,Next-Generation NCLEX® (NGN) Examination-Style Questions
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: An LPN is preparing morning medications for a client who
questions why a new heart pill was added. What is the LPN’s
priority action within the clinical judgment model?
A. Administer the medication and explain its purpose later.
B. Hold the dose until the RN or prescriber can clarify the
indication.
C. Tell the client that pharmacy always knows best.
D. Skip the dose to avoid a possible error.
Correct Answer: B
Rationale: Holding the dose and escalating for clarification
respects the client’s right to know and prevents potential harm.
Incorrect A: Giving an unfamiliar medication violates the “right
medication” and informed-consent rights.
Incorrect C: Pharmacy input is valuable but does not substitute
for prescriber clarification.
Incorrect D: Omitting a dose without justification can worsen
the client’s condition.
Teaching Point: “When in doubt, clarify before giving.”
2.
,Stem: During the assessment step of the nursing process, an
LPN notes a client’s allergy to sulfa drugs. What must the LPN
do next?
A. Document the allergy in the chart only.
A. Notify the RN and place an allergy band on the client.
C. Ask the client to remind staff each shift.
D. Wait until the next MAR review to act.
Correct Answer: B
Rationale: Immediate communication and visible identification
prevent administration of contraindicated drugs.
Incorrect A: Documentation alone is insufficient for safety.
Incorrect C: Relies on client memory and is unreliable.
Incorrect D: Delays critical safety measures.
Teaching Point: Allergy alerts require both documentation and
visible identifiers.
3.
Stem: Which action best demonstrates the LPN’s role in the
planning phase of the nursing process for a client starting
warfarin?
A. Adjusting the prescribed dose based on the INR result.
B. Teaching the client to avoid foods high in vitamin K.
C. Ordering follow-up labs for next week.
D. Deciding to switch the client to rivaroxaban.
Correct Answer: B
Rationale: Patient education on dietary interactions is within
LPN scope during planning.
, Incorrect A & D: Dose changes and drug switches require RN or
prescriber authority.
Incorrect C: Ordering labs exceeds LPN scope.
Teaching Point: LPNs educate; prescribers regulate.
4.
Stem: An LPN is reviewing the MAR and sees “Hold if SBP <100
mmHg” for a scheduled antihypertensive. The client’s BP is
98/60 mmHg. What is the LPN’s best action?
A. Administer half the dose.
B. Hold the dose and notify the RN.
C. Recheck BP in 30 minutes and then decide.
D. Give the dose and monitor closely.
Correct Answer: B
Rationale: Following the hold parameter and escalating
prevents hypotension.
Incorrect A & D: Dose alteration violates the order.
Incorrect C: Delay could prolong low perfusion.
Teaching Point: Follow hold parameters exactly.
5.
Stem: Which statement by an LPN best reflects understanding
of the evaluation step in the nursing process for a newly
administered analgesic?
A. “I’ll chart the medication as given.”
B. “I’ll reassess pain level in 30 minutes.”
C. “I’ll remind the client to request PRN meds early.”
D. “I’ll prepare the next scheduled dose now.”
Chapter 1 – Pharmacology and the Nursing Process in LPN
Practice
Stem: An LPN is preparing morning medications for a client who
questions why a new heart pill was added. What is the LPN’s
priority action within the clinical judgment model?
A. Administer the medication and explain its purpose later.
B. Hold the dose until the RN or prescriber can clarify the
indication.
C. Tell the client that pharmacy always knows best.
D. Skip the dose to avoid a possible error.
Correct Answer: B
Rationale: Holding the dose and escalating for clarification
respects the client’s right to know and prevents potential harm.
Incorrect A: Giving an unfamiliar medication violates the “right
medication” and informed-consent rights.
Incorrect C: Pharmacy input is valuable but does not substitute
for prescriber clarification.
Incorrect D: Omitting a dose without justification can worsen
the client’s condition.
Teaching Point: “When in doubt, clarify before giving.”
2.
,Stem: During the assessment step of the nursing process, an
LPN notes a client’s allergy to sulfa drugs. What must the LPN
do next?
A. Document the allergy in the chart only.
A. Notify the RN and place an allergy band on the client.
C. Ask the client to remind staff each shift.
D. Wait until the next MAR review to act.
Correct Answer: B
Rationale: Immediate communication and visible identification
prevent administration of contraindicated drugs.
Incorrect A: Documentation alone is insufficient for safety.
Incorrect C: Relies on client memory and is unreliable.
Incorrect D: Delays critical safety measures.
Teaching Point: Allergy alerts require both documentation and
visible identifiers.
3.
Stem: Which action best demonstrates the LPN’s role in the
planning phase of the nursing process for a client starting
warfarin?
A. Adjusting the prescribed dose based on the INR result.
B. Teaching the client to avoid foods high in vitamin K.
C. Ordering follow-up labs for next week.
D. Deciding to switch the client to rivaroxaban.
Correct Answer: B
Rationale: Patient education on dietary interactions is within
LPN scope during planning.
, Incorrect A & D: Dose changes and drug switches require RN or
prescriber authority.
Incorrect C: Ordering labs exceeds LPN scope.
Teaching Point: LPNs educate; prescribers regulate.
4.
Stem: An LPN is reviewing the MAR and sees “Hold if SBP <100
mmHg” for a scheduled antihypertensive. The client’s BP is
98/60 mmHg. What is the LPN’s best action?
A. Administer half the dose.
B. Hold the dose and notify the RN.
C. Recheck BP in 30 minutes and then decide.
D. Give the dose and monitor closely.
Correct Answer: B
Rationale: Following the hold parameter and escalating
prevents hypotension.
Incorrect A & D: Dose alteration violates the order.
Incorrect C: Delay could prolong low perfusion.
Teaching Point: Follow hold parameters exactly.
5.
Stem: Which statement by an LPN best reflects understanding
of the evaluation step in the nursing process for a newly
administered analgesic?
A. “I’ll chart the medication as given.”
B. “I’ll reassess pain level in 30 minutes.”
C. “I’ll remind the client to request PRN meds early.”
D. “I’ll prepare the next scheduled dose now.”
