Delights Test Banks 1
"PHARMACOLOGY & NURSING PROCESS 10th Ed. (LILLEY) -
CHAPTER 9 ANTIBIOTICS TEST BANK: 250 NCLEX NextGen Q&A +
DETAILED RATIONALES | PDF, EXCEL, ANKI"
This test bank is an **ORIGINAL STUDY GUIDE** created to supplement *Pharmacology and the Nu
rsing Process 10th Edition by Linda Lane Lilley
,Delights Test Banks 2
Question 1: Penicillin Allergy & Cross-Sensitivity
Q: A patient with a documented penicillin allergy is prescribed cefazolin
(Kefzol). What is the nurse’s priority action?
A) Administer the dose slowly over 1 hour
B) Perform a skin test prior to infusion
C) Premedicate with diphenhydramine
D) Monitor blood pressure every 15 minutes
Rationale:
✅ B – Lilley p. 168 states cross-sensitivity between penicillins and
cephalosporins occurs in ~10% of cases. Skin testing is the priority
assessment to prevent anaphylaxis.
Nursing Process: Assessment (allergy risk) → Implementation (skin test).
NCLEX: Reduction of Risk Potential
✖️ *A/C*: Mitigate reactions but do not prevent anaphylaxis if allergy exists.
✖️ D: Hypertension is not a hallmark sign of anaphylaxis (hypotension is).
Q6: Cephalosporin Renal Dosing
Q: A patient with CKD (eGFR 25 mL/min) is prescribed ceftriaxone. Which
action is essential?
A) Administer 50% of the standard dose
,Delights Test Banks 3
B) Monitor serum creatinine daily
C) Increase fluid intake to 3 L/day
D) Avoid concurrent NSAIDs
Rationale:
✅ B – Lilley p. 170 states cephalosporins accumulate in renal impairment.
Daily creatinine monitoring detects early nephrotoxicity.
Nursing Process: Assessment (renal function) → Evaluation (lab trends)
NCLEX: Reduction of Risk Potential
✖️ A: Ceftriaxone is hepatically metabolized; no renal dose adjustment needed.
✖️ C: Hydration supports renal function but doesn’t replace toxicity
monitoring.
✖️ D: NSAIDs exacerbate nephrotoxicity but are not the priority assessment.
Q7: Macrolide Interaction
Q: A patient taking simvastatin is prescribed clarithromycin. Which statement
by the nurse is correct?
A) "Space the doses 6 hours apart."
B) "Report any nausea or diarrhea."
, Delights Test Banks 4
C) "Expect to temporarily stop the statin."
D) "Take both drugs with grapefruit juice."
Rationale:
✅ C – Lilley p. 184 warns macrolides inhibit CYP3A4, increasing statin
toxicity (myopathy/rhabdo). Statins must be held.
Nursing Process: Planning (risk mitigation) → Implementation (education)
NCLEX: Safety and Infection Control
✖️ A: Spacing doses doesn’t prevent interaction.
✖️ B: GI upset is common but less critical than myopathy.
✖️ D: Grapefruit juice potentiates statin toxicity.
Q8: Sulfonamide Crystalluria
Q: A patient taking sulfamethoxazole-trimethoprim reports flank pain. What is
the priority intervention?
A) Administer PRN morphine
B) Increase oral fluids to 3 L/day
C) Collect a urine culture
D) Hold the next dose
Rationale:
"PHARMACOLOGY & NURSING PROCESS 10th Ed. (LILLEY) -
CHAPTER 9 ANTIBIOTICS TEST BANK: 250 NCLEX NextGen Q&A +
DETAILED RATIONALES | PDF, EXCEL, ANKI"
This test bank is an **ORIGINAL STUDY GUIDE** created to supplement *Pharmacology and the Nu
rsing Process 10th Edition by Linda Lane Lilley
,Delights Test Banks 2
Question 1: Penicillin Allergy & Cross-Sensitivity
Q: A patient with a documented penicillin allergy is prescribed cefazolin
(Kefzol). What is the nurse’s priority action?
A) Administer the dose slowly over 1 hour
B) Perform a skin test prior to infusion
C) Premedicate with diphenhydramine
D) Monitor blood pressure every 15 minutes
Rationale:
✅ B – Lilley p. 168 states cross-sensitivity between penicillins and
cephalosporins occurs in ~10% of cases. Skin testing is the priority
assessment to prevent anaphylaxis.
Nursing Process: Assessment (allergy risk) → Implementation (skin test).
NCLEX: Reduction of Risk Potential
✖️ *A/C*: Mitigate reactions but do not prevent anaphylaxis if allergy exists.
✖️ D: Hypertension is not a hallmark sign of anaphylaxis (hypotension is).
Q6: Cephalosporin Renal Dosing
Q: A patient with CKD (eGFR 25 mL/min) is prescribed ceftriaxone. Which
action is essential?
A) Administer 50% of the standard dose
,Delights Test Banks 3
B) Monitor serum creatinine daily
C) Increase fluid intake to 3 L/day
D) Avoid concurrent NSAIDs
Rationale:
✅ B – Lilley p. 170 states cephalosporins accumulate in renal impairment.
Daily creatinine monitoring detects early nephrotoxicity.
Nursing Process: Assessment (renal function) → Evaluation (lab trends)
NCLEX: Reduction of Risk Potential
✖️ A: Ceftriaxone is hepatically metabolized; no renal dose adjustment needed.
✖️ C: Hydration supports renal function but doesn’t replace toxicity
monitoring.
✖️ D: NSAIDs exacerbate nephrotoxicity but are not the priority assessment.
Q7: Macrolide Interaction
Q: A patient taking simvastatin is prescribed clarithromycin. Which statement
by the nurse is correct?
A) "Space the doses 6 hours apart."
B) "Report any nausea or diarrhea."
, Delights Test Banks 4
C) "Expect to temporarily stop the statin."
D) "Take both drugs with grapefruit juice."
Rationale:
✅ C – Lilley p. 184 warns macrolides inhibit CYP3A4, increasing statin
toxicity (myopathy/rhabdo). Statins must be held.
Nursing Process: Planning (risk mitigation) → Implementation (education)
NCLEX: Safety and Infection Control
✖️ A: Spacing doses doesn’t prevent interaction.
✖️ B: GI upset is common but less critical than myopathy.
✖️ D: Grapefruit juice potentiates statin toxicity.
Q8: Sulfonamide Crystalluria
Q: A patient taking sulfamethoxazole-trimethoprim reports flank pain. What is
the priority intervention?
A) Administer PRN morphine
B) Increase oral fluids to 3 L/day
C) Collect a urine culture
D) Hold the next dose
Rationale:
