NUR 210 – Exam 4
Galen College of Nursing
Questions with Answers
1. A nurse is preparing to administer amoxicillin to a client for the first time.
What is the priority nursing action before administration?
A. Administer the medication with a full glass of milk
B. Assess the client for a history of penicillin or cephalosporin allergy
C. Obtain a baseline complete blood count
D. Instruct the client to remain NPO for 1 hour after the dose
Answer: B. Assess the client for a history of penicillin or cephalosporin allergy
Rationale: Before giving any beta-lactam antibiotic, the nurse must assess for
prior allergic reactions because penicillins are one of the most common causes
of drug-induced anaphylaxis. Milk is not required, a baseline CBC is not a
priority safety step, and NPO status is unnecessary for oral amoxicillin.
2. The nurse is teaching a client about a new prescription for amoxicillin-
clavulanate. Which statement by the client indicates a need for further teaching?
A. "I will take this medication with food to reduce stomach upset."
B. "I will stop taking the medication as soon as I feel better."
C. "I will call my provider if I develop a rash or difficulty breathing."
D. "I will report persistent watery diarrhea to my provider."
Answer: B. "I will stop taking the medication as soon as I feel better."
Rationale: Antibiotics must be taken for the full prescribed course even after
symptoms improve to fully eradicate the organism and prevent development of
resistant bacteria. The other statements reflect correct understanding of food
administration, signs of anaphylaxis, and superinfection (C. diff).
3. A client with a documented penicillin allergy is prescribed cefepime. What is
the priority nursing consideration?
A. Administer as prescribed with no special precautions
B. Recognize a low but present risk of cross-sensitivity between penicillins and
cephalosporins and observe closely for reaction
, C. Refuse to administer the medication under any circumstance
D. Give the first dose intramuscularly to reduce allergy risk
Answer: B. Recognize a low but present risk of cross-sensitivity between
penicillins and cephalosporins and observe closely for reaction
Rationale: There is a small (approximately 1-10%) risk of cross-sensitivity
between penicillins and cephalosporins due to a shared beta-lactam ring
structure, so the nurse should administer cautiously and monitor closely rather
than automatically withholding or automatically giving without precaution.
4. Which assessment finding would require the nurse to hold a scheduled dose
of amoxicillin and notify the provider?
A. Mild nausea after the previous dose
B. Urticaria and lip swelling
C. Loose stool once during the day
D. Mild fatigue
Answer: B. Urticaria and lip swelling
Rationale: Urticaria (hives) with lip swelling are signs of an emerging
hypersensitivity/anaphylactic reaction and require holding the drug and
immediate provider notification. Mild GI upset and fatigue are common, non-
urgent side effects.
5. A client receiving amoxicillin develops white patches on the oral mucosa. The
nurse recognizes this as a sign of which complication?
A. Expected therapeutic response
B. Superinfection (oral candidiasis)
C. Signs of improving infection
D. Dehydration
Answer: B. Superinfection (oral candidiasis)
Rationale: Broad-spectrum antibiotics disrupt normal flora, allowing
overgrowth of Candida, resulting in oral thrush. This is a superinfection, not an
expected or improving finding, and is unrelated to hydration status.
, 6. The nurse should instruct a client taking probenecid concurrently with
amoxicillin about which effect of this combination?
A. Probenecid decreases the effectiveness of amoxicillin
B. Probenecid increases and prolongs the blood level of amoxicillin
C. Probenecid has no interaction with amoxicillin
D. Probenecid should be taken 12 hours apart from amoxicillin to avoid
interaction
Answer: B. Probenecid increases and prolongs the blood level of amoxicillin
Rationale: Probenecid blocks renal tubular secretion of penicillins, increasing
and prolonging their serum concentration; this combination is sometimes used
intentionally to boost antibiotic levels.
7. A client receives the first IV dose of penicillin G and 10 minutes later reports
itching, chest tightness, and difficulty breathing. What is the nurse's first action?
A. Slow the infusion rate and reassess in 15 minutes
B. Stop the infusion immediately and stay with the client while calling for help
C. Administer an antihistamine and continue the infusion
D. Document the finding and continue to monitor
Answer: B. Stop the infusion immediately and stay with the client while
calling for help
Rationale: These are signs of anaphylaxis, a medical emergency. The nurse
must stop the infusion immediately, maintain the IV line with saline, stay with
the client, and call for emergency assistance; continuing or slowing the infusion
delays lifesaving intervention.
8. Which instruction should the nurse include when teaching a client about
amoxicillin therapy?
A. Take the medication until symptoms resolve, then discontinue
B. Space doses evenly throughout the day and complete the entire course
C. Take the medication only when symptoms are severe
D. Double the next dose if a dose is missed
Answer: B. Space doses evenly throughout the day and complete the entire
course
Galen College of Nursing
Questions with Answers
1. A nurse is preparing to administer amoxicillin to a client for the first time.
What is the priority nursing action before administration?
