LPN HESI Pharmacology 2026: 300 Practice
Questions with Correct Answers and In-Depth
Rationales for Exam Success
1. A patient with heart failure is prescribed furosemide (Lasix) 40 mg orally twice
daily. Which laboratory value should the LPN report to the RN immediately?
A. Serum sodium 135 mEq/L
B. Serum potassium 3.0 mEq/L
C. Serum creatinine 0.8 mg/dL
D. Serum calcium 9.2 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A
potassium of 3.0 mEq/L is below normal (3.5–5.0) and increases arrhythmia risk.
Other values are normal.
2. A patient is receiving metformin (Glucophage) for type 2 diabetes. Which
instruction is most important for the LPN to reinforce?
A. “Take this medication with food to prevent nausea.”
B. “Notify the healthcare provider if you develop muscle pain or weakness.”
C. “You may experience a dry cough while taking metformin.”
D. “Monitor your blood glucose only once per week.”
Answer: B
Rationale: Muscle pain/weakness can indicate lactic acidosis, a rare but serious
metformin side effect. Report immediately. Dry cough is not typical of metformin.
3. An LPN is administering digoxin (Lanoxin). Before giving the dose, the patient’s
apical pulse is 52 bpm. What is the priority action?
A. Administer the medication as ordered.
B. Hold the dose and notify the RN.
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,C. Give the medication with a high-potassium snack.
D. Retake the pulse in 15 minutes.
Answer: B
Rationale: Digoxin is withheld for apical pulse <60 bpm (adult). Bradycardia
increases digoxin toxicity risk. Hold and report.
4. A patient prescribed warfarin (Coumadin) has an INR of 4.5. Which finding
requires immediate notification of the provider?
A. Bruising on the arms
B. Bleeding gums after brushing
C. Coffee-ground emesis
D. Small cut that stops bleeding in 5 minutes
Answer: C
Rationale: Coffee-ground emesis indicates upper GI bleeding – life-threatening.
INR goal is 2–3. Report internal bleeding immediately.
5. Which statement by a patient prescribed an albuterol (Proventil) metered-dose
inhaler indicates correct understanding of use?
A. “I will shake the inhaler well before each use.”
B. “I should exhale completely before inhaling the mist.”
C. “I will hold my breath for 1–2 seconds after inhaling.”
D. “I can use the inhaler every 10 minutes during an attack.”
Answer: A
Rationale: Shaking ensures proper dispersion. Exhale completely, then inhale
slowly; hold breath 5–10 seconds, not 1–2. Albuterol is every 4–6 hours unless
prescribed otherwise.
6. A patient is started on lisinopril (Zestril). Which adverse effect should the LPN
teach the patient to report immediately?
A. Dry, nonproductive cough
B. Swelling of the lips and tongue
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,C. Dizziness when standing up
D. Loss of taste sensation
Answer: B
Rationale: Lip/tongue swelling = angioedema, a life-threatening allergic reaction.
Dry cough is common but not emergent; dizziness is manageable.
7. A patient is receiving morphine sulfate 4 mg IV push for postoperative pain.
Fifteen minutes later, the respiratory rate is 8 breaths/min. Which medication
should the LPN anticipate administering?
A. Naloxone (Narcan)
B. Flumazenil (Romazicon)
C. Acetylcysteine (Mucomyst)
D. Protamine sulfate
Answer: A
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression.
Flumazenil reverses benzodiazepines; acetylcysteine for acetaminophen
overdose; protamine for heparin.
8. An LPN is reinforcing teaching about nitroglycerin sublingual tablets. Which
statement by the patient indicates a need for further teaching?
A. “I will keep the tablets in the original brown glass bottle.”
B. “I can take up to three tablets every 5 minutes for chest pain.”
C. “I will replace the tablets every 12 months even if unused.”
D. “I should sit down before taking the medication.”
Answer: C
Rationale: Nitroglycerin sublingual tablets lose potency after 6 months; replace
every 6 months, not 12. Brown bottle prevents light degradation; three tablets
(q5min) is correct; sitting prevents hypotension.
9. A patient with a urinary tract infection is prescribed phenazopyridine
(Pyridium). What information should the LPN include in discharge teaching?
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, A. “This medication will cure the infection.”
B. “Your urine may turn orange-red in color.”
C. “Take the medication on an empty stomach.”
D. “Avoid drinking any fluids while taking this drug.”
Answer: B
Rationale: Phenazopyridine turns urine orange-red (harmless). It is an analgesic,
not a cure; take with food; fluids encouraged.
10. A patient is prescribed enoxaparin (Lovenox) subcutaneously. Which
technique is correct for administration?
A. Expel the air bubble from the prefilled syringe before injection.
B. Insert the needle at a 90-degree angle into a skin fold.
C. Aspirate for blood return before injecting.
D. Rub the injection site vigorously after administration.
Answer: B
Rationale: Enoxaparin is given subcutaneously at 90° into a skin fold. Do not expel
air bubble (ensures full dose). Do not aspirate or rub.
11. A patient taking levothyroxine (Synthroid) reports feeling palpitations and
nervousness. What is the LPN’s priority action?
A. Reassure the patient that these are common side effects.
B. Instruct the patient to take the medication every other day.
C. Check the patient’s heart rate and notify the RN.
D. Suggest the patient take the medication with food.
Answer: C
Rationale: Palpitations/nervousness may indicate excessive dose
(hyperthyroidism). Assess heart rate and notify RN for possible dose adjustment.
12. Which vaccine should the LPN expect to be administered intramuscularly in
the deltoid muscle for an adult patient?
