Unlock hundreds more features
Save your Quiz to the Dashboard
View and Export Results
Use AI to Create Quizzes and Analyse Results

Sign inSign in with Facebook
Sign inSign in with Google

Test Your Pharmacological and Parenteral Therapies Knowledge

Challenge yourself with TPN administration, infection prevention, and medication safety scenarios

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration showing TPN bag syringe pills stethoscope shield for infection prevention on sky blue background

Calling all nurses! Ready to advance your expertise? Take our free Master Pharmacological & Parenteral Therapies quiz to test your command of pharmacological and parenteral therapies in real-world scenarios. Tackle TPN administration quiz cases, hone infection prevention nursing quiz protocols, and refine safe medication administration skills. Whether you're prepping for exams or boosting clinical confidence, this pharmacology nursing test provides instant feedback and targeted review. Also explore our parenteral medication administration exam and nursing pharmacology practice questions. Jump in now and elevate your patient care!

Which of the following best describes Total Parenteral Nutrition?
Administration of macro- and micronutrients via the intravenous route
Feeding through a nasogastric tube
Oral supplementation of vitamins and minerals
Topical application of nutrient creams
Total Parenteral Nutrition (TPN) involves delivering all essential nutrients intravenously when the gastrointestinal tract cannot be used. It contains carbohydrates, proteins, fats, electrolytes, vitamins, and trace elements. TPN is distinct from enteral nutrition, which involves feeding via the GI tract. INS Standards for Practice
Which macronutrient is NOT routinely included in a standard TPN solution?
Proteins (amino acids)
Carbohydrates
Lipids
Vitamin C
Standard TPN solutions include carbohydrates (usually as dextrose), amino acids for protein, and lipid emulsions for fat. Vitamins and minerals are considered micronutrients and are added separately in smaller concentrations. Vitamin C is not a macronutrient but rather a micronutrient. NCBI: Clinical Nutrition
Which type of vascular access device is preferred for long-term TPN administration?
Peripheral IV catheter
Midline catheter
Peripherally inserted central catheter (PICC)
Subcutaneous vascular port
Long-term TPN requires a central line to tolerate the high osmolarity of the solution. PICC lines provide reliable central venous access and are suitable for extended therapy. Peripheral and midline catheters cannot safely handle hyperosmolar solutions over time. CDC Bloodstream Infection Guidelines
How often should a TPN administration set typically be changed?
Every 24 hours
Every 48 hours
Every 72 hours
Every 7 days
Infusion sets for TPN are generally replaced every 72 hours to reduce the risk of contamination while accommodating solution stability. Lipid-containing sets may require more frequent changes (every 24 hours). Adhering to these timelines helps prevent infection. INS Practice Recommendations
What is the primary purpose of using an in-line filter during TPN infusion?
Prevent microbial contamination
Remove particulate matter
Control the infusion rate
Adjust the osmolarity of the solution
An in-line filter is used to remove particulate impurities and precipitates from TPN solutions before they enter the bloodstream. This reduces the risk of emboli and phlebitis. Filters do not directly control rate or osmolarity. UpToDate: TPN Administration
How frequently should the dressing at a central line site for TPN be changed?
Every shift
Every 24 hours
Every 48 hours
Every 7 days
According to CDC guidelines, transparent semipermeable dressings on central line sites may remain in place up to seven days unless soiled or loose. This interval balances infection prevention and catheter stability. CDC Central Line Dressings
Which laboratory value is most critical to monitor daily in a patient receiving TPN?
Serum creatinine
Blood glucose level
White blood cell count
Platelet count
TPN solutions are high in dextrose and can cause hyperglycemia. Daily monitoring of blood glucose is essential to adjust insulin therapy and prevent complications. Renal and hematologic labs are important but not as time-sensitive. NCBI: Nutrition Support Therapy
A patient on TPN develops new-onset fever and chills. What is the most appropriate initial action?
Slow down the TPN infusion rate
Change the catheter dressing immediately
Obtain paired blood cultures
Increase the lipid infusion rate
Fever and chills in a TPN patient may indicate catheter-related bloodstream infection. The priority is to obtain paired blood cultures (from catheter and peripheral site) before initiating antibiotics. This guides targeted therapy and prevents delays. CDC Bloodstream Infection Guidelines
Which infusion time is recommended for initiating a lipid emulsion in TPN to reduce risk of lipid intolerance?
30 minutes
1–2 hours
4–6 hours
24 hours
Lipid emulsions should be infused over at least 1–2 hours initially to monitor for allergic reactions and intolerance. Rapid infusion can cause fever, chills, or fat overload syndrome. Slow titration improves tolerance. NCBI Lipid Emulsion Guidelines
Which medication is commonly incompatible when administered via a Y-site with TPN?
Furosemide
Heparin
Phenytoin
Potassium chloride
Phenytoin is known to precipitate in dextrose-containing solutions like TPN when co-administered via Y-site. This can lead to catheter occlusion and emboli. Other drugs listed are compatible when administered separately. INS Drug Compatibility List
When compounding TPN, which pair of electrolytes poses the highest risk of precipitation if mixed in high concentrations?
Sodium and chloride
Calcium and phosphate
Potassium and magnesium
Glucose and amino acids
Calcium and phosphate can form insoluble precipitates if their concentrations exceed solubility limits or are mixed improperly. This poses a risk for emboli if infused. Careful ordering, pH control, and addition sequence are critical. ISMP Calcium-Phosphate Guide
What is the most common metabolic complication upon initiation of TPN?
Hypoglycemia
Hyperglycemia
Hypernatremia
Hypokalemia
