ATI PN PHARMACOLOGY 2023 EXAM WITH
NGN.docx
Exam
Questions 1–10: Antibiotics & Antifungals
1. A client is prescribed vancomycin IV. Which assessment finding requires
immediate action?
A) Red man syndrome (flushing, rash on upper body)
B) Serum creatinine 2.5 mg/dL
C) Nausea and vomiting
D) Tinnitus
Correct Answer: B
Rationale: Vancomycin is nephrotoxic. Serum creatinine >1.3 mg/dL (especially
2.5) indicates kidney injury. Red man syndrome (A) is managed by slowing
infusion but not as urgent as nephrotoxicity. Tinnitus (D) suggests ototoxicity but
is less immediately life-threatening than renal failure.
2. A client taking rifampin reports orange-red urine. What is the nurse’s best
response?
A) “Stop the medication immediately.”
B) “This is a harmless side effect.”
C) “You need a liver function test.”
D) “Drink more water to clear it.”
Correct Answer: B
Rationale: Rifampin causes harmless orange-red discoloration of urine, tears,
sweat, and saliva. It is not nephrotoxic. Stopping medication (A) could cause
treatment failure.
,3. A patient on isoniazid (INH) for TB reports peripheral neuropathy. Which
supplement should the nurse expect to administer?
A) Vitamin K
B) Vitamin B6 (pyridoxine)
C) Folic acid
D) Vitamin B12
Correct Answer: B
Rationale: INH causes vitamin B6 deficiency → peripheral neuropathy. Pyridoxine
prevents/treats this. Vitamin K (A) is for warfarin reversal.
4. Which antibiotic interacts with warfarin to increase bleeding risk?
A) Penicillin
B) Trimethoprim-sulfamethoxazole (Bactrim)
C) Azithromycin
D) Doxycycline
Correct Answer: B
Rationale: Bactrim displaces warfarin from protein-binding sites and kills gut
bacteria that produce vitamin K → increased INR, bleeding risk.
5. A client reports watery diarrhea for 5 days after finishing clindamycin. What is
the priority action?
A) Give loperamide (Imodium)
B) Send a stool sample for C. diff
C) Increase oral fluids
D) Restart the antibiotic
Correct Answer: B
Rationale: Clindamycin is high risk for C. difficile infection. Loperamide (A) can
worsen toxic megacolon. Test first, then treat.
, 6. A nurse administers ciprofloxacin. Which adverse effect requires immediate
reporting?
A) Nausea
B) Diarrhea
C) Tendon pain
D) Headache
Correct Answer: C
Rationale: Fluoroquinolones can cause tendonitis and tendon rupture (especially
Achilles). Stop drug immediately.
7. Which antifungal requires liver function monitoring?
A) Nystatin
B) Clotrimazole
C) Ketoconazole
D) Terbinafine
Correct Answer: C
Rationale: Ketoconazole is hepatotoxic. Nystatin (A) is topical or oral swish-and-
swallow – minimal absorption.
8. A female client taking tetracycline asks about birth control. What should the
nurse say?
A) “It’s safe to rely on your oral contraceptive.”
B) “Use a backup method like condoms.”
C) “Tetracycline increases estrogen levels.”
D) “You cannot get pregnant on tetracycline.”
Correct Answer: B
Rationale: Tetracycline reduces efficacy of oral contraceptives. Backup method is
needed.
NGN.docx
Exam
Questions 1–10: Antibiotics & Antifungals
1. A client is prescribed vancomycin IV. Which assessment finding requires
immediate action?
A) Red man syndrome (flushing, rash on upper body)
B) Serum creatinine 2.5 mg/dL
C) Nausea and vomiting
D) Tinnitus
Correct Answer: B
Rationale: Vancomycin is nephrotoxic. Serum creatinine >1.3 mg/dL (especially
2.5) indicates kidney injury. Red man syndrome (A) is managed by slowing
infusion but not as urgent as nephrotoxicity. Tinnitus (D) suggests ototoxicity but
is less immediately life-threatening than renal failure.
2. A client taking rifampin reports orange-red urine. What is the nurse’s best
response?
A) “Stop the medication immediately.”
B) “This is a harmless side effect.”
C) “You need a liver function test.”
D) “Drink more water to clear it.”
Correct Answer: B
Rationale: Rifampin causes harmless orange-red discoloration of urine, tears,
sweat, and saliva. It is not nephrotoxic. Stopping medication (A) could cause
treatment failure.
,3. A patient on isoniazid (INH) for TB reports peripheral neuropathy. Which
supplement should the nurse expect to administer?
A) Vitamin K
B) Vitamin B6 (pyridoxine)
C) Folic acid
D) Vitamin B12
Correct Answer: B
Rationale: INH causes vitamin B6 deficiency → peripheral neuropathy. Pyridoxine
prevents/treats this. Vitamin K (A) is for warfarin reversal.
4. Which antibiotic interacts with warfarin to increase bleeding risk?
A) Penicillin
B) Trimethoprim-sulfamethoxazole (Bactrim)
C) Azithromycin
D) Doxycycline
Correct Answer: B
Rationale: Bactrim displaces warfarin from protein-binding sites and kills gut
bacteria that produce vitamin K → increased INR, bleeding risk.
5. A client reports watery diarrhea for 5 days after finishing clindamycin. What is
the priority action?
A) Give loperamide (Imodium)
B) Send a stool sample for C. diff
C) Increase oral fluids
D) Restart the antibiotic
Correct Answer: B
Rationale: Clindamycin is high risk for C. difficile infection. Loperamide (A) can
worsen toxic megacolon. Test first, then treat.
, 6. A nurse administers ciprofloxacin. Which adverse effect requires immediate
reporting?
A) Nausea
B) Diarrhea
C) Tendon pain
D) Headache
Correct Answer: C
Rationale: Fluoroquinolones can cause tendonitis and tendon rupture (especially
Achilles). Stop drug immediately.
7. Which antifungal requires liver function monitoring?
A) Nystatin
B) Clotrimazole
C) Ketoconazole
D) Terbinafine
Correct Answer: C
Rationale: Ketoconazole is hepatotoxic. Nystatin (A) is topical or oral swish-and-
swallow – minimal absorption.
8. A female client taking tetracycline asks about birth control. What should the
nurse say?
A) “It’s safe to rely on your oral contraceptive.”
B) “Use a backup method like condoms.”
C) “Tetracycline increases estrogen levels.”
D) “You cannot get pregnant on tetracycline.”
Correct Answer: B
Rationale: Tetracycline reduces efficacy of oral contraceptives. Backup method is
needed.