A. Administer the medication with a full glass of milk
B. Assess the client for a history of penicillin or cephalosporin allergy
C. Obtain a baseline complete blood count
D. Instruct the client to remain NPO for 1 hour after the dose
Answer: B. Assess the client for a history of penicillin or cephalosporin allergy
Rationale: Before giving any beta-lactam antibiotic, the nurse must assess for
prior allergic reactions because penicillins are one of the most common causes
of drug-induced anaphylaxis. Milk is not required, a baseline CBC is not a
priority safety step, and NPO status is unnecessary for oral amoxicillin.
2. The nurse is teaching a client about a new prescription for amoxicillin-
clavulanate. Which statement by the client indicates a need for further teaching?
A. "I will take this medication with food to reduce stomach upset."
B. "I will stop taking the medication as soon as I feel better."
C. "I will call my provider if I develop a rash or difficulty breathing."
D. "I will report persistent watery diarrhea to my provider."
Answer: B. "I will stop taking the medication as soon as I feel better."
Rationale: Antibiotics must be taken for the full prescribed course even after
symptoms improve to fully eradicate the organism and prevent development of
resistant bacteria. The other statements reflect correct understanding of food
administration, signs of anaphylaxis, and superinfection (C. diff).
3. A client with a documented penicillin allergy is prescribed cefepime. What is
the priority nursing consideration?
A. Administer as prescribed with no special precautions
B. Recognize a low but present risk of cross-sensitivity between penicillins and
cephalosporins and observe closely for reaction
, C. Refuse to administer the medication under any circumstance
D. Give the first dose intramuscularly to reduce allergy risk
Answer: B. Recognize a low but present risk of cross-sensitivity between
penicillins and cephalosporins and observe closely for reaction
Rationale: There is a small (approximately 1-10%) risk of cross-sensitivity
between penicillins and cephalosporins due to a shared beta-lactam ring
structure, so the nurse should administer cautiously and monitor closely rather
than automatically withholding or automatically giving without precaution.
4. Which assessment finding would require the nurse to hold a scheduled dose
of amoxicillin and notify the provider?
A. Mild nausea after the previous dose
B. Urticaria and lip swelling
C. Loose stool once during the day
D. Mild fatigue
Answer: B. Urticaria and lip swelling
Rationale: Urticaria (hives) with lip swelling are signs of an emerging
hypersensitivity/anaphylactic reaction and require holding the drug and
immediate provider notification. Mild GI upset and fatigue are common, non-
urgent side effects.
5. A client receiving amoxicillin develops white patches on the oral mucosa. The
nurse recognizes this as a sign of which complication?
A. Expected therapeutic response
B. Superinfection (oral candidiasis)
C. Signs of improving infection
D. Dehydration
Answer: B. Superinfection (oral candidiasis)
Rationale: Broad-spectrum antibiotics disrupt normal flora, allowing
overgrowth of Candida, resulting in oral thrush. This is a superinfection, not an
expected or improving finding, and is unrelated to hydration status.
, 6. The nurse should instruct a client taking probenecid concurrently with
amoxicillin about which effect of this combination?
A. Probenecid decreases the effectiveness of amoxicillin
B. Probenecid increases and prolongs the blood level of amoxicillin
C. Probenecid has no interaction with amoxicillin
D. Probenecid should be taken 12 hours apart from amoxicillin to avoid
interaction
Answer: B. Probenecid increases and prolongs the blood level of amoxicillin
Rationale: Probenecid blocks renal tubular secretion of penicillins, increasing
and prolonging their serum concentration; this combination is sometimes used
intentionally to boost antibiotic levels.
7. A client receives the first IV dose of penicillin G and 10 minutes later reports
itching, chest tightness, and difficulty breathing. What is the nurse's first action?
A. Slow the infusion rate and reassess in 15 minutes
B. Stop the infusion immediately and stay with the client while calling for help
C. Administer an antihistamine and continue the infusion
D. Document the finding and continue to monitor
Answer: B. Stop the infusion immediately and stay with the client while
calling for help
Rationale: These are signs of anaphylaxis, a medical emergency. The nurse
must stop the infusion immediately, maintain the IV line with saline, stay with
the client, and call for emergency assistance; continuing or slowing the infusion
delays lifesaving intervention.
8. Which instruction should the nurse include when teaching a client about
amoxicillin therapy?
A. Take the medication until symptoms resolve, then discontinue
B. Space doses evenly throughout the day and complete the entire course
C. Take the medication only when symptoms are severe
D. Double the next dose if a dose is missed
Answer: B. Space doses evenly throughout the day and complete the entire
course
