NUR 210 Units 6, 7, 8 & 9 Practice
Questions and correct answers/ NUR 210
Principles of Pharmacology Unit 6-9
UNIT 6: ANTI-INFECTIVES & ANTIBIOTICS
1. A patient is prescribed amoxicillin for a respiratory infection. The nurse explains
that penicillin antibiotics work by:
A) Inhibiting protein synthesis
B) Disrupting bacterial cell wall synthesis
C) Inhibiting DNA gyrase
D) Disrupting cell membranes
Rationale: Penicillins are beta-lactam antibiotics that inhibit transpeptidase enzymes,
preventing peptidoglycan cross-linking in bacterial cell walls. This leads to cell lysis in
actively dividing bacteria .
2. A patient with a documented anaphylactic allergy to penicillin is prescribed a
cephalosporin. The nurse should:
A) Administer the cephalosporin as ordered; cross-reactivity is a myth
B) Consult with the provider; cross-reactivity may occur (approximately 5-10%)
C) Give a test dose of the cephalosporin
D) Refuse to administer the drug
Rationale: Cross-reactivity between penicillins and cephalosporins is approximately 5-
10%, with first-generation cephalosporins having the highest risk. A history of
anaphylaxis warrants caution and provider consultation .
3. The nurse is preparing to administer vancomycin IV. Which adverse effect
requires the most immediate intervention?
A) Red Man Syndrome (flushing, rash)
B) Nephrotoxicity
C) Ototoxicity
D) Phlebitis at the IV site
Rationale: Vancomycin can cause nephrotoxicity, which is a serious adverse effect
,requiring close monitoring of renal function. Red Man Syndrome is managed by slowing
the infusion rate .
4. A patient on vancomycin has a trough level drawn. The result is 25 mcg/mL. The
nurse should:
A) Continue the medication as ordered
B) Notify the provider; level is above therapeutic range
C) Administer a double dose
D) Draw a peak level
Rationale: Vancomycin therapeutic trough levels are 10-20 mcg/mL (15-20 for serious
MRSA infections). A level of 25 mcg/mL is above therapeutic range and increases
nephrotoxicity risk .
5. The nurse is educating a patient about azithromycin. Which statement indicates
the patient understands the teaching?
A) "I can take this medication with antacids."
B) "I should take this medication on an empty stomach, 1 hour before or 2 hours
after meals."
C) "I can stop taking it when I feel better."
D) "This medication works by killing viruses."
Rationale: Azithromycin absorption is affected by food and antacids. It should be taken
on an empty stomach (1 hour before or 2 hours after meals). Antacids should be
avoided .
6. A patient on clarithromycin for H. pylori should be warned about:
A) Nephrotoxicity
B) QT prolongation
C) Hepatotoxicity
D) Ototoxicity
Rationale: Macrolides (clarithromycin, azithromycin) are associated with QT
prolongation and risk of arrhythmias. They should be used cautiously with other QT-
prolonging drugs .
7. Tetracyclines (e.g., doxycycline) are contraindicated in which population?
A) Adults with acne
B) Children under 8 years and pregnant women
C) Elderly patients
D) Patients with asthma
Rationale: Tetracyclines bind to calcium in developing teeth and bones, causing
discoloration and enamel hypoplasia. They are contraindicated in children under 8 years
and in pregnancy (Category D) .
, 8. A patient prescribed doxycycline should be taught to:
A) Take with dairy products
B) Avoid direct sunlight and use sunscreen
C) Take on a full stomach
D) Take with antacids
Rationale: Doxycycline causes photosensitivity. Patients should avoid prolonged sun
exposure and use sunscreen while taking this medication .
9. Fluoroquinolones (e.g., ciprofloxacin) have a black box warning for:
A) Hepatotoxicity
B) Nephrotoxicity
C) Tendinopathy and tendon rupture
D) Photosensitivity
Rationale: Fluoroquinolones carry a black box warning for increased risk of tendinitis
and tendon rupture, especially in elderly patients, those on corticosteroids, and those
with renal impairment .
10. A patient on ciprofloxacin reports tendon pain in the Achilles area. The nurse
should:
A) Instruct the patient to rest and apply ice
B) Hold the medication and notify the provider immediately
C) Continue the medication with increased fluids
D) Add an NSAID for pain
Rationale: Tendon pain may be an early sign of tendinopathy or tendon rupture. The
medication should be held and the provider notified immediately .
11. Aminoglycosides (e.g., gentamicin) are associated with which adverse effects?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity
D) Photosensitivity
Rationale: Aminoglycosides have dose-dependent nephrotoxicity and ototoxicity
(vestibular and cochlear). Serum levels must be monitored, especially in patients with
renal impairment .
