NSG124 / NSG 124 Exam 2
| Latest Update |Newly Released
Pharmacology | Questions & Answers | Graded A+
Guaranteed Pass | 100% Correct - Herzing University
Q1: A patient is prescribed amoxicillin for a bacterial infection. The nurse reviews the patient's
medical history and notes a documented allergy to penicillin. What is the priority nursing
action?
A. Administer the drug and observe for anaphylaxis.
B. Clarify the type of allergic reaction with the patient.
C. Substitute the order with a cephalosporin.
D. Administer an antihistamine prior to the dose.
Correct Answer: B
Rationale: Correct because penicillin allergies can range from mild rash to life-threatening
anaphylaxis, and the nurse must determine the severity before proceeding. The mechanism of
action of penicillins involves inhibiting cell wall synthesis, but in allergic patients, the immune
system triggers IgE-mediated responses. If a severe allergy is confirmed, the nurse must
withhold the drug and notify the prescriber to select a non-penicillin antibiotic.
Q2: The nurse is teaching a patient prescribed ipratropium for COPD about the mechanism of
action. Which explanation by the nurse is accurate?
A. It blocks the paras ympathetic ner vous s ys tem to prevent bronchocons triction.
B. It stimulates beta-2 receptors to relax smooth muscle.
C. It reduces inflammation in the airways by inhibiting histamine.
D. It thins mucus secretions to improve expectoration.
Correct Answer: A
,Rationale: Correct because ipratropium is an anticholinergic that blocks muscarinic receptors
in the bronchial smooth muscle, preventing parasympathetic-induced bronchoconstriction.
This leads to bronchodilation and improved airflow. Unlike beta-agonists, it does not directly
stimulate beta-2 receptors but rather inhibits the vagal response.
Q3: A patient with atrial fibrillation is taking warfarin. The nurse reviews the laboratory results
and notes an International Normalized Ratio (INR) of 5.2. The patient is not experiencing
bleeding. What is the priority nursing intervention?
A. Administer vitamin K orally.
B. Administer a unit of fresh frozen plasma.
C. Hold the next dos e of warfarin and notify the provider.
D. Increase the dose of warfarin to reach a therapeutic range.
Correct Answer: C
Rationale: Correct because an INR of 5.2 is significantly above the therapeutic range of 2.0 to
3.0 for atrial fibrillation, placing the patient at high risk for bleeding. The priority action is to
hold the dose to allow the INR to decrease and notify the provider for further instructions.
Vitamin K or plasma are typically reserved for patients with severe bleeding or significantly
elevated INRs.
Q4: A 34-year-old female patient presents with a urinary tract infection (UTI). She reports a
history of anaphylaxis to penicillin. The physician orders cephalexin. What is the nurse's best
response?
A. Administer the cephalexin because cross-reactivity is rare.
B. Reques t an order for a different clas s of antibiotic.
C. Administer the cephalexin with diphenhydramine.
D. Perform a skin test before administering the drug.
Correct Answer: B
Rationale: Correct because there is a potential for cross-reactivity between penicillins and
cephalosporins, estimated between 1% and 10%, which is higher in patients with a history of
anaphylaxis. Patient safety dictates avoiding cephalosporins if the patient has had a severe
, penicillin allergy. The nurse should advocate for a non-beta-lactam antibiotic, such as a
fluoroquinolone or trimethoprim-sulfamethoxazole, if not contraindicated.
Q5: A patient receiving intravenous vancomycin complains of flushing and "redness" on the
face and neck during the infusion. What is the priority nursing action?
A. Stop the infusion and administer diphenhydramine.
B. Slow the infus ion rate and as s es s the patient's blood pres s ure.
C. Check the patient's oxygen saturation and administer oxygen.
D. Discontinue the vancomycin and notify the provider immediately.
Correct Answer: B
Rationale: Correct because the patient is likely experiencing Red Man Syndrome, a non-
allergic infusion-related reaction caused by histamine release. The mechanism of action of
vancomycin involves inhibiting cell wall synthesis, but rapid infusion causes direct mast cell
degranulation. Slowing the infusion rate usually resolves the symptoms, whereas stopping
the drug is only necessary if severe hypotension or anaphylaxis occurs.
Q6: The nurse is preparing to administer amphotericin B to a patient with a systemic fungal
infection. Which premedication and intervention are most important to prevent adverse
effects?
A. Acetaminophen and normal s aline hydration.
B. Diphenhydramine and potassium supplementation.
C. Corticosteroids and low-fat diet.
D. Ibuprofen and fluid restriction.
Correct Answer: A
Rationale: Correct because amphotericin B binds to ergosterol in fungal cell membranes but
can cause nephrotoxicity and infusion reactions such as fever and chills. Premedicating with
acetaminophen and diphenhydramine helps prevent infusion reactions, while aggressive
hydration with normal saline is crucial to dilute the drug in the kidneys and reduce the risk of
nephrotoxicity.
| Latest Update |Newly Released
Pharmacology | Questions & Answers | Graded A+
Guaranteed Pass | 100% Correct - Herzing University
Q1: A patient is prescribed amoxicillin for a bacterial infection. The nurse reviews the patient's
medical history and notes a documented allergy to penicillin. What is the priority nursing
action?
