NCLEX Pharmacology Exam LATEST
2026/2027 | Verified Q&A | 100% Pass
1. 1. Question
A 2-year-old child is receiving temporary total parenteral nutrition (TPN) through
a central venous line. This is the first day of TPN therapy. Although all of the
following nursing actions must be included in the plan of care of this child, which
one would be a priority at this time?
A. Use aseptic technique during dressing changes.
B. Maintain central line catheter integrity.
C. Monitor serum glucose levels.
D. Check results of liver function tests.
Correct Answer: C. Monitor serum glucose levels
Monitor serum glucose levels. Hyperglycemia may occur during the first day or 2
as the child adapts to the high-glucose load of the TPN solution. Thus, a chief
nursing responsibility is blood glucose testing. Total parenteral nutrition (TPN),
also known as parenteral nutrition (PN) is a form of nutritional support given
completely via the bloodstream, intravenously with an IV pump. TPN administers
proteins, carbohydrates, fats, vitamins, and minerals. It aims to prevent and
restore nutritional deficits, allowing bowel rest while supplying adequate caloric
intake and essential nutrients, and removing antigenic mucosal stimuli (Perry et
al., 2014).
Option A: With proper care, a central catheter can be maintained for several
days or even weeks for the delivery of TPN. Apply strict aseptic technique
during insertion, care, and maintenance. Frequently assess the CVC site for
redness, tenderness, or drainage. Notify the health care provider of any signs
and symptoms of infection.
Option B: Strict asepsis is to be observed during the placement of the
catheter. A chest radiograph should be taken prior to the commencement of
feeding to confirm the position of the catheter-tip and to exclude traumatic
pneumothorax, the commonest complication related to catheter placement.
Page 1 of 53
, Option D: Review lab values for increases and decreases out of the normal
range. Lab values include CBC, electrolytes, calcium, magnesium, phosphorus,
potassium, glucose, albumin, BUN (blood urea nitrogen), creatinine,
triglycerides, and transferrin.
2. 2. Question
Nurse Jamie is administering the initial total parenteral nutrition solution to a
client. Which of the following assessments requires the
nurse’s immediate attention?
A. Temperature of 37.5 degrees Celsius.
B. Urine output of 300 cc in 4 hours.
C. Poor skin turgor.
D. Blood glucose of 350 mg/dl.
Correct Answer: D. Blood glucose of 350 mg/dl.
Total parenteral nutrition formulas contain dextrose in concentrations of 10% or
greater to supply 20% to 50% of the total calories. Blood glucose levels should be
checked every 4 to 6 hours. A sliding scale dose of insulin may be ordered to
maintain the blood glucose level below 200mg/dl.
Option A: Catheter-related bloodstream infection or CR-BSI, which starts at
the hub connection, is the spread of bacteria through the bloodstream. There’s
an increased risk of CR-BSI with TPN, due to the high dextrose concentration
of TPN. Symptoms include tachycardia, hypotension, elevated or decreased
temperature, increased breathing, decreased urine output, and disorientation.
Strict adherence to aseptic technique with insertion, care, and maintenance;
avoid hyperglycemia to prevent infection complications; closely monitor vital
signs and temperature. IV antibiotic therapy is required. Monitor white blood
cell count and patient for the malaise. Replace IV tubing frequently as per
agency policy (usually every 24 hours).
Option B: Monitor and record every eight hours or as per agency policy.
Monitor for signs and symptoms of fluid overload (excessive weight gain) by
completing a cardiovascular and respiratory assessment. Assess intakes such as
IV (intravenous fluids), PO (oral intake), NG (nasogastric tube feeds). Assess
outputs: NG (removed gastric content through the nasogastric tube), fistula
drainage, BM (liquid bowel movements), colostomy/ileostomy drainage, closed
Page 2 of 53
, suction drainage devices (Penrose or Jackson-Pratt drainage), and chest tube
drainage.
Option C: Related to a sudden increase in glucose after a recent malnourished
state. After starvation, glucose intake suppresses gluconeogenesis by leading
to the release of insulin and the suppression of glycogen. Excessive glucose
may lead to hyperglycemia, with osmotic diuresis, dehydration, metabolic
acidosis, and ketoacidosis. Excess glucose also leads to lipogenesis (again
caused by insulin stimulation). This may cause fatty liver, increased CO2
production, hypercapnia, and respiratory failure.
3. 3. Question
Nurse Susan administered intravenous gamma globulin to an 18 month-old child
with AIDS. The parent asks why this medication is being given. What is the
nurse’s best response?
A. “It will slow down the replication of the virus.”
B. “This medication will improve your child’s overall health status.”
C. “This medication is used to prevent bacterial infections.”
Correct answer
D. “It will increase the effectiveness of the other medications your child
receives.”
Correct Answer: C. “This medication is used to prevent bacterial infections.”
Intravenous gamma globulin is given to help prevent as well as to fight bacterial
infections in young children with AIDS. Gamma globulin injections seem to lower
the number of certain infections among children with AIDS but do not cure the
lethal ailment.
