NUR 600 Exam 2 Advanced Clinical Pharmacology –
(2026/2027) Actual Questions, Verified Answers with
Rationales | Guarantee Pass
Section 1: Infectious Disease & Antimicrobials
1. A patient with a fungal infection of two toenails (onychomycosis) asks about
treatment. Which therapy is most appropriate?
• A) Miconazole cream
• B) Ketoconazole cream
• C) Oral griseofulvin
• D) Mupirocin cream
Answer: C) Oral griseofulvin
Rationale: Onychomycosis requires systemic therapy because topical agents
cannot penetrate the nail plate. Griseofulvin is a systemic antifungal used for nail
infections. Topical antifungals are ineffective for nail bed penetration, and
mupirocin is antibacterial.
2. When prescribing topical penciclovir (Denavir) for herpes labialis, which
patient education statement is correct?
• A) Spread liberally all over lips and surrounding area
• B) Start at the first sign of a cold sore outbreak
• C) Skin irritation is normal and should resolve
• D) Use for a minimum of 2 weeks to prevent recurrence
Answer: B) Start at the first sign of a cold sore outbreak
Rationale: Topical antivirals are most effective when initiated during the
prodromal phase. Application should be limited to the lesion, not surrounding
skin. Irritation is not normal and should be reported. Duration is typically shorter
than 2 weeks.
,3. A patient with genital herpes is using topical acyclovir. Which teaching points
apply? (Select all that apply.)
• A) Wash hands thoroughly before and after applying
• B) Apply until the lesion stops hurting
• C) Use a clean glove when applying
• D) If partner develops lesions, they can share the medication
• E) Avoid touching the area around your eyes
• F) Practice abstinence when lesions are active
Answer: A, C, E, F
Rationale: Hand hygiene (A), using a glove (C), avoiding eyes (E), and abstinence
during active lesions (F) are correct. Application should continue for the full
prescribed course (not just until pain stops), and medication should never be
shared (D).
4. A patient with a penicillin allergy would need to avoid which antibiotic class?
• A) Tetracyclines
• B) Sulfonamides
• C) Cephalosporins
• D) Quinolones
Answer: C) Cephalosporins
Rationale: There is 5–10% cross-sensitivity between penicillins and
cephalosporins due to shared beta-lactam ring structure. Tetracyclines,
sulfonamides, and quinolones do not share this cross-reactivity.
5. A patient taking oral tetracycline should receive which instruction?
• A) Avoid direct sunlight and tanning beds
, • B) Milk products increase tetracycline levels
• C) Antacids help reduce GI distress
• D) Stop when you feel better
Answer: A) Avoid direct sunlight and tanning beds
Rationale: Tetracyclines cause photosensitivity. Dairy and antacids decrease
absorption via chelation. The full course must be completed to prevent
resistance.
6. A patient on warfarin is prescribed penicillin. What interaction occurs?
• A) Enhanced anticoagulant effect of warfarin
• B) Decreased anticoagulant effect of warfarin
• C) Reduced antiinfective action of penicillin
• D) Increased effectiveness of penicillin
Answer: A) Enhanced anticoagulant effect of warfarin
Rationale: Penicillins reduce vitamin K production by gut flora and inhibit warfarin
metabolism, increasing INR and bleeding risk. Monitor closely.
7. A patient receiving IV penicillin reports anxiety and difficulty breathing. What
is the nurse's first action?
• A) Notify the prescriber
• B) Take vital signs
• C) Stop the antibiotic infusion
• D) Check for allergies
Answer: C) Stop the antibiotic infusion
Rationale: These symptoms suggest anaphylaxis. The priority is to immediately
discontinue the offending medication. Then assess, notify, and treat.
, 8. A patient takes an antibiotic for 1 week before oral surgery. This is an
example of:
• A) Empirical therapy
• B) Prophylactic therapy
• C) Definitive therapy
• D) Resistance therapy
Answer: B) Prophylactic therapy
Rationale: Prophylactic therapy prevents infection before it occurs, often before
procedures that risk bacteremia (e.g., dental surgery in cardiac patients).
9. A female patient develops a vaginal superinfection during pneumonia
treatment. This is caused by:
• A) Large antibiotic doses killing normal flora
• B) Infection spreading from lungs
• C) Resistance of pneumonia bacteria
• D) Allergic reaction to antibiotics
Answer: A) Large antibiotic doses killing normal flora
Rationale: Superinfections occur when broad-spectrum antibiotics disrupt normal
flora, allowing opportunistic organisms like Candida to overgrow.
