NCLEX-RN Pharmacology Infection Drugs
Exam Questions |
Antibiotics, Antifungals & Antivirals
Practice Test Bank with Rationales
Question 1
Clinical Scenario
A 24-year-old woman is prescribed nitrofurantoin for an
uncomplicated urinary tract infection. She asks the nurse when
she should expect symptom improvement and what adverse
effects should be reported.
Question Stem
Which instruction should the nurse provide?
A. Stop taking the medication once dysuria improves.
B. Report shortness of breath or persistent cough immediately.
C. Avoid taking the medication with food.
D. Expect orange discoloration of body fluids.
,Correct Answer: B. Report shortness of breath or persistent
cough immediately.
Detailed Rationale
Nitrofurantoin is commonly used for lower urinary tract
infections. Although generally well tolerated, a serious adverse
effect is pulmonary toxicity, which can present with cough,
dyspnea, fever, and pulmonary infiltrates. Prompt reporting is
essential because pulmonary reactions may become severe or
permanent.
Option A is incorrect because patients should complete the
entire prescribed antibiotic course to prevent relapse and
antimicrobial resistance. Option C is incorrect because
nitrofurantoin should be taken with food or milk to improve
absorption and reduce gastrointestinal upset. Option D is
incorrect because orange discoloration of body fluids is more
commonly associated with rifampin, not nitrofurantoin.
Nurses should also assess renal function because nitrofurantoin
is less effective and potentially more toxic in significant renal
impairment.
Learning Objectives
After completing this question, the learner should be able to:
• Identify serious adverse effects of nitrofurantoin.
• Teach patients appropriate antibiotic adherence.
, • Recognize the importance of monitoring respiratory
symptoms.
Medication Safety Focus: Adverse effect monitoring
Question 2
Clinical Scenario
A 68-year-old man receiving intravenous vancomycin develops
flushing of the face, neck, and upper chest during the infusion.
Question Stem
Which action should the nurse take first?
A. Stop the infusion and notify the provider immediately.
B. Administer epinephrine.
C. Slow the infusion rate and assess the patient.
D. Administer diphenhydramine and continue at the same rate.
Correct Answer: C. Slow the infusion rate and assess the
patient.
Detailed Rationale
The patient is exhibiting manifestations of "Red Man
Syndrome," an infusion-related reaction associated with rapid
vancomycin administration. Symptoms include flushing,
pruritus, hypotension, and erythema. The priority intervention
Exam Questions |
Antibiotics, Antifungals & Antivirals
Practice Test Bank with Rationales
Question 1
Clinical Scenario
A 24-year-old woman is prescribed nitrofurantoin for an
uncomplicated urinary tract infection. She asks the nurse when
she should expect symptom improvement and what adverse
effects should be reported.
Question Stem
Which instruction should the nurse provide?
A. Stop taking the medication once dysuria improves.
B. Report shortness of breath or persistent cough immediately.
C. Avoid taking the medication with food.
D. Expect orange discoloration of body fluids.
,Correct Answer: B. Report shortness of breath or persistent
cough immediately.
Detailed Rationale
Nitrofurantoin is commonly used for lower urinary tract
infections. Although generally well tolerated, a serious adverse
effect is pulmonary toxicity, which can present with cough,
dyspnea, fever, and pulmonary infiltrates. Prompt reporting is
essential because pulmonary reactions may become severe or
permanent.
Option A is incorrect because patients should complete the
entire prescribed antibiotic course to prevent relapse and
antimicrobial resistance. Option C is incorrect because
nitrofurantoin should be taken with food or milk to improve
absorption and reduce gastrointestinal upset. Option D is
incorrect because orange discoloration of body fluids is more
commonly associated with rifampin, not nitrofurantoin.
Nurses should also assess renal function because nitrofurantoin
is less effective and potentially more toxic in significant renal
impairment.
Learning Objectives
After completing this question, the learner should be able to:
• Identify serious adverse effects of nitrofurantoin.
• Teach patients appropriate antibiotic adherence.
, • Recognize the importance of monitoring respiratory
symptoms.
Medication Safety Focus: Adverse effect monitoring
Question 2
Clinical Scenario
A 68-year-old man receiving intravenous vancomycin develops
flushing of the face, neck, and upper chest during the infusion.
Question Stem
Which action should the nurse take first?
A. Stop the infusion and notify the provider immediately.
B. Administer epinephrine.
C. Slow the infusion rate and assess the patient.
D. Administer diphenhydramine and continue at the same rate.
Correct Answer: C. Slow the infusion rate and assess the
patient.
Detailed Rationale
The patient is exhibiting manifestations of "Red Man
Syndrome," an infusion-related reaction associated with rapid
vancomycin administration. Symptoms include flushing,
pruritus, hypotension, and erythema. The priority intervention