Option A: The main immunological abnormality in human immunodeficiency
virus (HIV)-infected patients, and particularly those with the acquired immune
deficiency syndrome (AIDS), is a deficiency in cellular immunity. However,
symptomatic HIV-infected children also have evidence of deficiency of specific
antibody synthesis, and intravenous immune globulin (IVIG) preparations in
doses of 0.2-0.4 g/kg every 2-4 weeks have been shown to reduce the
incidence of respiratory infections.
Option B: IVIG therapy may also reduce the mortality and incidence of
bacterial infections in adults but further studies are required. In addition, high-
Page 3 of 53
, dose IVIG therapy (1-2 g/kg over 2-5 days) produces increased platelet counts
in patients with idiopathic thrombocytopenic purpura (ITP) associated with HIV
infection. Finally, IVIG therapy may have a role in HIV-infected patients
suffering from severe parvovirus B19 or measles infection, or in patients
suffering from autoimmune disorders where high-dose IVIG therapy has been
shown to be efficacious.
Option C: Doctors said that although the gamma globulin treatment did not
cure AIDS it seemed to” enhance the quality” the lives of the children in the
study group because it freed them from the constant infections that added to
their suffering. Such episodes of sepsis are often a result of bacterial infection.
The gamma globulin contains antibodies to many common bacteria, including
ones that often kill children whose immune systems have been paralyzed by
the AIDS virus.
4. 4. Question
When caring for a client with total parenteral nutrition (TPN), what is
the most important action on the part of the nurse?
A. Record the number of stools per day.
B. Maintain strict intake and output records.
C. Sterile technique for dressing change at IV site.
Correct answer
D. Monitor for cardiac arrhythmias.
Correct Answer: C. Sterile technique for dressing change at IV site.
Clients receiving TPN are very susceptible to infection. The concentrated glucose
solutions are a good medium for bacterial growth. Strict sterile technique is
crucial in preventing infection at IV infusion sites. Catheter-related sepsis rates
have decreased since the introduction of guidelines that emphasize sterile
techniques for catheter insertion and skin care around the insertion site. The
increasing use of dedicated teams of physicians and nurses who specialize in
various procedures including catheter insertion also has accounted for a decrease
in catheter-related infection rates.
Option A: Progress of patients with a TPN line should be followed on a
flowchart. An interdisciplinary nutrition team, if available, should monitor
patients. Weight, complete blood count, electrolytes, and blood urea nitrogen
Page 4 of 53
2026/2027 | Verified Q&A | 100% Pass
1. 1. Question
A 2-year-old child is receiving temporary total parenteral nutrition (TPN) through
a central venous line. This is the first day of TPN therapy. Although all of the
following nursing actions must be included in the plan of care of this child, which
one would be a priority at this time?
A. Use aseptic technique during dressing changes.
B. Maintain central line catheter integrity.
C. Monitor serum glucose levels.
D. Check results of liver function tests.
Correct Answer: C. Monitor serum glucose levels
Monitor serum glucose levels. Hyperglycemia may occur during the first day or 2
as the child adapts to the high-glucose load of the TPN solution. Thus, a chief
nursing responsibility is blood glucose testing. Total parenteral nutrition (TPN),
also known as parenteral nutrition (PN) is a form of nutritional support given
completely via the bloodstream, intravenously with an IV pump. TPN administers
proteins, carbohydrates, fats, vitamins, and minerals. It aims to prevent and
restore nutritional deficits, allowing bowel rest while supplying adequate caloric
intake and essential nutrients, and removing antigenic mucosal stimuli (Perry et
al., 2014).
Option A: With proper care, a central catheter can be maintained for several
days or even weeks for the delivery of TPN. Apply strict aseptic technique
during insertion, care, and maintenance. Frequently assess the CVC site for
redness, tenderness, or drainage. Notify the health care provider of any signs
and symptoms of infection.
Option B: Strict asepsis is to be observed during the placement of the
catheter. A chest radiograph should be taken prior to the commencement of
feeding to confirm the position of the catheter-tip and to exclude traumatic
pneumothorax, the commonest complication related to catheter placement.
Page 1 of 53
, Option D: Review lab values for increases and decreases out of the normal
range. Lab values include CBC, electrolytes, calcium, magnesium, phosphorus,
potassium, glucose, albumin, BUN (blood urea nitrogen), creatinine,
triglycerides, and transferrin.
2. 2. Question
Nurse Jamie is administering the initial total parenteral nutrition solution to a
client. Which of the following assessments requires the
nurse’s immediate attention?
A. Temperature of 37.5 degrees Celsius.
B. Urine output of 300 cc in 4 hours.
C. Poor skin turgor.
D. Blood glucose of 350 mg/dl.
Correct Answer: D. Blood glucose of 350 mg/dl.
