,Next-Generation NCLEX®-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
A 78-year-old resident is ordered sliding-scale insulin AC & HS.
The LPN reviews the MAR and notes the last three blood
glucose readings were 285 mg/dL, 310 mg/dL, and 295 mg/dL.
Using the clinical judgment model, what is the LPN’s priority
action?
A. Give the prescribed insulin dose now.
B. Hold the dose and notify the RN.
C. Recalibrate the glucometer.
D. Reassess the site for lipodystrophy.
Correct Answer: B
Rationale: Persistent hyperglycemia indicates the current
sliding-scale coverage is inadequate; the LPN’s priority is to hold
the medication and escalate to the RN for possible order
modification.
A. Giving the same insufficient dose perpetuates ineffective
glycemic control.
C. Glucometer calibration is unlikely to explain consistent high
readings.
D. Lipodystrophy affects absorption but not the immediate
,need for dose adjustment.
Teaching Point: Escalate unresolved medication issues promptly.
2.
During morning med pass, an LPN discovers a patient’s PO
potassium tablet is missing from the blister pack. What step of
the nursing process is being implemented when the LPN checks
the e-MAR and pharmacy log?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer: A
Rationale: Investigating the discrepancy is data collection—part
of assessment.
B. Diagnosis labels the problem, not the search for missing
meds.
C. Planning involves setting goals, not locating a dose.
D. Evaluation measures outcome achievement after the
intervention.
Teaching Point: Assessment drives every subsequent step.
3.
The LPN is preparing to administer digoxin 0.25 mg PO. The
apical pulse is 58 bpm and irregular. Using the clinical judgment
model, which cue demands immediate action?
A. Dose time is 0900.
B. Pulse irregularity
, C. Patient reports mild nausea.
D. Tablet is scored.
Correct Answer: B
Rationale: Irregular bradycardia is a red flag for digoxin toxicity;
withhold drug and notify RN.
A. Time is routine data, not urgent.
C. Nausea is an early sign but less acute than bradycardia.
D. Scored tablet is irrelevant to safety.
Teaching Point: Always assess apical pulse before digoxin.
4.
An LPN working in long-term care is asked to transcribe a new
opioid order. What is the LPN’s most appropriate response
according to most state nurse practice acts?
A. Transcribe the order and begin the next med pass.
B. Ask the charge nurse to co-sign the transcription.
C. Inform the RN that transcription is outside LPN scope.
D. Enter the order into the e-MAR after double-checking dose.
Correct Answer: C
Rationale: Transcribing new orders typically exceeds LPN scope;
the RN must perform or verify it.
A. Acting beyond scope risks legal liability.
B. Co-signature does not expand scope.
D. Entering new orders remains an RN function.
Teaching Point: Know your state’s role boundaries.
5.
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
A 78-year-old resident is ordered sliding-scale insulin AC & HS.
The LPN reviews the MAR and notes the last three blood
glucose readings were 285 mg/dL, 310 mg/dL, and 295 mg/dL.
Using the clinical judgment model, what is the LPN’s priority
action?
A. Give the prescribed insulin dose now.
B. Hold the dose and notify the RN.
C. Recalibrate the glucometer.
D. Reassess the site for lipodystrophy.
Correct Answer: B
Rationale: Persistent hyperglycemia indicates the current
sliding-scale coverage is inadequate; the LPN’s priority is to hold
the medication and escalate to the RN for possible order
modification.
A. Giving the same insufficient dose perpetuates ineffective
glycemic control.
C. Glucometer calibration is unlikely to explain consistent high
readings.
D. Lipodystrophy affects absorption but not the immediate
,need for dose adjustment.
Teaching Point: Escalate unresolved medication issues promptly.
2.
During morning med pass, an LPN discovers a patient’s PO
potassium tablet is missing from the blister pack. What step of
the nursing process is being implemented when the LPN checks
the e-MAR and pharmacy log?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer: A
Rationale: Investigating the discrepancy is data collection—part
of assessment.
B. Diagnosis labels the problem, not the search for missing
meds.
C. Planning involves setting goals, not locating a dose.
D. Evaluation measures outcome achievement after the
intervention.
Teaching Point: Assessment drives every subsequent step.
3.
The LPN is preparing to administer digoxin 0.25 mg PO. The
apical pulse is 58 bpm and irregular. Using the clinical judgment
model, which cue demands immediate action?
A. Dose time is 0900.
B. Pulse irregularity
, C. Patient reports mild nausea.
D. Tablet is scored.
Correct Answer: B
Rationale: Irregular bradycardia is a red flag for digoxin toxicity;
withhold drug and notify RN.
A. Time is routine data, not urgent.
C. Nausea is an early sign but less acute than bradycardia.
D. Scored tablet is irrelevant to safety.
Teaching Point: Always assess apical pulse before digoxin.
4.
An LPN working in long-term care is asked to transcribe a new
opioid order. What is the LPN’s most appropriate response
according to most state nurse practice acts?
A. Transcribe the order and begin the next med pass.
B. Ask the charge nurse to co-sign the transcription.
C. Inform the RN that transcription is outside LPN scope.
D. Enter the order into the e-MAR after double-checking dose.
Correct Answer: C
Rationale: Transcribing new orders typically exceeds LPN scope;
the RN must perform or verify it.
A. Acting beyond scope risks legal liability.
B. Co-signature does not expand scope.
D. Entering new orders remains an RN function.
Teaching Point: Know your state’s role boundaries.
5.
