NCLEX-RN Pharmacology Infection Exam
Questions |
20 Original Antibiotics, Antifungals &
Antivirals NCLEX NGN Practice Questions with
Detailed Rationales |
ATI Pharmacology Made Easy Style |
Nursing Test Bank |
RN Exam Prep
Question 1
Clinical Scenario
A 72-year-old male client is admitted to the medical-surgical
unit with community-acquired pneumonia. The provider orders
intravenous levofloxacin. The nurse reviews the client's
electronic health record and notes a history of a tendon rupture
in the left Achilles tendon two years ago following ciprofloxacin
therapy. The client also reports current bilateral ankle pain and
swelling.
Question Stem
,Which action should the nurse take first?
A. Administer the levofloxacin as prescribed and monitor for
tendon pain.
B. Request an order for an analgesic to manage the ankle pain.
C. Hold the levofloxacin and notify the healthcare provider.
D. Apply compression stockings to reduce ankle swelling.
Correct Answer
C. Hold the levofloxacin and notify the healthcare provider.
Detailed Rationale
Fluoroquinolones, including levofloxacin and ciprofloxacin, carry
a Black Box Warning for tendinitis and tendon rupture, which
can occur within hours or days of initiation and may affect the
Achilles, rotator cuff, or other tendons. Risk factors include age
over 60, concurrent corticosteroid use, renal impairment, and a
history of tendon disorders related to fluoroquinolone use. This
client has a documented history of tendon injury from a prior
fluoroquinolone, placing him at exceptionally high risk for a
repeat, potentially more severe injury. The nurse must
recognize this contraindication and hold the medication while
notifying the provider to request an alternative antibiotic class,
such as a macrolide or beta-lactam, that is appropriate for
pneumonia but lacks this adverse effect profile.
,Option A is incorrect because administering the medication
despite known risk factors would place the client in significant
danger of further tendon damage. Option B is incorrect because
managing the pain does not address the underlying safety
concern and could mask early warning signs of tendon injury.
Option D is incorrect because compression stockings would not
prevent or treat fluoroquinolone-associated tendon injury. The
priority nursing action is medication safety and preventing harm
through recognition of absolute contraindications.
Learning Objective
After completing this question, the learner should be able to:
• Identify Black Box Warnings associated with
fluoroquinolone antibiotics.
• Recognize contraindications to levofloxacin based on client
history.
• Prioritize medication safety by holding medications with
known risks and notifying the provider.
Medication Safety Focus
Black Box Warning
Question 2
Clinical Scenario
, A 45-year-old female client is prescribed oral doxycycline for a
confirmed Mycoplasma pneumoniae infection. During the
nursing assessment, the client reports taking a multivitamin
with calcium and iron every morning with breakfast. She also
mentions using over-the-counter antacids for occasional
heartburn.
Question Stem
Which instruction should the nurse prioritize when teaching this
client about doxycycline administration?
A. "Take your doxycycline with a glass of milk to reduce stomach
upset."
B. "Take the doxycycline at least 2 hours before or 4 hours after
your multivitamin and antacids."
C. "You may take the doxycycline with your antacid if you
experience stomach discomfort."
D. "Take the doxycycline with food to enhance its absorption."
Correct Answer
B. "Take the doxycycline at least 2 hours before or 4 hours after
your multivitamin and antacids."
Detailed Rationale
Tetracyclines, including doxycycline, form nonabsorbable
chelates with divalent and trivalent cations such as calcium,
Questions |
20 Original Antibiotics, Antifungals &
Antivirals NCLEX NGN Practice Questions with
Detailed Rationales |
ATI Pharmacology Made Easy Style |
Nursing Test Bank |
RN Exam Prep
Question 1
Clinical Scenario
A 72-year-old male client is admitted to the medical-surgical
unit with community-acquired pneumonia. The provider orders
intravenous levofloxacin. The nurse reviews the client's
electronic health record and notes a history of a tendon rupture
in the left Achilles tendon two years ago following ciprofloxacin
therapy. The client also reports current bilateral ankle pain and
swelling.
Question Stem
,Which action should the nurse take first?
A. Administer the levofloxacin as prescribed and monitor for
tendon pain.
B. Request an order for an analgesic to manage the ankle pain.
C. Hold the levofloxacin and notify the healthcare provider.
D. Apply compression stockings to reduce ankle swelling.
Correct Answer
C. Hold the levofloxacin and notify the healthcare provider.
Detailed Rationale
Fluoroquinolones, including levofloxacin and ciprofloxacin, carry
a Black Box Warning for tendinitis and tendon rupture, which
can occur within hours or days of initiation and may affect the
Achilles, rotator cuff, or other tendons. Risk factors include age
over 60, concurrent corticosteroid use, renal impairment, and a
history of tendon disorders related to fluoroquinolone use. This
client has a documented history of tendon injury from a prior
fluoroquinolone, placing him at exceptionally high risk for a
repeat, potentially more severe injury. The nurse must
recognize this contraindication and hold the medication while
notifying the provider to request an alternative antibiotic class,
such as a macrolide or beta-lactam, that is appropriate for
pneumonia but lacks this adverse effect profile.
,Option A is incorrect because administering the medication
despite known risk factors would place the client in significant
danger of further tendon damage. Option B is incorrect because
managing the pain does not address the underlying safety
concern and could mask early warning signs of tendon injury.
Option D is incorrect because compression stockings would not
prevent or treat fluoroquinolone-associated tendon injury. The
priority nursing action is medication safety and preventing harm
through recognition of absolute contraindications.
Learning Objective
After completing this question, the learner should be able to:
• Identify Black Box Warnings associated with
fluoroquinolone antibiotics.
• Recognize contraindications to levofloxacin based on client
history.
• Prioritize medication safety by holding medications with
known risks and notifying the provider.
Medication Safety Focus
Black Box Warning
Question 2
Clinical Scenario
, A 45-year-old female client is prescribed oral doxycycline for a
confirmed Mycoplasma pneumoniae infection. During the
nursing assessment, the client reports taking a multivitamin
with calcium and iron every morning with breakfast. She also
mentions using over-the-counter antacids for occasional
heartburn.
Question Stem
Which instruction should the nurse prioritize when teaching this
client about doxycycline administration?
A. "Take your doxycycline with a glass of milk to reduce stomach
upset."
B. "Take the doxycycline at least 2 hours before or 4 hours after
your multivitamin and antacids."
C. "You may take the doxycycline with your antacid if you
experience stomach discomfort."
D. "Take the doxycycline with food to enhance its absorption."
Correct Answer
B. "Take the doxycycline at least 2 hours before or 4 hours after
your multivitamin and antacids."
Detailed Rationale
Tetracyclines, including doxycycline, form nonabsorbable
chelates with divalent and trivalent cations such as calcium,
