LPN Pharmacology I - Module 3 Exam (2026 Update)
1. A nurse is preparing to administer a medication that is primarily metabolized
by the liver. Which laboratory value should the nurse prioritize reviewing?
A. Alanine Aminotransferase (ALT)
B. Blood Urea Nitrogen (BUN)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Rationale: ALT is a liver enzyme; elevated levels indicate liver damage, which affects the
metabolism of medications. BUN and Creatinine assess renal function.
2. The nurse understands that the ‘first-pass effect’ refers to which process?
A. The metabolism of a drug by the liver before it reaches systemic circulation.
B. The excretion of a drug through the kidneys on the first cycle.
C. The initial distribution of a drug to the heart and brain.
D. The rapid absorption of a drug through the gastric mucosa.
Answer: A
Rationale: The first-pass effect occurs when an oral medication is absorbed from the GI
tract and carried to the liver via the portal vein, where a portion is metabolized before
reaching the bloodstream.
,3. A patient is prescribed sublingual nitroglycerin for chest pain. What
instruction should the nurse provide?
A. Swallow the tablet with a full glass of water.
B. Place the tablet under the tongue and let it dissolve.
C. Chew the tablet thoroughly before swallowing.
D. Crush the tablet and mix it with applesauce.
Answer: B
Rationale: Sublingual medications must dissolve under the tongue to bypass the digestive
system and enter the bloodstream directly.
4. Which of the following is considered a ‘Right’ of medication administration to
ensure patient safety?
A. Right Pharmacy
B. Right Documentation
C. Right Room Number
D. Right Insurance Provider
Answer: B
Rationale: Right Documentation is one of the core ‘Rights’ (Patient, Drug, Dose, Route,
Time, Documentation).
5. A nurse is administering Digoxin to a patient. Which vital sign must be
assessed for one full minute before administration?
A. Apical Pulse
B. Respiratory Rate
C. Blood Pressure
D. Temperature
Answer: A
Rationale: Digoxin can cause bradycardia. The apical pulse must be checked for 60
seconds, and the drug is usually held if the heart rate is below 60 bpm.
, 6. A patient on Warfarin therapy has an International Normalized Ratio (INR) of
5.5. What is the nurse’s priority action?
A. Administer the next dose as scheduled.
B. Encourage the patient to eat leafy green vegetables.
C. Notify the provider and prepare Vitamin K.
D. Prepare to administer Protamine Sulfate.
Answer: C
Rationale: An INR of 5.5 is dangerously high (normal therapeutic range is 2.0-3.0). Vitamin
K is the antidote for Warfarin. Protamine Sulfate is for Heparin.
7. Which medication is classified as a Loop Diuretic?
A. Spironolactone
B. Hydrochlorothiazide
C. Lisinopril
D. Furosemide
Answer: D
Rationale: Furosemide (Lasix) is a loop diuretic. Spironolactone is potassium-sparing, and
Hydrochlorothiazide is a thiazide diuretic.
8. A nurse is teaching a patient about a new prescription for Albuterol inhaler.
What is a common side effect?
A. Bradycardia
B. Drowsiness
C. Tachycardia
D. Hypoglycemia
Answer: C
Rationale: Albuterol is a sympathomimetic bronchodilator that often causes tremors,
nervousness, and tachycardia (increased heart rate).
1. A nurse is preparing to administer a medication that is primarily metabolized
by the liver. Which laboratory value should the nurse prioritize reviewing?
A. Alanine Aminotransferase (ALT)
B. Blood Urea Nitrogen (BUN)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Rationale: ALT is a liver enzyme; elevated levels indicate liver damage, which affects the
metabolism of medications. BUN and Creatinine assess renal function.
2. The nurse understands that the ‘first-pass effect’ refers to which process?
A. The metabolism of a drug by the liver before it reaches systemic circulation.
B. The excretion of a drug through the kidneys on the first cycle.
C. The initial distribution of a drug to the heart and brain.
D. The rapid absorption of a drug through the gastric mucosa.
Answer: A
Rationale: The first-pass effect occurs when an oral medication is absorbed from the GI
tract and carried to the liver via the portal vein, where a portion is metabolized before
reaching the bloodstream.
,3. A patient is prescribed sublingual nitroglycerin for chest pain. What
instruction should the nurse provide?
A. Swallow the tablet with a full glass of water.
B. Place the tablet under the tongue and let it dissolve.
C. Chew the tablet thoroughly before swallowing.
D. Crush the tablet and mix it with applesauce.
Answer: B
Rationale: Sublingual medications must dissolve under the tongue to bypass the digestive
system and enter the bloodstream directly.
4. Which of the following is considered a ‘Right’ of medication administration to
ensure patient safety?
A. Right Pharmacy
B. Right Documentation
C. Right Room Number
D. Right Insurance Provider
Answer: B
Rationale: Right Documentation is one of the core ‘Rights’ (Patient, Drug, Dose, Route,
Time, Documentation).
5. A nurse is administering Digoxin to a patient. Which vital sign must be
assessed for one full minute before administration?
A. Apical Pulse
B. Respiratory Rate
C. Blood Pressure
D. Temperature
Answer: A
Rationale: Digoxin can cause bradycardia. The apical pulse must be checked for 60
seconds, and the drug is usually held if the heart rate is below 60 bpm.
, 6. A patient on Warfarin therapy has an International Normalized Ratio (INR) of
5.5. What is the nurse’s priority action?
A. Administer the next dose as scheduled.
B. Encourage the patient to eat leafy green vegetables.
C. Notify the provider and prepare Vitamin K.
D. Prepare to administer Protamine Sulfate.
Answer: C
Rationale: An INR of 5.5 is dangerously high (normal therapeutic range is 2.0-3.0). Vitamin
K is the antidote for Warfarin. Protamine Sulfate is for Heparin.
7. Which medication is classified as a Loop Diuretic?
A. Spironolactone
B. Hydrochlorothiazide
C. Lisinopril
D. Furosemide
Answer: D
Rationale: Furosemide (Lasix) is a loop diuretic. Spironolactone is potassium-sparing, and
Hydrochlorothiazide is a thiazide diuretic.
8. A nurse is teaching a patient about a new prescription for Albuterol inhaler.
What is a common side effect?
A. Bradycardia
B. Drowsiness
C. Tachycardia
D. Hypoglycemia
Answer: C
Rationale: Albuterol is a sympathomimetic bronchodilator that often causes tremors,
nervousness, and tachycardia (increased heart rate).
