,Next-Generation NCLEX®-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
An 82-year-old client is prescribed a new antihypertensive.
During the assessment step of the nursing process, which
finding most clearly indicates the LPN/VN should immediately
notify the RN?
A. BP 142/88 mmHg on admission
B. Serum potassium 2.9 mEq/L
C. Reports “dizziness when I stand”
D. Takes an 81-mg aspirin daily
Correct Answer: B
Rationale: Hypokalemia places the client at high risk for digoxin-
like toxicity or dysrhythmias when many antihypertensives are
added.
A: Elevated admission BP is expected; monitoring continues.
C: Orthostatic symptoms require teaching but are not
emergent.
D: Daily aspirin is not a contraindication.
Teaching Point: Hypokalemia + new antihypertensive = priority
RN communication.
, 2.
Using the Clinical Judgment Model, an LPN/VN analyzes cues
after a client receives the first dose of IV penicillin. Which cue
warrants priority action?
A. Temperature 37.2 °C (99 °F)
B. Heart rate 88 beats/min
C. Urticaria on chest and arms
D. Pain 2/10 at infusion site
Correct Answer: C
Rationale: Urticaria signals an allergic reaction that could
rapidly progress to anaphylaxis.
A, B: Mild fever and normal HR are non-urgent.
D: Pain 2/10 is expected with IV therapy.
Teaching Point: Skin rash after penicillin = possible anaphylaxis.
3.
An LPN/VN is preparing to administer a scheduled oral
medication. Which step best demonstrates the “recognize cues”
phase of the Clinical Judgment Model?
A. Checking the MAR against the prescriber’s order
B. Observing the client swallow the tablet
C. Noting the client reports nausea 30 min after breakfast
D. Recording the dose given in the eMAR
Correct Answer: C
Rationale: “Recognize cues” involves gathering relevant data;
nausea may affect absorption or indicate intolerance.
A, D: Verification and documentation occur in other phases.
, B: Ensures ingestion but is not data collection.
Teaching Point: Observe for cues that alter drug absorption or
tolerance.
4.
A client refuses a newly prescribed anticoagulant. According to
the LPN/VN’s legal scope, what is the most appropriate action?
A. Administer the drug via NG tube while the client sleeps
B. Explain the risks and notify the RN and prescriber
C. Chart the refusal and omit further attempts
D. Ask the family to convince the client
Correct Answer: B
Rationale: The LPN/VN must educate, respect autonomy, and
escalate per facility policy.
A: Covert administration is battery.
C: May miss needed education or alternative therapy.
D: Undermines client autonomy.
Teaching Point: Client refusal requires RN/MD notification and
documentation.
5.
During the evaluation step, the LPN/VN reviews lab results for a
client on lithium. Which outcome best indicates the drug is
effective?
A. Serum lithium 0.5 mEq/L (low therapeutic)
B. Client denies tremors
C. Mood rating scale improved from 8/10 to 3/10
D. Urine output 40 mL/hr
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
An 82-year-old client is prescribed a new antihypertensive.
During the assessment step of the nursing process, which
finding most clearly indicates the LPN/VN should immediately
notify the RN?
A. BP 142/88 mmHg on admission
B. Serum potassium 2.9 mEq/L
C. Reports “dizziness when I stand”
D. Takes an 81-mg aspirin daily
Correct Answer: B
Rationale: Hypokalemia places the client at high risk for digoxin-
like toxicity or dysrhythmias when many antihypertensives are
added.
A: Elevated admission BP is expected; monitoring continues.
C: Orthostatic symptoms require teaching but are not
emergent.
D: Daily aspirin is not a contraindication.
Teaching Point: Hypokalemia + new antihypertensive = priority
RN communication.
, 2.
Using the Clinical Judgment Model, an LPN/VN analyzes cues
after a client receives the first dose of IV penicillin. Which cue
warrants priority action?
A. Temperature 37.2 °C (99 °F)
B. Heart rate 88 beats/min
C. Urticaria on chest and arms
D. Pain 2/10 at infusion site
Correct Answer: C
Rationale: Urticaria signals an allergic reaction that could
rapidly progress to anaphylaxis.
A, B: Mild fever and normal HR are non-urgent.
D: Pain 2/10 is expected with IV therapy.
Teaching Point: Skin rash after penicillin = possible anaphylaxis.
3.
An LPN/VN is preparing to administer a scheduled oral
medication. Which step best demonstrates the “recognize cues”
phase of the Clinical Judgment Model?
A. Checking the MAR against the prescriber’s order
B. Observing the client swallow the tablet
C. Noting the client reports nausea 30 min after breakfast
D. Recording the dose given in the eMAR
Correct Answer: C
Rationale: “Recognize cues” involves gathering relevant data;
nausea may affect absorption or indicate intolerance.
A, D: Verification and documentation occur in other phases.
, B: Ensures ingestion but is not data collection.
Teaching Point: Observe for cues that alter drug absorption or
tolerance.
4.
A client refuses a newly prescribed anticoagulant. According to
the LPN/VN’s legal scope, what is the most appropriate action?
A. Administer the drug via NG tube while the client sleeps
B. Explain the risks and notify the RN and prescriber
C. Chart the refusal and omit further attempts
D. Ask the family to convince the client
Correct Answer: B
Rationale: The LPN/VN must educate, respect autonomy, and
escalate per facility policy.
A: Covert administration is battery.
C: May miss needed education or alternative therapy.
D: Undermines client autonomy.
Teaching Point: Client refusal requires RN/MD notification and
documentation.
5.
During the evaluation step, the LPN/VN reviews lab results for a
client on lithium. Which outcome best indicates the drug is
effective?
A. Serum lithium 0.5 mEq/L (low therapeutic)
B. Client denies tremors
C. Mood rating scale improved from 8/10 to 3/10
D. Urine output 40 mL/hr