A. Measles, mumps, rubella (MMR)
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Questions with Correct Answers and In-Depth
Rationales for Exam Success
1. A patient with heart failure is prescribed furosemide (Lasix) 40 mg orally twice
daily. Which laboratory value should the LPN report to the RN immediately?
A. Serum sodium 135 mEq/L
B. Serum potassium 3.0 mEq/L
C. Serum creatinine 0.8 mg/dL
D. Serum calcium 9.2 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A
potassium of 3.0 mEq/L is below normal (3.5–5.0) and increases arrhythmia risk.
Other values are normal.
2. A patient is receiving metformin (Glucophage) for type 2 diabetes. Which
instruction is most important for the LPN to reinforce?
A. “Take this medication with food to prevent nausea.”
B. “Notify the healthcare provider if you develop muscle pain or weakness.”
C. “You may experience a dry cough while taking metformin.”
D. “Monitor your blood glucose only once per week.”
Answer: B
Rationale: Muscle pain/weakness can indicate lactic acidosis, a rare but serious
metformin side effect. Report immediately. Dry cough is not typical of metformin.
3. An LPN is administering digoxin (Lanoxin). Before giving the dose, the patient’s
apical pulse is 52 bpm. What is the priority action?
A. Administer the medication as ordered.
B. Hold the dose and notify the RN.
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,C. Give the medication with a high-potassium snack.
D. Retake the pulse in 15 minutes.
Answer: B
Rationale: Digoxin is withheld for apical pulse <60 bpm (adult). Bradycardia
increases digoxin toxicity risk. Hold and report.
4. A patient prescribed warfarin (Coumadin) has an INR of 4.5. Which finding
requires immediate notification of the provider?
A. Bruising on the arms
B. Bleeding gums after brushing
C. Coffee-ground emesis
D. Small cut that stops bleeding in 5 minutes
Answer: C
Rationale: Coffee-ground emesis indicates upper GI bleeding – life-threatening.
INR goal is 2–3. Report internal bleeding immediately.
5. Which statement by a patient prescribed an albuterol (Proventil) metered-dose
inhaler indicates correct understanding of use?
A. “I will shake the inhaler well before each use.”
B. “I should exhale completely before inhaling the mist.”
C. “I will hold my breath for 1–2 seconds after inhaling.”
D. “I can use the inhaler every 10 minutes during an attack.”
Answer: A
Rationale: Shaking ensures proper dispersion. Exhale completely, then inhale
slowly; hold breath 5–10 seconds, not 1–2. Albuterol is every 4–6 hours unless
prescribed otherwise.
6. A patient is started on lisinopril (Zestril). Which adverse effect should the LPN
teach the patient to report immediately?
A. Dry, nonproductive cough
B. Swelling of the lips and tongue
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,C. Dizziness when standing up
D. Loss of taste sensation
Answer: B
Rationale: Lip/tongue swelling = angioedema, a life-threatening allergic reaction.
Dry cough is common but not emergent; dizziness is manageable.
7. A patient is receiving morphine sulfate 4 mg IV push for postoperative pain.
Fifteen minutes later, the respiratory rate is 8 breaths/min. Which medication
should the LPN anticipate administering?
A. Naloxone (Narcan)
B. Flumazenil (Romazicon)
C. Acetylcysteine (Mucomyst)
D. Protamine sulfate
Answer: A
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression.
Flumazenil reverses benzodiazepines; acetylcysteine for acetaminophen
overdose; protamine for heparin.
8. An LPN is reinforcing teaching about nitroglycerin sublingual tablets. Which
statement by the patient indicates a need for further teaching?
A. “I will keep the tablets in the original brown glass bottle.”
B. “I can take up to three tablets every 5 minutes for chest pain.”
C. “I will replace the tablets every 12 months even if unused.”
D. “I should sit down before taking the medication.”
Answer: C
Rationale: Nitroglycerin sublingual tablets lose potency after 6 months; replace
every 6 months, not 12. Brown bottle prevents light degradation; three tablets
(q5min) is correct; sitting prevents hypotension.
9. A patient with a urinary tract infection is prescribed phenazopyridine
(Pyridium). What information should the LPN include in discharge teaching?
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, A. “This medication will cure the infection.”
B. “Your urine may turn orange-red in color.”
C. “Take the medication on an empty stomach.”
D. “Avoid drinking any fluids while taking this drug.”
Answer: B
Rationale: Phenazopyridine turns urine orange-red (harmless). It is an analgesic,
not a cure; take with food; fluids encouraged.
10. A patient is prescribed enoxaparin (Lovenox) subcutaneously. Which
technique is correct for administration?
A. Expel the air bubble from the prefilled syringe before injection.
B. Insert the needle at a 90-degree angle into a skin fold.
C. Aspirate for blood return before injecting.
D. Rub the injection site vigorously after administration.
Answer: B
Rationale: Enoxaparin is given subcutaneously at 90° into a skin fold. Do not expel
air bubble (ensures full dose). Do not aspirate or rub.
11. A patient taking levothyroxine (Synthroid) reports feeling palpitations and
nervousness. What is the LPN’s priority action?
A. Reassure the patient that these are common side effects.
B. Instruct the patient to take the medication every other day.
C. Check the patient’s heart rate and notify the RN.
D. Suggest the patient take the medication with food.
Answer: C
Rationale: Palpitations/nervousness may indicate excessive dose
(hyperthyroidism). Assess heart rate and notify RN for possible dose adjustment.
12. Which vaccine should the LPN expect to be administered intramuscularly in
the deltoid muscle for an adult patient?
A. Measles, mumps, rubella (MMR)
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