NCLEX NURSING PHARMACOLOGY 2026 EXAM WITH
SOLUTIONS TO ANSWERS TESTBANK
1. Question1 point(s)
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.
Incorrect
C. Monitor serum glucose levels.
Correct Answer
D. Check results of liver function tests.
Incorrect
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.
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. Question1 point(s)
,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.
Incorrect
D. Blood glucose of 350 mg/dl.
Correct Answer
Incorrect
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 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. Question1 point(s)
SOLUTIONS TO ANSWERS TESTBANK
1. Question1 point(s)
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.
Incorrect
C. Monitor serum glucose levels.
Correct Answer
D. Check results of liver function tests.
Incorrect
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.
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. Question1 point(s)
,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.
Incorrect
D. Blood glucose of 350 mg/dl.
Correct Answer
Incorrect
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 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. Question1 point(s)
