,Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
1. An 82-year-old resident in a long-term-care facility is
prescribed a new benzodiazepine at bedtime. Which action
best demonstrates the LPN’s role in the nursing process
when using the Clinical Judgment Model (CJM)?
A. Decide independently to withhold the dose if the
resident appears sleepy.
B. Collaborate with the RN to assess fall-risk factors before
administration.
C. Document the medication after the family confirms it is
safe.
D. Administer the drug and reassess the resident in 4–6
hours.
Correct Answer: B
Rationale: The CJM emphasizes recognizing cues and
prioritizing hypotheses; fall risk is a major cue for
benzodiazepines. Collaboration with the RN aligns with the
LPN’s scope and the CJM phase “Analyze Cues & Prioritize.”
A. Independent withholding exceeds LPN scope unless an
order exists.
C. Family confirmation is not a substitute for evidence-
based assessment.
D. Reassessment in 4–6 hours misses the immediate fall-
risk concern.
, Teaching Point: “Collaborate early when high-risk
medications are ordered.”
2. During morning medication pass, an LPN notes a patient’s
blood pressure is 88/52 mm Hg, yet the MAR lists
scheduled enalapril. According to the CJM, which action is
priority?
A. Give half the ordered dose to avoid missing the
medication.
B. Hold the medication and immediately notify the
supervising RN.
C. Encourage the patient to drink fluids, then give the drug.
D. Re-check the blood pressure in 30 minutes before
deciding.
Correct Answer: B
Rationale: Hypotension is a critical cue; the CJM requires
prioritizing safety and generating solutions—holding and
notifying the RN is safest.
A. Altering dose without authorization is unsafe.
C. Fluid intake may not correct medication-induced
hypotension.
D. Delaying intervention increases risk of syncope or injury.
Teaching Point: “Hold & report when vital signs
contraindicate the drug.”
3. An LPN is caring for a client receiving warfarin. Which
assessment finding best supports the LPN’s next step in the
CJM phase “Take Action”?
, A. INR = 4.8
B. Petechiae on lower legs
C. Dark amber urine
D. Gums bleeding after brushing
Correct Answer: A
Rationale: INR ≥4.0 is the clearest evidence-based cue for
potential hemorrhage, guiding immediate collaboration
and possible dose adjustment.
B, C, D are bleeding signs but less specific or severe than
supratherapeutic INR.
Teaching Point: “Lab values guide priority action with
anticoagulants.”
4. A postpartum patient reports pain 8/10 after a cesarean
section. The LPN reviews the MAR and sees the last opioid
was given 2 hours ago, with a q4h PRN order. What is the
LPN’s best response using the CJM?
A. Administer the PRN opioid now to stay “ahead of the
pain.”
B. Reassess pain in another 2 hours per order frequency.
C. Notify the RN to discuss possible dose increase.
D. Offer non-pharmacologic comfort measures and
reassess in 30 minutes.
Correct Answer: D
Rationale: The CJM stresses recognizing cues (pain 8/10)
and testing less-invasive hypotheses first; reassessment
follows evidence-based pain management.
A. Early redosing violates order parameters.
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
1. An 82-year-old resident in a long-term-care facility is
prescribed a new benzodiazepine at bedtime. Which action
best demonstrates the LPN’s role in the nursing process
when using the Clinical Judgment Model (CJM)?
A. Decide independently to withhold the dose if the
resident appears sleepy.
B. Collaborate with the RN to assess fall-risk factors before
administration.
C. Document the medication after the family confirms it is
safe.
D. Administer the drug and reassess the resident in 4–6
hours.
Correct Answer: B
Rationale: The CJM emphasizes recognizing cues and
prioritizing hypotheses; fall risk is a major cue for
benzodiazepines. Collaboration with the RN aligns with the
LPN’s scope and the CJM phase “Analyze Cues & Prioritize.”
A. Independent withholding exceeds LPN scope unless an
order exists.
C. Family confirmation is not a substitute for evidence-
based assessment.
D. Reassessment in 4–6 hours misses the immediate fall-
risk concern.
, Teaching Point: “Collaborate early when high-risk
medications are ordered.”
2. During morning medication pass, an LPN notes a patient’s
blood pressure is 88/52 mm Hg, yet the MAR lists
scheduled enalapril. According to the CJM, which action is
priority?
A. Give half the ordered dose to avoid missing the
medication.
B. Hold the medication and immediately notify the
supervising RN.
C. Encourage the patient to drink fluids, then give the drug.
D. Re-check the blood pressure in 30 minutes before
deciding.
Correct Answer: B
Rationale: Hypotension is a critical cue; the CJM requires
prioritizing safety and generating solutions—holding and
notifying the RN is safest.
A. Altering dose without authorization is unsafe.
C. Fluid intake may not correct medication-induced
hypotension.
D. Delaying intervention increases risk of syncope or injury.
Teaching Point: “Hold & report when vital signs
contraindicate the drug.”
3. An LPN is caring for a client receiving warfarin. Which
assessment finding best supports the LPN’s next step in the
CJM phase “Take Action”?
, A. INR = 4.8
B. Petechiae on lower legs
C. Dark amber urine
D. Gums bleeding after brushing
Correct Answer: A
Rationale: INR ≥4.0 is the clearest evidence-based cue for
potential hemorrhage, guiding immediate collaboration
and possible dose adjustment.
B, C, D are bleeding signs but less specific or severe than
supratherapeutic INR.
Teaching Point: “Lab values guide priority action with
anticoagulants.”
4. A postpartum patient reports pain 8/10 after a cesarean
section. The LPN reviews the MAR and sees the last opioid
was given 2 hours ago, with a q4h PRN order. What is the
LPN’s best response using the CJM?
A. Administer the PRN opioid now to stay “ahead of the
pain.”
B. Reassess pain in another 2 hours per order frequency.
C. Notify the RN to discuss possible dose increase.
D. Offer non-pharmacologic comfort measures and
reassess in 30 minutes.
Correct Answer: D
Rationale: The CJM stresses recognizing cues (pain 8/10)
and testing less-invasive hypotheses first; reassessment
follows evidence-based pain management.
A. Early redosing violates order parameters.
