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NR 566 Advanced Pharmacology – Focused Practice Weeks 1–4:
Antifungal, Antiviral, Bacterial, Gender-Related, Urinary
Original Questions with Answers & Rationales
Section 1: Antibacterial Agents (Questions 1–12)
1. A patient with a severe penicillin allergy requires
treatment for a gram-positive infection. Which antibiotic
class is most appropriate?
A. Amoxicillin
B. Cephalexin
C. Vancomycin
D. Piperacillin
Answer: C
Rationale: Vancomycin is a glycopeptide effective against
gram-positive organisms and is safe in most penicillin-
allergic patients (though cross-reactivity with
cephalosporins is possible, vancomycin is structurally
different).
2. Which antibiotic is contraindicated in pregnancy due to risk
of fetal harm?
A. Penicillin
B. Doxycycline
C. Amoxicillin
D. Nitrofurantoin (caution near term)
Answer: B
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Rationale: Tetracyclines (doxycycline) cause permanent
tooth discoloration and bone growth inhibition in the
fetus; they are contraindicated in pregnancy.
3. A patient is prescribed gentamicin. Which laboratory test
should be monitored to prevent nephrotoxicity?
A. AST and ALT
B. Serum creatinine and BUN
C. Platelet count
D. INR
Answer: B
Rationale: Aminoglycosides like gentamicin are
nephrotoxic; monitor renal function (creatinine, BUN)
and drug levels (peak/trough).
4. Which antibiotic should be taken on an empty stomach for
optimal absorption?
A. Azithromycin
B. Tetracycline
C. Amoxicillin-clavulanate
D. Clindamycin
Answer: B
Rationale: Tetracycline chelates with calcium, iron,
magnesium, and antacids; it should be taken on an empty
stomach, 1 hour before or 2 hours after meals/dairy.
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5. A patient on warfarin is prescribed sulfamethoxazole-
trimethoprim. The nurse practitioner should anticipate:
A. Decreased INR
B. Increased INR and risk of bleeding
C. No change
D. Hypoglycemia
Answer: B
Rationale: Sulfamethoxazole-trimethoprim inhibits
warfarin metabolism and displaces it from albumin,
increasing INR and bleeding risk.
6. Which of the following is a macrolide antibiotic?
A. Ciprofloxacin
B. Azithromycin
C. Cephalexin
D. Vancomycin
Answer: B
Rationale: Azithromycin, clarithromycin, and
erythromycin are macrolides that inhibit protein
synthesis at the 50S ribosomal subunit.
7. A patient develops Clostridium difficile-associated diarrhea
after taking clindamycin. Which medication is first-line for
this infection?
A. Loperamide
B. Metronidazole or oral vancomycin
NR 566 Advanced Pharmacology – Focused Practice Weeks 1–4:
Antifungal, Antiviral, Bacterial, Gender-Related, Urinary
Original Questions with Answers & Rationales
Section 1: Antibacterial Agents (Questions 1–12)
1. A patient with a severe penicillin allergy requires
treatment for a gram-positive infection. Which antibiotic
class is most appropriate?
A. Amoxicillin
B. Cephalexin
C. Vancomycin
D. Piperacillin
Answer: C
Rationale: Vancomycin is a glycopeptide effective against
gram-positive organisms and is safe in most penicillin-
allergic patients (though cross-reactivity with
cephalosporins is possible, vancomycin is structurally
different).
2. Which antibiotic is contraindicated in pregnancy due to risk
of fetal harm?
A. Penicillin
B. Doxycycline
C. Amoxicillin
D. Nitrofurantoin (caution near term)
Answer: B
,https://www.stuvia.com/user/performance
Rationale: Tetracyclines (doxycycline) cause permanent
tooth discoloration and bone growth inhibition in the
fetus; they are contraindicated in pregnancy.
3. A patient is prescribed gentamicin. Which laboratory test
should be monitored to prevent nephrotoxicity?
A. AST and ALT
B. Serum creatinine and BUN
C. Platelet count
D. INR
Answer: B
Rationale: Aminoglycosides like gentamicin are
nephrotoxic; monitor renal function (creatinine, BUN)
and drug levels (peak/trough).
4. Which antibiotic should be taken on an empty stomach for
optimal absorption?
A. Azithromycin
B. Tetracycline
C. Amoxicillin-clavulanate
D. Clindamycin
Answer: B
Rationale: Tetracycline chelates with calcium, iron,
magnesium, and antacids; it should be taken on an empty
stomach, 1 hour before or 2 hours after meals/dairy.
, https://www.stuvia.com/user/performance
5. A patient on warfarin is prescribed sulfamethoxazole-
trimethoprim. The nurse practitioner should anticipate:
A. Decreased INR
B. Increased INR and risk of bleeding
C. No change
D. Hypoglycemia
Answer: B
Rationale: Sulfamethoxazole-trimethoprim inhibits
warfarin metabolism and displaces it from albumin,
increasing INR and bleeding risk.
6. Which of the following is a macrolide antibiotic?
A. Ciprofloxacin
B. Azithromycin
C. Cephalexin
D. Vancomycin
Answer: B
Rationale: Azithromycin, clarithromycin, and
erythromycin are macrolides that inhibit protein
synthesis at the 50S ribosomal subunit.
7. A patient develops Clostridium difficile-associated diarrhea
after taking clindamycin. Which medication is first-line for
this infection?
A. Loperamide
B. Metronidazole or oral vancomycin
