NURS 6521N ADVANCED
PHARMACOLOGY - WEEK 5
ANTIMICROBIAL THERAPY EXAM
QUESTIONS WITH COMPLETE AND
VERIFIED SOLUTIONS: WALDEN
UNIVERSITY
1. A patient is prescribed Linezolid for a vancomycin-resistant enterococcus (VRE) infection.
Which concurrent medication would require the nurse to intervene due to a high risk of
serotonin syndrome?
A. Lisinopril
B. Sertraline
C. Metformin
D. Atorvastatin
Answer: B
Conceptual Explanation: Linezolid has nonselective MAO inhibitory properties and can
interact with Serotonin Reuptake Inhibitors (SSRIs) like Sertraline, leading to potentially
fatal serotonin syndrome.
,2. Which pharmacokinetic property of aminoglycosides like Gentamicin necessitates the
monitoring of trough levels primarily to prevent toxicity?
A. Accumulation in the renal cortex and inner ear
B. Post-antibiotic effect (PAE)
C. Concentration-dependent killing
D. Extensive hepatic metabolism
Answer: A
Conceptual Explanation: Aminoglycosides are known for nephrotoxicity and ototoxicity
because they concentrate in the renal cortex and the endolymph/perilymph of the ear.
Trough levels ensure the drug clears enough to minimize this accumulation.
3. A 24-year-old female patient presents with a suspected urinary tract infection. The
provider considers prescribing Ciprofloxacin. What is a major contraindication or caution for
this drug class in specific populations?
A. Immediate renal failure if taken with dairy
B. Discoloration of teeth in children
C. Development of Red Man Syndrome
D. Risk of tendon rupture in all ages
Answer: D
, Conceptual Explanation: Fluoroquinolones like Ciprofloxacin carry a Black Box Warning
for tendinitis and tendon rupture, as well as peripheral neuropathy and CNS effects.
4. When administering Vancomycin, the patient begins to develop flushing, pruritus, and an
erythematous rash on the face and upper torso. What is the most appropriate next step?
A. Administer Epinephrine immediately for anaphylaxis
B. Slow the infusion rate and consider pre-treating with antihistamines
C. Stop the infusion and prepare to administer a corticosteroid
D. Continue the infusion as this is a normal therapeutic response
Answer: B
Conceptual Explanation: These symptoms describe ‘Red Man Syndrome,’ a rate-
dependent infusion reaction caused by histamine release, not a true allergy. Slowing the
rate usually resolves the issue.
5. A patient with a history of penicillin allergy is prescribed Cefazolin for surgical prophylaxis.
Which factor most influences the safety of this choice?
A. The patient’s age and weight
B. The severity and type of the previous penicillin reaction
C. The presence of a concurrent viral infection
D. The specific strain of bacteria being targeted
Answer: B
PHARMACOLOGY - WEEK 5
ANTIMICROBIAL THERAPY EXAM
QUESTIONS WITH COMPLETE AND
VERIFIED SOLUTIONS: WALDEN
UNIVERSITY
1. A patient is prescribed Linezolid for a vancomycin-resistant enterococcus (VRE) infection.
Which concurrent medication would require the nurse to intervene due to a high risk of
serotonin syndrome?
A. Lisinopril
B. Sertraline
C. Metformin
D. Atorvastatin
Answer: B
Conceptual Explanation: Linezolid has nonselective MAO inhibitory properties and can
interact with Serotonin Reuptake Inhibitors (SSRIs) like Sertraline, leading to potentially
fatal serotonin syndrome.
,2. Which pharmacokinetic property of aminoglycosides like Gentamicin necessitates the
monitoring of trough levels primarily to prevent toxicity?
A. Accumulation in the renal cortex and inner ear
B. Post-antibiotic effect (PAE)
C. Concentration-dependent killing
D. Extensive hepatic metabolism
Answer: A
Conceptual Explanation: Aminoglycosides are known for nephrotoxicity and ototoxicity
because they concentrate in the renal cortex and the endolymph/perilymph of the ear.
Trough levels ensure the drug clears enough to minimize this accumulation.
3. A 24-year-old female patient presents with a suspected urinary tract infection. The
provider considers prescribing Ciprofloxacin. What is a major contraindication or caution for
this drug class in specific populations?
A. Immediate renal failure if taken with dairy
B. Discoloration of teeth in children
C. Development of Red Man Syndrome
D. Risk of tendon rupture in all ages
Answer: D
, Conceptual Explanation: Fluoroquinolones like Ciprofloxacin carry a Black Box Warning
for tendinitis and tendon rupture, as well as peripheral neuropathy and CNS effects.
4. When administering Vancomycin, the patient begins to develop flushing, pruritus, and an
erythematous rash on the face and upper torso. What is the most appropriate next step?
A. Administer Epinephrine immediately for anaphylaxis
B. Slow the infusion rate and consider pre-treating with antihistamines
C. Stop the infusion and prepare to administer a corticosteroid
D. Continue the infusion as this is a normal therapeutic response
Answer: B
Conceptual Explanation: These symptoms describe ‘Red Man Syndrome,’ a rate-
dependent infusion reaction caused by histamine release, not a true allergy. Slowing the
rate usually resolves the issue.
5. A patient with a history of penicillin allergy is prescribed Cefazolin for surgical prophylaxis.
Which factor most influences the safety of this choice?
A. The patient’s age and weight
B. The severity and type of the previous penicillin reaction
C. The presence of a concurrent viral infection
D. The specific strain of bacteria being targeted
Answer: B
