NUR 210 Pharmacology, NUR 210, Nursing
Program, 2026/2027 – Exam 4 Study Guide and
Practice Material, Questions & Answers (Verified
Answers) | Complete A+ Guide - PDF
1. A patient is prescribed penicillin V for strep throat.
Which statement indicates need for further teaching?
A) "I should take this medication with food to avoid an
upset stomach."
B) "I will finish all the medication even if I feel better."
C) "I will report any hives or difficulty breathing."
D) "I can take this medication with orange juice."
ANSWER: D
Rationale: Penicillins are acid-labile; acidic beverages
like orange juice can decrease absorption. Taking with
water is best.
2. A patient with a penicillin allergy requires an antibiotic
for a gram-negative infection. Which drug is most likely
1
,to cause cross-sensitivity?
A) Vancomycin
B) Cephalexin
C) Azithromycin
D) Doxycycline
ANSWER: B
Rationale: Cross-allergy between penicillins and
cephalosporins occurs in about 5–10% of patients due to
similar beta-lactam ring structure.
3. The nurse administers vancomycin IV. Which adverse
effect requires immediate discontinuation?
A) Red man syndrome
B) Nausea
C) Headache
D) Elevated BUN
ANSWER: A
Rationale: Red man syndrome (flushing, hypotension, rash)
2
,results from rapid infusion. Slowing the rate often resolves
it; stopping is needed if severe.
4. A patient on vancomycin has a trough level of 25
mcg/mL. What is the priority action?
A) Administer next dose as ordered
B) Hold next dose and notify provider
C) Increase IV fluid rate
D) Draw a peak level
ANSWER: B
Rationale: Therapeutic trough for vancomycin is 10–20
mcg/mL. 25 mcg/mL increases nephrotoxicity risk.
5. Which lab finding is most critical to monitor during
extended-course cephalosporin therapy?
A) Platelet count
B) PT/INR
C) Serum glucose
D) Creatinine kinase
ANSWER: B
3
, Rationale: Cephalosporins (especially cefoperazone,
cefotetan) can cause vitamin K deficiency, leading to
prolonged PT/INR and bleeding risk.
6. A patient develops watery diarrhea 10 times/day, 7
days after finishing clindamycin. What is the likely cause?
A) Viral gastroenteritis
B) Clostridium difficile infection
C) Antibiotic-induced lactose intolerance
D) Irritable bowel syndrome
ANSWER: B
Rationale: Clindamycin is strongly associated with C. diff
infection, often appearing up to 8 weeks post-antibiotic.
7. Which antibiotic requires therapeutic drug monitoring
for trough levels to prevent ototoxicity and nephrotoxicity?
A) Amoxicillin
B) Gentamicin
C) Doxycycline
D) Azithromycin
4
Program, 2026/2027 – Exam 4 Study Guide and
Practice Material, Questions & Answers (Verified
Answers) | Complete A+ Guide - PDF
1. A patient is prescribed penicillin V for strep throat.
Which statement indicates need for further teaching?
A) "I should take this medication with food to avoid an
upset stomach."
B) "I will finish all the medication even if I feel better."
C) "I will report any hives or difficulty breathing."
D) "I can take this medication with orange juice."
ANSWER: D
Rationale: Penicillins are acid-labile; acidic beverages
like orange juice can decrease absorption. Taking with
water is best.
2. A patient with a penicillin allergy requires an antibiotic
for a gram-negative infection. Which drug is most likely
1
,to cause cross-sensitivity?
A) Vancomycin
B) Cephalexin
C) Azithromycin
D) Doxycycline
ANSWER: B
Rationale: Cross-allergy between penicillins and
cephalosporins occurs in about 5–10% of patients due to
similar beta-lactam ring structure.
3. The nurse administers vancomycin IV. Which adverse
effect requires immediate discontinuation?
A) Red man syndrome
B) Nausea
C) Headache
D) Elevated BUN
ANSWER: A
Rationale: Red man syndrome (flushing, hypotension, rash)
2
,results from rapid infusion. Slowing the rate often resolves
it; stopping is needed if severe.
4. A patient on vancomycin has a trough level of 25
mcg/mL. What is the priority action?
A) Administer next dose as ordered
B) Hold next dose and notify provider
C) Increase IV fluid rate
D) Draw a peak level
ANSWER: B
Rationale: Therapeutic trough for vancomycin is 10–20
mcg/mL. 25 mcg/mL increases nephrotoxicity risk.
5. Which lab finding is most critical to monitor during
extended-course cephalosporin therapy?
A) Platelet count
B) PT/INR
C) Serum glucose
D) Creatinine kinase
ANSWER: B
3
, Rationale: Cephalosporins (especially cefoperazone,
cefotetan) can cause vitamin K deficiency, leading to
prolonged PT/INR and bleeding risk.
6. A patient develops watery diarrhea 10 times/day, 7
days after finishing clindamycin. What is the likely cause?
A) Viral gastroenteritis
B) Clostridium difficile infection
C) Antibiotic-induced lactose intolerance
D) Irritable bowel syndrome
ANSWER: B
Rationale: Clindamycin is strongly associated with C. diff
infection, often appearing up to 8 weeks post-antibiotic.
7. Which antibiotic requires therapeutic drug monitoring
for trough levels to prevent ototoxicity and nephrotoxicity?
A) Amoxicillin
B) Gentamicin
C) Doxycycline
D) Azithromycin
4
