold the medication and administer it after the surgery.
- BContact the registered nurse (RN) or healthcare provider for clarification.
- CAdminister the medication with a small sip of water.
- DCrush the medication and mix it with applesauce for easier swallowing.
Show answer & explanationAnswer & explanation
Correct answer: B. Contact the registered nurse (RN) or healthcare provider for clarification.
Clients who are NPO (nil per os) should not receive anything by mouth. However, some essential medications, like antihypertensives, may be permitted with a small sip of water or given via an alternative route, depending on the healthcare provider's orders and facility policy. The LPN must clarify the order before proceeding.
Why the other options are wrong
- A. Holding an antihypertensive medication could lead to an increase in blood pressure, potentially delaying or complicating surgery. This decision should not be made by the LPN independently.
- C. Administering medication with water when NPO without a specific order violates the NPO status and could pose an aspiration risk or delay surgery.
- D. Crushing medication and mixing with applesauce still involves oral intake and violates NPO status. Additionally, not all medications can be crushed.
NPO & Medications
For clients designated NPO, all oral intake, including medications, requires explicit clarification from the healthcare provider or RN due to the risk of aspiration or interference with the medical procedure.
- NPO means nothing by mouth.
- Certain medications (e.g., cardiac, seizure) may be allowed.
- Always clarify with provider/RN.
- Risk of aspiration or surgical delay.
Memory trick: NPO: Not Permitted Orally, Provider Order!