NCLEX-RN Pharmacology Infection Practice
Questions |
20 Antibiotics, Antifungals & Antivirals NCLEX-
Style MCQs with Rationales |
ATI & NGN Nursing Exam Prep
Question 1
Clinical Scenario
A 24-year-old woman is admitted with pyelonephritis. The
provider prescribes ciprofloxacin 400 mg IV every 12 hr. During
medication reconciliation, the nurse learns the client takes
calcium supplements daily and reports a history of Achilles
tendonitis.
Question Stem
Which information is most important for the nurse to report to
the provider before administering ciprofloxacin?
A. Daily calcium supplement use
,B. History of Achilles tendonitis
C. Age younger than 30 years
D. Diagnosis of pyelonephritis
Correct Answer
Correct Answer: B. History of Achilles tendonitis
Detailed Rationale
Fluoroquinolones such as ciprofloxacin carry a Black Box
Warning for tendinitis and tendon rupture. Clients with a
history of tendon disorders are at increased risk for serious
tendon injury. The nurse should report this finding because an
alternative antibiotic may be safer.
A. Daily calcium supplement use is important but not the
highest priority. Calcium can reduce oral ciprofloxacin
absorption, but the medication is prescribed intravenously.
C. Age younger than 30 years is not a contraindication.
Increased tendon rupture risk is more commonly associated
with older adults and corticosteroid use.
D. Diagnosis of pyelonephritis is an appropriate indication for
ciprofloxacin.
The nurse should assess for tendon pain, swelling, or
inflammation and educate the client to report musculoskeletal
symptoms immediately.
,Learning Objective
After completing this question, the learner should be able to:
• Identify major fluoroquinolone safety concerns.
• Recognize contraindication-related assessment findings.
• Prioritize communication of significant medication risks.
• Apply Black Box Warning knowledge in clinical practice.
Medication Safety Focus
Black Box Warning
Question 2
Clinical Scenario
A 67-year-old client is receiving vancomycin IV for methicillin-
resistant Staphylococcus aureus (MRSA). Laboratory results
show a serum creatinine increase from 0.9 mg/dL to 1.8 mg/dL
over 4 days.
Question Stem
Which action should the nurse take first?
A. Administer the medication as prescribed
B. Encourage increased oral fluids
C. Notify the provider of the renal function changes
, D. Request an antiemetic prescription
Correct Answer
Correct Answer: C. Notify the provider of the renal function
changes
Detailed Rationale
Vancomycin can cause nephrotoxicity. A significant rise in serum
creatinine suggests worsening renal function and requires
prompt provider notification before further doses are
administered. Renal impairment may necessitate dosage
adjustment or drug discontinuation.
A. Administer the medication as prescribed could worsen
kidney injury.
B. Encourage increased oral fluids may be beneficial but does
not address the immediate safety concern.
D. Request an antiemetic prescription is unrelated to the
priority problem.
Nurses should monitor renal function, urine output, trough
levels when ordered, and signs of toxicity throughout therapy.
Learning Objective
After completing this question, the learner should be able to:
• Recognize vancomycin-associated nephrotoxicity.
Questions |
20 Antibiotics, Antifungals & Antivirals NCLEX-
Style MCQs with Rationales |
ATI & NGN Nursing Exam Prep
Question 1
Clinical Scenario
A 24-year-old woman is admitted with pyelonephritis. The
provider prescribes ciprofloxacin 400 mg IV every 12 hr. During
medication reconciliation, the nurse learns the client takes
calcium supplements daily and reports a history of Achilles
tendonitis.
Question Stem
Which information is most important for the nurse to report to
the provider before administering ciprofloxacin?
A. Daily calcium supplement use
,B. History of Achilles tendonitis
C. Age younger than 30 years
D. Diagnosis of pyelonephritis
Correct Answer
Correct Answer: B. History of Achilles tendonitis
Detailed Rationale
Fluoroquinolones such as ciprofloxacin carry a Black Box
Warning for tendinitis and tendon rupture. Clients with a
history of tendon disorders are at increased risk for serious
tendon injury. The nurse should report this finding because an
alternative antibiotic may be safer.
A. Daily calcium supplement use is important but not the
highest priority. Calcium can reduce oral ciprofloxacin
absorption, but the medication is prescribed intravenously.
C. Age younger than 30 years is not a contraindication.
Increased tendon rupture risk is more commonly associated
with older adults and corticosteroid use.
D. Diagnosis of pyelonephritis is an appropriate indication for
ciprofloxacin.
The nurse should assess for tendon pain, swelling, or
inflammation and educate the client to report musculoskeletal
symptoms immediately.
,Learning Objective
After completing this question, the learner should be able to:
• Identify major fluoroquinolone safety concerns.
• Recognize contraindication-related assessment findings.
• Prioritize communication of significant medication risks.
• Apply Black Box Warning knowledge in clinical practice.
Medication Safety Focus
Black Box Warning
Question 2
Clinical Scenario
A 67-year-old client is receiving vancomycin IV for methicillin-
resistant Staphylococcus aureus (MRSA). Laboratory results
show a serum creatinine increase from 0.9 mg/dL to 1.8 mg/dL
over 4 days.
Question Stem
Which action should the nurse take first?
A. Administer the medication as prescribed
B. Encourage increased oral fluids
C. Notify the provider of the renal function changes
, D. Request an antiemetic prescription
Correct Answer
Correct Answer: C. Notify the provider of the renal function
changes
Detailed Rationale
Vancomycin can cause nephrotoxicity. A significant rise in serum
creatinine suggests worsening renal function and requires
prompt provider notification before further doses are
administered. Renal impairment may necessitate dosage
adjustment or drug discontinuation.
A. Administer the medication as prescribed could worsen
kidney injury.
B. Encourage increased oral fluids may be beneficial but does
not address the immediate safety concern.
D. Request an antiemetic prescription is unrelated to the
priority problem.
Nurses should monitor renal function, urine output, trough
levels when ordered, and signs of toxicity throughout therapy.
Learning Objective
After completing this question, the learner should be able to:
• Recognize vancomycin-associated nephrotoxicity.
