NEW YORK PHARMACOLOGY FOR LPNS PRACTICE EXAM | STUDY GUIDE |
TESTBANK | LATEST UPDATE 2026/2027 | QUESTIONS & 100% CORRECT
ANSWERS
*Table of Contents:
1. Pharmacokinetics, Pharmacodynamics & Medication Safety — Questions 1–5
2. Cardiovascular, Endocrine & Renal Pharmacology — Questions 6–10
3. Antimicrobials, Respiratory & Gastrointestinal Pharmacology — Questions 11–
15
4. Neurologic, Psychiatric & Pain Medications — Questions 16–20
5. Medication Calculations, Interactions & Adverse Effects — Questions 21–25
6. New York LPN Medication Administration, Delegation & Professional Practice
— Questions 26–30*
INTRODUCTION
This practice examination is designed for advanced study of pharmacology as
applied to Licensed Practical Nursing practice in New York. It emphasizes
medication safety, pharmacokinetics, pharmacodynamics, adverse effects, drug
interactions, clinical calculations, high-alert medications, patient-specific decision-
making, and professional responsibilities. Questions also incorporate New York-
specific nursing practice considerations, including medication administration under
appropriate direction and supervision. New York LPNs may administer most
medications when properly trained and acting within their lawful scope and
applicable orders. Expect clinically complex scenarios requiring prioritization,
interpretation of patient findings, identification of contraindications, evaluation of
therapeutic response, and recognition of situations requiring escalation rather than
simple medication recall.
Question 1
A patient receiving digoxin has an apical pulse of 54/min, potassium of 3.0 mEq/L,
and reports nausea and yellow-green visual disturbances. The prescription is for
digoxin 0.125 mg PO now. Which action by the LPN is most appropriate?
,A. Administer the digoxin because the apical pulse is above 50/min
B. Administer the medication with food to decrease gastrointestinal effects
C. Hold the medication and promptly notify the RN or prescribing practitioner of
the findings
D. Give the medication and recheck the potassium level in 4 hours
Correct Answer: C
Explanation: The combination of bradycardia, hypokalemia, nausea, and visual
disturbances strongly suggests possible digoxin toxicity. Hypokalemia increases
myocardial sensitivity to digoxin, so administration should be withheld and the
patient promptly evaluated.
Question 2
A patient taking warfarin has an INR of 5.8 and reports new spontaneous gum
bleeding. Which pharmacologic principle best explains why this finding requires
immediate attention?
A. Warfarin produces irreversible platelet inhibition
B. Warfarin reduces synthesis of vitamin K-dependent clotting factors
C. Warfarin directly dissolves existing thrombi
D. Warfarin increases fibrinogen production
Correct Answer: B
Explanation: Warfarin inhibits vitamin K-dependent synthesis of clotting factors II,
VII, IX, and X and regulatory proteins C and S. A markedly elevated INR with
active bleeding indicates excessive anticoagulant effect and requires prompt
intervention.
Question 3
A patient prescribed lisinopril develops facial swelling, difficulty swallowing, and
hoarseness shortly after receiving the medication. What is the priority
interpretation?
A. Expected first-dose hypotension
B. Angiotensin-converting enzyme inhibitor-associated angioedema
,C. Hyperkalemia without clinical significance
D. Orthostatic intolerance caused by diuresis
Correct Answer: B
Explanation: Facial and upper-airway swelling after an ACE inhibitor is
characteristic of potentially life-threatening angioedema. The medication should
not be administered again, and immediate emergency evaluation is required
because airway compromise can progress rapidly.
Question 4
An LPN is preparing to administer subcutaneous insulin. The patient is diaphoretic,
trembling, confused, and has a blood glucose of 48 mg/dL. Which action has the
highest priority?
A. Administer the scheduled insulin and recheck glucose afterward
B. Hold the insulin and initiate treatment for hypoglycemia according to the
patient's orders and facility protocol
C. Administer glucagon routinely before checking the patient's ability to swallow
D. Document the findings and wait for the next scheduled glucose measurement
Correct Answer: B
Explanation: The patient has symptomatic hypoglycemia, making administration
of scheduled insulin unsafe. The insulin should be withheld and hypoglycemia
treated promptly according to the patient's clinical condition, orders, and
applicable protocol.
