,Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
1. A 78-year-old resident is prescribed a new transdermal
fentanyl patch. Which action by the LPN best demonstrates
the “Recognize Cues” step of the Clinical Judgment Model?
A. Check the MAR against the prescriber’s order for dose
and route
B. Ask the resident about current pain level and prior
opioid tolerance
C. Document the time the patch is applied on the
medication record
D. Teach the resident to avoid heating pads over the patch
site
Correct Answer: B
Rationale: Recognize Cues involves collecting relevant
subjective/objective data to identify potential problems;
assessing pain and tolerance history uncovers high-risk
cues.
A. This action supports “Take Action,” not cue recognition.
C. Documentation occurs after administration, during
“Evaluate Outcomes.”
D. Patient education is part of “Take Action,” not initial cue
, gathering.
Teaching Point: Recognize Cues = collect data first.
2. During morning med pass, an LPN notes a patient’s BP is
88/52 mm Hg prior to scheduled lisinopril. Using the
Clinical Judgment Model, what is the LPN’s priority
response?
A. Administer the drug and recheck BP in 30 minutes
B. Hold the dose and promptly notify the RN or prescriber
C. Encourage the patient to drink 500 mL of water first
D. Document the BP and continue with the remaining
medications
Correct Answer: B
Rationale: Hypotension is a serious cue; holding the ACE
inhibitor and escalating protects patient safety.
A. Giving an antihypertensive risks severe hypotension.
C. Fluid intake alone will not safely correct potential drug-
induced hypotension.
D. Failing to intervene ignores the clinical cue.
Teaching Point: Prioritize safety—hold & escalate.
3. Which statement best describes the LPN’s legal scope
when administering medications via nasogastric tube in
most states?
A. LPNs may give all ordered drugs independently after
initial training
B. LPNs must verify placement with an RN before each
medication
, C. LPNs can administer drugs if competency validated and
facility policy allows
D. LPNs are restricted to oral and topical routes exclusively
Correct Answer: C
Rationale: State nurse practice acts and facility policy
define expanded roles; validated competency permits NG
administration.
A. “Independently” overstates scope; oversight is required.
B. LPNs can verify placement themselves when competent.
D. LPNs may perform enteral routes when authorized.
Teaching Point: Scope = statute + policy + competency.
4. A patient asks why the LPN checks two forms of
identification before giving morphine. The LPN explains
this action primarily supports which medication right?
A. Right dose
B. Right patient
C. Right time
D. Right route
Correct Answer: B
Rationale: Two identifiers ensure the medication is given to
the correct patient.
A. Dose verification occurs by reading the MAR, not ID
bands.
C. Time is checked against the scheduled time, not
identifiers.
D. Route is confirmed by order and assessment, not ID.
Teaching Point: Two IDs = Right patient.
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
1. A 78-year-old resident is prescribed a new transdermal
fentanyl patch. Which action by the LPN best demonstrates
the “Recognize Cues” step of the Clinical Judgment Model?
A. Check the MAR against the prescriber’s order for dose
and route
B. Ask the resident about current pain level and prior
opioid tolerance
C. Document the time the patch is applied on the
medication record
D. Teach the resident to avoid heating pads over the patch
site
Correct Answer: B
Rationale: Recognize Cues involves collecting relevant
subjective/objective data to identify potential problems;
assessing pain and tolerance history uncovers high-risk
cues.
A. This action supports “Take Action,” not cue recognition.
C. Documentation occurs after administration, during
“Evaluate Outcomes.”
D. Patient education is part of “Take Action,” not initial cue
, gathering.
Teaching Point: Recognize Cues = collect data first.
2. During morning med pass, an LPN notes a patient’s BP is
88/52 mm Hg prior to scheduled lisinopril. Using the
Clinical Judgment Model, what is the LPN’s priority
response?
A. Administer the drug and recheck BP in 30 minutes
B. Hold the dose and promptly notify the RN or prescriber
C. Encourage the patient to drink 500 mL of water first
D. Document the BP and continue with the remaining
medications
Correct Answer: B
Rationale: Hypotension is a serious cue; holding the ACE
inhibitor and escalating protects patient safety.
A. Giving an antihypertensive risks severe hypotension.
C. Fluid intake alone will not safely correct potential drug-
induced hypotension.
D. Failing to intervene ignores the clinical cue.
Teaching Point: Prioritize safety—hold & escalate.
3. Which statement best describes the LPN’s legal scope
when administering medications via nasogastric tube in
most states?
A. LPNs may give all ordered drugs independently after
initial training
B. LPNs must verify placement with an RN before each
medication
, C. LPNs can administer drugs if competency validated and
facility policy allows
D. LPNs are restricted to oral and topical routes exclusively
Correct Answer: C
Rationale: State nurse practice acts and facility policy
define expanded roles; validated competency permits NG
administration.
A. “Independently” overstates scope; oversight is required.
B. LPNs can verify placement themselves when competent.
D. LPNs may perform enteral routes when authorized.
Teaching Point: Scope = statute + policy + competency.
4. A patient asks why the LPN checks two forms of
identification before giving morphine. The LPN explains
this action primarily supports which medication right?
A. Right dose
B. Right patient
C. Right time
D. Right route
Correct Answer: B
Rationale: Two identifiers ensure the medication is given to
the correct patient.
A. Dose verification occurs by reading the MAR, not ID
bands.
C. Time is checked against the scheduled time, not
identifiers.
D. Route is confirmed by order and assessment, not ID.
Teaching Point: Two IDs = Right patient.