A. Administer the drug and observe for anaphylaxis.
B. Clarify the type of allergic reaction with the patient.
C. Substitute the order with a cephalosporin.
D. Administer an antihistamine prior to the dose.
Correct Answer: B
Rationale: Correct because penicillin allergies can range from mild rash to life-threatening
anaphylaxis, and the nurse must determine the severity before proceeding. The mechanism of
action of penicillins involves inhibiting cell wall synthesis, but in allergic patients, the immune
system triggers IgE-mediated responses. If a severe allergy is confirmed, the nurse must
withhold the drug and notify the prescriber to select a non-penicillin antibiotic.
Q2: The nurse is teaching a patient prescribed ipratropium for COPD about the mechanism of
action. Which explanation by the nurse is accurate?
A. It blocks the paras ympathetic ner vous s ys tem to prevent bronchocons triction.
B. It stimulates beta-2 receptors to relax smooth muscle.
C. It reduces inflammation in the airways by inhibiting histamine.
D. It thins mucus secretions to improve expectoration.
Correct Answer: A
,Rationale: Correct because ipratropium is an anticholinergic that blocks muscarinic receptors
in the bronchial smooth muscle, preventing parasympathetic-induced bronchoconstriction.
This leads to bronchodilation and improved airflow. Unlike beta-agonists, it does not directly
stimulate beta-2 receptors but rather inhibits the vagal response.
Q3: A patient with atrial fibrillation is taking warfarin. The nurse reviews the laboratory results
and notes an International Normalized Ratio (INR) of 5.2. The patient is not experiencing
bleeding. What is the priority nursing intervention?
A. Administer vitamin K orally.
B. Administer a unit of fresh frozen plasma.
C. Hold the next dos e of warfarin and notify the provider.
D. Increase the dose of warfarin to reach a therapeutic range.
Correct Answer: C
Rationale: Correct because an INR of 5.2 is significantly above the therapeutic range of 2.0 to
3.0 for atrial fibrillation, placing the patient at high risk for bleeding. The priority action is to
hold the dose to allow the INR to decrease and notify the provider for further instructions.
Vitamin K or plasma are typically reserved for patients with severe bleeding or significantly
elevated INRs.
Q4: A 34-year-old female patient presents with a urinary tract infection (UTI). She reports a
history of anaphylaxis to penicillin. The physician orders cephalexin. What is the nurse's best
response?
A. Administer the cephalexin because cross-reactivity is rare.
B. Reques t an order for a different clas s of antibiotic.
C. Administer the cephalexin with diphenhydramine.
D. Perform a skin test before administering the drug.
Correct Answer: B
Rationale: Correct because there is a potential for cross-reactivity between penicillins and
cephalosporins, estimated between 1% and 10%, which is higher in patients with a history of
anaphylaxis. Patient safety dictates avoiding cephalosporins if the patient has had a severe
, penicillin allergy. The nurse should advocate for a non-beta-lactam antibiotic, such as a
fluoroquinolone or trimethoprim-sulfamethoxazole, if not contraindicated.
Q5: A patient receiving intravenous vancomycin complains of flushing and "redness" on the
face and neck during the infusion. What is the priority nursing action?
A. Stop the infusion and administer diphenhydramine.
B. Slow the infus ion rate and as s es s the patient's blood pres s ure.
C. Check the patient's oxygen saturation and administer oxygen.
D. Discontinue the vancomycin and notify the provider immediately.
Correct Answer: B
Rationale: Correct because the patient is likely experiencing Red Man Syndrome, a non-
allergic infusion-related reaction caused by histamine release. The mechanism of action of
vancomycin involves inhibiting cell wall synthesis, but rapid infusion causes direct mast cell
degranulation. Slowing the infusion rate usually resolves the symptoms, whereas stopping
the drug is only necessary if severe hypotension or anaphylaxis occurs.
Q6: The nurse is preparing to administer amphotericin B to a patient with a systemic fungal
infection. Which premedication and intervention are most important to prevent adverse
effects?
A. Acetaminophen and normal s aline hydration.
B. Diphenhydramine and potassium supplementation.
C. Corticosteroids and low-fat diet.
D. Ibuprofen and fluid restriction.
Correct Answer: A
Rationale: Correct because amphotericin B binds to ergosterol in fungal cell membranes but
can cause nephrotoxicity and infusion reactions such as fever and chills. Premedicating with
acetaminophen and diphenhydramine helps prevent infusion reactions, while aggressive
hydration with normal saline is crucial to dilute the drug in the kidneys and reduce the risk of
nephrotoxicity.
