NCLEX-RN Pharmacology
Mastery Challenge Exam
With Answers Focus On Your
Success
1. Question
1 point(s)
A central venous line is being used to provide temporary total parenteral nutrition (TPN) to a 2-
year-old child. Today marks the start of TPN treatment.
Which nursing action would be prioritized right now, even if the child's care plan must contain al
l of the following?
A. Use aseptic technique during dressing changes.
B. Maintain central line catheter integrity.
C. Monitor serum glucose levels.
D. Check the results of liver function tests.
Correct Answer: C. Monitor serum glucose levels
Keep an eye on your blood sugar levels. As the child adjusts to the high-
glucose load of the TPN solution, hyperglycemia may happen during the first or s
econd day. Therefore, blood glucose testing is a primary nursing role.
A type of nutritional support administered entirely through the circulation using a
n IV pump is called total parenteral nutrition (TPN), sometimes referred to as pare
nteral nutrition (PN).
Proteins, carbs, lipids, vitamins, and minerals are all administered by TPN.
By eliminating antigenic mucosal stimulation, providing sufficient caloric intake a
nd vital nutrients, and permitting intestinal relaxation, it seeks to prevent and repai
r nutritional deficiencies (Perry et al., 2014).
,2. Question
1 point(s)
A client is receiving the first whole parenteral feeding solution from Nurse Jamie.
Which assessment from the list below needs 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.
Dextrose is added to total parenteral nutrition formulae at 10% or higher concentr
ations to provide 20% to 50% of the total calories.
Checking blood glucose levels should occur every four to six hours.
To keep the blood glucose level below 200 mg/dl, an insulin dosage on a sliding s
cale may be prescribed.
3. Question
1 point(s)
An 18-month-old child with AIDS received intravenous gamma globulin from nurse Susan.
The parent queries the reason for administering this medication.
What is the best way for the nurse to respond?
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.”
D. “It will increase the effectiveness of the other medications your child receives.”
Correct Answer: C. "The purpose of this drug is to stop bacterial infections."
Gamma globulin is administered intravenously to young children with AIDS in order to both pre
vent and treat bacterial infections.
Injections of gamma globulin appear to reduce the incidence of specific infections in children wit
h AIDS, but they do not treat the fatal illness.
,4. Question
1 point(s)
What is the most crucial thing a nurse should do when providing total parenteral nutrition (TPN)
to a patient?
A. Record the number of stools per day.
B. Maintain strict intake and output records.
C. Sterile technique for dressing change at IV site.
D. Monitor for cardiac arrhythmias.
Correct Answer: C. sterile method for changing the dressing at the intravenous site.
Patients taking TPN are particularly vulnerable to infection.
The concentrated glucose solutions provide an ideal environment for the growth of bacteria.
In order to prevent infection at IV infusion sites, strict sterile technique is essential.
Since the implementation of recommendations emphasizing sterile procedures for catheter inserti
on and skin care surrounding the insertion site, the incidence of sepsis associated with catheter us
e have declined. Catheter-
related infection rates have decreased, which can partly be explained by the growing usage of spe
cialized teams of doctors and nurses that specialize in different procedures, including catheter ins
ertion.
5. Question
1 point(s)
An intravenous vesicant chemotherapeutic agent is being given to a patient by the nurse.
Which assessment calls for the nurse to act right away?
A. Stomatitis lesion in the mouth.
B. Severe nausea and vomiting.
C. Complaints of pain at the site of infusion.
D. A rash on the client’s extremities.
Correct Response: C. Infusion site pain complaints.
A vesicant is a type of chemotherapeutic agent that can blister tissues and, in the e
, vent of extravasation, cause tissue necrosis.
These substances are irritants that, with or without inflammation, produce pain alo
ng the venous wall.
6. Question
1 point(s)
A client with clinical depression using an MAO inhibitor is under the care of nurse Celine.
The nurse should advise the patient to take the following precautions when using this medication
:
A. Avoid chocolate and cheese.
B. Take frequent naps.
C. Take the medication with milk.
D. Avoid walking without assistance.
Correct Answer: A. Avoid chocolate and cheese.
Chocolate and cheese are examples of foods high in tryptophan, tyramine, and caf
feine that can cause hypertensive crises.
An amino acid called tyramine aids in blood pressure regulation.
It is present in some meals and happens spontaneously in the body.
Monoamine oxidase, an enzyme that breaks down excess tyramine in the body, is
blocked by medications known as monoamine oxidase inhibitors (MAOIs).
Depressive symptoms can be alleviated by blocking this enzyme.
7. Question
1 point(s)
The nurse is asked how long a client with congestive heart failure needs to take diuretics while re
ceiving home care. For this client, the optimum course of action should be:
A. “As you urinate more, you will need less medication to control fluid.”
B. “You will have to take this medication for about a year.”
C. “The medication must be continued so the fluid problem is controlled.”
D. “Please talk to your physician about medications and treatments.”
Mastery Challenge Exam
With Answers Focus On Your
Success
1. Question
1 point(s)
A central venous line is being used to provide temporary total parenteral nutrition (TPN) to a 2-
year-old child. Today marks the start of TPN treatment.
