NUR612/NUR612 Exam 3 V1 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with a known severe allergy to penicillin is prescribed a cephalosporin. What is
the most appropriate nursing action?
A. Administer the cephalosporin as ordered.
B. Suggest using a macrolide instead of the cephalosporin.
C. Check for a history of anaphylaxis before administration.
D. Monitor the patient for 30 minutes after the first dose.
Answer: C
Rationale: While many patients with a penicillin allergy can tolerate cephalosporins, those
with a history of anaphylaxis have a higher risk of cross-reactivity. It is essential to
determine the severity of the previous penicillin reaction before proceeding. Clinical
guidelines suggest avoiding cephalosporins if the previous reaction was immediate or life-
threatening.
2. Which teaching point is most critical for a patient prescribed Tetracycline for acne?
A. Take the medication with a glass of milk.
B. Avoid direct sunlight and use sunscreen.
C. Expect urine to turn a dark orange color.
,D. Continue the medication if you become pregnant.
Answer: B
Rationale: Tetracyclines are known to cause photosensitivity, which can lead to severe
sunburns even with minimal sun exposure. Patients should be instructed to wear
protective clothing and use high-SPF sunscreen. Additionally, this drug should be avoided
during pregnancy due to its effects on fetal bone and tooth development.
3. What is the primary reason Vancomycin is administered over a minimum of 60 minutes?
A. To prevent the development of drug-resistant bacteria.
B. To ensure the drug reaches therapeutic peak levels.
C. To reduce the risk of permanent ototoxicity.
D. To avoid the occurrence of Red Man Syndrome.
Answer: D
Rationale: Rapid infusion of Vancomycin can trigger a histamine release known as Red
Man Syndrome, characterized by flushing, rash, and hypotension. Slowing the infusion rate
to at least 60 minutes prevents this infusion-related reaction. If the reaction occurs, the
infusion should be stopped and then restarted at a slower rate.
4. A patient is receiving Gentamicin for a systemic infection. Which laboratory values should
the nurse monitor most closely?
A. Serum glucose and potassium levels.
, B. Platelet count and hemoglobin levels.
C. Blood urea nitrogen (BUN) and creatinine.
D. Alanine aminotransferase (ALT) and bilirubin.
Answer: C
Rationale: Aminoglycosides like Gentamicin are highly nephrotoxic and are excreted
unchanged by the kidneys. Monitoring renal function through BUN and creatinine is vital to
prevent acute kidney injury. The nurse should also monitor for ototoxicity, which is
another major side effect of this class.
5. Which adverse effect is unique to the fluoroquinolone class of antibiotics, such as
Ciprofloxacin?
A. Risk of Achilles tendon rupture.
B. Severe gastrointestinal distress.
C. Pseudomembranous colitis.
D. Development of a metallic taste.
Answer: A
Rationale: Fluoroquinolones carry a black box warning for the risk of tendonitis and
tendon rupture, particularly in the Achilles tendon. This risk is higher in elderly patients,
those taking corticosteroids, or transplant recipients. Patients should be advised to stop the
medication and report any new tendon pain immediately.
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with a known severe allergy to penicillin is prescribed a cephalosporin. What is
the most appropriate nursing action?
A. Administer the cephalosporin as ordered.
B. Suggest using a macrolide instead of the cephalosporin.
C. Check for a history of anaphylaxis before administration.
D. Monitor the patient for 30 minutes after the first dose.
Answer: C
Rationale: While many patients with a penicillin allergy can tolerate cephalosporins, those
with a history of anaphylaxis have a higher risk of cross-reactivity. It is essential to
determine the severity of the previous penicillin reaction before proceeding. Clinical
guidelines suggest avoiding cephalosporins if the previous reaction was immediate or life-
threatening.
2. Which teaching point is most critical for a patient prescribed Tetracycline for acne?
A. Take the medication with a glass of milk.
B. Avoid direct sunlight and use sunscreen.
C. Expect urine to turn a dark orange color.
,D. Continue the medication if you become pregnant.
Answer: B
Rationale: Tetracyclines are known to cause photosensitivity, which can lead to severe
sunburns even with minimal sun exposure. Patients should be instructed to wear
protective clothing and use high-SPF sunscreen. Additionally, this drug should be avoided
during pregnancy due to its effects on fetal bone and tooth development.
3. What is the primary reason Vancomycin is administered over a minimum of 60 minutes?
A. To prevent the development of drug-resistant bacteria.
B. To ensure the drug reaches therapeutic peak levels.
C. To reduce the risk of permanent ototoxicity.
D. To avoid the occurrence of Red Man Syndrome.
Answer: D
Rationale: Rapid infusion of Vancomycin can trigger a histamine release known as Red
Man Syndrome, characterized by flushing, rash, and hypotension. Slowing the infusion rate
to at least 60 minutes prevents this infusion-related reaction. If the reaction occurs, the
infusion should be stopped and then restarted at a slower rate.
4. A patient is receiving Gentamicin for a systemic infection. Which laboratory values should
the nurse monitor most closely?
A. Serum glucose and potassium levels.
, B. Platelet count and hemoglobin levels.
C. Blood urea nitrogen (BUN) and creatinine.
D. Alanine aminotransferase (ALT) and bilirubin.
Answer: C
Rationale: Aminoglycosides like Gentamicin are highly nephrotoxic and are excreted
unchanged by the kidneys. Monitoring renal function through BUN and creatinine is vital to
prevent acute kidney injury. The nurse should also monitor for ototoxicity, which is
another major side effect of this class.
5. Which adverse effect is unique to the fluoroquinolone class of antibiotics, such as
Ciprofloxacin?
A. Risk of Achilles tendon rupture.
B. Severe gastrointestinal distress.
C. Pseudomembranous colitis.
D. Development of a metallic taste.
Answer: A
Rationale: Fluoroquinolones carry a black box warning for the risk of tendonitis and
tendon rupture, particularly in the Achilles tendon. This risk is higher in elderly patients,
those taking corticosteroids, or transplant recipients. Patients should be advised to stop the
medication and report any new tendon pain immediately.