Question 5
A patient taking phenytoin has a serum albumin concentration of 2.0 g/dL and a
measured total phenytoin level within the conventional therapeutic range. The
patient nevertheless exhibits nystagmus and ataxia. Which interpretation is most
appropriate?
A. Low albumin can increase the free, pharmacologically active fraction of
phenytoin
B. Low albumin makes phenytoin completely inactive
, C. The symptoms prove the patient has developed tolerance
D. The measured total concentration always accurately reflects active phenytoin
Correct Answer: A
Explanation: Phenytoin is highly protein bound. Hypoalbuminemia can increase
the unbound fraction, so a seemingly therapeutic total concentration may coexist
with toxicity. Clinical findings and, when appropriate, corrected or free levels
should be considered.
Question 6
A patient taking furosemide develops muscle weakness, irregular heartbeats, and a
serum potassium of 2.7 mEq/L. Which pharmacologic effect most directly accounts
for these findings?
A. Potassium retention caused by increased aldosterone blockade
B. Increased renal potassium loss associated with loop diuretic therapy
C. Decreased gastrointestinal potassium absorption caused by furosemide
D. Increased intracellular potassium caused by insulin-like activity
Correct Answer: B
Explanation: Furosemide is a loop diuretic that promotes substantial renal sodium
and water excretion and can increase potassium loss. Severe hypokalemia can
produce weakness and potentially dangerous cardiac dysrhythmias.
Question 7
A patient taking metformin is scheduled for a contrast-enhanced diagnostic study.
The patient has significantly reduced renal function. Why is the medication history
particularly important?
A. Metformin directly causes contrast media to become nephrotoxic
B. Reduced renal clearance can increase metformin accumulation and the risk of
lactic acidosis
C. Metformin causes immediate hypoglycemia whenever contrast is administered
D. Contrast media permanently blocks intestinal absorption of metformin
TESTBANK | LATEST UPDATE 2026/2027 | QUESTIONS & 100% CORRECT
ANSWERS
*Table of Contents:
1. Pharmacokinetics, Pharmacodynamics & Medication Safety — Questions 1–5
2. Cardiovascular, Endocrine & Renal Pharmacology — Questions 6–10
3. Antimicrobials, Respiratory & Gastrointestinal Pharmacology — Questions 11–
15
4. Neurologic, Psychiatric & Pain Medications — Questions 16–20
5. Medication Calculations, Interactions & Adverse Effects — Questions 21–25
6. New York LPN Medication Administration, Delegation & Professional Practice
— Questions 26–30*
INTRODUCTION
This practice examination is designed for advanced study of pharmacology as
applied to Licensed Practical Nursing practice in New York. It emphasizes
medication safety, pharmacokinetics, pharmacodynamics, adverse effects, drug
interactions, clinical calculations, high-alert medications, patient-specific decision-
making, and professional responsibilities. Questions also incorporate New York-
specific nursing practice considerations, including medication administration under
appropriate direction and supervision. New York LPNs may administer most
medications when properly trained and acting within their lawful scope and
applicable orders. Expect clinically complex scenarios requiring prioritization,
interpretation of patient findings, identification of contraindications, evaluation of
therapeutic response, and recognition of situations requiring escalation rather than
simple medication recall.
Question 1
A patient receiving digoxin has an apical pulse of 54/min, potassium of 3.0 mEq/L,
and reports nausea and yellow-green visual disturbances. The prescription is for
digoxin 0.125 mg PO now. Which action by the LPN is most appropriate?
,A. Administer the digoxin because the apical pulse is above 50/min
B. Administer the medication with food to decrease gastrointestinal effects
C. Hold the medication and promptly notify the RN or prescribing practitioner of
the findings
D. Give the medication and recheck the potassium level in 4 hours
Correct Answer: C
Explanation: The combination of bradycardia, hypokalemia, nausea, and visual
disturbances strongly suggests possible digoxin toxicity. Hypokalemia increases
myocardial sensitivity to digoxin, so administration should be withheld and the
patient promptly evaluated.
