NR 293 Exam 2 | Pharmacology for Nursing Practice
(2026) Verified Questions & Rationales
SECTION 1: ANTIMICROBIAL AGENTS (Questions 1–40)
1. A nurse is administering gentamicin to a client. Which laboratory value requires immediate
intervention?
A) Serum creatinine 0.8 mg/dL
B) Serum creatinine 2.5 mg/dL
C) BUN 15 mg/dL
D) Potassium 4.0 mEq/L
Answer: B
Rationale:
Gentamicin is an aminoglycoside that is nephrotoxic. An elevated serum creatinine of 2.5 mg/dL indicates
impaired renal function, placing the client at risk for further kidney damage and drug accumulation.
2. A nurse is teaching a client about penicillin. Which statement by the client indicates
understanding?
A) "I should take it with milk."
B) "I should report any rash or difficulty breathing."
C) "I can stop taking it when I feel better."
D) "It is safe to take with all other medications."
Answer: B
Rationale:
Penicillin can cause hypersensitivity reactions ranging from rash to anaphylaxis. Clients must report rash,
hives, or difficulty breathing immediately for prompt intervention.
3. Which antibiotic is associated with a disulfiram-like reaction when combined with alcohol?
A) Penicillin
B) Metronidazole
C) Vancomycin
D) Azithromycin
,Answer: B
Rationale:
Metronidazole combined with alcohol can cause a disulfiram-like reaction characterized by severe nausea,
vomiting, flushing, tachycardia, and hypotension. Clients must avoid alcohol during and for 3 days after
therapy.
4. A nurse is administering vancomycin. Which adverse effect requires monitoring?
A) Hyperglycemia
B) Ototoxicity and nephrotoxicity
C) Hypertension
D) Bradycardia
Answer: B
Rationale:
Vancomycin can cause ototoxicity (hearing loss, tinnitus) and nephrotoxicity (elevated creatinine, BUN).
Serum levels and renal function must be monitored closely.
5. A nurse is teaching a client about tetracycline. Which instruction is correct?
A) "Take it with dairy products."
B) "Avoid sun exposure and use sunscreen."
C) "Take it with antacids."
D) "It is safe during pregnancy."
Answer: B
Rationale:
Tetracycline causes photosensitivity, increasing the risk of severe sunburn. Clients should avoid prolonged
sun exposure and use sunscreen. Dairy and antacids reduce absorption.
6. Which antibiotic class is associated with tendon rupture?
A) Penicillins
B) Cephalosporins
C) Fluoroquinolones
D) Macrolides
Answer: C
2
,Rationale:
Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) carry a black box warning for tendinitis and tendon
rupture, especially in older adults and those taking corticosteroids.
7. A nurse is administering ceftriaxone. Which finding indicates a possible allergic reaction?
A) Mild nausea
B) Urticaria and wheezing
C) Constipation
D) Dry mouth
Answer: B
Rationale:
Urticaria and wheezing indicate an allergic reaction to ceftriaxone (a cephalosporin), requiring immediate
discontinuation and emergency treatment.
8. Which antibiotic requires monitoring for "red man syndrome"?
A) Vancomycin
B) Amoxicillin
C) Azithromycin
D) Doxycycline
Answer: A
Rationale:
Red man syndrome is a histamine-mediated reaction to rapid vancomycin infusion, characterized by flushing
of the face, neck, and torso, hypotension, and rash. Infusion should be over at least 60 minutes.
9. A nurse is teaching a client about isoniazid (INH). Which instruction is essential?
A) "Avoid alcohol and report yellowing of eyes or skin."
B) "Take it with food."
C) "You do not need liver function tests."
D) "Take it only when symptomatic."
Answer: A
Rationale:
INH is hepatotoxic, especially when combined with alcohol. Clients must report signs of hepatotoxicity
(jaundice, dark urine, right upper quadrant pain) and avoid alcohol.
3
, 10. A nurse is administering rifampin. Which finding indicates the need for client teaching?
A) Orange discoloration of body fluids
B) Hypertension
C) Bradycardia
D) Constipation
Answer: A
Rationale:
Rifampin causes harmless orange-red discoloration of urine, sweat, tears, and saliva. Clients should be
informed to prevent alarm and to avoid contact lenses.
11. Which antifungal agent requires monitoring for hepatotoxicity?
A) Fluconazole
B) Nystatin
C) Terbinafine
D) Clotrimazole
Answer: A
Rationale:
Fluconazole is an azole antifungal that can cause hepatotoxicity. Liver function tests should be monitored
before and during therapy.
12. A nurse is administering acyclovir. Which instruction is essential?
A) "Increase fluid intake."
B) "Decrease fluid intake."
C) "Avoid all fluids."
D) "Take with antacids."
Answer: A
Rationale:
Acyclovir can cause nephrotoxicity if crystals form in the renal tubules. Adequate hydration (2–3 L/day)
helps prevent crystal formation and renal damage.
