NCLEX Practice Exam for Pharmacology 2
QUESTIONS AND ANSWERS WITH
RATIONALES.
1. An infection in a central venous access device is not eliminated by giving antibiotics
through the catheter. How would bacterial glycocalyx contribute to this?
A. It protects the bacteria from antibiotic and immunologic destruction.
B. Glycocalyx neutralizes the antibiotic rendering it ineffective.
C. It competes with the antibiotic for binding sites on the microbe.
D. Glycocalyx provides nutrients for microbial growth.
Rationale: Glycocalyx is a viscous polysaccharide or polypeptide slime that covers
microbes. It enhances adherence to surfaces, resists phagocytic engulfment by the
white blood cells, and prevents antibiotics from contacting the microbe. Glycocalyx
does not have the effects in options B-D
2. Central venous access devices are beneficial in pediatric therapy because:
A. They don’t frighten children.
B. Use of the arms is not restricted.
C. They cannot be dislodged.
D. They are difficult to see.
Rationale: The child can move his extremities and function in a normal fashion. This
lessens stress associated with position restriction and promotes normal activity. Fear
may not be eliminated. All lines can be dislodged. Even small catheters can be readily
seen.
3. How can central venous access devices (CVADs) be of value in a patient receiving
chemotherapy who has stomatitis and severe diarrhea?
A. The chemotherapy can be rapidly completed allowing the stomatitis and diarrhea to
resolve.
B. Crystalloid can be administered to prevent dehydration.
, C. Concentrated hyperalimentation fluid can be administered through the CVAD.
D. The chemotherapy dose can be reduced.
Rationale: In patients unable to take oral nutrition, parenteral hyperalimentation is an
option for providing nutritional support. High concentrations of dextrose, protein,
minerals, vitamins, and trace elements can be provided. Dosing is not affected with
options a and d. Crystalloid can provide free water but has very little nutritional
benefits. Hyperalimentation can provide free water and considerable nutritional
benefits.
4. Some central venous access devices (CVAD) have more than one lumen. These multi
lumen catheters:
A. Have an increased risk of infiltration.
B. Only work a short while because the small bore clots off.
C. Are beneficial to patient care but are prohibitively expensive.
D. Allow different medications or solutions to be administered simultaneously.
Rationale: A multilumen catheter contains separate ports and means to administer
agents. An agent infusing in one port cannot mix with an agent infusing into another
port. Thus, agents that would be incompatible if given together can be given in
separate ports simultaneously.
5. Some institutions will not infuse a fat emulsion, such as Intralipid, into central venous
access devices (CVAD) because:
A. Lipid residue may accumulate in the CVAD and occlude the catheter.
B. If the catheter clogs, there is no treatment other than removal and replacement.
C. Lipids are necessary only in the most extreme cases to prevent essential fatty acid
(EFA) deficiency.
D. Fat emulsions are very caustic.
Rationale: Occlusion occurs with slow infusion rates and concurrent administration
of some medications. Lipid occlusions may be treated with 70 percent ethanol or with
0.1 mmol/mL NaOH. Lipids provide essential fatty acids. It is recommended that
approximately 4 percent of daily calories be EFAs. A deficiency can quickly develop.
Daily essential fatty acids are necessary for constant prostaglandin production. Lipids
are almost isotonic with blood.
6. A male patient needs a percutaneously inserted central catheter (PICC) for prolonged IV
therapy. He knows it can be inserted without going to the operating room. He mentions
QUESTIONS AND ANSWERS WITH
RATIONALES.
1. An infection in a central venous access device is not eliminated by giving antibiotics
through the catheter. How would bacterial glycocalyx contribute to this?
A. It protects the bacteria from antibiotic and immunologic destruction.
B. Glycocalyx neutralizes the antibiotic rendering it ineffective.
C. It competes with the antibiotic for binding sites on the microbe.
D. Glycocalyx provides nutrients for microbial growth.
Rationale: Glycocalyx is a viscous polysaccharide or polypeptide slime that covers
microbes. It enhances adherence to surfaces, resists phagocytic engulfment by the
white blood cells, and prevents antibiotics from contacting the microbe. Glycocalyx
does not have the effects in options B-D
2. Central venous access devices are beneficial in pediatric therapy because:
A. They don’t frighten children.
B. Use of the arms is not restricted.
C. They cannot be dislodged.
D. They are difficult to see.
Rationale: The child can move his extremities and function in a normal fashion. This
lessens stress associated with position restriction and promotes normal activity. Fear
may not be eliminated. All lines can be dislodged. Even small catheters can be readily
seen.
3. How can central venous access devices (CVADs) be of value in a patient receiving
chemotherapy who has stomatitis and severe diarrhea?
A. The chemotherapy can be rapidly completed allowing the stomatitis and diarrhea to
resolve.
B. Crystalloid can be administered to prevent dehydration.
, C. Concentrated hyperalimentation fluid can be administered through the CVAD.
D. The chemotherapy dose can be reduced.
Rationale: In patients unable to take oral nutrition, parenteral hyperalimentation is an
option for providing nutritional support. High concentrations of dextrose, protein,
minerals, vitamins, and trace elements can be provided. Dosing is not affected with
options a and d. Crystalloid can provide free water but has very little nutritional
benefits. Hyperalimentation can provide free water and considerable nutritional
benefits.
4. Some central venous access devices (CVAD) have more than one lumen. These multi
lumen catheters:
A. Have an increased risk of infiltration.
B. Only work a short while because the small bore clots off.
C. Are beneficial to patient care but are prohibitively expensive.
D. Allow different medications or solutions to be administered simultaneously.
Rationale: A multilumen catheter contains separate ports and means to administer
agents. An agent infusing in one port cannot mix with an agent infusing into another
port. Thus, agents that would be incompatible if given together can be given in
separate ports simultaneously.
5. Some institutions will not infuse a fat emulsion, such as Intralipid, into central venous
access devices (CVAD) because:
A. Lipid residue may accumulate in the CVAD and occlude the catheter.
B. If the catheter clogs, there is no treatment other than removal and replacement.
C. Lipids are necessary only in the most extreme cases to prevent essential fatty acid
(EFA) deficiency.
D. Fat emulsions are very caustic.
Rationale: Occlusion occurs with slow infusion rates and concurrent administration
of some medications. Lipid occlusions may be treated with 70 percent ethanol or with
0.1 mmol/mL NaOH. Lipids provide essential fatty acids. It is recommended that
approximately 4 percent of daily calories be EFAs. A deficiency can quickly develop.
Daily essential fatty acids are necessary for constant prostaglandin production. Lipids
are almost isotonic with blood.
6. A male patient needs a percutaneously inserted central catheter (PICC) for prolonged IV
therapy. He knows it can be inserted without going to the operating room. He mentions