10. How do antiseptics differ from disinfectants?
• A) Antiseptics sterilize surgical equipment
• B) Disinfectants are used for preoperative skin prep
• C) Antiseptics are used only on living tissue
• D) Disinfectants are used only on living tissue
(2026/2027) Actual Questions, Verified Answers with
Rationales | Guarantee Pass
Section 1: Infectious Disease & Antimicrobials
1. A patient with a fungal infection of two toenails (onychomycosis) asks about
treatment. Which therapy is most appropriate?
• A) Miconazole cream
• B) Ketoconazole cream
• C) Oral griseofulvin
• D) Mupirocin cream
Answer: C) Oral griseofulvin
Rationale: Onychomycosis requires systemic therapy because topical agents
cannot penetrate the nail plate. Griseofulvin is a systemic antifungal used for nail
infections. Topical antifungals are ineffective for nail bed penetration, and
mupirocin is antibacterial.
2. When prescribing topical penciclovir (Denavir) for herpes labialis, which
patient education statement is correct?
• A) Spread liberally all over lips and surrounding area
• B) Start at the first sign of a cold sore outbreak
• C) Skin irritation is normal and should resolve
• D) Use for a minimum of 2 weeks to prevent recurrence
Answer: B) Start at the first sign of a cold sore outbreak
Rationale: Topical antivirals are most effective when initiated during the
prodromal phase. Application should be limited to the lesion, not surrounding
skin. Irritation is not normal and should be reported. Duration is typically shorter
than 2 weeks.
,3. A patient with genital herpes is using topical acyclovir. Which teaching points
apply? (Select all that apply.)
• A) Wash hands thoroughly before and after applying
• B) Apply until the lesion stops hurting
• C) Use a clean glove when applying
• D) If partner develops lesions, they can share the medication
• E) Avoid touching the area around your eyes
• F) Practice abstinence when lesions are active
Answer: A, C, E, F
Rationale: Hand hygiene (A), using a glove (C), avoiding eyes (E), and abstinence
during active lesions (F) are correct. Application should continue for the full
prescribed course (not just until pain stops), and medication should never be
shared (D).
4. A patient with a penicillin allergy would need to avoid which antibiotic class?
• A) Tetracyclines
• B) Sulfonamides
• C) Cephalosporins
• D) Quinolones
Answer: C) Cephalosporins
Rationale: There is 5–10% cross-sensitivity between penicillins and
cephalosporins due to shared beta-lactam ring structure. Tetracyclines,
sulfonamides, and quinolones do not share this cross-reactivity.
5. A patient taking oral tetracycline should receive which instruction?
• A) Avoid direct sunlight and tanning beds
, • B) Milk products increase tetracycline levels
• C) Antacids help reduce GI distress
• D) Stop when you feel better
Answer: A) Avoid direct sunlight and tanning beds
Rationale: Tetracyclines cause photosensitivity. Dairy and antacids decrease
absorption via chelation. The full course must be completed to prevent
resistance.
6. A patient on warfarin is prescribed penicillin. What interaction occurs?
• A) Enhanced anticoagulant effect of warfarin
• B) Decreased anticoagulant effect of warfarin
• C) Reduced antiinfective action of penicillin
• D) Increased effectiveness of penicillin
Answer: A) Enhanced anticoagulant effect of warfarin
Rationale: Penicillins reduce vitamin K production by gut flora and inhibit warfarin
metabolism, increasing INR and bleeding risk. Monitor closely.
7. A patient receiving IV penicillin reports anxiety and difficulty breathing. What
is the nurse's first action?
• A) Notify the prescriber
• B) Take vital signs
• C) Stop the antibiotic infusion
• D) Check for allergies
Answer: C) Stop the antibiotic infusion
Rationale: These symptoms suggest anaphylaxis. The priority is to immediately
discontinue the offending medication. Then assess, notify, and treat.
, 8. A patient takes an antibiotic for 1 week before oral surgery. This is an
example of:
• A) Empirical therapy
• B) Prophylactic therapy
• C) Definitive therapy
• D) Resistance therapy
Answer: B) Prophylactic therapy
Rationale: Prophylactic therapy prevents infection before it occurs, often before
procedures that risk bacteremia (e.g., dental surgery in cardiac patients).
9. A female patient develops a vaginal superinfection during pneumonia
treatment. This is caused by:
• A) Large antibiotic doses killing normal flora
• B) Infection spreading from lungs
• C) Resistance of pneumonia bacteria
• D) Allergic reaction to antibiotics
Answer: A) Large antibiotic doses killing normal flora
Rationale: Superinfections occur when broad-spectrum antibiotics disrupt normal
flora, allowing opportunistic organisms like Candida to overgrow.
10. How do antiseptics differ from disinfectants?
• A) Antiseptics sterilize surgical equipment
• B) Disinfectants are used for preoperative skin prep
• C) Antiseptics are used only on living tissue
• D) Disinfectants are used only on living tissue