13. Which antibiotic is contraindicated in clients with a history of anaphylaxis to penicillin?
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(2026) Verified Questions & Rationales
SECTION 1: ANTIMICROBIAL AGENTS (Questions 1–40)
1. A nurse is administering gentamicin to a client. Which laboratory value requires immediate
intervention?
A) Serum creatinine 0.8 mg/dL
B) Serum creatinine 2.5 mg/dL
C) BUN 15 mg/dL
D) Potassium 4.0 mEq/L
Answer: B
Rationale:
Gentamicin is an aminoglycoside that is nephrotoxic. An elevated serum creatinine of 2.5 mg/dL indicates
impaired renal function, placing the client at risk for further kidney damage and drug accumulation.
2. A nurse is teaching a client about penicillin. Which statement by the client indicates
understanding?
A) "I should take it with milk."
B) "I should report any rash or difficulty breathing."
C) "I can stop taking it when I feel better."
D) "It is safe to take with all other medications."
Answer: B
Rationale:
Penicillin can cause hypersensitivity reactions ranging from rash to anaphylaxis. Clients must report rash,
hives, or difficulty breathing immediately for prompt intervention.
3. Which antibiotic is associated with a disulfiram-like reaction when combined with alcohol?
A) Penicillin
B) Metronidazole
C) Vancomycin
D) Azithromycin
,Answer: B
Rationale:
Metronidazole combined with alcohol can cause a disulfiram-like reaction characterized by severe nausea,
vomiting, flushing, tachycardia, and hypotension. Clients must avoid alcohol during and for 3 days after
therapy.
4. A nurse is administering vancomycin. Which adverse effect requires monitoring?
A) Hyperglycemia
B) Ototoxicity and nephrotoxicity
C) Hypertension
D) Bradycardia
Answer: B
Rationale:
Vancomycin can cause ototoxicity (hearing loss, tinnitus) and nephrotoxicity (elevated creatinine, BUN).
Serum levels and renal function must be monitored closely.
5. A nurse is teaching a client about tetracycline. Which instruction is correct?
A) "Take it with dairy products."
B) "Avoid sun exposure and use sunscreen."
C) "Take it with antacids."
D) "It is safe during pregnancy."
Answer: B
Rationale:
Tetracycline causes photosensitivity, increasing the risk of severe sunburn. Clients should avoid prolonged
sun exposure and use sunscreen. Dairy and antacids reduce absorption.
6. Which antibiotic class is associated with tendon rupture?
A) Penicillins
B) Cephalosporins
C) Fluoroquinolones
D) Macrolides
Answer: C
2
,Rationale:
Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) carry a black box warning for tendinitis and tendon
rupture, especially in older adults and those taking corticosteroids.
7. A nurse is administering ceftriaxone. Which finding indicates a possible allergic reaction?
A) Mild nausea
B) Urticaria and wheezing
C) Constipation
D) Dry mouth
Answer: B
Rationale:
Urticaria and wheezing indicate an allergic reaction to ceftriaxone (a cephalosporin), requiring immediate
discontinuation and emergency treatment.
8. Which antibiotic requires monitoring for "red man syndrome"?
A) Vancomycin
B) Amoxicillin
C) Azithromycin
D) Doxycycline
Answer: A
Rationale:
Red man syndrome is a histamine-mediated reaction to rapid vancomycin infusion, characterized by flushing
of the face, neck, and torso, hypotension, and rash. Infusion should be over at least 60 minutes.
9. A nurse is teaching a client about isoniazid (INH). Which instruction is essential?
A) "Avoid alcohol and report yellowing of eyes or skin."
B) "Take it with food."
C) "You do not need liver function tests."
D) "Take it only when symptomatic."
Answer: A
Rationale:
INH is hepatotoxic, especially when combined with alcohol. Clients must report signs of hepatotoxicity
(jaundice, dark urine, right upper quadrant pain) and avoid alcohol.
3
, 10. A nurse is administering rifampin. Which finding indicates the need for client teaching?
A) Orange discoloration of body fluids
B) Hypertension
C) Bradycardia
D) Constipation
Answer: A
Rationale:
Rifampin causes harmless orange-red discoloration of urine, sweat, tears, and saliva. Clients should be
informed to prevent alarm and to avoid contact lenses.
11. Which antifungal agent requires monitoring for hepatotoxicity?
A) Fluconazole
B) Nystatin
C) Terbinafine
D) Clotrimazole
Answer: A
Rationale:
Fluconazole is an azole antifungal that can cause hepatotoxicity. Liver function tests should be monitored
before and during therapy.
12. A nurse is administering acyclovir. Which instruction is essential?
A) "Increase fluid intake."
B) "Decrease fluid intake."
C) "Avoid all fluids."
D) "Take with antacids."
Answer: A
Rationale:
Acyclovir can cause nephrotoxicity if crystals form in the renal tubules. Adequate hydration (2–3 L/day)
helps prevent crystal formation and renal damage.
13. Which antibiotic is contraindicated in clients with a history of anaphylaxis to penicillin?
4
