D441 Pharmacology Week 5 Study Guide 2026 |WGU
1. A patient with a documented severe anaphylactic reaction to Penicillin G is
prescribed Cephalexin. Which action by the nurse is most appropriate?
A. Hold the medication and notify the provider due to potential cross-sensitivity.
B. Administer the medication as prescribed.
C. Administer an antihistamine before giving the cephalosporin.
D. Monitor the patient closely for 15 minutes after administration.
Answer: A
Rationale: There is a documented cross-sensitivity risk (1% to 10%) between penicillins
and cephalosporins. In cases of severe anaphylaxis, cephalosporins should be avoided.
2. Which laboratory value must be monitored closely in a patient receiving
Gentamicin?
A. Serum glucose
B. Prothrombin time (PT)
C. Serum creatinine and BUN
D. Amylase and lipase
Answer: C
Rationale: Gentamicin is an aminoglycoside known for nephrotoxicity. Monitoring renal
function (BUN/Creatinine) is essential to prevent kidney damage.
,3. A patient receiving Vancomycin intravenously develops flushing,
hypotension, and a red rash on the upper body. What is the nurse’s priority
action?
A. Slow the infusion rate to be administered over at least 60 minutes.
B. Stop the infusion and prepare to administer epinephrine.
C. Increase the IV fluid rate to treat hypotension.
D. Apply cold compresses to the rash area.
Answer: A
Rationale: This describes ‘Red Man Syndrome,’ a rate-dependent reaction, not a true
allergy. It is managed by slowing the infusion rate.
4. What is a critical teaching point for a 10-year-old child prescribed
Tetracycline?
A. The drug can cause permanent discoloration of developing teeth.
B. The drug should be taken with a large glass of milk.
C. The drug causes excessive hair growth.
D. The drug should be taken only at bedtime.
Answer: A
Rationale: Tetracyclines bind to calcium in developing teeth, causing permanent yellow or
brown staining in children under 8 years of age.
5. Which black box warning is associated with Fluoroquinolones such as
Ciprofloxacin?
A. Tendon rupture and tendonitis
B. Severe hepatotoxicity
C. Aplastic anemia
D. Stevens-Johnson Syndrome
Answer: A
, Rationale: Fluoroquinolones carry a black box warning for the risk of tendon rupture,
especially the Achilles tendon, particularly in older adults or those on steroids.
6. A patient on Sulfamethoxazole-Trimethoprim (Bactrim) should be encouraged
to increase fluid intake to prevent which complication?
A. Gastrointestinal bleeding
B. Crystalluria
C. Hypertension
D. Oral thrush
Answer: B
Rationale: Sulfonamides can precipitate in the kidneys, leading to crystalluria. High fluid
intake (1.5-2L/day) helps prevent stone formation.
7. Erythromycin is often avoided in patients taking certain cardiac medications
because it can cause:
A. Severe bradycardia
B. Prolonged QT interval and sudden cardiac death
C. Hypertensive crisis
D. Hyperkalemia
Answer: B
Rationale: Macrolides like erythromycin can prolong the QT interval, increasing the risk of
potentially fatal ventricular arrhythmias.
8. A patient taking Metronidazole (Flagyl) for a C. difficile infection should be
warned to avoid:
A. Grapefruit juice
B. Alcoholic beverages
C. Aged cheeses
D. Direct sunlight
Answer: B
1. A patient with a documented severe anaphylactic reaction to Penicillin G is
prescribed Cephalexin. Which action by the nurse is most appropriate?
A. Hold the medication and notify the provider due to potential cross-sensitivity.
B. Administer the medication as prescribed.
C. Administer an antihistamine before giving the cephalosporin.
D. Monitor the patient closely for 15 minutes after administration.
Answer: A
Rationale: There is a documented cross-sensitivity risk (1% to 10%) between penicillins
and cephalosporins. In cases of severe anaphylaxis, cephalosporins should be avoided.
2. Which laboratory value must be monitored closely in a patient receiving
Gentamicin?
A. Serum glucose
B. Prothrombin time (PT)
C. Serum creatinine and BUN
D. Amylase and lipase
Answer: C
Rationale: Gentamicin is an aminoglycoside known for nephrotoxicity. Monitoring renal
function (BUN/Creatinine) is essential to prevent kidney damage.
,3. A patient receiving Vancomycin intravenously develops flushing,
hypotension, and a red rash on the upper body. What is the nurse’s priority
action?
A. Slow the infusion rate to be administered over at least 60 minutes.
B. Stop the infusion and prepare to administer epinephrine.
C. Increase the IV fluid rate to treat hypotension.
D. Apply cold compresses to the rash area.
Answer: A
Rationale: This describes ‘Red Man Syndrome,’ a rate-dependent reaction, not a true
allergy. It is managed by slowing the infusion rate.
4. What is a critical teaching point for a 10-year-old child prescribed
Tetracycline?
A. The drug can cause permanent discoloration of developing teeth.
B. The drug should be taken with a large glass of milk.
C. The drug causes excessive hair growth.
D. The drug should be taken only at bedtime.
Answer: A
Rationale: Tetracyclines bind to calcium in developing teeth, causing permanent yellow or
brown staining in children under 8 years of age.
5. Which black box warning is associated with Fluoroquinolones such as
Ciprofloxacin?
A. Tendon rupture and tendonitis
B. Severe hepatotoxicity
C. Aplastic anemia
D. Stevens-Johnson Syndrome
Answer: A
, Rationale: Fluoroquinolones carry a black box warning for the risk of tendon rupture,
especially the Achilles tendon, particularly in older adults or those on steroids.
6. A patient on Sulfamethoxazole-Trimethoprim (Bactrim) should be encouraged
to increase fluid intake to prevent which complication?
A. Gastrointestinal bleeding
B. Crystalluria
C. Hypertension
D. Oral thrush
Answer: B
Rationale: Sulfonamides can precipitate in the kidneys, leading to crystalluria. High fluid
intake (1.5-2L/day) helps prevent stone formation.
7. Erythromycin is often avoided in patients taking certain cardiac medications
because it can cause:
A. Severe bradycardia
B. Prolonged QT interval and sudden cardiac death
C. Hypertensive crisis
D. Hyperkalemia
Answer: B
Rationale: Macrolides like erythromycin can prolong the QT interval, increasing the risk of
potentially fatal ventricular arrhythmias.
8. A patient taking Metronidazole (Flagyl) for a C. difficile infection should be
warned to avoid:
A. Grapefruit juice
B. Alcoholic beverages
C. Aged cheeses
D. Direct sunlight
Answer: B
