NSG 124 Exam 4 Actual Exam V1 | NSG 124 Pharmacology (NSG124
Exam 4) | Herzing University PDF
1. A patient who is allergic to penicillin is prescribed cephalexin for a skin infection. Which
action by the nurse is most appropriate?
A. Inform the provider about the allergy and the risk of cross-sensitivity.
B. Administer the medication as ordered since they are different classes.
C. Monitor the patient for 15 minutes after the first dose only.
D. Instruct the patient to take the medication with an antacid to prevent a reaction.
Answer: A
Rationale: Penicillins and cephalosporins share a similar chemical structure known as the
beta-lactam ring. Patients with a known allergy to penicillin have a 1% to 10% chance of
being cross-sensitive to cephalosporins. The nurse must notify the provider to determine if
the benefit outweighs the risk or if an alternative class is needed.
2. A client is prescribed tetracycline for the treatment of acne. What information should the
nurse include in the discharge teaching?
A. Take the medication with a full glass of milk to prevent GI upset.
B. Store the medication in a clear container on the windowsill.
C. Use sunscreen and wear protective clothing when outdoors.
D. Stop taking the medication as soon as the skin clears up.
Answer: C
Rationale: Tetracyclines are known to cause significant photosensitivity, increasing the
risk of severe sunburns. Patients should also avoid dairy products and antacids as they
interfere with the absorption of the drug. It is essential to complete the entire course of
therapy to prevent antibiotic resistance.
3. A patient is receiving intravenous gentamicin for a severe infection. The nurse should
prioritize monitoring which of the following laboratory values?
A. Serum glucose and potassium
B. Blood urea nitrogen (BUN) and creatinine
C. Prothrombin time (PT) and INR
D. Hemoglobin and hematocrit
Answer: B
,Rationale: Gentamicin is an aminoglycoside that carries a high risk for nephrotoxicity and
ototoxicity. Monitoring BUN and creatinine levels is vital to assess renal function and
prevent permanent kidney damage. The nurse should also monitor peak and trough levels
to ensure the dose is within the therapeutic range.
4. While receiving an intravenous infusion of vancomycin, the patient begins to experience
flushing of the neck and upper chest. Which action should the nurse take first?
A. Immediately stop the infusion and notify the provider.
B. Administer an immediate dose of epinephrine.
C. Apply cold compresses to the affected areas.
D. Slow the rate of the infusion and assess the patient.
Answer: D
Rationale: This reaction is known as Red Man Syndrome, which is caused by the rapid
infusion of vancomycin rather than a true allergic reaction. Slowing the infusion rate
typically resolves the flushing and hypotension associated with the syndrome. The nurse
should continue to monitor the patient’s vital signs and document the occurrence.
5. A patient has been prescribed ciprofloxacin for a urinary tract infection. Which statement
by the patient indicates a need for further teaching?
A. ‘I will take my calcium supplement at the same time as this drug.’
B. ‘I will stop my daily jogging routine until I finish this medication.’
C. ‘I will drink plenty of fluids while taking this pill.’
D. ‘I will report any pain or swelling in my ankles or heels.’
Answer: A
Rationale: Ciprofloxacin can bind with calcium and other minerals, which significantly
reduces its absorption and efficacy. It is also associated with a Black Box Warning for
tendon rupture and tendonitis, particularly in the Achilles tendon. Patients should be
taught to space out mineral supplements and report any musculoskeletal pain immediately.
6. A patient diagnosed with tuberculosis is starting therapy with rifampin. What side effect
should the nurse tell the patient to expect?
A. Peripheral neuropathy in the hands and feet.
B. Orange-red discoloration of urine, sweat, and tears.
C. Severe muscle aches and joint pain.
D. Persistent ringing in the ears.
Answer: B
, Rationale: Rifampin is known to cause a harmless orange-red discoloration of body fluids,
including urine, saliva, and tears. Patients wearing soft contact lenses should be warned
that they may become permanently stained. It is important to distinguish this side effect
from jaundice, which would indicate hepatotoxicity.
7. A nurse is preparing to administer acyclovir to a patient with a herpes simplex infection.
The nurse understands that this drug works by:
A. Inhibiting viral DNA synthesis.
B. Destroying the cell wall of the virus.
C. Preventing the virus from entering the host cell.
D. Stimulating the host’s immune system to attack the virus.
Answer: A
Rationale: Acyclovir is an antiviral agent that acts as a synthetic purine nucleoside
analogue. It works by interfering with viral DNA polymerase, thereby inhibiting viral DNA
replication. This drug is effective against herpes simplex viruses and varicella-zoster virus.
8. A patient is prescribed fluoxetine for depression. Which finding would indicate that the
patient is experiencing serotonin syndrome?
A. Hallucinations, diaphoresis, and hyperreflexia.
B. Bradycardia and hypotension.
C. Urinary retention and dry mouth.
D. Extreme lethargy and slow respirations.
Answer: A
Rationale: Serotonin syndrome is a potentially life-threatening condition caused by
excessive serotonergic activity. Symptoms include mental status changes like
hallucinations, autonomic instability such as diaphoresis and tachycardia, and
neuromuscular hyperactivity like hyperreflexia. It often occurs when SSRIs are combined
with other serotonergic drugs or MAOIs.
9. A patient is being treated with lithium for bipolar disorder. The nurse notes a serum
lithium level of 1.8 mEq/L. Which action is the priority?
