LPN Pharmacology Midterm Review NCLEX-PN 2026/2027 UPDATE
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
of the following vital signs is most important to assess before administration?
A. Blood Pressure
B. Respiratory Rate
C. Apical Pulse
D. Temperature
Answer: C
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The apical pulse must be
checked for one full minute; if it is below 60 bpm in an adult, the dose is typically withheld.
2. Which medication is considered the antidote for an overdose of heparin?
A. Vitamin K
B. Glucagon
C. Acetylcysteine
D. Protamine sulfate
Answer: D
Rationale: Protamine sulfate is the specific antagonist used to reverse the effects of
heparin. Vitamin K is for warfarin, and Acetylcysteine is for acetaminophen.
,3. A client is prescribed furosemide for pulmonary edema. Which electrolyte
imbalance should the nurse monitor for most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium, leading to
a risk of hypokalemia.
4. A nurse is teaching a client how to use a metered-dose inhaler (MDI) with a
spacer. What is the primary purpose of using a spacer?
A. To increase the taste of the medication
B. To reduce the risk of oral fungal infections
C. To ensure more medication reaches the lungs
D. To make the inhaler easier to hold
Answer: C
Rationale: A spacer traps the medication and allows the client to inhale it more effectively,
ensuring more of the dose reaches the lower airways rather than hitting the back of the
throat.
5. Which of the following is a common side effect of ACE inhibitors, such as
lisinopril?
A. Persistent dry cough
B. Peripheral edema
C. Constipation
D. Tachycardia
Answer: A
, Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs, which
frequently results in a dry, nonproductive, persistent cough.
6. When administering sublingual nitroglycerin for chest pain, how many doses
can be given before calling emergency services if pain persists?
A. One dose
B. Two doses
C. Three doses
D. Four doses
Answer: A
Rationale: According to current guidelines, if pain is not relieved after the first dose, the
client should call 911 immediately before taking subsequent doses.
7. A nurse is reviewing a client’s lab results and notes an INR of 5.0. The client is
taking warfarin. What is the nurse’s priority action?
A. Administer the scheduled dose of warfarin
B. Check the client’s blood pressure
C. Encourage the client to eat green leafy vegetables
D. Prepare to administer Vitamin K
Answer: D
Rationale: An INR of 5.0 is above the therapeutic range (usually 2-3), indicating a high risk
of bleeding. Vitamin K is the antidote.
8. A client with type 1 diabetes is prescribed NPH insulin and Regular insulin.
Which step is correct when mixing them in one syringe?
A. Draw NPH first, then Regular
B. Draw Regular first, then NPH
C. Shake the NPH vial vigorously
D. Mix them in separate syringes only
Answer: B
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
of the following vital signs is most important to assess before administration?
A. Blood Pressure
B. Respiratory Rate
C. Apical Pulse
D. Temperature
Answer: C
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The apical pulse must be
checked for one full minute; if it is below 60 bpm in an adult, the dose is typically withheld.
2. Which medication is considered the antidote for an overdose of heparin?
A. Vitamin K
B. Glucagon
C. Acetylcysteine
D. Protamine sulfate
Answer: D
Rationale: Protamine sulfate is the specific antagonist used to reverse the effects of
heparin. Vitamin K is for warfarin, and Acetylcysteine is for acetaminophen.
,3. A client is prescribed furosemide for pulmonary edema. Which electrolyte
imbalance should the nurse monitor for most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium, leading to
a risk of hypokalemia.
4. A nurse is teaching a client how to use a metered-dose inhaler (MDI) with a
spacer. What is the primary purpose of using a spacer?
A. To increase the taste of the medication
B. To reduce the risk of oral fungal infections
C. To ensure more medication reaches the lungs
D. To make the inhaler easier to hold
Answer: C
Rationale: A spacer traps the medication and allows the client to inhale it more effectively,
ensuring more of the dose reaches the lower airways rather than hitting the back of the
throat.
5. Which of the following is a common side effect of ACE inhibitors, such as
lisinopril?
A. Persistent dry cough
B. Peripheral edema
C. Constipation
D. Tachycardia
Answer: A
, Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs, which
frequently results in a dry, nonproductive, persistent cough.
6. When administering sublingual nitroglycerin for chest pain, how many doses
can be given before calling emergency services if pain persists?
A. One dose
B. Two doses
C. Three doses
D. Four doses
Answer: A
Rationale: According to current guidelines, if pain is not relieved after the first dose, the
client should call 911 immediately before taking subsequent doses.
7. A nurse is reviewing a client’s lab results and notes an INR of 5.0. The client is
taking warfarin. What is the nurse’s priority action?
A. Administer the scheduled dose of warfarin
B. Check the client’s blood pressure
C. Encourage the client to eat green leafy vegetables
D. Prepare to administer Vitamin K
Answer: D
Rationale: An INR of 5.0 is above the therapeutic range (usually 2-3), indicating a high risk
of bleeding. Vitamin K is the antidote.
8. A client with type 1 diabetes is prescribed NPH insulin and Regular insulin.
Which step is correct when mixing them in one syringe?
A. Draw NPH first, then Regular
B. Draw Regular first, then NPH
C. Shake the NPH vial vigorously
D. Mix them in separate syringes only
Answer: B
