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ESI Pharmacology RN Exam 2025/2026 – Actual
H
Exam Questions with Verified Answers &
Drug-Specific Rationales | Graded A+
Student Name:________________________ Date:_______________
Time Limit:90 minutesTotal Questions:70
Instructions
ead each question carefully. Select the best answer(s) for each question. For medication math questions,
R
show calculations where applicable. Correct answers are highlighted in yellow. Rationales are provided in
red after each question.
Section 1: Antibiotics (14 Questions)
Question 1
client is prescribed amoxicillin for a sinus infection. What should the nurse teach the client?
A
A. Take the medication with grapefruit juice.
B. Complete the full course of antibiotics.
C. Stop the medication if symptoms improve.
D. Double the dose if a dose is missed.
Rationale:Completing the full course of amoxicillinprevents antibiotic resistance and ensures infection
resolution.
Question 2 (SATA)
hich instructions should the nurse provide for a client starting levofloxacin?
W
A. Take on an empty stomach.
B. Avoid prolonged sun exposure.
C. Take with dairy products.
D. Report tendon pain immediately.
, ationale:Levofloxacin is best absorbed on an empty stomach, can cause photosensitivity, and is
R
associated with tendon rupture risk. Dairy products reduce absorption.
Question 3 (Case Study)
cenario: A 6-year-old is prescribed azithromycinfor otitis media. The parent reports diarrhea after two
S
days.
What is the nurse’s best action?
A. Stop the medication immediately.
B. Notify the provider and monitor hydration.
C. Increase the dose to reduce symptoms.
D. Ignore the diarrhea.
Rationale:Diarrhea is a common side effect of azithromycin;notifying the provider and monitoring
hydration are appropriate.
Question 4
client receiving vancomycin IV reports itching and flushing. What should the nurse suspect?
A
A. Ototoxicity
B. Red man syndrome
C. Nephrotoxicity
D. Hepatotoxicity
Rationale:Itching and flushing during vancomycininfusion indicate red man syndrome, often due to
rapid infusion.
Question 5
nurse is administering ceftriaxone IM to a client. What is the priority action before administration?
A
A. Administer without checking allergies.
B. Verify the client’s allergy history.
C. Dilute the medication with saline.
D. Give the injection in the deltoid.
Rationale:Verifying allergies prevents anaphylaxis,as ceftriaxone can cause severe reactions in
penicillin-allergic clients.
Question 6 (SATA)
hich are potential adverse effects of gentamicin?
W
A. Ototoxicity
B. Nephrotoxicity
C. Hyperglycemia
D. Tinnitus
Rationale:Gentamicin can cause ototoxicity (hearingloss, tinnitus) and nephrotoxicity. Hyperglycemia
is not a common side effect.
, Question 7 (Medication Math)
child is prescribed amoxicillin 50 mg/kg/day in two divided doses. The child weighs 20 kg. How many
A
mg should the nurse administer per dose?
A. 250 mg
B. 500 mg
C. 750 mg
D. 1000 mg
Calculation: 50 mg/kg/day × 20 kg = 1000 mg/day.Divided into two doses: 1000 mg ÷ 2 = 500 mg per
dose.
Rationale:The total daily dose is 1000 mg, splitinto 500 mg per dose for a 20-kg child.
Question 8
client is prescribed doxycycline for acne. What should the nurse teach the client?
A
A. Take with milk to enhance absorption.
B. Avoid lying down for 30 minutes after taking.
C. Take on an empty stomach only.
D. Stop if no improvement in 2 days.
Rationale:Doxycycline can cause esophageal irritation;avoiding lying down for 30 minutes reduces this
risk.
Question 9
client receiving metronidazole reports a metallic taste. What is the nurse’s best action?
A
A. Stop the medication.
B. Reassure the client that this is a common sideeffect.
C. Notify the provider to change the dose.
D. Administer an antacid.
Rationale:A metallic taste is a common, benign sideeffect of metronidazole and does not require
intervention.
Question 10
nurse is preparing to administer IV vancomycin. What is the priority action?
A
A. Infuse over 30 minutes.
B. Infuse over at least 60 minutes.
C. Administer as a bolus.
D. Mix with dextrose only.
Rationale:Vancomycin must be infused slowly (overat least 60 minutes) to prevent red man syndrome.
Question 11 (SATA)
hich laboratory tests should the nurse monitor for a client on clindamycin?
