NCLEX-RN Pharmacology Infection Practice
Exam |
20 Antibiotics, Antifungals & Antivirals
Questions with Rationales
Question 1 (Easy)
Clinical Scenario
A 23-year-old woman is admitted with dysuria, urinary
frequency, and suprapubic discomfort. Urinalysis reveals
positive leukocyte esterase and nitrites. The provider prescribes
nitrofurantoin 100 mg orally twice daily for 5 days. The client
asks the nurse, "I usually stop antibiotics once I feel better. Is
that okay?"
Question Stem
Which response by the nurse is most appropriate?
A. "You may stop taking the medication once your symptoms
resolve."
B. "Take the medication exactly as prescribed until it is finished,
even if you feel better."
,C. "Skip doses if you develop mild nausea to prevent stomach
irritation."
D. "Take the medication only when urinary discomfort returns."
Correct Answer
Correct Answer: B. Take the medication exactly as prescribed
until it is finished, even if you feel better.
Detailed Rationale
Completing the full prescribed course of antibiotics is essential
to eradicate susceptible bacteria, reduce the risk of recurrent
infection, and help limit the development of antimicrobial
resistance. Although symptoms often improve within a few
days, viable bacteria may remain. Stopping therapy early
increases the likelihood of treatment failure and recurrent
infection. Nurses play a key role in reinforcing adherence,
assessing for adverse effects, and encouraging adequate
hydration unless contraindicated.
Option A is incorrect because symptom improvement does not
indicate complete eradication of the infection.
Option C is incorrect because mild gastrointestinal upset can
often be minimized by taking nitrofurantoin with food. Patients
should not skip doses without consulting the provider.
,Option D is incorrect because antibiotics should never be taken
on an "as-needed" basis. Maintaining therapeutic drug
concentrations is necessary for effective bacterial eradication.
Additional teaching includes reporting persistent fever, flank
pain, rash, or worsening symptoms, which may indicate
treatment failure or a more serious infection. The nurse should
also verify allergies and assess renal function because
inadequate kidney function may reduce the drug's effectiveness
and increase toxicity.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the importance of completing prescribed antibiotic
therapy.
• Provide appropriate patient education regarding
medication adherence.
• Recognize strategies to reduce antimicrobial resistance.
Medication Safety Focus
Patient education
Question 2 (Moderate)
Clinical Scenario
, A 72-year-old man is hospitalized with community-acquired
pneumonia and is receiving gentamicin IV. His history includes
chronic kidney disease and hypertension. Morning laboratory
results are:
• Serum creatinine: 2.1 mg/dL
• BUN: 36 mg/dL
• Urine output: 28 mL/hr
The client reports new ringing in both ears.
Question Stem
Which nursing action is the priority?
A. Continue the infusion and reassess hearing in 24 hours.
B. Administer the prescribed dose with food.
C. Hold the medication and notify the healthcare provider
immediately.
D. Encourage increased oral fluid intake without further
assessment.
Correct Answer
Correct Answer: C. Hold the medication and notify the
healthcare provider immediately.
Detailed Rationale
Exam |
20 Antibiotics, Antifungals & Antivirals
Questions with Rationales
Question 1 (Easy)
Clinical Scenario
A 23-year-old woman is admitted with dysuria, urinary
frequency, and suprapubic discomfort. Urinalysis reveals
positive leukocyte esterase and nitrites. The provider prescribes
nitrofurantoin 100 mg orally twice daily for 5 days. The client
asks the nurse, "I usually stop antibiotics once I feel better. Is
that okay?"
Question Stem
Which response by the nurse is most appropriate?
A. "You may stop taking the medication once your symptoms
resolve."
B. "Take the medication exactly as prescribed until it is finished,
even if you feel better."
,C. "Skip doses if you develop mild nausea to prevent stomach
irritation."
D. "Take the medication only when urinary discomfort returns."
Correct Answer
Correct Answer: B. Take the medication exactly as prescribed
until it is finished, even if you feel better.
Detailed Rationale
Completing the full prescribed course of antibiotics is essential
to eradicate susceptible bacteria, reduce the risk of recurrent
infection, and help limit the development of antimicrobial
resistance. Although symptoms often improve within a few
days, viable bacteria may remain. Stopping therapy early
increases the likelihood of treatment failure and recurrent
infection. Nurses play a key role in reinforcing adherence,
assessing for adverse effects, and encouraging adequate
hydration unless contraindicated.
Option A is incorrect because symptom improvement does not
indicate complete eradication of the infection.
Option C is incorrect because mild gastrointestinal upset can
often be minimized by taking nitrofurantoin with food. Patients
should not skip doses without consulting the provider.
,Option D is incorrect because antibiotics should never be taken
on an "as-needed" basis. Maintaining therapeutic drug
concentrations is necessary for effective bacterial eradication.
Additional teaching includes reporting persistent fever, flank
pain, rash, or worsening symptoms, which may indicate
treatment failure or a more serious infection. The nurse should
also verify allergies and assess renal function because
inadequate kidney function may reduce the drug's effectiveness
and increase toxicity.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the importance of completing prescribed antibiotic
therapy.
• Provide appropriate patient education regarding
medication adherence.
• Recognize strategies to reduce antimicrobial resistance.
Medication Safety Focus
Patient education
Question 2 (Moderate)
Clinical Scenario
, A 72-year-old man is hospitalized with community-acquired
pneumonia and is receiving gentamicin IV. His history includes
chronic kidney disease and hypertension. Morning laboratory
results are:
• Serum creatinine: 2.1 mg/dL
• BUN: 36 mg/dL
• Urine output: 28 mL/hr
The client reports new ringing in both ears.
Question Stem
Which nursing action is the priority?
A. Continue the infusion and reassess hearing in 24 hours.
B. Administer the prescribed dose with food.
C. Hold the medication and notify the healthcare provider
immediately.
D. Encourage increased oral fluid intake without further
assessment.
Correct Answer
Correct Answer: C. Hold the medication and notify the
healthcare provider immediately.
Detailed Rationale
