NSG 318 Exam 4: Pharmacology Review - Anti-infectives, Antivirals,
and Oncology 2026 – GCU
1. A patient with a documented severe anaphylactic reaction to Penicillin G is
prescribed Cefazolin. Which action by the nurse is most appropriate?
A. Administer the medication and monitor for 30 minutes.
B. Withhold the medication and notify the healthcare provider.
C. Premedicate the patient with diphenhydramine before administration.
D. Administer the medication as ordered since they are in different classes.
Answer: B
Rationale: Due to structural similarities, there is a risk of cross-sensitivity between
penicillins and cephalosporins. In patients with a history of anaphylaxis to penicillin,
cephalosporins should be avoided.
2. The nurse is preparing to administer intravenous Vancomycin. Which action is
essential to prevent Red Man Syndrome?
A. Administer the medication as a rapid IV bolus.
B. Infuse the medication over at least 60 minutes.
C. Mix the medication with a heparinized solution.
D. Restrict fluid intake during the infusion.
Answer: B
Rationale: Red Man Syndrome is a rate-dependent reaction. Infusing Vancomycin slowly
(over 60 minutes or more) prevents the massive histamine release associated with this
condition.
,3. A patient is prescribed oral Tetracycline for acne. What dietary instruction
should the nurse provide?
A. Take the medication with a full glass of milk.
B. Avoid dairy products and antacids for 2 hours before and after dosing.
C. Take the medication with an antacid to prevent GI upset.
D. Consume a high-calcium diet while on this therapy.
Answer: B
Rationale: Tetracyclines chelate with calcium, magnesium, and aluminum, which
significantly reduces drug absorption.
4. Which laboratory value is most important for the nurse to monitor in a
patient receiving Gentamicin?
A. Serum glucose
B. Serum creatinine
C. Prothrombin time (PT)
D. Serum potassium
Answer: B
Rationale: Aminoglycosides like Gentamicin are highly nephrotoxic. Monitoring serum
creatinine and BUN is essential to detect early renal impairment.
5. A patient starting Rifampin for tuberculosis (TB) expresses concern that his
urine has turned orange. What is the nurse’s best response?
A. This is a sign of liver toxicity and must be reported immediately.
B. This is a normal and harmless side effect of the medication.
C. You may be developing a urinary tract infection.
D. We need to reduce your dosage immediately.
Answer: B
Rationale: Rifampin commonly causes a harmless red-orange discoloration of urine, sweat,
tears, and saliva.
, 6. To prevent peripheral neuropathy associated with Isoniazid (INH) therapy,
the nurse anticipates administering which supplement?
A. Vitamin B12
B. Vitamin B6 (Pyridoxine)
C. Vitamin C
D. Folic acid
Answer: B
Rationale: Isoniazid can cause Vitamin B6 deficiency, leading to peripheral neuropathy.
Pyridoxine is often co-administered to prevent this.
7. A patient taking Metronidazole for a protozoal infection should be warned to
avoid which of the following?
A. Grapefruit juice
B. Sunlight exposure
C. Alcoholic beverages
D. Aged cheeses
Answer: C
Rationale: Metronidazole can cause a disulfiram-like reaction (nausea, vomiting, flushing,
tachycardia) if consumed with alcohol.
8. Before administering Amphotericin B, the nurse expects to premedicate the
patient with which drugs to minimize infusion reactions?
A. Furosemide and Spironolactone
B. Insulin and Glucose
C. Aspirin and Warfarin
D. Diphenhydramine and Acetaminophen
Answer: D
Rationale: Amphotericin B often causes ‘shake and bake’ symptoms (fever, chills, rigors).
Premedicating with an antihistamine and an antipyretic helps mitigate these effects.
and Oncology 2026 – GCU
1. A patient with a documented severe anaphylactic reaction to Penicillin G is
prescribed Cefazolin. Which action by the nurse is most appropriate?
A. Administer the medication and monitor for 30 minutes.
B. Withhold the medication and notify the healthcare provider.
C. Premedicate the patient with diphenhydramine before administration.
D. Administer the medication as ordered since they are in different classes.
Answer: B
Rationale: Due to structural similarities, there is a risk of cross-sensitivity between
penicillins and cephalosporins. In patients with a history of anaphylaxis to penicillin,
cephalosporins should be avoided.
2. The nurse is preparing to administer intravenous Vancomycin. Which action is
essential to prevent Red Man Syndrome?
A. Administer the medication as a rapid IV bolus.
B. Infuse the medication over at least 60 minutes.
C. Mix the medication with a heparinized solution.
D. Restrict fluid intake during the infusion.
Answer: B
Rationale: Red Man Syndrome is a rate-dependent reaction. Infusing Vancomycin slowly
(over 60 minutes or more) prevents the massive histamine release associated with this
condition.
,3. A patient is prescribed oral Tetracycline for acne. What dietary instruction
should the nurse provide?
A. Take the medication with a full glass of milk.
B. Avoid dairy products and antacids for 2 hours before and after dosing.
C. Take the medication with an antacid to prevent GI upset.
D. Consume a high-calcium diet while on this therapy.
Answer: B
Rationale: Tetracyclines chelate with calcium, magnesium, and aluminum, which
significantly reduces drug absorption.
4. Which laboratory value is most important for the nurse to monitor in a
patient receiving Gentamicin?
A. Serum glucose
B. Serum creatinine
C. Prothrombin time (PT)
D. Serum potassium
Answer: B
Rationale: Aminoglycosides like Gentamicin are highly nephrotoxic. Monitoring serum
creatinine and BUN is essential to detect early renal impairment.
5. A patient starting Rifampin for tuberculosis (TB) expresses concern that his
urine has turned orange. What is the nurse’s best response?
A. This is a sign of liver toxicity and must be reported immediately.
B. This is a normal and harmless side effect of the medication.
C. You may be developing a urinary tract infection.
D. We need to reduce your dosage immediately.
Answer: B
Rationale: Rifampin commonly causes a harmless red-orange discoloration of urine, sweat,
tears, and saliva.
, 6. To prevent peripheral neuropathy associated with Isoniazid (INH) therapy,
the nurse anticipates administering which supplement?
A. Vitamin B12
B. Vitamin B6 (Pyridoxine)
C. Vitamin C
D. Folic acid
Answer: B
Rationale: Isoniazid can cause Vitamin B6 deficiency, leading to peripheral neuropathy.
Pyridoxine is often co-administered to prevent this.
7. A patient taking Metronidazole for a protozoal infection should be warned to
avoid which of the following?
A. Grapefruit juice
B. Sunlight exposure
C. Alcoholic beverages
D. Aged cheeses
Answer: C
Rationale: Metronidazole can cause a disulfiram-like reaction (nausea, vomiting, flushing,
tachycardia) if consumed with alcohol.
8. Before administering Amphotericin B, the nurse expects to premedicate the
patient with which drugs to minimize infusion reactions?
A. Furosemide and Spironolactone
B. Insulin and Glucose
C. Aspirin and Warfarin
D. Diphenhydramine and Acetaminophen
Answer: D
Rationale: Amphotericin B often causes ‘shake and bake’ symptoms (fever, chills, rigors).
Premedicating with an antihistamine and an antipyretic helps mitigate these effects.
