Page |1
NUR 521 Advanced Pharmacology – Exam 4 Practice Questions complete
Exam 4 TEST BANK Practice Questions with 100% correct Answers and
Rationale 2026 | 2027 UPDATED!!!!! University of Alabama
Exam Coverage: This exam emphasizes antimicrobial pharmacotherapy
(antibacterials, antifungals, antivirals, antimycobacterials), gastrointestinal
pharmacology, hematologic agents, immunologic pharmacology, and special
populations (pediatrics, geriatrics, pregnancy). You are responsible for the name,
MOA, indication, common adverse effects, serious adverse effects, dosing,
administration, contraindications, interactions, and patient education for all
prototype drugs presented in each module.
Section 1: Antibacterial Pharmacology (Questions)
Beta-Lactams
1. Which antibiotic inhibits bacterial cell wall synthesis by
binding penicillin-binding proteins (PBPs)?
A) Tetracycline
B) Penicillin
C) Erythromycin
D) Ciprofloxacin
Answer: B
Rationale: Penicillins are beta-lactam antibiotics that inhibit cell
, Page |2
wall synthesis by binding to penicillin-binding proteins (PBPs),
preventing peptidoglycan cross-linking.
2. A patient is prescribed amoxicillin-clavulanate. The
clavulanate component:
A) Is a beta-lactamase inhibitor that broadens activity against
susceptible bacteria
B) Is an additional beta-lactam antibiotic
C) Increases renal excretion
D) Reduces GI side effects
Answer: A
Rationale: Clavulanate is a beta-lactamase inhibitor that
protects amoxicillin from enzymatic degradation, broadening its
spectrum of activity.
3. A patient with an anaphylactic penicillin allergy requires
treatment for streptococcal pharyngitis. Which antibiotic is
contraindicated?
A) Azithromycin
B) Cephalexin
C) Clindamycin
D) Erythromycin
Answer: B
Rationale: Cephalexin is contraindicated due to potential cross-
reactivity with penicillin allergy (approximately 1-2% risk).
, Page |3
4. Which cephalosporin generation is most appropriate for
treating a hospitalized patient with suspected Pseudomonas
aeruginosa pneumonia?
A) First-generation (cefazolin)
B) Second-generation (cefuroxime)
C) Third-generation (ceftazidime)
D) Fourth-generation (cefepime)
Answer: C
Rationale: Ceftazidime (third-generation) has enhanced activity
against Pseudomonas aeruginosa.
5. A patient receiving a beta-lactam antibiotic develops a
maculopapular rash. The nurse practitioner should:
A) Continue the antibiotic and monitor
B) Discontinue the antibiotic and document the reaction
C) Add an antihistamine
D) Double the dose
Answer: B
Rationale: A maculopapular rash may indicate a true allergic
reaction; the antibiotic should be discontinued and the reaction
documented.
6. A patient is prescribed aztreonam. This drug is:
A) A monobactam antibiotic
B) A penicillin
C) A cephalosporin
, Page |4
D) A carbapenem
Answer: A
Rationale: Aztreonam is a monobactam antibiotic with activity
against Gram-negative bacteria, safe in penicillin-allergic
patients.
7. A patient is prescribed meropenem. This drug is:
A) A carbapenem antibiotic
B) A penicillin
C) A cephalosporin
D) A monobactam
Answer: A
Rationale: Meropenem is a carbapenem with broad-spectrum
activity, including ESBL-producing organisms.
8. A patient taking meropenem should be monitored for:
A) Seizures
B) Hypertension
C) Bradycardia
D) Hyperkalemia
Answer: A
Rationale: Carbapenems can lower the seizure threshold,
especially in patients with CNS disorders.
9. A patient is prescribed vancomycin. The nurse practitioner
should monitor for:
A) Nephrotoxicity and ototoxicity
NUR 521 Advanced Pharmacology – Exam 4 Practice Questions complete
Exam 4 TEST BANK Practice Questions with 100% correct Answers and
Rationale 2026 | 2027 UPDATED!!!!! University of Alabama
Exam Coverage: This exam emphasizes antimicrobial pharmacotherapy
(antibacterials, antifungals, antivirals, antimycobacterials), gastrointestinal
pharmacology, hematologic agents, immunologic pharmacology, and special
populations (pediatrics, geriatrics, pregnancy). You are responsible for the name,
MOA, indication, common adverse effects, serious adverse effects, dosing,
administration, contraindications, interactions, and patient education for all
prototype drugs presented in each module.
Section 1: Antibacterial Pharmacology (Questions)
Beta-Lactams
1. Which antibiotic inhibits bacterial cell wall synthesis by
binding penicillin-binding proteins (PBPs)?
A) Tetracycline
B) Penicillin
C) Erythromycin
D) Ciprofloxacin
Answer: B
Rationale: Penicillins are beta-lactam antibiotics that inhibit cell
, Page |2
wall synthesis by binding to penicillin-binding proteins (PBPs),
preventing peptidoglycan cross-linking.
2. A patient is prescribed amoxicillin-clavulanate. The
clavulanate component:
A) Is a beta-lactamase inhibitor that broadens activity against
susceptible bacteria
B) Is an additional beta-lactam antibiotic
C) Increases renal excretion
D) Reduces GI side effects
Answer: A
Rationale: Clavulanate is a beta-lactamase inhibitor that
protects amoxicillin from enzymatic degradation, broadening its
spectrum of activity.
3. A patient with an anaphylactic penicillin allergy requires
treatment for streptococcal pharyngitis. Which antibiotic is
contraindicated?
A) Azithromycin
B) Cephalexin
C) Clindamycin
D) Erythromycin
Answer: B
Rationale: Cephalexin is contraindicated due to potential cross-
reactivity with penicillin allergy (approximately 1-2% risk).
, Page |3
4. Which cephalosporin generation is most appropriate for
treating a hospitalized patient with suspected Pseudomonas
aeruginosa pneumonia?
A) First-generation (cefazolin)
B) Second-generation (cefuroxime)
C) Third-generation (ceftazidime)
D) Fourth-generation (cefepime)
Answer: C
Rationale: Ceftazidime (third-generation) has enhanced activity
against Pseudomonas aeruginosa.
5. A patient receiving a beta-lactam antibiotic develops a
maculopapular rash. The nurse practitioner should:
A) Continue the antibiotic and monitor
B) Discontinue the antibiotic and document the reaction
C) Add an antihistamine
D) Double the dose
Answer: B
Rationale: A maculopapular rash may indicate a true allergic
reaction; the antibiotic should be discontinued and the reaction
documented.
6. A patient is prescribed aztreonam. This drug is:
A) A monobactam antibiotic
B) A penicillin
C) A cephalosporin
, Page |4
D) A carbapenem
Answer: A
Rationale: Aztreonam is a monobactam antibiotic with activity
against Gram-negative bacteria, safe in penicillin-allergic
patients.
7. A patient is prescribed meropenem. This drug is:
A) A carbapenem antibiotic
B) A penicillin
C) A cephalosporin
D) A monobactam
Answer: A
Rationale: Meropenem is a carbapenem with broad-spectrum
activity, including ESBL-producing organisms.
8. A patient taking meropenem should be monitored for:
A) Seizures
B) Hypertension
C) Bradycardia
D) Hyperkalemia
Answer: A
Rationale: Carbapenems can lower the seizure threshold,
especially in patients with CNS disorders.
9. A patient is prescribed vancomycin. The nurse practitioner
should monitor for:
A) Nephrotoxicity and ototoxicity
