,Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1: Pharmacology and the Nursing Process in LPN
Practice
1. A 78-year-old client is ordered sliding-scale insulin before
breakfast. The LPN notices the capillary blood glucose is 52
mg/dL. Using the Clinical Judgment Model, which action is
priority?
A. Hold the insulin and give the client 4 oz orange juice
B. Administer the insulin exactly as prescribed
C. Recheck the glucose in 30 minutes before deciding
D. Document the finding and report it at end of shift
Correct Answer: A
Rationale (Correct): Hypoglycemia (<70 mg/dL) is a
contraindication to insulin; immediate treatment with 15 g
rapid-acting carbohydrate prevents further decline.
Rationale (Incorrect):
B – Giving insulin would worsen hypoglycemia.
C – Delays treatment, increasing seizure/coma risk.
D – Fails to address immediate patient safety.
Teaching Point: Treat hypoglycemia before any drug
administration.
,2. While preparing medications, the LPN notes that the
prescribed dose of digoxin is 0.5 mg PO daily and the
client’s apical pulse is 58 beats/min. What is the LPN’s best
next step?
A. Give the drug and recheck pulse in 1 hour
B. Hold the dose and notify the RN or prescriber
immediately
C. Cut the tablet in half and give 0.25 mg instead
D. Reassess pulse in 15 minutes and then decide
Correct Answer: B
Rationale: Digoxin is held for pulse <60 bpm to avoid
toxicity; prescriber must evaluate.
A – Risks toxicity.
C – Unauthorized dose alteration.
D – Delays needed prescriber notification.
Teaching Point: Pulse <60 bpm is a red flag for digoxin.
3. The LPN is caring for a client who states, “I stopped taking
my warfarin because I read it causes bleeding.” Which
response reflects the best use of the Clinical Judgment
Model?
A. “You’re right; you should never take blood thinners.”
B. “Let’s review why warfarin was prescribed and discuss
bleeding precautions.”
C. “I’ll tell the RN you’re noncompliant.”
D. “Restarting it tomorrow should be fine.”
Correct Answer: B
Rationale: Assesses understanding and provides education,
, aligning with recognize/analyze cues and generate
solutions.
A – Reinforces non-adherence.
C – Labels patient, halts dialogue.
D – Minimizes risk of thromboembolism.
Teaching Point: Patient education bridges knowledge gaps
and supports adherence.
4. A client newly prescribed lisinopril asks the LPN what side
effects to monitor. Which statement by the LPN is most
accurate?
A. “Watch for a dry, persistent cough.”
B. “Constipation is the most common complaint.”
C. “You’ll probably feel very jittery.”
D. “Expect your heart rate to increase.”
Correct Answer: A
Rationale: ACE inhibitors commonly cause dry cough due
to bradykinin accumulation.
B – Constipation is not typical.
C – Jitteriness is unrelated.
D – Lisinopril does not increase heart rate.
Teaching Point: Persistent dry cough signals ACE inhibitor
adverse effect.
5. The LPN receives a new medication order for levofloxacin
750 mg IV every 24 h. What assessment information is
most important for the LPN to validate before
administration?
Chapter 1: Pharmacology and the Nursing Process in LPN
Practice
1. A 78-year-old client is ordered sliding-scale insulin before
breakfast. The LPN notices the capillary blood glucose is 52
mg/dL. Using the Clinical Judgment Model, which action is
priority?
A. Hold the insulin and give the client 4 oz orange juice
B. Administer the insulin exactly as prescribed
C. Recheck the glucose in 30 minutes before deciding
D. Document the finding and report it at end of shift
Correct Answer: A
Rationale (Correct): Hypoglycemia (<70 mg/dL) is a
contraindication to insulin; immediate treatment with 15 g
rapid-acting carbohydrate prevents further decline.
Rationale (Incorrect):
B – Giving insulin would worsen hypoglycemia.
C – Delays treatment, increasing seizure/coma risk.
D – Fails to address immediate patient safety.
Teaching Point: Treat hypoglycemia before any drug
administration.
,2. While preparing medications, the LPN notes that the
prescribed dose of digoxin is 0.5 mg PO daily and the
client’s apical pulse is 58 beats/min. What is the LPN’s best
next step?
A. Give the drug and recheck pulse in 1 hour
B. Hold the dose and notify the RN or prescriber
immediately
C. Cut the tablet in half and give 0.25 mg instead
D. Reassess pulse in 15 minutes and then decide
Correct Answer: B
Rationale: Digoxin is held for pulse <60 bpm to avoid
toxicity; prescriber must evaluate.
A – Risks toxicity.
C – Unauthorized dose alteration.
D – Delays needed prescriber notification.
Teaching Point: Pulse <60 bpm is a red flag for digoxin.
3. The LPN is caring for a client who states, “I stopped taking
my warfarin because I read it causes bleeding.” Which
response reflects the best use of the Clinical Judgment
Model?
A. “You’re right; you should never take blood thinners.”
B. “Let’s review why warfarin was prescribed and discuss
bleeding precautions.”
C. “I’ll tell the RN you’re noncompliant.”
D. “Restarting it tomorrow should be fine.”
Correct Answer: B
Rationale: Assesses understanding and provides education,
, aligning with recognize/analyze cues and generate
solutions.
A – Reinforces non-adherence.
C – Labels patient, halts dialogue.
D – Minimizes risk of thromboembolism.
Teaching Point: Patient education bridges knowledge gaps
and supports adherence.
4. A client newly prescribed lisinopril asks the LPN what side
effects to monitor. Which statement by the LPN is most
accurate?
A. “Watch for a dry, persistent cough.”
B. “Constipation is the most common complaint.”
C. “You’ll probably feel very jittery.”
D. “Expect your heart rate to increase.”
Correct Answer: A
Rationale: ACE inhibitors commonly cause dry cough due
to bradykinin accumulation.
B – Constipation is not typical.
C – Jitteriness is unrelated.
D – Lisinopril does not increase heart rate.
Teaching Point: Persistent dry cough signals ACE inhibitor
adverse effect.
5. The LPN receives a new medication order for levofloxacin
750 mg IV every 24 h. What assessment information is
most important for the LPN to validate before
administration?