Because TPN solutions contain high concentrations of dextrose, hyperglycemia is common, especially if insulin is not adequately adjusted. Monitoring and insulin supplementation are essential. UpToDate: TPN Metabolic Complications
Which intervention reduces the risk of infection during TPN administration?
Leaving the line open between doses
Adding heparin to the solution
Using multi-lumen catheters
Using sutureless securement devices
Sutureless securement devices reduce catheter movement and microbial entry at the insertion site, lowering infection risk. They are recommended in current vascular access guidelines. Adding heparin and multi-lumens do not directly prevent infection. CDC Catheter Securement
Which clinical sign suggests a catheter-related thrombosis in a patient receiving TPN?
Hyperglycemia
Bradycardia
Edema of the limb near the catheter site
Hypotension
Unilateral swelling or edema of the limb on the catheter insertion side may indicate catheter-related thrombosis. Early detection via ultrasound prevents serious complications. Vital sign changes are less specific. NCBI: Vascular Access Thrombosis
Which mixing sequence best prevents calcium-phosphate precipitation in a TPN bag?
Add calcium first, then phosphate
Add phosphate first, then calcium
Add calcium and phosphate simultaneously
Store admixture at 4°C overnight
Adding phosphate before calcium helps maintain pH and solubility, reducing precipitation risk. Simultaneous addition or reversing the order can push the solution beyond its saturation point. Temperature control alone is insufficient. ISMP Calcium-Phosphate Guide
Which insulin type is most appropriate for addition to a TPN solution for glycemic control?
Regular insulin
NPH insulin
Insulin glargine
Insulin lispro
Regular insulin is compatible with TPN solutions and has a predictable onset and duration, allowing for steady control of the high dextrose infusion. Intermediate and long-acting insulins are not recommended in TPN due to their different absorption profiles. UpToDate: Insulin in TPN
A patient on overnight TPN has serum triglycerides of 450 mg/dL. What is the most appropriate intervention?
Increase the lipid infusion rate
Hold the lipid emulsion until levels decrease
Decrease dextrose concentration
Continue infusion as ordered
Serum triglycerides above 400 mg/dL indicate lipid intolerance and risk of fat overload. Lipid emulsions should be held until levels decline, then reintroduced at a lower rate. Continuing or increasing rate could worsen the condition. NCBI: Lipid Monitoring
What maximum difference between calcium and phosphate concentrations (mEq/L) helps minimize precipitation risk in TPN?
5
10
20
30
Maintaining a difference of no more than 10 mEq/L between calcium and phosphate concentrations reduces the risk of precipitation in TPN admixtures. This guideline is based on solubility charts and clinical compounding standards. ISMP Solubility Data
Which hand hygiene method is most effective for preventing catheter-related infections during TPN administration?
Plain soap and water
Alcohol-based hand rub
Antibacterial soap with water
Donning sterile gloves without hand hygiene
Alcohol-based hand rubs are more effective and faster at reducing skin microbial counts than plain or antibacterial soap and water, per CDC guidelines. They are recommended before and after catheter manipulation. Gloves must follow proper hand hygiene. CDC Hand Hygiene Guidelines
Which USP standard governs sterile compounding of TPN admixtures?
USP <800>
USP <825>
USP <797>
USP <825>Chapter 3
USP <797> provides standards for sterile compounding, including requirements for personnel, facilities, and procedures for TPN admixture preparation. USP <800> covers hazardous drugs, and <825> focuses on radiopharmaceuticals. USP General Chapter <797>
When assessing a patient for refeeding syndrome risk before TPN initiation, which electrolyte is most critical to monitor?
Calcium
Phosphate
Sodium
Chloride
Hypophosphatemia is the hallmark of refeeding syndrome and can lead to muscle weakness, arrhythmias, and respiratory failure. Phosphate must be closely monitored and supplemented if low when initiating TPN in malnourished patients. NCBI: Refeeding Syndrome
A TPN line is disconnected for 90 minutes. What is the best nursing action to prevent hypoglycemia?
Flush the line and resume TPN
Discard remaining TPN and start a new bag
Hang 10% dextrose at the same infusion rate
Restart TPN at double rate
An interruption longer than 1–2 hours in TPN infusion can cause hypoglycemia. Hanging a 10% dextrose solution at the same rate maintains glucose delivery until TPN is reconnected. Restarting at a higher rate or flushing without dextrose risks glycemic instability. UpToDate: TPN Interruptions
To avoid hyperglycemia, dextrose infusion rates in TPN should generally not exceed how many mg/kg/min?
2 mg/kg/min
4 mg/kg/min
8 mg/kg/min
12 mg/kg/min
A dextrose infusion rate of up to 4–5 mg/kg/min is recommended to minimize hyperglycemia and glucose intolerance. Rates above this threshold increase the risk of metabolic complications. UpToDate: Dextrose Infusion Rates
Which advanced strategy can reduce catheter-related bloodstream infection rates in long-term TPN patients?
Reducing dressing change frequency
Ethanol lock therapy
Using multi-lumen catheters
Increasing lipid concentration
Ethanol lock therapy involves instilling an ethanol solution into the catheter lumen between uses to eradicate biofilm-forming organisms. Studies show it significantly lowers catheter-related infection rates in long-term TPN. Standard care alone may not address biofilm. PMC: Ethanol Lock Therapy
According to semiquantitative roll-plate culture, what colony count threshold indicates catheter-related infection?
>1,000 CFU
>100 CFU
>15 CFU
>50 CFU
A semiquantitative roll-plate culture yielding more than 15 colony-forming units (CFU) from a catheter tip suggests catheter-related infection. This threshold helps distinguish colonization from true infection. CDC Surgical Care Guidelines
0
{"name":"Which of the following best describes Total Parenteral Nutrition?", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Which of the following best describes Total Parenteral Nutrition?, Which macronutrient is NOT routinely included in a standard TPN solution?, Which type of vascular access device is preferred for long-term TPN administration?","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}

