NSG 318 Exam 3 – GCU Pharmacology – 2026 Actual Questions & Answers
Section 1: Antibiotics & Antimicrobials (Questions 1–40)
A nurse is administering IV vancomycin. Which adverse effect requires immediate
nursing intervention?
a) Red man syndrome
b) Nausea
c) Headache
d) Metallic taste
Answer: a) Red man syndrome
Rationale: Red man syndrome (flushing, hypotension, rash) is caused by rapid IV
infusion. Slow infusion over ≥60 minutes prevents it.
A patient on gentamicin reports tinnitus. What is the priority action?
a) Increase fluids
b) Hold the next dose and notify provider
c) Administer aspirin
d) Continue as ordered
Answer: b) Hold the next dose and notify provider
,Rationale: Tinnitus indicates ototoxicity, an irreversible side effect of
aminoglycosides.
Which lab value is most critical to monitor in a patient receiving
piperacillin/tazobactam?
a) Serum potassium
b) Creatinine
c) Hemoglobin
d) Platelets
Answer: b) Creatinine
Rationale: Renal impairment can occur; monitor BUN/creatinine, especially with
high doses.
A patient with a penicillin allergy is prescribed cephalexin. What should the nurse
do?
a) Administer as ordered
b) Give with an antihistamine
c) Notify provider – possible cross-sensitivity
d) Give a test dose
Answer: c) Notify provider – possible cross-sensitivity
,Rationale: 1–10% cross-reactivity between penicillins and cephalosporins.
Which instruction is correct for doxycycline?
a) Take with dairy products
b) Take with antacids
c) Avoid sunlight, use sunscreen
d) Take on an empty stomach only
Answer: c) Avoid sunlight, use sunscreen
Rationale: Tetracyclines cause photosensitivity; patient should use protective
clothing/sunscreen.
A patient on metronidazole drinks alcohol and develops severe nausea, vomiting,
and flushing. This is:
a) Anaphylaxis
b) Disulfiram-like reaction
c) Serotonin syndrome
d) Hemolytic crisis
Answer: b) Disulfiram-like reaction
Rationale: Metronidazole inhibits aldehyde dehydrogenase, causing acetaldehyde
accumulation.
, Which antibiotic is associated with tendon rupture, especially in patients over 60?
a) Azithromycin
b) Ciprofloxacin
c) Doxycycline
d) Amoxicillin
Answer: b) Ciprofloxacin
Rationale: Fluoroquinolones increase risk of tendonitis/tendon rupture, especially
with corticosteroids.
A child receiving amoxicillin for otitis media develops a diffuse, maculopapular
rash 5 days into treatment. The nurse suspects:
a) Serum sickness
b) Type I hypersensitivity
c) Viral exanthem or delayed allergic reaction
d) Stevens-Johnson syndrome
Answer: c) Viral exanthem or delayed allergic reaction
Rationale: Amoxicillin rash is common in children with viral infections; not always
true allergy.
Section 1: Antibiotics & Antimicrobials (Questions 1–40)
A nurse is administering IV vancomycin. Which adverse effect requires immediate
nursing intervention?
a) Red man syndrome
b) Nausea
c) Headache
d) Metallic taste
Answer: a) Red man syndrome
Rationale: Red man syndrome (flushing, hypotension, rash) is caused by rapid IV
infusion. Slow infusion over ≥60 minutes prevents it.
A patient on gentamicin reports tinnitus. What is the priority action?
a) Increase fluids
b) Hold the next dose and notify provider
c) Administer aspirin
d) Continue as ordered
Answer: b) Hold the next dose and notify provider
,Rationale: Tinnitus indicates ototoxicity, an irreversible side effect of
aminoglycosides.
Which lab value is most critical to monitor in a patient receiving
piperacillin/tazobactam?
a) Serum potassium
b) Creatinine
c) Hemoglobin
d) Platelets
Answer: b) Creatinine
Rationale: Renal impairment can occur; monitor BUN/creatinine, especially with
high doses.
A patient with a penicillin allergy is prescribed cephalexin. What should the nurse
do?
a) Administer as ordered
b) Give with an antihistamine
c) Notify provider – possible cross-sensitivity
d) Give a test dose
Answer: c) Notify provider – possible cross-sensitivity
,Rationale: 1–10% cross-reactivity between penicillins and cephalosporins.
Which instruction is correct for doxycycline?
a) Take with dairy products
b) Take with antacids
c) Avoid sunlight, use sunscreen
d) Take on an empty stomach only
Answer: c) Avoid sunlight, use sunscreen
Rationale: Tetracyclines cause photosensitivity; patient should use protective
clothing/sunscreen.
A patient on metronidazole drinks alcohol and develops severe nausea, vomiting,
and flushing. This is:
a) Anaphylaxis
b) Disulfiram-like reaction
c) Serotonin syndrome
d) Hemolytic crisis
Answer: b) Disulfiram-like reaction
Rationale: Metronidazole inhibits aldehyde dehydrogenase, causing acetaldehyde
accumulation.
, Which antibiotic is associated with tendon rupture, especially in patients over 60?
a) Azithromycin
b) Ciprofloxacin
c) Doxycycline
d) Amoxicillin
Answer: b) Ciprofloxacin
Rationale: Fluoroquinolones increase risk of tendonitis/tendon rupture, especially
with corticosteroids.
A child receiving amoxicillin for otitis media develops a diffuse, maculopapular
rash 5 days into treatment. The nurse suspects:
a) Serum sickness
b) Type I hypersensitivity
c) Viral exanthem or delayed allergic reaction
d) Stevens-Johnson syndrome
Answer: c) Viral exanthem or delayed allergic reaction
Rationale: Amoxicillin rash is common in children with viral infections; not always
true allergy.
