NCLEX Nursing Pharmacology Mastery
Challenge Exam (Quiz #1: 50 Questions)
Latest Edition
1. 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
Answer: C. Monitor serum glucose levels
Explanation:
TPN contains high glucose → risk of hyperglycemia, especially on day 1. This can
quickly become life-threatening, making glucose monitoring the top priority.
2. 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°C
B. Urine output of 300 cc in 4 hours
,C. Poor skin turgor
D. Blood glucose of 350 mg/dL
Answer: D. Blood glucose of 350 mg/dL
Explanation:
A glucose level of 350 mg/dL = severe hyperglycemia, requiring immediate intervention
(insulin, adjust TPN).
3. 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. Slows viral replication
B. Improves overall health
C. Prevents bacterial infections
D. Enhances other medications
Answer: C. Prevents bacterial infections
Explanation:
IVIG provides passive immunity, helping prevent infections in immunocompromised
clients.
4. When caring for a client with total parenteral nutrition (TPN),
what is the most important action on the part of the nurse?
A. Record number of stools
B. Maintain strict intake and output
C. Use sterile technique for dressing change
, D. Monitor for cardiac arrhythmias
Answer: C. Use sterile technique for dressing change
Explanation:
Central lines + glucose-rich TPN = high infection risk (sepsis) → sterile technique is
priority.
5. The nurse is administering an intravenous vesicant
chemotherapeutic agent to a client. Which assessment would
require the nurse’s immediate action?
A. Stomatitis
B. Severe nausea and vomiting
C. Pain at IV site
D. Rash on extremities
Answer: C. Pain at IV site
Explanation:
Pain indicates extravasation, which can cause tissue necrosis → stop infusion
immediately.
6. Nurse Celine is caring for a client with clinical depression who
is receiving an MAO inhibitor. When providing instructions about
precautions with this medication, the nurse should instruct the
client to:
A. Avoid chocolate and cheese
B. Take frequent naps
Challenge Exam (Quiz #1: 50 Questions)
Latest Edition
1. 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
Answer: C. Monitor serum glucose levels
Explanation:
TPN contains high glucose → risk of hyperglycemia, especially on day 1. This can
quickly become life-threatening, making glucose monitoring the top priority.
2. 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°C
B. Urine output of 300 cc in 4 hours
,C. Poor skin turgor
D. Blood glucose of 350 mg/dL
Answer: D. Blood glucose of 350 mg/dL
Explanation:
A glucose level of 350 mg/dL = severe hyperglycemia, requiring immediate intervention
(insulin, adjust TPN).
3. 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. Slows viral replication
B. Improves overall health
C. Prevents bacterial infections
D. Enhances other medications
Answer: C. Prevents bacterial infections
Explanation:
IVIG provides passive immunity, helping prevent infections in immunocompromised
clients.
4. When caring for a client with total parenteral nutrition (TPN),
what is the most important action on the part of the nurse?
A. Record number of stools
B. Maintain strict intake and output
C. Use sterile technique for dressing change
, D. Monitor for cardiac arrhythmias
Answer: C. Use sterile technique for dressing change
Explanation:
Central lines + glucose-rich TPN = high infection risk (sepsis) → sterile technique is
priority.
5. The nurse is administering an intravenous vesicant
chemotherapeutic agent to a client. Which assessment would
require the nurse’s immediate action?
A. Stomatitis
B. Severe nausea and vomiting
C. Pain at IV site
D. Rash on extremities
Answer: C. Pain at IV site
Explanation:
Pain indicates extravasation, which can cause tissue necrosis → stop infusion
immediately.
6. Nurse Celine is caring for a client with clinical depression who
is receiving an MAO inhibitor. When providing instructions about
precautions with this medication, the nurse should instruct the
client to:
A. Avoid chocolate and cheese
B. Take frequent naps
