NSG 124 Exam 4 Actual Exam V2 | NSG 124 Pharmacology (NSG124
Exam 4) | Herzing University PDF
1. A nurse is preparing to administer the first dose of amoxicillin to a patient with no known
drug allergies. Which action is most important for the nurse to perform?
A. Monitor the patient for at least 30 minutes after administration.
B. Check the patient’s blood glucose level.
C. Administer the medication with a large meal to prevent GI upset.
D. Tell the patient that a mild rash is expected and normal.
Answer: A
Rationale: Even if a patient reports no allergies, the first dose of a penicillin carries a risk
of anaphylaxis. The nurse must monitor the patient closely for immediate hypersensitivity
reactions such as wheezing or urticaria. Early recognition of an allergic reaction is critical
for timely intervention and patient safety.
2. A patient has been prescribed a 10-day course of cephalexin for a skin infection. The
patient states, ‘I feel much better after 3 days, so I will stop taking it to save money.’ How
should the nurse respond?
A. It is important to finish the entire course to prevent the infection from returning or
becoming resistant.
B. You should save the remaining pills for the next time you feel sick.
C. That is a good idea to prevent unnecessary side effects.
D. You can stop the medication if you remain fever-free for 24 hours.
Answer: A
Rationale: Completing the full course of prescribed antimicrobial therapy is a cornerstone
of antimicrobial stewardship. Stopping antibiotics early allows surviving bacteria to
develop resistance, making future infections harder to treat. The nurse must educate the
patient that symptom relief does not equate to the complete eradication of the pathogen.
3. A patient is receiving intravenous vancomycin. The nurse notes the patient’s face and neck
have become bright red and itchy. What is the nurse’s priority action?
A. Administer a dose of epinephrine immediately.
B. Slow the infusion rate of the vancomycin.
C. Apply cold compresses to the affected areas.
D. Stop the infusion and notify the provider immediately.
,Answer: B
Rationale: Red Man Syndrome is a common infusion-related reaction to vancomycin
caused by rapid histamine release, not a true allergy. Slowing the infusion rate usually
alleviates the symptoms and prevents recurrence. While monitoring is necessary, this
specific reaction does not typically require the cessation of therapy unless it progresses to
anaphylaxis.
4. A nurse is teaching a patient about a new prescription for tetracycline. Which instruction is
most important to include?
A. Take the medication with a full glass of milk.
B. Expect your urine to turn a bright orange color.
C. Use an effective form of sun protection when outdoors.
D. This medication is safe to take during pregnancy.
Answer: C
Rationale: Tetracyclines are known to cause significant photosensitivity, increasing the
risk of severe sunburn. Patients must be educated to avoid prolonged sun exposure and use
protective clothing or sunscreen. Additionally, these drugs should not be taken with dairy
products as calcium interferes with absorption.
5. Which laboratory value is most important for a nurse to monitor in a patient receiving
gentamicin?
A. Serum potassium levels
B. Serum creatinine and BUN
C. Prothrombin time (PT)
D. Hemoglobin and Hematocrit
Answer: B
Rationale: Aminoglycosides like gentamicin are highly nephrotoxic and ototoxic.
Monitoring serum creatinine and blood urea nitrogen (BUN) is essential to detect early
signs of kidney damage. The nurse should also assess the patient for changes in hearing or
balance during therapy.
6. A patient taking phenelzine, an MAOI, is at a party and consumes aged cheese and red
wine. The nurse should monitor for which serious adverse effect?
A. Hypertensive crisis
B. Severe hypotension and bradycardia
C. Acute renal failure
, D. Hypoglycemic shock
Answer: A
Rationale: MAOIs interact with tyramine-containing foods like aged cheese and wine to
cause a massive release of norepinephrine. This results in a hypertensive crisis, which can
lead to stroke or heart attack. Patient education regarding a low-tyramine diet is a critical
component of MAOI therapy.
7. A patient recently started on fluoxetine (an SSRI) for depression presents with agitation,
confusion, tremors, and a high fever. Which condition should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Extrapyramidal symptoms
Answer: B
Rationale: Serotonin syndrome is a potentially life-threatening condition caused by excess
serotonin, often from starting a new medication or combining serotonergic agents. Key
symptoms include mental status changes, autonomic hyperactivity, and neuromuscular
abnormalities. The nurse must recognize these symptoms as a medical emergency and
notify the provider.
8. A patient is prescribed lithium for bipolar disorder. The nurse should instruct the patient to
maintain a consistent intake of which substance?
A. Vitamin C
B. Calcium
C. Potassium
D. Sodium
Answer: D
Rationale: Lithium levels are closely related to sodium levels in the body; the kidneys treat
lithium and sodium similarly. If sodium levels drop, the kidneys retain lithium, leading to
toxic levels. Patients must maintain a consistent sodium and fluid intake to keep lithium
levels within the narrow therapeutic range.
9. A nurse is caring for a patient who has been taking haloperidol for several years. The nurse
observes the patient making involuntary tongue protrusions and lip-smacking movements.
How should the nurse document this?
