NUR 210 Exam 4 Galen Pharmacology – (2026) Actual Questions and Answers
(PDF).
Section 1: Penicillins & Cephalosporins (Q1–20)
1. A patient with strep throat is prescribed amoxicillin. Which statement indicates
a need for further teaching?
a) “I should take this until the prescription is finished.”
b) “I can stop when I feel better to avoid diarrhea.”
c) “Mild rash might occur but report severe hives.”
d) “Taking with food can reduce stomach upset.”
Answer: b
Rationale: Stopping antibiotics early promotes resistance and relapse. Patients
must complete the full course even if symptoms improve.
2. A nurse administers cefazolin IV. Which allergy history requires holding the
dose and notifying the provider?
a) Penicillin anaphylaxis
b) Sulfa rash
c) Peanuts
,d) Codeine nausea
Answer: a
Rationale: Cross-sensitivity between penicillins and cephalosporins occurs in 1–
10% of patients. Severe penicillin allergy (anaphylaxis) warrants avoidance.
3. Which lab finding is most concerning in a patient on high-dose piperacillin-
tazobactam?
a) Sodium 138 mEq/L
b) Potassium 2.9 mEq/L
c) Glucose 110 mg/dL
d) Creatinine 0.8 mg/dL
Answer: b
Rationale: Piperacillin increases renal potassium excretion, causing hypokalemia
(normal K+ 3.5–5.0 mEq/L).
4. A patient with prior urticaria from penicillin is ordered cefuroxime. What
should the nurse do first?
a) Administer as ordered
,b) Give diphenhydramine prophylactically
c) Request a different antibiotic class
d) Flush IV line with saline
Answer: c
Rationale: Urticaria indicates moderate allergy; cephalosporins should be avoided
unless no alternative exists and desensitization is planned.
5. A patient on ampicillin develops watery diarrhea 10 times/day, abdominal pain,
and fever. What is the priority action?
a) Administer loperamide
b) Obtain stool for C. diff toxin
c) Increase oral fluids
d) Give probiotic
Answer: b
Rationale: These symptoms suggest Clostridioides difficile infection, a serious
complication of antibiotics. Testing is needed before treatment.
, 6. Nafcillin is infusing IV when the patient reports burning at the site and redness
tracking up the vein. The nurse suspects:
a) Anaphylaxis
b) Extravasation
c) Thrombophlebitis
d) Stevens-Johnson syndrome
Answer: c
Rationale: Nafcillin is highly irritating; thrombophlebitis is common. Rotate sites
and dilute properly.
7. Which cephalosporin carries the highest risk of bleeding complications?
a) Cephalexin
b) Cefazolin
c) Cefotetan
d) Ceftriaxone
Answer: c
Rationale: Cefotetan and cefoperazone contain an NMTT side chain that inhibits
vitamin K–dependent clotting factors.
(PDF).
Section 1: Penicillins & Cephalosporins (Q1–20)
1. A patient with strep throat is prescribed amoxicillin. Which statement indicates
a need for further teaching?
a) “I should take this until the prescription is finished.”
b) “I can stop when I feel better to avoid diarrhea.”
c) “Mild rash might occur but report severe hives.”
d) “Taking with food can reduce stomach upset.”
Answer: b
Rationale: Stopping antibiotics early promotes resistance and relapse. Patients
must complete the full course even if symptoms improve.
2. A nurse administers cefazolin IV. Which allergy history requires holding the
dose and notifying the provider?
a) Penicillin anaphylaxis
b) Sulfa rash
c) Peanuts
,d) Codeine nausea
Answer: a
Rationale: Cross-sensitivity between penicillins and cephalosporins occurs in 1–
10% of patients. Severe penicillin allergy (anaphylaxis) warrants avoidance.
3. Which lab finding is most concerning in a patient on high-dose piperacillin-
tazobactam?
a) Sodium 138 mEq/L
b) Potassium 2.9 mEq/L
c) Glucose 110 mg/dL
d) Creatinine 0.8 mg/dL
Answer: b
Rationale: Piperacillin increases renal potassium excretion, causing hypokalemia
(normal K+ 3.5–5.0 mEq/L).
4. A patient with prior urticaria from penicillin is ordered cefuroxime. What
should the nurse do first?
a) Administer as ordered
,b) Give diphenhydramine prophylactically
c) Request a different antibiotic class
d) Flush IV line with saline
Answer: c
Rationale: Urticaria indicates moderate allergy; cephalosporins should be avoided
unless no alternative exists and desensitization is planned.
5. A patient on ampicillin develops watery diarrhea 10 times/day, abdominal pain,
and fever. What is the priority action?
a) Administer loperamide
b) Obtain stool for C. diff toxin
c) Increase oral fluids
d) Give probiotic
Answer: b
Rationale: These symptoms suggest Clostridioides difficile infection, a serious
complication of antibiotics. Testing is needed before treatment.
, 6. Nafcillin is infusing IV when the patient reports burning at the site and redness
tracking up the vein. The nurse suspects:
a) Anaphylaxis
b) Extravasation
c) Thrombophlebitis
d) Stevens-Johnson syndrome
Answer: c
Rationale: Nafcillin is highly irritating; thrombophlebitis is common. Rotate sites
and dilute properly.
7. Which cephalosporin carries the highest risk of bleeding complications?
a) Cephalexin
b) Cefazolin
c) Cefotetan
d) Ceftriaxone
Answer: c
Rationale: Cefotetan and cefoperazone contain an NMTT side chain that inhibits
vitamin K–dependent clotting factors.
