Page 1 of 60
GCU NSG 318 PHARMACOLOGY 2026 EXAM 2
COMPLETE (160) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES|GRADED A+.
PHARMACOLOGY
Here is the GCU NSG 318 Pharmacology Exam 2 – Practice Exam with 160
questions, formatted for easy copying. Each question includes four
answer choices (A–D), the correct answer, and an explanation. Topics
include antibiotics, antivirals, antifungals, CNS drugs, autonomic nervous
system agents, and other common pharmacological categories
appropriate for a second exam in a nursing pharmacology course.
Multiple choice.
Section 1: Antibiotics (Questions 1–35)
1. A patient is prescribed amoxicillin for strep throat. Which
statement indicates understanding of the medication?
A) “I should take this medication until I feel better.”
B) “I will take the full course of antibiotics even if I feel better.”
C) “I can stop if I have side effects.”
D) “I will take it with orange juice to improve absorption.”
Answer: B. “I will take the full course of antibiotics even if I feel
better.”
Explanation: Completing the full course prevents bacterial
resistance and recurrence. Stopping early can lead to incomplete
eradication.
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2. A patient with a severe penicillin allergy (anaphylaxis) is
prescribed a cephalosporin. The nurse should:
A) Administer as ordered; cross-reactivity is minimal
B) Hold the medication and notify the provider
C) Give a test dose
D) Administer with diphenhydramine
Answer: B. Hold the medication and notify the provider
Explanation: Although cross-reactivity between penicillins and
cephalosporins is low (1-2%), in patients with severe anaphylaxis to
penicillin, cephalosporins are usually avoided unless absolutely
necessary.
3. Which antibiotic is associated with red man syndrome
(flushing, hypotension) when infused too rapidly?
A) Gentamicin
B) Vancomycin
C) Ciprofloxacin
D) Doxycycline
Answer: B. Vancomycin
Explanation: Red man syndrome is a histamine-mediated reaction
to rapid vancomycin infusion. Slow infusion over at least 60 minutes
and premedication with antihistamines can prevent it.
4. A patient with Clostridioides difficile infection (CDI) is being
treated. Which medication is first-line?
A) IV metronidazole
B) Oral vancomycin
C) Oral metronidazole
D) IV ceftriaxone
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Answer: B. Oral vancomycin
Explanation: Oral vancomycin is first-line for CDI. Fidaxomicin is
also effective. IV vancomycin does not reach the colon.
5. A patient taking warfarin is prescribed
trimethoprim-sulfamethoxazole (TMP-SMX) for a UTI. The nurse
should monitor for:
A) Decreased INR (clotting risk)
B) Increased INR (bleeding risk)
C) No interaction
D) Increased warfarin metabolism
Answer: B. Increased INR (bleeding risk)
Explanation: TMP-SMX inhibits CYP2C9, decreasing warfarin
metabolism, and displaces warfarin from protein binding,
increasing INR and bleeding risk.
6. A patient with a UTI is prescribed ciprofloxacin. Which
instruction is most important?
A) Take with dairy products
B) Avoid sun exposure (photosensitivity)
C) Take on an empty stomach
D) Expect orange urine
Answer: B. Avoid sun exposure (photosensitivity)
Explanation: Fluoroquinolones (ciprofloxacin, levofloxacin) cause
photosensitivity; patients should use sunscreen and avoid tanning
beds.
7. A patient receiving gentamicin IV has a trough level of 2.5
mcg/mL (therapeutic trough <1). The nurse should:
A) Administer the next dose as ordered
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B) Hold the dose and notify the provider
C) Increase the dose
D) Give the dose with a loading dose
Answer: B. Hold the dose and notify the provider
Explanation: Elevated trough indicates accumulation and
increased risk of nephrotoxicity and ototoxicity. Hold and adjust
dose.
8. Which antibiotic is contraindicated in children under 8 years
due to tooth discoloration?
A) Amoxicillin
B) Azithromycin
C) Doxycycline
D) Cefdinir
Answer: C. Doxycycline
Explanation: Tetracyclines (doxycycline, minocycline) cause
permanent tooth discoloration and enamel hypoplasia in children
under 8 years.
9. A patient with an anaphylactic penicillin allergy needs
treatment for a mixed anaerobic infection. Which agent is safe?
A) Piperacillin-tazobactam
B) Imipenem
C) Metronidazole
D) Ampicillin-sulbactam
Answer: C. Metronidazole
Explanation: Metronidazole has no cross-reactivity with penicillins.
Carbapenems have about 1% cross-reactivity and are generally
avoided in severe penicillin allergy.