A. Akathisia
B. Pseudoparkinsonism
Exam 4) | Herzing University PDF
1. A nurse is preparing to administer the first dose of amoxicillin to a patient with no known
drug allergies. Which action is most important for the nurse to perform?
A. Monitor the patient for at least 30 minutes after administration.
B. Check the patient’s blood glucose level.
C. Administer the medication with a large meal to prevent GI upset.
D. Tell the patient that a mild rash is expected and normal.
Answer: A
Rationale: Even if a patient reports no allergies, the first dose of a penicillin carries a risk
of anaphylaxis. The nurse must monitor the patient closely for immediate hypersensitivity
reactions such as wheezing or urticaria. Early recognition of an allergic reaction is critical
for timely intervention and patient safety.
2. A patient has been prescribed a 10-day course of cephalexin for a skin infection. The
patient states, ‘I feel much better after 3 days, so I will stop taking it to save money.’ How
should the nurse respond?
A. It is important to finish the entire course to prevent the infection from returning or
becoming resistant.
B. You should save the remaining pills for the next time you feel sick.
C. That is a good idea to prevent unnecessary side effects.
D. You can stop the medication if you remain fever-free for 24 hours.
Answer: A
Rationale: Completing the full course of prescribed antimicrobial therapy is a cornerstone
of antimicrobial stewardship. Stopping antibiotics early allows surviving bacteria to
develop resistance, making future infections harder to treat. The nurse must educate the
patient that symptom relief does not equate to the complete eradication of the pathogen.
3. A patient is receiving intravenous vancomycin. The nurse notes the patient’s face and neck
have become bright red and itchy. What is the nurse’s priority action?
A. Administer a dose of epinephrine immediately.
B. Slow the infusion rate of the vancomycin.
C. Apply cold compresses to the affected areas.
D. Stop the infusion and notify the provider immediately.
,Answer: B
Rationale: Red Man Syndrome is a common infusion-related reaction to vancomycin
caused by rapid histamine release, not a true allergy. Slowing the infusion rate usually
alleviates the symptoms and prevents recurrence. While monitoring is necessary, this
specific reaction does not typically require the cessation of therapy unless it progresses to
anaphylaxis.
4. A nurse is teaching a patient about a new prescription for tetracycline. Which instruction is
most important to include?
A. Take the medication with a full glass of milk.
B. Expect your urine to turn a bright orange color.
C. Use an effective form of sun protection when outdoors.
D. This medication is safe to take during pregnancy.
Answer: C
Rationale: Tetracyclines are known to cause significant photosensitivity, increasing the
risk of severe sunburn. Patients must be educated to avoid prolonged sun exposure and use
protective clothing or sunscreen. Additionally, these drugs should not be taken with dairy
products as calcium interferes with absorption.
5. Which laboratory value is most important for a nurse to monitor in a patient receiving
gentamicin?
A. Serum potassium levels
B. Serum creatinine and BUN
C. Prothrombin time (PT)
D. Hemoglobin and Hematocrit
Answer: B
Rationale: Aminoglycosides like gentamicin are highly nephrotoxic and ototoxic.
Monitoring serum creatinine and blood urea nitrogen (BUN) is essential to detect early
signs of kidney damage. The nurse should also assess the patient for changes in hearing or
balance during therapy.
6. A patient taking phenelzine, an MAOI, is at a party and consumes aged cheese and red
wine. The nurse should monitor for which serious adverse effect?
A. Hypertensive crisis
B. Severe hypotension and bradycardia
C. Acute renal failure
, D. Hypoglycemic shock
Answer: A
Rationale: MAOIs interact with tyramine-containing foods like aged cheese and wine to
cause a massive release of norepinephrine. This results in a hypertensive crisis, which can
lead to stroke or heart attack. Patient education regarding a low-tyramine diet is a critical
component of MAOI therapy.
7. A patient recently started on fluoxetine (an SSRI) for depression presents with agitation,
confusion, tremors, and a high fever. Which condition should the nurse suspect?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Extrapyramidal symptoms
Answer: B
Rationale: Serotonin syndrome is a potentially life-threatening condition caused by excess
serotonin, often from starting a new medication or combining serotonergic agents. Key
symptoms include mental status changes, autonomic hyperactivity, and neuromuscular
abnormalities. The nurse must recognize these symptoms as a medical emergency and
notify the provider.
8. A patient is prescribed lithium for bipolar disorder. The nurse should instruct the patient to
maintain a consistent intake of which substance?
A. Vitamin C
B. Calcium
C. Potassium
D. Sodium
Answer: D
Rationale: Lithium levels are closely related to sodium levels in the body; the kidneys treat
lithium and sodium similarly. If sodium levels drop, the kidneys retain lithium, leading to
toxic levels. Patients must maintain a consistent sodium and fluid intake to keep lithium
levels within the narrow therapeutic range.
9. A nurse is caring for a patient who has been taking haloperidol for several years. The nurse
observes the patient making involuntary tongue protrusions and lip-smacking movements.
How should the nurse document this?
A. Akathisia
B. Pseudoparkinsonism
