,. Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: An LPN/VN is preparing to give the first dose of digoxin
0.25 mg PO to a 78-year-old client with heart failure. Which
action best fulfills the LPN role within the clinical judgment
model?
A. Hold the dose because the apical pulse is 58 bpm and notify
the RN.
B. Administer the dose as scheduled because the order is
written correctly.
C. Split the tablet to give 0.125 mg to avoid digitalis toxicity.
D. Give the medication with grapefruit juice to enhance
absorption.
Correct Answer: A
Rationale: A heart rate <60 bpm is a common parameter to
withhold digoxin; the LPN must recognize this cue and
collaborate with the RN.
Incorrect: B ignores the bradycardic cue; C alters dose without
authorization; D uses an interacting substance.
Teaching Point: Always assess apical pulse before giving digoxin.
2.
Stem: During the evaluation phase of the nursing process, an
LPN notes that a client’s blood glucose remains >300 mg/dL 2 h
,after regular insulin. What is the LPN’s priority action?
A. Document the finding and recheck in 4 h.
B. Notify the RN for possible insulin adjustment.
C. Administer an extra sliding-scale dose independently.
D. Encourage the client to skip the next meal.
Correct Answer: B
Rationale: Persistent hyperglycemia requires RN assessment
and possible prescriber contact; LPNs do not titrate insulin
independently.
Incorrect: A delays needed intervention; C exceeds LPN scope; D
risks hypoglycemia.
Teaching Point: LPNs report out-of-range values; they do not
alter insulin orders.
3.
Stem: The LPN/VN is reviewing new prescriptions. Which order
requires clarification before administration?
A. Lisinopril 10 mg PO daily
B. Humulin R insulin 6 U SC qAM AC
C. Acetaminophen 650 mg PO q6h PRN pain
D. Furosemide 20 mg IV push BID
Correct Answer: B
Rationale: “qAM AC” (before breakfast) is ambiguous; insulin
orders must specify exact time and meal relationship.
Incorrect: A, C, and D are complete, standard orders.
Teaching Point: Question unclear abbreviations to prevent
insulin timing errors.
, 4.
Stem: An LPN discovers that a client received another patient’s
morning medications. After ensuring client safety, what is the
LPN’s next responsibility?
A. Complete an incident report and notify the RN.
B. Reassure the client and take no further action.
C. Replace the pills in the original packaging.
D. Blame the unit clerk for wrong labels.
Correct Answer: A
Rationale: Incident reporting is mandatory for quality
improvement and legal compliance.
Incorrect: B omits required documentation; C does not address
safety; D is unprofessional.
Teaching Point: Medication errors must be reported promptly
per facility policy.
5.
Stem: Using clinical judgment, the LPN/VN identifies that an
older adult is at high risk for orthostatic hypotension after the
first dose of prazosin. Which assessment is most important
before administration?
A. Last bowel movement
B. Baseline blood pressure lying and standing
C. Serum potassium level
D. Pain rating
Correct Answer: B
Rationale: Orthostatic vitals establish baseline to detect
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: An LPN/VN is preparing to give the first dose of digoxin
0.25 mg PO to a 78-year-old client with heart failure. Which
action best fulfills the LPN role within the clinical judgment
model?
A. Hold the dose because the apical pulse is 58 bpm and notify
the RN.
B. Administer the dose as scheduled because the order is
written correctly.
C. Split the tablet to give 0.125 mg to avoid digitalis toxicity.
D. Give the medication with grapefruit juice to enhance
absorption.
Correct Answer: A
Rationale: A heart rate <60 bpm is a common parameter to
withhold digoxin; the LPN must recognize this cue and
collaborate with the RN.
Incorrect: B ignores the bradycardic cue; C alters dose without
authorization; D uses an interacting substance.
Teaching Point: Always assess apical pulse before giving digoxin.
2.
Stem: During the evaluation phase of the nursing process, an
LPN notes that a client’s blood glucose remains >300 mg/dL 2 h
,after regular insulin. What is the LPN’s priority action?
A. Document the finding and recheck in 4 h.
B. Notify the RN for possible insulin adjustment.
C. Administer an extra sliding-scale dose independently.
D. Encourage the client to skip the next meal.
Correct Answer: B
Rationale: Persistent hyperglycemia requires RN assessment
and possible prescriber contact; LPNs do not titrate insulin
independently.
Incorrect: A delays needed intervention; C exceeds LPN scope; D
risks hypoglycemia.
Teaching Point: LPNs report out-of-range values; they do not
alter insulin orders.
3.
Stem: The LPN/VN is reviewing new prescriptions. Which order
requires clarification before administration?
A. Lisinopril 10 mg PO daily
B. Humulin R insulin 6 U SC qAM AC
C. Acetaminophen 650 mg PO q6h PRN pain
D. Furosemide 20 mg IV push BID
Correct Answer: B
Rationale: “qAM AC” (before breakfast) is ambiguous; insulin
orders must specify exact time and meal relationship.
Incorrect: A, C, and D are complete, standard orders.
Teaching Point: Question unclear abbreviations to prevent
insulin timing errors.
, 4.
Stem: An LPN discovers that a client received another patient’s
morning medications. After ensuring client safety, what is the
LPN’s next responsibility?
A. Complete an incident report and notify the RN.
B. Reassure the client and take no further action.
C. Replace the pills in the original packaging.
D. Blame the unit clerk for wrong labels.
Correct Answer: A
Rationale: Incident reporting is mandatory for quality
improvement and legal compliance.
Incorrect: B omits required documentation; C does not address
safety; D is unprofessional.
Teaching Point: Medication errors must be reported promptly
per facility policy.
5.
Stem: Using clinical judgment, the LPN/VN identifies that an
older adult is at high risk for orthostatic hypotension after the
first dose of prazosin. Which assessment is most important
before administration?
A. Last bowel movement
B. Baseline blood pressure lying and standing
C. Serum potassium level
D. Pain rating
Correct Answer: B
Rationale: Orthostatic vitals establish baseline to detect
