D441 Pharmacology Week 4 Study Guide 2026/2027 WGU
1. A patient with a history of severe anaphylaxis to penicillin is prescribed
cephalexin. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Monitor the patient closely for 30 minutes after administration.
D. Administer an antihistamine before giving the cephalexin.
Answer: B
Rationale: There is a cross-sensitivity risk (approx. 1-10%) between penicillins and
cephalosporins. In patients with a history of severe anaphylaxis to penicillin,
cephalosporins should be avoided.
2. A patient is receiving Vancomycin IV for a MRSA infection. The nurse notes
the patient’s face and neck are becoming flushed and red. What is the priority
action?
A. Stop the infusion immediately and notify the provider.
B. Administer epinephrine subcutaneously.
C. Apply cold compresses to the flushed areas.
D. Slow the infusion rate and monitor the patient.
Answer: D
Rationale: Red Man Syndrome is a rate-dependent infusion reaction, not a true allergy.
Slowing the infusion rate usually resolves the flushing and hypotension.
,3. Which laboratory value is most important to monitor in a patient receiving
Gentamicin?
A. Prothrombin time (PT)
B. Serum creatinine
C. Serum potassium
D. Hemoglobin and hematocrit
Answer: B
Rationale: Gentamicin is an aminoglycoside known for nephrotoxicity. Monitoring serum
creatinine and BUN is essential to detect renal impairment.
4. A nurse is providing education to a patient prescribed Tetracycline. Which
instruction should be included?
A. Take the medication with a glass of milk.
B. Expect your urine to turn bright orange.
C. Take an antacid if you experience stomach upset.
D. Use sunscreen and wear protective clothing outdoors.
Answer: D
Rationale: Tetracyclines cause photosensitivity. Patients should also avoid dairy, antacids,
and iron, as they decrease absorption.
5. Which adverse effect is a primary concern for a patient taking Erythromycin (a
Macrolide)?
A. QT interval prolongation
B. Tendon rupture
C. Orange-colored sweat
D. Gingival hyperplasia
Answer: A
Rationale: Macrolides like erythromycin and clarithromycin can cause QT prolongation,
leading to potentially fatal dysrhythmias like Torsades de Pointes.
, 6. A patient taking Ciprofloxacin reports new-onset pain and swelling in the
back of the ankle. What is the nurse’s priority action?
A. Instruct the patient to stop the medication and avoid exercise.
B. Advise the patient to apply ice to the area.
C. Tell the patient this is a common side effect that will resolve.
D. Administer an NSAID for pain relief.
Answer: A
Rationale: Fluoroquinolones carry a black box warning for tendonitis and tendon rupture,
most commonly the Achilles tendon.
7. A patient is prescribed Trimethoprim-Sulfamethoxazole (Bactrim). The nurse
should instruct the patient to report which symptom immediately?
A. A widespread blistering rash
B. Fatigue
C. Nausea
D. Increased thirst
Answer: A
Rationale: Sulfonamides are associated with Stevens-Johnson Syndrome (SJS), a life-
threatening skin reaction characterized by blistering and sloughing.
8. What is the primary indication for Nitrofurantoin?
A. Upper respiratory tract infections
B. Skin and soft tissue infections
C. Uncomplicated urinary tract infections (UTIs)
D. Systemic fungal infections
Answer: C
Rationale: Nitrofurantoin is a urinary tract antiseptic that reaches therapeutic
concentrations only in the urine.
1. A patient with a history of severe anaphylaxis to penicillin is prescribed
cephalexin. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Monitor the patient closely for 30 minutes after administration.
D. Administer an antihistamine before giving the cephalexin.
Answer: B
Rationale: There is a cross-sensitivity risk (approx. 1-10%) between penicillins and
cephalosporins. In patients with a history of severe anaphylaxis to penicillin,
cephalosporins should be avoided.
2. A patient is receiving Vancomycin IV for a MRSA infection. The nurse notes
the patient’s face and neck are becoming flushed and red. What is the priority
action?
A. Stop the infusion immediately and notify the provider.
B. Administer epinephrine subcutaneously.
C. Apply cold compresses to the flushed areas.
D. Slow the infusion rate and monitor the patient.
Answer: D
Rationale: Red Man Syndrome is a rate-dependent infusion reaction, not a true allergy.
Slowing the infusion rate usually resolves the flushing and hypotension.
,3. Which laboratory value is most important to monitor in a patient receiving
Gentamicin?
A. Prothrombin time (PT)
B. Serum creatinine
C. Serum potassium
D. Hemoglobin and hematocrit
Answer: B
Rationale: Gentamicin is an aminoglycoside known for nephrotoxicity. Monitoring serum
creatinine and BUN is essential to detect renal impairment.
4. A nurse is providing education to a patient prescribed Tetracycline. Which
instruction should be included?
A. Take the medication with a glass of milk.
B. Expect your urine to turn bright orange.
C. Take an antacid if you experience stomach upset.
D. Use sunscreen and wear protective clothing outdoors.
Answer: D
Rationale: Tetracyclines cause photosensitivity. Patients should also avoid dairy, antacids,
and iron, as they decrease absorption.
5. Which adverse effect is a primary concern for a patient taking Erythromycin (a
Macrolide)?
A. QT interval prolongation
B. Tendon rupture
C. Orange-colored sweat
D. Gingival hyperplasia
Answer: A
Rationale: Macrolides like erythromycin and clarithromycin can cause QT prolongation,
leading to potentially fatal dysrhythmias like Torsades de Pointes.
, 6. A patient taking Ciprofloxacin reports new-onset pain and swelling in the
back of the ankle. What is the nurse’s priority action?
A. Instruct the patient to stop the medication and avoid exercise.
B. Advise the patient to apply ice to the area.
C. Tell the patient this is a common side effect that will resolve.
D. Administer an NSAID for pain relief.
Answer: A
Rationale: Fluoroquinolones carry a black box warning for tendonitis and tendon rupture,
most commonly the Achilles tendon.
7. A patient is prescribed Trimethoprim-Sulfamethoxazole (Bactrim). The nurse
should instruct the patient to report which symptom immediately?
A. A widespread blistering rash
B. Fatigue
C. Nausea
D. Increased thirst
Answer: A
Rationale: Sulfonamides are associated with Stevens-Johnson Syndrome (SJS), a life-
threatening skin reaction characterized by blistering and sloughing.
8. What is the primary indication for Nitrofurantoin?
A. Upper respiratory tract infections
B. Skin and soft tissue infections
C. Uncomplicated urinary tract infections (UTIs)
D. Systemic fungal infections
Answer: C
Rationale: Nitrofurantoin is a urinary tract antiseptic that reaches therapeutic
concentrations only in the urine.