Question 2
A patient taking warfarin has an INR of 5.8 and reports new spontaneous gum
bleeding. Which pharmacologic principle best explains why this finding requires
immediate attention?
A. Warfarin produces irreversible platelet inhibition
B. Warfarin reduces synthesis of vitamin K-dependent clotting factors
C. Warfarin directly dissolves existing thrombi
D. Warfarin increases fibrinogen production
Correct Answer: B
Explanation: Warfarin inhibits vitamin K-dependent synthesis of clotting factors II,
VII, IX, and X and regulatory proteins C and S. A markedly elevated INR with
active bleeding indicates excessive anticoagulant effect and requires prompt
intervention.
Question 3
A patient prescribed lisinopril develops facial swelling, difficulty swallowing, and
hoarseness shortly after receiving the medication. What is the priority
interpretation?
A. Expected first-dose hypotension
B. Angiotensin-converting enzyme inhibitor-associated angioedema
,C. Hyperkalemia without clinical significance
D. Orthostatic intolerance caused by diuresis
Correct Answer: B
Explanation: Facial and upper-airway swelling after an ACE inhibitor is
characteristic of potentially life-threatening angioedema. The medication should
not be administered again, and immediate emergency evaluation is required
because airway compromise can progress rapidly.
Question 4
An LPN is preparing to administer subcutaneous insulin. The patient is diaphoretic,
trembling, confused, and has a blood glucose of 48 mg/dL. Which action has the
highest priority?
A. Administer the scheduled insulin and recheck glucose afterward
B. Hold the insulin and initiate treatment for hypoglycemia according to the
patient's orders and facility protocol
C. Administer glucagon routinely before checking the patient's ability to swallow
D. Document the findings and wait for the next scheduled glucose measurement
Correct Answer: B
Explanation: The patient has symptomatic hypoglycemia, making administration
of scheduled insulin unsafe. The insulin should be withheld and hypoglycemia
treated promptly according to the patient's clinical condition, orders, and
applicable protocol.
Question 5
A patient taking phenytoin has a serum albumin concentration of 2.0 g/dL and a
measured total phenytoin level within the conventional therapeutic range. The
patient nevertheless exhibits nystagmus and ataxia. Which interpretation is most
appropriate?
A. Low albumin can increase the free, pharmacologically active fraction of
phenytoin
B. Low albumin makes phenytoin completely inactive
, C. The symptoms prove the patient has developed tolerance
D. The measured total concentration always accurately reflects active phenytoin
Correct Answer: A
Explanation: Phenytoin is highly protein bound. Hypoalbuminemia can increase
the unbound fraction, so a seemingly therapeutic total concentration may coexist
with toxicity. Clinical findings and, when appropriate, corrected or free levels
should be considered.
Question 6
A patient taking furosemide develops muscle weakness, irregular heartbeats, and a
serum potassium of 2.7 mEq/L. Which pharmacologic effect most directly accounts
for these findings?
A. Potassium retention caused by increased aldosterone blockade
B. Increased renal potassium loss associated with loop diuretic therapy
C. Decreased gastrointestinal potassium absorption caused by furosemide
D. Increased intracellular potassium caused by insulin-like activity
Correct Answer: B
Explanation: Furosemide is a loop diuretic that promotes substantial renal sodium
and water excretion and can increase potassium loss. Severe hypokalemia can
produce weakness and potentially dangerous cardiac dysrhythmias.
Question 7
A patient taking metformin is scheduled for a contrast-enhanced diagnostic study.
The patient has significantly reduced renal function. Why is the medication history
particularly important?
A. Metformin directly causes contrast media to become nephrotoxic
B. Reduced renal clearance can increase metformin accumulation and the risk of
lactic acidosis
C. Metformin causes immediate hypoglycemia whenever contrast is administered
D. Contrast media permanently blocks intestinal absorption of metformin