Which nursing action would be prioritized right now, even if the child's care plan must contain al
l of the following?
A. Use aseptic technique during dressing changes.
B. Maintain central line catheter integrity.
C. Monitor serum glucose levels.
D. Check the results of liver function tests.
Correct Answer: C. Monitor serum glucose levels
Keep an eye on your blood sugar levels. As the child adjusts to the high-
glucose load of the TPN solution, hyperglycemia may happen during the first or s
econd day. Therefore, blood glucose testing is a primary nursing role.
A type of nutritional support administered entirely through the circulation using a
n IV pump is called total parenteral nutrition (TPN), sometimes referred to as pare
nteral nutrition (PN).
Proteins, carbs, lipids, vitamins, and minerals are all administered by TPN.
By eliminating antigenic mucosal stimulation, providing sufficient caloric intake a
nd vital nutrients, and permitting intestinal relaxation, it seeks to prevent and repai
r nutritional deficiencies (Perry et al., 2014).
,2. Question
1 point(s)
A client is receiving the first whole parenteral feeding solution from Nurse Jamie.
Which assessment from the list below needs 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.
Dextrose is added to total parenteral nutrition formulae at 10% or higher concentr
ations to provide 20% to 50% of the total calories.
Checking blood glucose levels should occur every four to six hours.
To keep the blood glucose level below 200 mg/dl, an insulin dosage on a sliding s
cale may be prescribed.
3. Question
1 point(s)
An 18-month-old child with AIDS received intravenous gamma globulin from nurse Susan.
The parent queries the reason for administering this medication.
What is the best way for the nurse to respond?
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.”
D. “It will increase the effectiveness of the other medications your child receives.”
Correct Answer: C. "The purpose of this drug is to stop bacterial infections."
Gamma globulin is administered intravenously to young children with AIDS in order to both pre
vent and treat bacterial infections.
Injections of gamma globulin appear to reduce the incidence of specific infections in children wit
h AIDS, but they do not treat the fatal illness.
,4. Question
1 point(s)
What is the most crucial thing a nurse should do when providing total parenteral nutrition (TPN)
to a patient?
A. Record the number of stools per day.
B. Maintain strict intake and output records.
C. Sterile technique for dressing change at IV site.
D. Monitor for cardiac arrhythmias.
Correct Answer: C. sterile method for changing the dressing at the intravenous site.
Patients taking TPN are particularly vulnerable to infection.
The concentrated glucose solutions provide an ideal environment for the growth of bacteria.
In order to prevent infection at IV infusion sites, strict sterile technique is essential.
Since the implementation of recommendations emphasizing sterile procedures for catheter inserti
on and skin care surrounding the insertion site, the incidence of sepsis associated with catheter us
e have declined. Catheter-
related infection rates have decreased, which can partly be explained by the growing usage of spe
cialized teams of doctors and nurses that specialize in different procedures, including catheter ins
ertion.
5. Question
1 point(s)
An intravenous vesicant chemotherapeutic agent is being given to a patient by the nurse.
Which assessment calls for the nurse to act right away?
A. Stomatitis lesion in the mouth.
B. Severe nausea and vomiting.
C. Complaints of pain at the site of infusion.
D. A rash on the client’s extremities.
Correct Response: C. Infusion site pain complaints.
A vesicant is a type of chemotherapeutic agent that can blister tissues and, in the e
, vent of extravasation, cause tissue necrosis.
These substances are irritants that, with or without inflammation, produce pain alo
ng the venous wall.
6. Question
1 point(s)
A client with clinical depression using an MAO inhibitor is under the care of nurse Celine.
The nurse should advise the patient to take the following precautions when using this medication
:
A. Avoid chocolate and cheese.
B. Take frequent naps.
C. Take the medication with milk.
D. Avoid walking without assistance.
Correct Answer: A. Avoid chocolate and cheese.
Chocolate and cheese are examples of foods high in tryptophan, tyramine, and caf
feine that can cause hypertensive crises.
An amino acid called tyramine aids in blood pressure regulation.
It is present in some meals and happens spontaneously in the body.
Monoamine oxidase, an enzyme that breaks down excess tyramine in the body, is
blocked by medications known as monoamine oxidase inhibitors (MAOIs).
Depressive symptoms can be alleviated by blocking this enzyme.
7. Question
1 point(s)
The nurse is asked how long a client with congestive heart failure needs to take diuretics while re
ceiving home care. For this client, the optimum course of action should be:
A. “As you urinate more, you will need less medication to control fluid.”
B. “You will have to take this medication for about a year.”
C. “The medication must be continued so the fluid problem is controlled.”
D. “Please talk to your physician about medications and treatments.”