12. The drug of choice for anaerobic infections is:
A) Gentamicin
B) Amoxicillin
C) Metronidazole
D) Azithromycin
Rationale: Metronidazole is highly effective against anaerobes (Bacteroides,
Questions and correct answers/ NUR 210
Principles of Pharmacology Unit 6-9
UNIT 6: ANTI-INFECTIVES & ANTIBIOTICS
1. A patient is prescribed amoxicillin for a respiratory infection. The nurse explains
that penicillin antibiotics work by:
A) Inhibiting protein synthesis
B) Disrupting bacterial cell wall synthesis
C) Inhibiting DNA gyrase
D) Disrupting cell membranes
Rationale: Penicillins are beta-lactam antibiotics that inhibit transpeptidase enzymes,
preventing peptidoglycan cross-linking in bacterial cell walls. This leads to cell lysis in
actively dividing bacteria .
2. A patient with a documented anaphylactic allergy to penicillin is prescribed a
cephalosporin. The nurse should:
A) Administer the cephalosporin as ordered; cross-reactivity is a myth
B) Consult with the provider; cross-reactivity may occur (approximately 5-10%)
C) Give a test dose of the cephalosporin
D) Refuse to administer the drug
Rationale: Cross-reactivity between penicillins and cephalosporins is approximately 5-
10%, with first-generation cephalosporins having the highest risk. A history of
anaphylaxis warrants caution and provider consultation .
3. The nurse is preparing to administer vancomycin IV. Which adverse effect
requires the most immediate intervention?
A) Red Man Syndrome (flushing, rash)
B) Nephrotoxicity
C) Ototoxicity
D) Phlebitis at the IV site
Rationale: Vancomycin can cause nephrotoxicity, which is a serious adverse effect
,requiring close monitoring of renal function. Red Man Syndrome is managed by slowing
the infusion rate .
4. A patient on vancomycin has a trough level drawn. The result is 25 mcg/mL. The
nurse should:
A) Continue the medication as ordered
B) Notify the provider; level is above therapeutic range
C) Administer a double dose
D) Draw a peak level
Rationale: Vancomycin therapeutic trough levels are 10-20 mcg/mL (15-20 for serious
MRSA infections). A level of 25 mcg/mL is above therapeutic range and increases
nephrotoxicity risk .
5. The nurse is educating a patient about azithromycin. Which statement indicates
the patient understands the teaching?
A) "I can take this medication with antacids."
B) "I should take this medication on an empty stomach, 1 hour before or 2 hours
after meals."
C) "I can stop taking it when I feel better."
D) "This medication works by killing viruses."
Rationale: Azithromycin absorption is affected by food and antacids. It should be taken
on an empty stomach (1 hour before or 2 hours after meals). Antacids should be
avoided .
6. A patient on clarithromycin for H. pylori should be warned about:
A) Nephrotoxicity
B) QT prolongation
C) Hepatotoxicity
D) Ototoxicity
Rationale: Macrolides (clarithromycin, azithromycin) are associated with QT
prolongation and risk of arrhythmias. They should be used cautiously with other QT-
prolonging drugs .
7. Tetracyclines (e.g., doxycycline) are contraindicated in which population?
A) Adults with acne
B) Children under 8 years and pregnant women
C) Elderly patients
D) Patients with asthma
Rationale: Tetracyclines bind to calcium in developing teeth and bones, causing
discoloration and enamel hypoplasia. They are contraindicated in children under 8 years
and in pregnancy (Category D) .
, 8. A patient prescribed doxycycline should be taught to:
A) Take with dairy products
B) Avoid direct sunlight and use sunscreen
C) Take on a full stomach
D) Take with antacids
Rationale: Doxycycline causes photosensitivity. Patients should avoid prolonged sun
exposure and use sunscreen while taking this medication .
9. Fluoroquinolones (e.g., ciprofloxacin) have a black box warning for:
A) Hepatotoxicity
B) Nephrotoxicity
C) Tendinopathy and tendon rupture
D) Photosensitivity
Rationale: Fluoroquinolones carry a black box warning for increased risk of tendinitis
and tendon rupture, especially in elderly patients, those on corticosteroids, and those
with renal impairment .
10. A patient on ciprofloxacin reports tendon pain in the Achilles area. The nurse
should:
A) Instruct the patient to rest and apply ice
B) Hold the medication and notify the provider immediately
C) Continue the medication with increased fluids
D) Add an NSAID for pain
Rationale: Tendon pain may be an early sign of tendinopathy or tendon rupture. The
medication should be held and the provider notified immediately .
11. Aminoglycosides (e.g., gentamicin) are associated with which adverse effects?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity
D) Photosensitivity
Rationale: Aminoglycosides have dose-dependent nephrotoxicity and ototoxicity
(vestibular and cochlear). Serum levels must be monitored, especially in patients with
renal impairment .
12. The drug of choice for anaerobic infections is:
A) Gentamicin
B) Amoxicillin
C) Metronidazole
D) Azithromycin
Rationale: Metronidazole is highly effective against anaerobes (Bacteroides,