GCU NSG 318 PHARMACOLOGY 2026 EXAM 2
COMPLETE (160) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES|GRADED A+.
PHARMACOLOGY
Here is the GCU NSG 318 Pharmacology Exam 2 – Practice Exam with 160
questions, formatted for easy copying. Each question includes four
answer choices (A–D), the correct answer, and an explanation. Topics
include antibiotics, antivirals, antifungals, CNS drugs, autonomic nervous
system agents, and other common pharmacological categories
appropriate for a second exam in a nursing pharmacology course.
Multiple choice.
Section 1: Antibiotics (Questions 1–35)
1. A patient is prescribed amoxicillin for strep throat. Which
statement indicates understanding of the medication?
A) “I should take this medication until I feel better.”
B) “I will take the full course of antibiotics even if I feel better.”
C) “I can stop if I have side effects.”
D) “I will take it with orange juice to improve absorption.”
Answer: B. “I will take the full course of antibiotics even if I feel
better.”
Explanation: Completing the full course prevents bacterial
resistance and recurrence. Stopping early can lead to incomplete
eradication.
, Page 2 of 60
2. A patient with a severe penicillin allergy (anaphylaxis) is
prescribed a cephalosporin. The nurse should:
A) Administer as ordered; cross-reactivity is minimal
B) Hold the medication and notify the provider
C) Give a test dose
D) Administer with diphenhydramine
Answer: B. Hold the medication and notify the provider
Explanation: Although cross-reactivity between penicillins and
cephalosporins is low (1-2%), in patients with severe anaphylaxis to
penicillin, cephalosporins are usually avoided unless absolutely
necessary.
3. Which antibiotic is associated with red man syndrome
(flushing, hypotension) when infused too rapidly?
A) Gentamicin
B) Vancomycin
C) Ciprofloxacin
D) Doxycycline
Answer: B. Vancomycin
Explanation: Red man syndrome is a histamine-mediated reaction
to rapid vancomycin infusion. Slow infusion over at least 60 minutes
and premedication with antihistamines can prevent it.
4. A patient with Clostridioides difficile infection (CDI) is being
treated. Which medication is first-line?
A) IV metronidazole
B) Oral vancomycin
C) Oral metronidazole
D) IV ceftriaxone
, Page 3 of 60
Answer: B. Oral vancomycin
Explanation: Oral vancomycin is first-line for CDI. Fidaxomicin is
also effective. IV vancomycin does not reach the colon.
5. A patient taking warfarin is prescribed
trimethoprim-sulfamethoxazole (TMP-SMX) for a UTI. The nurse
should monitor for:
A) Decreased INR (clotting risk)
B) Increased INR (bleeding risk)
C) No interaction
D) Increased warfarin metabolism
Answer: B. Increased INR (bleeding risk)
Explanation: TMP-SMX inhibits CYP2C9, decreasing warfarin
metabolism, and displaces warfarin from protein binding,
increasing INR and bleeding risk.
6. A patient with a UTI is prescribed ciprofloxacin. Which
instruction is most important?
A) Take with dairy products
B) Avoid sun exposure (photosensitivity)
C) Take on an empty stomach
D) Expect orange urine
Answer: B. Avoid sun exposure (photosensitivity)
Explanation: Fluoroquinolones (ciprofloxacin, levofloxacin) cause
photosensitivity; patients should use sunscreen and avoid tanning
beds.
7. A patient receiving gentamicin IV has a trough level of 2.5
mcg/mL (therapeutic trough <1). The nurse should:
A) Administer the next dose as ordered
, Page 4 of 60
B) Hold the dose and notify the provider
C) Increase the dose
D) Give the dose with a loading dose
Answer: B. Hold the dose and notify the provider
Explanation: Elevated trough indicates accumulation and
increased risk of nephrotoxicity and ototoxicity. Hold and adjust
dose.
8. Which antibiotic is contraindicated in children under 8 years
due to tooth discoloration?
A) Amoxicillin
B) Azithromycin
C) Doxycycline
D) Cefdinir
Answer: C. Doxycycline
Explanation: Tetracyclines (doxycycline, minocycline) cause
permanent tooth discoloration and enamel hypoplasia in children
under 8 years.
9. A patient with an anaphylactic penicillin allergy needs
treatment for a mixed anaerobic infection. Which agent is safe?
A) Piperacillin-tazobactam
B) Imipenem
C) Metronidazole
D) Ampicillin-sulbactam
Answer: C. Metronidazole
Explanation: Metronidazole has no cross-reactivity with penicillins.
Carbapenems have about 1% cross-reactivity and are generally
avoided in severe penicillin allergy.
