,Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: A newly licensed LPN is asked to administer a first-time
dose of enoxaparin. Which action best demonstrates the LPN’s
appropriate role in the nursing process?
A. Verify the order, check allergies, and administer after RN co-
signature.
B. Independently verify the order and administer without
further validation.
C. Ask the RN to administer because LPNs cannot give
anticoagulants.
D. Give the drug then tell the RN after the shift ends.
Correct Answer: A
Rationale: LPNs may administer enoxaparin after validating the
order and patient allergies; most agencies require RN co-
signature for first doses (Visovsky, 11e).
Distractor Rationales:
B. LPNs cannot act independently on first doses without
validation.
C. LPNs are permitted to give anticoagulants within scope.
D. Delayed reporting violates safe practice and nursing process.
Teaching Point: Validate & co-sign first-time high-alert drugs.
2.
,Stem: Using the clinical judgment model, an LPN reviews a
patient’s MAR and notes a scheduled furosemide dose that is
overdue. What is the LPN’s priority action?
A. Assess the patient’s current blood pressure and lung sounds.
B. Omit the dose and document “late—given next scheduled
time.”
C. Ask the unit secretary to reschedule the dose.
D. Give the dose immediately to catch up.
Correct Answer: A
Rationale: Assessment drives the next clinical judgment step;
giving without assessment risks harm (Visovsky, 11e, Ch 1).
Distractor Rationales:
B. Omitting without assessment is unsafe.
C. Secretaries cannot make clinical decisions.
D. Immediate administration may be contraindicated.
Teaching Point: Always assess before late-dose administration.
3.
Stem: An LPN is caring for a client receiving warfarin. Which
nursing-process action reflects the LPN’s role in evaluation?
A. Compare the latest INR result to therapeutic range.
B. Write a new warfarin order based on INR.
C. Teach the client about vitamin K-rich foods.
D. Transcribe the order onto the MAR.
Correct Answer: A
Rationale: Evaluation involves comparing actual outcomes (INR)
to expected outcomes; LPNs report findings (Visovsky, 11e).
, Distractor Rationales:
B. Prescribing is outside LPN scope.
C. Teaching is implementation, not evaluation.
D. Transcribing is part of planning/implementation.
Teaching Point: LPNs evaluate, then report—do not prescribe.
4.
Stem: An LPN discovers a transcription error on the MAR:
digoxin 0.25 mg daily is written as 0.5 mg. What is the LPN’s first
step in the nursing process?
A. Hold the medication and notify the RN immediately.
B. Administer 0.25 mg assuming the higher dose is a typo.
C. Ask another LPN what dose to give.
D. Document the error after the next shift.
Correct Answer: A
Rationale: Assessment/recognition of error precedes any
action; withholding protects patient safety (Visovsky, 11e).
Distractor Rationales:
B. Assuming is unsafe and violates rights.
C. Peer consultation does not replace RN notification.
D. Delayed reporting increases patient risk.
Teaching Point: Recognize, hold, and report medication
discrepancies.
5.
Stem: The LPN is preparing to administer insulin aspart per
sliding scale. Which action best demonstrates clinical judgment
during the planning phase?
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: A newly licensed LPN is asked to administer a first-time
dose of enoxaparin. Which action best demonstrates the LPN’s
appropriate role in the nursing process?
A. Verify the order, check allergies, and administer after RN co-
signature.
B. Independently verify the order and administer without
further validation.
C. Ask the RN to administer because LPNs cannot give
anticoagulants.
D. Give the drug then tell the RN after the shift ends.
Correct Answer: A
Rationale: LPNs may administer enoxaparin after validating the
order and patient allergies; most agencies require RN co-
signature for first doses (Visovsky, 11e).
Distractor Rationales:
B. LPNs cannot act independently on first doses without
validation.
C. LPNs are permitted to give anticoagulants within scope.
D. Delayed reporting violates safe practice and nursing process.
Teaching Point: Validate & co-sign first-time high-alert drugs.
2.
,Stem: Using the clinical judgment model, an LPN reviews a
patient’s MAR and notes a scheduled furosemide dose that is
overdue. What is the LPN’s priority action?
A. Assess the patient’s current blood pressure and lung sounds.
B. Omit the dose and document “late—given next scheduled
time.”
C. Ask the unit secretary to reschedule the dose.
D. Give the dose immediately to catch up.
Correct Answer: A
Rationale: Assessment drives the next clinical judgment step;
giving without assessment risks harm (Visovsky, 11e, Ch 1).
Distractor Rationales:
B. Omitting without assessment is unsafe.
C. Secretaries cannot make clinical decisions.
D. Immediate administration may be contraindicated.
Teaching Point: Always assess before late-dose administration.
3.
Stem: An LPN is caring for a client receiving warfarin. Which
nursing-process action reflects the LPN’s role in evaluation?
A. Compare the latest INR result to therapeutic range.
B. Write a new warfarin order based on INR.
C. Teach the client about vitamin K-rich foods.
D. Transcribe the order onto the MAR.
Correct Answer: A
Rationale: Evaluation involves comparing actual outcomes (INR)
to expected outcomes; LPNs report findings (Visovsky, 11e).
, Distractor Rationales:
B. Prescribing is outside LPN scope.
C. Teaching is implementation, not evaluation.
D. Transcribing is part of planning/implementation.
Teaching Point: LPNs evaluate, then report—do not prescribe.
4.
Stem: An LPN discovers a transcription error on the MAR:
digoxin 0.25 mg daily is written as 0.5 mg. What is the LPN’s first
step in the nursing process?
A. Hold the medication and notify the RN immediately.
B. Administer 0.25 mg assuming the higher dose is a typo.
C. Ask another LPN what dose to give.
D. Document the error after the next shift.
Correct Answer: A
Rationale: Assessment/recognition of error precedes any
action; withholding protects patient safety (Visovsky, 11e).
Distractor Rationales:
B. Assuming is unsafe and violates rights.
C. Peer consultation does not replace RN notification.
D. Delayed reporting increases patient risk.
Teaching Point: Recognize, hold, and report medication
discrepancies.
5.
Stem: The LPN is preparing to administer insulin aspart per
sliding scale. Which action best demonstrates clinical judgment
during the planning phase?
