LPN/LVN Medication Administration
Competency Exam — Code: LPN-MED-
COMP | 100-Question Advanced
Practice Exam 2026 | Questions &
Answers with Detailed Rationales |
Complete Exam Prep & Study Guide
1. A client is prescribed digoxin 0.125 mg PO daily. Before administration, the
LPN obtains an apical pulse of 54/min. What is the priority action?
A. Administer the medication with food
B. Recheck the pulse after 15 minutes
C. Hold the medication and notify the appropriate provider
D. Administer half the prescribed dose
Answer: Hold the medication and notify the appropriate provider
Rationale: A significantly low apical pulse can indicate digoxin-related
bradycardia. The medication should generally be withheld and the finding
reported according to the facility's parameters.
, 2. An LPN is preparing to administer insulin lispro to a client with diabetes.
The client's meal tray has not arrived. What should the nurse do?
A. Administer the insulin immediately
B. Wait until the meal is available and the client is ready to eat
C. Substitute regular insulin
D. Hold insulin for the entire day
Answer: Wait until the meal is available and the client is ready to eat
Rationale: Rapid-acting insulin such as lispro begins working quickly.
Administering it without timely carbohydrate intake increases the risk of
hypoglycemia.
3. A client taking warfarin has an INR of 5.8. Which action is most
appropriate?
A. Administer the scheduled dose
B. Give the medication with grapefruit juice
C. Hold the dose and notify the provider
D. Administer vitamin K independently
Answer: Hold the dose and notify the provider
Rationale: An INR of 5.8 represents substantially increased bleeding risk for
many patients receiving warfarin. The medication should be held and the
abnormal result promptly communicated.
4. A client receiving IV vancomycin develops flushing and pruritus during the
infusion. Which complication should the LPN suspect?
A. Hypoglycemia
B. Infusion-related reaction
C. Digoxin toxicity
D. Acute urinary retention
Answer: Infusion-related reaction
,Rationale: Flushing and pruritus during vancomycin administration may indicate
vancomycin infusion reaction. The infusion rate and prescribed management
should be evaluated, and the reaction reported.
5. A medication order reads, “Morphine 2 mg IV q2h PRN severe pain.” Which
assessment is most important before administering the medication?
A. Bowel sounds
B. Respiratory rate and level of consciousness
C. Skin turgor
D. Visual acuity
Answer: Respiratory rate and level of consciousness
Rationale: Opioids can cause respiratory depression and sedation. Respiratory
status and level of consciousness are critical safety assessments before
administration.
6. The LPN discovers that a client's medication was administered to the wrong
patient 10 minutes ago. What is the priority action?
A. Complete the medication record and wait for symptoms
B. Assess the client immediately and notify the appropriate nurse/provider
C. Delete the medication entry
D. Ask another nurse to document the incident
Answer: Assess the client immediately and notify the appropriate
nurse/provider
Rationale: The first priority after a medication error is patient safety. The client
should be assessed promptly, appropriate clinical personnel notified, and the
error documented according to policy.
7. A client prescribed potassium chloride tablets reports difficulty swallowing.
What should the LPN do?
A. Crush the tablet automatically
B. Dissolve the tablet in a small amount of water without checking
, C. Verify whether the formulation can be altered before administering
D. Give the medication subcutaneously
Answer: Verify whether the formulation can be altered before administering
Rationale: Some potassium formulations are extended-release or otherwise
unsuitable for crushing. The formulation must be verified before altering the
dosage form.
8. A client receiving furosemide has a potassium level of 2.8 mEq/L. Which
assessment finding is most concerning?
A. Increased appetite
B. Muscle weakness and irregular pulse
C. Mild thirst
D. Warm skin
Answer: Muscle weakness and irregular pulse
Rationale: Significant hypokalemia can cause muscle weakness and potentially
life-threatening cardiac dysrhythmias. The abnormal laboratory result requires
prompt attention.
9. The LPN is administering subcutaneous heparin. Which site is generally
appropriate?
A. Abdomen away from the umbilicus
B. Deltoid muscle
C. Dorsogluteal muscle
D. Forearm vein
Answer: Abdomen away from the umbilicus
Rationale: Subcutaneous heparin is commonly administered in abdominal tissue
while avoiding the umbilicus and areas of bruising or scarring.
10.A client taking lisinopril develops swelling of the lips and tongue. What is
the priority action?
