NSG 318 Exam 4 Pharmacology Review 2026 – GCU
1. A patient with a history of a severe anaphylactic reaction to Penicillin G is
prescribed Cefazolin. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider due to potential cross-sensitivity.
C. Administer the medication and monitor for a rash.
D. Pre-medicate the patient with acetaminophen.
Answer: B
Rationale: Patients with a history of severe immediate allergic reactions to penicillins have
a risk of cross-sensitivity with cephalosporins and should generally avoid them.
2. Which instruction is most important for a patient prescribed Tetracycline for
acne?
A. Take the medication with a full glass of milk.
B. Decrease fluid intake to prevent polyuria.
C. Avoid direct sunlight and use sunscreen.
D. Take the medication immediately before lying down for sleep.
Answer: C
Rationale: Tetracyclines cause photosensitivity. Patients should also avoid dairy products
and antacids as they inhibit absorption.
,3. A nurse is monitoring a patient receiving Gentamicin IV. Which laboratory
values are most important to monitor?
A. Serum creatinine and BUN.
B. Serum glucose and potassium.
C. Prothrombin time (PT) and INR.
D. Amylase and lipase.
Answer: A
Rationale: Aminoglycosides like Gentamicin are highly nephrotoxic and ototoxic,
necessitating close monitoring of renal function.
4. A patient receiving Vancomycin IV develops flushing, hypotension, and a red
rash on the upper body. What is the nurse’s priority action?
A. Slow the infusion rate and monitor the patient.
B. Increase the infusion rate to finish the dose quickly.
C. Stop the infusion and notify the provider of an allergic reaction.
D. Apply cold compresses to the rash area.
Answer: A
Rationale: These are symptoms of ‘Red Man Syndrome,’ which is related to rapid infusion
of Vancomycin. Slowing the rate usually resolves the issue.
5. A patient is prescribed Metronidazole for a vaginal infection. Which
substance must the patient avoid during therapy?
A. Grapefruit juice.
B. Leafy green vegetables.
C. Aged cheeses.
D. Alcoholic beverages.
Answer: D
Rationale: Metronidazole causes a disulfiram-like reaction (nausea, vomiting, flushing,
tachycardia) if consumed with alcohol.
, 6. Which finding is an expected, harmless side effect of Rifampin?
A. Orange-colored urine and tears.
B. Visual disturbances.
C. Peripheral neuropathy.
D. Persistent dry cough.
Answer: A
Rationale: Rifampin is known to cause harmless orange-red discoloration of body fluids.
7. A patient is starting Amphotericin B for a systemic fungal infection. What
should the nurse prepare to administer as a pre-medication?
A. Regular insulin and potassium.
B. Omeprazole and sucralfate.
C. Vitamin B6 and folic acid.
D. Diphenhydramine and acetaminophen.
Answer: D
Rationale: Amphotericin B often causes infusion reactions (chills, fever, nausea). Pre-
medicating with antihistamines and antipyretics is standard practice.
8. A nurse is providing teaching for a patient prescribed Acyclovir for herpes
simplex. What should be emphasized?
A. Increase fluid intake to prevent renal damage.
B. The drug cures the underlying viral infection.
C. Restrict fluids to prevent edema.
D. Take only when symptoms are absent.
Answer: A
Rationale: Acyclovir can precipitate in the renal tubules, so maintaining high fluid intake is
necessary to prevent nephrotoxicity.
1. A patient with a history of a severe anaphylactic reaction to Penicillin G is
prescribed Cefazolin. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider due to potential cross-sensitivity.
C. Administer the medication and monitor for a rash.
D. Pre-medicate the patient with acetaminophen.
Answer: B
Rationale: Patients with a history of severe immediate allergic reactions to penicillins have
a risk of cross-sensitivity with cephalosporins and should generally avoid them.
2. Which instruction is most important for a patient prescribed Tetracycline for
acne?
A. Take the medication with a full glass of milk.
B. Decrease fluid intake to prevent polyuria.
C. Avoid direct sunlight and use sunscreen.
D. Take the medication immediately before lying down for sleep.
Answer: C
Rationale: Tetracyclines cause photosensitivity. Patients should also avoid dairy products
and antacids as they inhibit absorption.
,3. A nurse is monitoring a patient receiving Gentamicin IV. Which laboratory
values are most important to monitor?
A. Serum creatinine and BUN.
B. Serum glucose and potassium.
C. Prothrombin time (PT) and INR.
D. Amylase and lipase.
Answer: A
Rationale: Aminoglycosides like Gentamicin are highly nephrotoxic and ototoxic,
necessitating close monitoring of renal function.
4. A patient receiving Vancomycin IV develops flushing, hypotension, and a red
rash on the upper body. What is the nurse’s priority action?
A. Slow the infusion rate and monitor the patient.
B. Increase the infusion rate to finish the dose quickly.
C. Stop the infusion and notify the provider of an allergic reaction.
D. Apply cold compresses to the rash area.
Answer: A
Rationale: These are symptoms of ‘Red Man Syndrome,’ which is related to rapid infusion
of Vancomycin. Slowing the rate usually resolves the issue.
5. A patient is prescribed Metronidazole for a vaginal infection. Which
substance must the patient avoid during therapy?
A. Grapefruit juice.
B. Leafy green vegetables.
C. Aged cheeses.
D. Alcoholic beverages.
Answer: D
Rationale: Metronidazole causes a disulfiram-like reaction (nausea, vomiting, flushing,
tachycardia) if consumed with alcohol.
, 6. Which finding is an expected, harmless side effect of Rifampin?
A. Orange-colored urine and tears.
B. Visual disturbances.
C. Peripheral neuropathy.
D. Persistent dry cough.
Answer: A
Rationale: Rifampin is known to cause harmless orange-red discoloration of body fluids.
7. A patient is starting Amphotericin B for a systemic fungal infection. What
should the nurse prepare to administer as a pre-medication?
A. Regular insulin and potassium.
B. Omeprazole and sucralfate.
C. Vitamin B6 and folic acid.
D. Diphenhydramine and acetaminophen.
Answer: D
Rationale: Amphotericin B often causes infusion reactions (chills, fever, nausea). Pre-
medicating with antihistamines and antipyretics is standard practice.
8. A nurse is providing teaching for a patient prescribed Acyclovir for herpes
simplex. What should be emphasized?
A. Increase fluid intake to prevent renal damage.
B. The drug cures the underlying viral infection.
C. Restrict fluids to prevent edema.
D. Take only when symptoms are absent.
Answer: A
Rationale: Acyclovir can precipitate in the renal tubules, so maintaining high fluid intake is
necessary to prevent nephrotoxicity.
