Pharmacology Made Incredibly Easy
5th Edition
• Author(s)Cherie R. Rebar; Nicole M.
Heimgartner; Carolyn Gersch
NCLEX-RN Pharmacology Practice
Questions
Essential Pharmacology: Mastering
Infection Treatment
Test Bank
,Question 1
Clinical Scenario
A 34-year-old woman with bacterial cellulitis is prescribed amoxicillin.
During medication reconciliation, she reports that five years ago she
developed generalized hives, wheezing, and facial swelling within 30
minutes of taking amoxicillin. Her current vital signs are stable, and no
antibiotic has yet been administered.
Question Stem
Which action should the nurse take?
A. Administer amoxicillin with food to reduce adverse effects.
B. Hold the amoxicillin and notify the prescriber of the history of
immediate hypersensitivity.
C. Administer half the prescribed dose and observe the patient.
D. Give diphenhydramine prophylactically before administering
amoxicillin.
Correct Answer
Correct Answer: B. Hold the amoxicillin and notify the prescriber of
the history of immediate hypersensitivity.
Detailed Rationale
The correct answer is B because the patient describes a previous
immediate systemic hypersensitivity reaction consistent with
anaphylaxis. Wheezing, facial swelling, and generalized urticaria
occurring shortly after amoxicillin exposure create a major medication-
safety concern. The nurse should not administer the medication until
the allergy is clarified and an appropriate alternative is prescribed.
,Allergy history is a critical component of medication reconciliation
because preventable exposure to a known allergen can produce rapid
airway compromise, hypotension, and cardiovascular collapse.
Option A is incorrect because taking the drug with food does not
prevent IgE-mediated hypersensitivity. Option C is unsafe because
reducing the dose does not reliably prevent anaphylaxis; even a small
exposure can trigger a serious reaction. Option D is incorrect because
prophylactic diphenhydramine does not make administration of a
contraindicated antibiotic safe and could potentially mask early
cutaneous manifestations while the reaction progresses.
The nurse should document the allergy clearly, verify the reaction and
timing, communicate promptly with the prescriber, and ensure the
electronic medication record reflects the allergy. When administering
any new antimicrobial, nurses should also assess for previous allergic
reactions to related medications and monitor the patient closely after
initiation.
Learning Objective
After completing this question, the learner should be able to:
• Identify a medication history consistent with immediate
hypersensitivity.
• Apply medication-reconciliation principles before antibiotic
administration.
• Prioritize withholding a potentially dangerous medication.
• Distinguish true allergy precautions from routine side-effect
management.
, Medication Safety Focus: Contraindication
Question 2
Clinical Scenario
A 45-year-old man is prescribed oral metronidazole for an anaerobic
bacterial infection. During discharge teaching, he says, “I usually have a
beer with dinner, so I will just skip the beer on the days I take the
medication.”
Question Stem
Which response by the nurse is most appropriate?
A. “That is safe as long as you wait at least 2 hours after the
medication.”
B. “Beer is acceptable, but wine should be avoided.”
C. “Avoid alcohol while taking metronidazole and for at least 3 days
after the last dose.”
D. “Alcohol only needs to be avoided if you experience nausea.”
Correct Answer
Correct Answer: C. “Avoid alcohol while taking metronidazole and for
at least 3 days after the last dose.”
Detailed Rationale
The correct answer is C. Oral metronidazole labeling advises patients to
discontinue alcoholic beverages and products containing propylene
glycol during therapy and for at least three days afterward because a
5th Edition
• Author(s)Cherie R. Rebar; Nicole M.
Heimgartner; Carolyn Gersch
NCLEX-RN Pharmacology Practice
Questions
Essential Pharmacology: Mastering
Infection Treatment
Test Bank
,Question 1
Clinical Scenario
A 34-year-old woman with bacterial cellulitis is prescribed amoxicillin.
During medication reconciliation, she reports that five years ago she
developed generalized hives, wheezing, and facial swelling within 30
minutes of taking amoxicillin. Her current vital signs are stable, and no
antibiotic has yet been administered.
Question Stem
Which action should the nurse take?
A. Administer amoxicillin with food to reduce adverse effects.
B. Hold the amoxicillin and notify the prescriber of the history of
immediate hypersensitivity.
C. Administer half the prescribed dose and observe the patient.
D. Give diphenhydramine prophylactically before administering
amoxicillin.
Correct Answer
Correct Answer: B. Hold the amoxicillin and notify the prescriber of
the history of immediate hypersensitivity.
Detailed Rationale
The correct answer is B because the patient describes a previous
immediate systemic hypersensitivity reaction consistent with
anaphylaxis. Wheezing, facial swelling, and generalized urticaria
occurring shortly after amoxicillin exposure create a major medication-
safety concern. The nurse should not administer the medication until
the allergy is clarified and an appropriate alternative is prescribed.
,Allergy history is a critical component of medication reconciliation
because preventable exposure to a known allergen can produce rapid
airway compromise, hypotension, and cardiovascular collapse.
Option A is incorrect because taking the drug with food does not
prevent IgE-mediated hypersensitivity. Option C is unsafe because
reducing the dose does not reliably prevent anaphylaxis; even a small
exposure can trigger a serious reaction. Option D is incorrect because
prophylactic diphenhydramine does not make administration of a
contraindicated antibiotic safe and could potentially mask early
cutaneous manifestations while the reaction progresses.
The nurse should document the allergy clearly, verify the reaction and
timing, communicate promptly with the prescriber, and ensure the
electronic medication record reflects the allergy. When administering
any new antimicrobial, nurses should also assess for previous allergic
reactions to related medications and monitor the patient closely after
initiation.
Learning Objective
After completing this question, the learner should be able to:
• Identify a medication history consistent with immediate
hypersensitivity.
• Apply medication-reconciliation principles before antibiotic
administration.
• Prioritize withholding a potentially dangerous medication.
• Distinguish true allergy precautions from routine side-effect
management.
, Medication Safety Focus: Contraindication
Question 2
Clinical Scenario
A 45-year-old man is prescribed oral metronidazole for an anaerobic
bacterial infection. During discharge teaching, he says, “I usually have a
beer with dinner, so I will just skip the beer on the days I take the
medication.”
Question Stem
Which response by the nurse is most appropriate?
A. “That is safe as long as you wait at least 2 hours after the
medication.”
B. “Beer is acceptable, but wine should be avoided.”
C. “Avoid alcohol while taking metronidazole and for at least 3 days
after the last dose.”
D. “Alcohol only needs to be avoided if you experience nausea.”
Correct Answer
Correct Answer: C. “Avoid alcohol while taking metronidazole and for
at least 3 days after the last dose.”
Detailed Rationale
The correct answer is C. Oral metronidazole labeling advises patients to
discontinue alcoholic beverages and products containing propylene
glycol during therapy and for at least three days afterward because a
