,NU 578 Pharmacology for Advanced Practice
Nurses Unit 5 Exam Study Guide University of
South Alabama Exam Prep & 100 Q&A MCQs
2026/2027
1. A patient develops watery diarrhea 7 days after starting clindamycin for a dental infection.
Which condition should the APN suspect?
A. Viral gastroenteritis
B. *Clostridioides difficile* infection
C. Lactose intolerance
D. Antibiotic-associated nausea
Correct Answer: B
Rationale: *Clostridioides difficile* infection (CDI) is a classic complication of broad-spectrum
antibiotic therapy, particularly clindamycin, cephalosporins, and fluoroquinolones. The patient
should be tested for *C. difficile* toxin and started on appropriate therapy (oral vancomycin or
fidaxomicin).
2. A patient is prescribed metronidazole for bacterial vaginosis. Which patient education point is
most critical?
A. "Take this medication with dairy products."
B. "Avoid all alcohol during therapy and for 3 days after completion."
,C. "Take this medication at bedtime only."
D. "Stop the medication if you experience nausea."
Correct Answer: B
Rationale: Metronidazole inhibits aldehyde dehydrogenase, causing a disulfiram-like (Antabuse)
reaction when combined with alcohol. This can result in severe nausea, vomiting, flushing, and
tachycardia. Patients must avoid alcohol during therapy and for at least 3 days after completion.
3. A patient is started on isoniazid for latent tuberculosis. Which vitamin should be
supplemented to prevent peripheral neuropathy?
A. Vitamin C
B. Vitamin B6 (pyridoxine)
C. Vitamin D
D. Vitamin B12
Correct Answer: B
Rationale: Isoniazid can cause peripheral neuropathy due to interference with pyridoxine
(vitamin B6) metabolism. Pyridoxine supplementation (25-50 mg/day) is recommended for
patients at risk, including those with diabetes, alcohol use disorder, or malnutrition.
4. A patient on rifampin should be counseled about which expected body fluid change?
, A. Urine turning bright yellow
B. Urine, sweat, and tears turning orange-red
C. Saliva turning green
D. Stool turning black
Correct Answer: B
Rationale: Rifampin causes harmless orange-red discoloration of urine, sweat, tears, and other
body fluids. Patients should be warned about this effect to prevent alarm. It also permanently
stains soft contact lenses.
5. Which antibiotic class is associated with tendinopathy and tendon rupture?
A. Macrolides
B. Fluoroquinolones
C. Tetracyclines
D. Beta-lactams
Correct Answer: B
Rationale: Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) carry a black box warning for
tendinitis and tendon rupture, especially in patients over 60, those taking corticosteroids, and
transplant recipients. Patients should be advised to report tendon pain immediately.
Nurses Unit 5 Exam Study Guide University of
South Alabama Exam Prep & 100 Q&A MCQs
2026/2027
1. A patient develops watery diarrhea 7 days after starting clindamycin for a dental infection.
Which condition should the APN suspect?
A. Viral gastroenteritis
B. *Clostridioides difficile* infection
C. Lactose intolerance
D. Antibiotic-associated nausea
Correct Answer: B
Rationale: *Clostridioides difficile* infection (CDI) is a classic complication of broad-spectrum
antibiotic therapy, particularly clindamycin, cephalosporins, and fluoroquinolones. The patient
should be tested for *C. difficile* toxin and started on appropriate therapy (oral vancomycin or
fidaxomicin).
2. A patient is prescribed metronidazole for bacterial vaginosis. Which patient education point is
most critical?
A. "Take this medication with dairy products."
B. "Avoid all alcohol during therapy and for 3 days after completion."
,C. "Take this medication at bedtime only."
D. "Stop the medication if you experience nausea."
Correct Answer: B
Rationale: Metronidazole inhibits aldehyde dehydrogenase, causing a disulfiram-like (Antabuse)
reaction when combined with alcohol. This can result in severe nausea, vomiting, flushing, and
tachycardia. Patients must avoid alcohol during therapy and for at least 3 days after completion.
3. A patient is started on isoniazid for latent tuberculosis. Which vitamin should be
supplemented to prevent peripheral neuropathy?
A. Vitamin C
B. Vitamin B6 (pyridoxine)
C. Vitamin D
D. Vitamin B12
Correct Answer: B
Rationale: Isoniazid can cause peripheral neuropathy due to interference with pyridoxine
(vitamin B6) metabolism. Pyridoxine supplementation (25-50 mg/day) is recommended for
patients at risk, including those with diabetes, alcohol use disorder, or malnutrition.
4. A patient on rifampin should be counseled about which expected body fluid change?
, A. Urine turning bright yellow
B. Urine, sweat, and tears turning orange-red
C. Saliva turning green
D. Stool turning black
Correct Answer: B
Rationale: Rifampin causes harmless orange-red discoloration of urine, sweat, tears, and other
body fluids. Patients should be warned about this effect to prevent alarm. It also permanently
stains soft contact lenses.
5. Which antibiotic class is associated with tendinopathy and tendon rupture?
A. Macrolides
B. Fluoroquinolones
C. Tetracyclines
D. Beta-lactams
Correct Answer: B
Rationale: Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) carry a black box warning for
tendinitis and tendon rupture, especially in patients over 60, those taking corticosteroids, and
transplant recipients. Patients should be advised to report tendon pain immediately.