W
A. Liver function tests
ESI Pharmacology RN Exam 2025/2026 – Actual
H
Exam Questions with Verified Answers &
Drug-Specific Rationales | Graded A+
Student Name:________________________ Date:_______________
Time Limit:90 minutesTotal Questions:70
Instructions
ead each question carefully. Select the best answer(s) for each question. For medication math questions,
R
show calculations where applicable. Correct answers are highlighted in yellow. Rationales are provided in
red after each question.
Section 1: Antibiotics (14 Questions)
Question 1
client is prescribed amoxicillin for a sinus infection. What should the nurse teach the client?
A
A. Take the medication with grapefruit juice.
B. Complete the full course of antibiotics.
C. Stop the medication if symptoms improve.
D. Double the dose if a dose is missed.
Rationale:Completing the full course of amoxicillinprevents antibiotic resistance and ensures infection
resolution.
Question 2 (SATA)
hich instructions should the nurse provide for a client starting levofloxacin?
W
A. Take on an empty stomach.
B. Avoid prolonged sun exposure.
C. Take with dairy products.
D. Report tendon pain immediately.
, ationale:Levofloxacin is best absorbed on an empty stomach, can cause photosensitivity, and is
R
associated with tendon rupture risk. Dairy products reduce absorption.
Question 3 (Case Study)
cenario: A 6-year-old is prescribed azithromycinfor otitis media. The parent reports diarrhea after two
S
days.
What is the nurse’s best action?
A. Stop the medication immediately.
B. Notify the provider and monitor hydration.
C. Increase the dose to reduce symptoms.
D. Ignore the diarrhea.
Rationale:Diarrhea is a common side effect of azithromycin;notifying the provider and monitoring
hydration are appropriate.
Question 4
client receiving vancomycin IV reports itching and flushing. What should the nurse suspect?
A
A. Ototoxicity
B. Red man syndrome
C. Nephrotoxicity
D. Hepatotoxicity
Rationale:Itching and flushing during vancomycininfusion indicate red man syndrome, often due to
rapid infusion.
Question 5
nurse is administering ceftriaxone IM to a client. What is the priority action before administration?
A
A. Administer without checking allergies.
B. Verify the client’s allergy history.
C. Dilute the medication with saline.
D. Give the injection in the deltoid.
Rationale:Verifying allergies prevents anaphylaxis,as ceftriaxone can cause severe reactions in
penicillin-allergic clients.
Question 6 (SATA)
hich are potential adverse effects of gentamicin?
W
A. Ototoxicity
B. Nephrotoxicity
C. Hyperglycemia
D. Tinnitus
Rationale:Gentamicin can cause ototoxicity (hearingloss, tinnitus) and nephrotoxicity. Hyperglycemia
is not a common side effect.
, Question 7 (Medication Math)
child is prescribed amoxicillin 50 mg/kg/day in two divided doses. The child weighs 20 kg. How many
A
mg should the nurse administer per dose?
A. 250 mg
B. 500 mg
C. 750 mg
D. 1000 mg
Calculation: 50 mg/kg/day × 20 kg = 1000 mg/day.Divided into two doses: 1000 mg ÷ 2 = 500 mg per
dose.
Rationale:The total daily dose is 1000 mg, splitinto 500 mg per dose for a 20-kg child.
Question 8
client is prescribed doxycycline for acne. What should the nurse teach the client?
A
A. Take with milk to enhance absorption.
B. Avoid lying down for 30 minutes after taking.
C. Take on an empty stomach only.
D. Stop if no improvement in 2 days.
Rationale:Doxycycline can cause esophageal irritation;avoiding lying down for 30 minutes reduces this
risk.
Question 9
client receiving metronidazole reports a metallic taste. What is the nurse’s best action?
A
A. Stop the medication.
B. Reassure the client that this is a common sideeffect.
C. Notify the provider to change the dose.
D. Administer an antacid.
Rationale:A metallic taste is a common, benign sideeffect of metronidazole and does not require
intervention.
Question 10
nurse is preparing to administer IV vancomycin. What is the priority action?
A
A. Infuse over 30 minutes.
B. Infuse over at least 60 minutes.
C. Administer as a bolus.
D. Mix with dextrose only.
Rationale:Vancomycin must be infused slowly (overat least 60 minutes) to prevent red man syndrome.
Question 11 (SATA)
hich laboratory tests should the nurse monitor for a client on clindamycin?
W
A. Liver function tests
