,Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: An LPN is preparing morning medications. Which action
best demonstrates the LPN’s role within the clinical judgment
model?
A. Decide independently to withhold a diuretic if the patient’s
BP is low.
B. Compare the patient’s current status with expected
outcomes for each drug.
C. Ask the RN to administer all high-alert medications.
D. Document that the patient took the pills without difficulty.
Correct Answer: B
Rationale (Correct): The LPN compares current data
(assessment) with expected therapeutic outcomes (analysis) to
determine if the plan is effective or needs modification, aligning
with the clinical judgment model.
Rationale (Incorrect): A—Independent decision exceeds LPN
scope; C—LPNs may administer many high-alert drugs under
protocol; D—Documentation is important but not the best
example of clinical judgment.
Teaching Point: Apply data-to-outcome comparison to judge
drug effectiveness.
2.
,Stem: During the analysis step of the nursing process, an LPN
reviewing digoxin therapy should prioritize which finding?
A. Serum potassium 3.2 mEq/L
B. Patient states, “I take the pill every morning.”
C. Tablet color changed from white to yellow.
D. Pulse rate 88 beats/min
Correct Answer: A
Rationale (Correct): Hypokalemia increases digoxin toxicity risk;
therefore, it is the priority finding during analysis.
Rationale (Incorrect): B—Adherence data are collected during
assessment; C—Color change prompts inspection, not
immediate analysis; D—Pulse 88 is within acceptable range.
Teaching Point: Identify lab values that heighten drug toxicity
risk.
3.
Stem: An LPN notes a patient’s INR is 4.8 (therapeutic 2–3).
According to the clinical judgment model, what is the LPN’s next
best action?
A. Hold the next warfarin dose and notify the RN immediately.
B. Administer the scheduled dose and recheck INR tomorrow.
C. Document the value and continue the plan.
D. Instruct the patient to eat more green leafy vegetables.
Correct Answer: A
Rationale (Correct): An INR above the therapeutic range
indicates bleeding risk; holding the dose and communicating
promptly aligns with safe practice and the LPN’s collaborative
, role.
Rationale (Incorrect): B—Continued dosing could increase
bleeding; C—Documentation alone is insufficient; D—Dietary
advice is not the immediate priority.
Teaching Point: Elevated INR → hold anticoagulant & escalate
care.
4.
Stem: Which statement best describes the LPN’s legal
responsibility during medication administration?
A. The LPN’s signature verifies the physician’s order is correct.
B. The LPN is accountable for giving the right drug to the right
patient.
C. The LPN can modify doses within 10% without physician
approval.
D. The RN assumes liability once the LPN reports an error.
Correct Answer: B
Rationale (Correct): LPNs are legally accountable for the “right”
aspects of medication administration, even when following
orders.
Rationale (Incorrect): A—Order accuracy is the prescriber’s
responsibility; C—Dose changes require new orders; D—
Liability is not transferred solely by reporting.
Teaching Point: LPN remains legally accountable for each “right”
of drug administration.
5.
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: An LPN is preparing morning medications. Which action
best demonstrates the LPN’s role within the clinical judgment
model?
A. Decide independently to withhold a diuretic if the patient’s
BP is low.
B. Compare the patient’s current status with expected
outcomes for each drug.
C. Ask the RN to administer all high-alert medications.
D. Document that the patient took the pills without difficulty.
Correct Answer: B
Rationale (Correct): The LPN compares current data
(assessment) with expected therapeutic outcomes (analysis) to
determine if the plan is effective or needs modification, aligning
with the clinical judgment model.
Rationale (Incorrect): A—Independent decision exceeds LPN
scope; C—LPNs may administer many high-alert drugs under
protocol; D—Documentation is important but not the best
example of clinical judgment.
Teaching Point: Apply data-to-outcome comparison to judge
drug effectiveness.
2.
,Stem: During the analysis step of the nursing process, an LPN
reviewing digoxin therapy should prioritize which finding?
A. Serum potassium 3.2 mEq/L
B. Patient states, “I take the pill every morning.”
C. Tablet color changed from white to yellow.
D. Pulse rate 88 beats/min
Correct Answer: A
Rationale (Correct): Hypokalemia increases digoxin toxicity risk;
therefore, it is the priority finding during analysis.
Rationale (Incorrect): B—Adherence data are collected during
assessment; C—Color change prompts inspection, not
immediate analysis; D—Pulse 88 is within acceptable range.
Teaching Point: Identify lab values that heighten drug toxicity
risk.
3.
Stem: An LPN notes a patient’s INR is 4.8 (therapeutic 2–3).
According to the clinical judgment model, what is the LPN’s next
best action?
A. Hold the next warfarin dose and notify the RN immediately.
B. Administer the scheduled dose and recheck INR tomorrow.
C. Document the value and continue the plan.
D. Instruct the patient to eat more green leafy vegetables.
Correct Answer: A
Rationale (Correct): An INR above the therapeutic range
indicates bleeding risk; holding the dose and communicating
promptly aligns with safe practice and the LPN’s collaborative
, role.
Rationale (Incorrect): B—Continued dosing could increase
bleeding; C—Documentation alone is insufficient; D—Dietary
advice is not the immediate priority.
Teaching Point: Elevated INR → hold anticoagulant & escalate
care.
4.
Stem: Which statement best describes the LPN’s legal
responsibility during medication administration?
A. The LPN’s signature verifies the physician’s order is correct.
B. The LPN is accountable for giving the right drug to the right
patient.
C. The LPN can modify doses within 10% without physician
approval.
D. The RN assumes liability once the LPN reports an error.
Correct Answer: B
Rationale (Correct): LPNs are legally accountable for the “right”
aspects of medication administration, even when following
orders.
Rationale (Incorrect): A—Order accuracy is the prescriber’s
responsibility; C—Dose changes require new orders; D—
Liability is not transferred solely by reporting.
Teaching Point: LPN remains legally accountable for each “right”
of drug administration.
5.