Competency Exam — Code: LPN-MED-
COMP | 100-Question Advanced
Practice Exam 2026 | Questions &
Answers with Detailed Rationales |
Complete Exam Prep & Study Guide
1. A client is prescribed digoxin 0.125 mg PO daily. Before administration, the
LPN obtains an apical pulse of 54/min. What is the priority action?
A. Administer the medication with food
B. Recheck the pulse after 15 minutes
C. Hold the medication and notify the appropriate provider
D. Administer half the prescribed dose
Answer: Hold the medication and notify the appropriate provider
Rationale: A significantly low apical pulse can indicate digoxin-related
bradycardia. The medication should generally be withheld and the finding
reported according to the facility's parameters.
, 2. An LPN is preparing to administer insulin lispro to a client with diabetes.
The client's meal tray has not arrived. What should the nurse do?
A. Administer the insulin immediately
B. Wait until the meal is available and the client is ready to eat
C. Substitute regular insulin
D. Hold insulin for the entire day
Answer: Wait until the meal is available and the client is ready to eat
Rationale: Rapid-acting insulin such as lispro begins working quickly.
Administering it without timely carbohydrate intake increases the risk of
hypoglycemia.
3. A client taking warfarin has an INR of 5.8. Which action is most
appropriate?
A. Administer the scheduled dose
B. Give the medication with grapefruit juice
C. Hold the dose and notify the provider
D. Administer vitamin K independently
Answer: Hold the dose and notify the provider
Rationale: An INR of 5.8 represents substantially increased bleeding risk for
many patients receiving warfarin. The medication should be held and the
abnormal result promptly communicated.
4. A client receiving IV vancomycin develops flushing and pruritus during the
infusion. Which complication should the LPN suspect?
A. Hypoglycemia
B. Infusion-related reaction
C. Digoxin toxicity
D. Acute urinary retention
Answer: Infusion-related reaction
,Rationale: Flushing and pruritus during vancomycin administration may indicate
vancomycin infusion reaction. The infusion rate and prescribed management
should be evaluated, and the reaction reported.
5. A medication order reads, “Morphine 2 mg IV q2h PRN severe pain.” Which
assessment is most important before administering the medication?
A. Bowel sounds
B. Respiratory rate and level of consciousness
C. Skin turgor
D. Visual acuity
Answer: Respiratory rate and level of consciousness
Rationale: Opioids can cause respiratory depression and sedation. Respiratory
status and level of consciousness are critical safety assessments before
administration.
6. The LPN discovers that a client's medication was administered to the wrong
patient 10 minutes ago. What is the priority action?
A. Complete the medication record and wait for symptoms
B. Assess the client immediately and notify the appropriate nurse/provider
C. Delete the medication entry
D. Ask another nurse to document the incident
Answer: Assess the client immediately and notify the appropriate
nurse/provider
Rationale: The first priority after a medication error is patient safety. The client
should be assessed promptly, appropriate clinical personnel notified, and the
error documented according to policy.
7. A client prescribed potassium chloride tablets reports difficulty swallowing.
What should the LPN do?
A. Crush the tablet automatically
B. Dissolve the tablet in a small amount of water without checking
, C. Verify whether the formulation can be altered before administering
D. Give the medication subcutaneously
Answer: Verify whether the formulation can be altered before administering
Rationale: Some potassium formulations are extended-release or otherwise
unsuitable for crushing. The formulation must be verified before altering the
dosage form.
8. A client receiving furosemide has a potassium level of 2.8 mEq/L. Which
assessment finding is most concerning?
A. Increased appetite
B. Muscle weakness and irregular pulse
C. Mild thirst
D. Warm skin
Answer: Muscle weakness and irregular pulse
Rationale: Significant hypokalemia can cause muscle weakness and potentially
life-threatening cardiac dysrhythmias. The abnormal laboratory result requires
prompt attention.
9. The LPN is administering subcutaneous heparin. Which site is generally
appropriate?
A. Abdomen away from the umbilicus
B. Deltoid muscle
C. Dorsogluteal muscle
D. Forearm vein
Answer: Abdomen away from the umbilicus
Rationale: Subcutaneous heparin is commonly administered in abdominal tissue
while avoiding the umbilicus and areas of bruising or scarring.
10.A client taking lisinopril develops swelling of the lips and tongue. What is
the priority action?