Study Outcomes

  1. Analyze Pharmacological Principles -

    Break down drug mechanisms, interactions, and side effects to optimize patient outcomes in pharmacology nursing tests.

  2. Apply Safe Medication Administration -

    Demonstrate the "five rights" and best practices for delivering medications intravenously and intramuscularly.

  3. Demonstrate TPN Administration -

    Outline the steps for total parenteral nutrition nursing quiz scenarios, including line setup, solution preparation, and monitoring.

  4. Implement Infection Prevention -

    Identify and apply aseptic techniques and bundle strategies to reduce catheter”related and infusion”related infections.

  5. Calculate Accurate Dosages -

    Use formula-based methods to determine correct medication volumes and infusion rates for safe parenteral therapy.

  6. Interpret Clinical Scenarios -

    Evaluate real-world case studies to reinforce decision-making skills in pharmacological and parenteral therapies.

Cheat Sheet

  1. Calculating TPN Macronutrients -

    When mastering pharmacological and parenteral therapies and preparing for a TPN administration quiz, determining TPN macronutrient requirements involves precise formulas for dextrose, amino acids, and lipids, usually prescribed in g/kg/day. For instance, dextrose is given at 4 - 6 mg/kg/min; recall the "CAL" mnemonic for Carbs, Aminos, Lipids. Accurate calculations help prevent refeeding syndrome and electrolyte imbalances.

  2. Infection Prevention in Parenteral Therapy -

    During an infection prevention nursing quiz or real-world parenteral therapy scenario, strict sterile technique and CDC catheter-care bundles reduce bloodstream infection risk. Use the SHARP mnemonic (Scrub hub, Hand hygiene, Aseptic field, Rotate site, Protect dressing) during every line access. Regularly monitoring for redness, warmth, or discharge can catch infections early.

  3. Safe Medication Administration -

    Implement the "Six Rights" of medication (patient, drug, dose, route, time, documentation) to minimize errors in both pharmacology nursing tests and clinical practice. For high-alert medications, incorporate a second nurse verification and barcoding technology. A simple mnemonic - "PDDRTD" - helps recall each right before every dose.

  4. Key Pharmacokinetic Equations -

    Memorize loading dose (LD = target concentration × Vd/F) and maintenance dose (MD = clearance × target concentration/F) to optimize IV therapy and ace your pharmacology nursing test. Understanding half-life (t½) and volume of distribution (Vd) informs dosing intervals and time to steady state. Tip: two half-lives achieve ~75% drug elimination, guiding tapering and discontinuation plans.

  5. Monitoring Adverse Effects and Complications -

    Regularly assess blood glucose every 4 - 6 hours and monitor electrolytes (Na, K, Mg) to detect hyperglycemia or refeeding syndrome in parenteral nutrition nursing quizzes and practice. Examine infusion sites for phlebitis, infiltration, or lipid overload, and watch for sudden fever indicating anaphylaxis. Prompt recognition and intervention, per JBI recommendations, ensure patient safety.

Powered by: Quiz Maker