Total parenteral nutrition formulas contain dextrose in concentrations of 10% or
greater to supply 20% to 50% of the total calories. Blood glucose levels should be
checked every 4 to 6 hours. A sliding scale dose of insulin may be ordered to
maintain the blood glucose level below 200mg/dl.
Option A: Catheter-related bloodstream infection or CR-BSI, which starts at
the hub connection, is the spread of bacteria through the bloodstream. There’s
an increased risk of CR-BSI with TPN, due to the high dextrose concentration
of TPN. Symptoms include tachycardia, hypotension, elevated or decreased
temperature, increased breathing, decreased urine output, and disorientation.
Strict adherence to aseptic technique with insertion, care, and maintenance;
avoid hyperglycemia to prevent infection complications; closely monitor vital
signs and temperature. IV antibiotic therapy is required. Monitor white blood
cell count and patient for the malaise. Replace IV tubing frequently as per
agency policy (usually every 24 hours).
Option B: Monitor and record every eight hours or as per agency policy.
Monitor for signs and symptoms of fluid overload (excessive weight gain) by
completing a cardiovascular and respiratory assessment. Assess intakes such as
IV (intravenous fluids), PO (oral intake), NG (nasogastric tube feeds). Assess
outputs: NG (removed gastric content through the nasogastric tube), fistula
drainage, BM (liquid bowel movements), colostomy/ileostomy drainage, closed
Page 2 of 53
, suction drainage devices (Penrose or Jackson-Pratt drainage), and chest tube
drainage.
Option C: Related to a sudden increase in glucose after a recent malnourished
state. After starvation, glucose intake suppresses gluconeogenesis by leading
to the release of insulin and the suppression of glycogen. Excessive glucose
may lead to hyperglycemia, with osmotic diuresis, dehydration, metabolic
acidosis, and ketoacidosis. Excess glucose also leads to lipogenesis (again
caused by insulin stimulation). This may cause fatty liver, increased CO2
production, hypercapnia, and respiratory failure.
3. 3. Question
Nurse Susan administered intravenous gamma globulin to an 18 month-old child
with AIDS. The parent asks why this medication is being given. What is the
nurse’s best response?
A. “It will slow down the replication of the virus.”
B. “This medication will improve your child’s overall health status.”
C. “This medication is used to prevent bacterial infections.”
Correct answer
D. “It will increase the effectiveness of the other medications your child
receives.”
Correct Answer: C. “This medication is used to prevent bacterial infections.”
Intravenous gamma globulin is given to help prevent as well as to fight bacterial
infections in young children with AIDS. Gamma globulin injections seem to lower
the number of certain infections among children with AIDS but do not cure the
lethal ailment.
Option A: The main immunological abnormality in human immunodeficiency
virus (HIV)-infected patients, and particularly those with the acquired immune
deficiency syndrome (AIDS), is a deficiency in cellular immunity. However,
symptomatic HIV-infected children also have evidence of deficiency of specific
antibody synthesis, and intravenous immune globulin (IVIG) preparations in
doses of 0.2-0.4 g/kg every 2-4 weeks have been shown to reduce the
incidence of respiratory infections.
Option B: IVIG therapy may also reduce the mortality and incidence of
bacterial infections in adults but further studies are required. In addition, high-
Page 3 of 53
, dose IVIG therapy (1-2 g/kg over 2-5 days) produces increased platelet counts
in patients with idiopathic thrombocytopenic purpura (ITP) associated with HIV
infection. Finally, IVIG therapy may have a role in HIV-infected patients
suffering from severe parvovirus B19 or measles infection, or in patients
suffering from autoimmune disorders where high-dose IVIG therapy has been
shown to be efficacious.
Option C: Doctors said that although the gamma globulin treatment did not
cure AIDS it seemed to” enhance the quality” the lives of the children in the
study group because it freed them from the constant infections that added to
their suffering. Such episodes of sepsis are often a result of bacterial infection.
The gamma globulin contains antibodies to many common bacteria, including
ones that often kill children whose immune systems have been paralyzed by
the AIDS virus.
4. 4. Question
When caring for a client with total parenteral nutrition (TPN), what is
the most important action on the part of the nurse?
A. Record the number of stools per day.
B. Maintain strict intake and output records.
C. Sterile technique for dressing change at IV site.
Correct answer
D. Monitor for cardiac arrhythmias.
Correct Answer: C. Sterile technique for dressing change at IV site.
Clients receiving TPN are very susceptible to infection. The concentrated glucose
solutions are a good medium for bacterial growth. Strict sterile technique is
crucial in preventing infection at IV infusion sites. Catheter-related sepsis rates
have decreased since the introduction of guidelines that emphasize sterile
techniques for catheter insertion and skin care around the insertion site. The
increasing use of dedicated teams of physicians and nurses who specialize in
various procedures including catheter insertion also has accounted for a decrease
in catheter-related infection rates.
Option A: Progress of patients with a TPN line should be followed on a
flowchart. An interdisciplinary nutrition team, if available, should monitor
patients. Weight, complete blood count, electrolytes, and blood urea nitrogen
Page 4 of 53