A. Administer the next scheduled dose as planned.
B. Advise the patient to increase sodium intake immediately.
C. Hold the medication and notify the healthcare provider.
D. Document the result as being within the therapeutic range.
Answer: C
Exam 4) | Herzing University PDF
1. A patient who is allergic to penicillin is prescribed cephalexin for a skin infection. Which
action by the nurse is most appropriate?
A. Inform the provider about the allergy and the risk of cross-sensitivity.
B. Administer the medication as ordered since they are different classes.
C. Monitor the patient for 15 minutes after the first dose only.
D. Instruct the patient to take the medication with an antacid to prevent a reaction.
Answer: A
Rationale: Penicillins and cephalosporins share a similar chemical structure known as the
beta-lactam ring. Patients with a known allergy to penicillin have a 1% to 10% chance of
being cross-sensitive to cephalosporins. The nurse must notify the provider to determine if
the benefit outweighs the risk or if an alternative class is needed.
2. A client is prescribed tetracycline for the treatment of acne. What information should the
nurse include in the discharge teaching?
A. Take the medication with a full glass of milk to prevent GI upset.
B. Store the medication in a clear container on the windowsill.
C. Use sunscreen and wear protective clothing when outdoors.
D. Stop taking the medication as soon as the skin clears up.
Answer: C
Rationale: Tetracyclines are known to cause significant photosensitivity, increasing the
risk of severe sunburns. Patients should also avoid dairy products and antacids as they
interfere with the absorption of the drug. It is essential to complete the entire course of
therapy to prevent antibiotic resistance.
3. A patient is receiving intravenous gentamicin for a severe infection. The nurse should
prioritize monitoring which of the following laboratory values?
A. Serum glucose and potassium
B. Blood urea nitrogen (BUN) and creatinine
C. Prothrombin time (PT) and INR
D. Hemoglobin and hematocrit
Answer: B
,Rationale: Gentamicin is an aminoglycoside that carries a high risk for nephrotoxicity and
ototoxicity. Monitoring BUN and creatinine levels is vital to assess renal function and
prevent permanent kidney damage. The nurse should also monitor peak and trough levels
to ensure the dose is within the therapeutic range.
4. While receiving an intravenous infusion of vancomycin, the patient begins to experience
flushing of the neck and upper chest. Which action should the nurse take first?
A. Immediately stop the infusion and notify the provider.
B. Administer an immediate dose of epinephrine.
C. Apply cold compresses to the affected areas.
D. Slow the rate of the infusion and assess the patient.
Answer: D
Rationale: This reaction is known as Red Man Syndrome, which is caused by the rapid
infusion of vancomycin rather than a true allergic reaction. Slowing the infusion rate
typically resolves the flushing and hypotension associated with the syndrome. The nurse
should continue to monitor the patient’s vital signs and document the occurrence.
5. A patient has been prescribed ciprofloxacin for a urinary tract infection. Which statement
by the patient indicates a need for further teaching?
A. ‘I will take my calcium supplement at the same time as this drug.’
B. ‘I will stop my daily jogging routine until I finish this medication.’
C. ‘I will drink plenty of fluids while taking this pill.’
D. ‘I will report any pain or swelling in my ankles or heels.’
Answer: A
Rationale: Ciprofloxacin can bind with calcium and other minerals, which significantly
reduces its absorption and efficacy. It is also associated with a Black Box Warning for
tendon rupture and tendonitis, particularly in the Achilles tendon. Patients should be
taught to space out mineral supplements and report any musculoskeletal pain immediately.
6. A patient diagnosed with tuberculosis is starting therapy with rifampin. What side effect
should the nurse tell the patient to expect?
A. Peripheral neuropathy in the hands and feet.
B. Orange-red discoloration of urine, sweat, and tears.
C. Severe muscle aches and joint pain.
D. Persistent ringing in the ears.
Answer: B
, Rationale: Rifampin is known to cause a harmless orange-red discoloration of body fluids,
including urine, saliva, and tears. Patients wearing soft contact lenses should be warned
that they may become permanently stained. It is important to distinguish this side effect
from jaundice, which would indicate hepatotoxicity.
7. A nurse is preparing to administer acyclovir to a patient with a herpes simplex infection.
The nurse understands that this drug works by:
A. Inhibiting viral DNA synthesis.
B. Destroying the cell wall of the virus.
C. Preventing the virus from entering the host cell.
D. Stimulating the host’s immune system to attack the virus.
Answer: A
Rationale: Acyclovir is an antiviral agent that acts as a synthetic purine nucleoside
analogue. It works by interfering with viral DNA polymerase, thereby inhibiting viral DNA
replication. This drug is effective against herpes simplex viruses and varicella-zoster virus.
8. A patient is prescribed fluoxetine for depression. Which finding would indicate that the
patient is experiencing serotonin syndrome?
A. Hallucinations, diaphoresis, and hyperreflexia.
B. Bradycardia and hypotension.
C. Urinary retention and dry mouth.
D. Extreme lethargy and slow respirations.
Answer: A
Rationale: Serotonin syndrome is a potentially life-threatening condition caused by
excessive serotonergic activity. Symptoms include mental status changes like
hallucinations, autonomic instability such as diaphoresis and tachycardia, and
neuromuscular hyperactivity like hyperreflexia. It often occurs when SSRIs are combined
with other serotonergic drugs or MAOIs.
9. A patient is being treated with lithium for bipolar disorder. The nurse notes a serum
lithium level of 1.8 mEq/L. Which action is the priority?
A. Administer the next scheduled dose as planned.
B. Advise the patient to increase sodium intake immediately.
C. Hold the medication and notify the healthcare provider.
D. Document the result as being within the therapeutic range.
Answer: C
