NUR 340 EXAM 170 QUESTIONS & CORRECT
ANSWERS LATEST 2025
A nurse is preparing to administer the antibiotic for a hospitalized patient who
acquired a Methicillin-resistant Staph. aureus (MRSA) infection. Based on the
nurses' knowledge of antibiotics for the treatment of MRSA, which medication
may be ordered?
Vancomycin
Neomycin
Cefazolin
Ceftaroline
Metronidazole
Piperacillin - ANSWER-Answer: Vancomycin and ceftaroline
Rationale: Methicillin-resistant Staph. aureus(MRSA), highly resistant bacteria, are
resistant to all penicillins and all cephalosporins. Because most strains of MRSA
are multidrug resistant, many other antibiotics are ineffective, including
tetracyclines, clindamycin, trimethoprim/sulfamethoxazole, and beta-lactam agents
(except ceftaroline). Preferred drugs are IV vancomycin, linezolid [Zyvox],
daptomycin [Cubicin], telavancin [Vibativ], clindamycin, and ceftaroline. See
Lehne p. 1017
A nurse transcribes a new prescription for potassium penicillin G given
intravenously (IV) q 8 hours and gentamicin IV q 12 hours. Which plan is the best
schedule for administering these drugs?
a.) penicillin at 0800, 1600, and 2400; gentamicin at 1200 and 2400
b.) penicillin at 0600, 1400, and 2200; gentamicin at 0600 and 1800
,c.) penicillin at 0800, 1600, and 2400; gentamicin at 0600 and 1800
d.) penicillin at 0100, 0900, and 1700; gentamicin at 0900 and 1800 - ANSWER-
Answer: C Rationale: Gentamicin should never be administered concurrently with
penicillin, because they will interact, and the penicillin may inactivate the
aminoglycoside. All options except A show concurrent administration. See Lehne
p. 1064
A patient who works as a landscaper is preparing to be discharged home.
Ciprofloxacin (Cipro) has been prescribed for outpatient therapy. Which of the
following will the nurse include in the discharge teaching for this patient?
"You may take the medication with milk of magnesia."
"Use sunscreen and protective clothing when outdoors."
"Take the medication with crackers and cheese."
"Take the medication until all symptoms subside." - ANSWER-"Use sunscreen
and protective clothing when outdoors."
Rationale: The patient, a landscaper, should be advised to wear sunscreen and
protective clothing when outdoors, because the medication may cause
phototoxicity. The medication should be taken until it is gone, not just until the
patient's symptoms are improved. Absorption of fluoroquinolones is reduced when
taken with a number of products including aluminum or magnesium containing
antacids and milk or other dairy products. See Lehne p. 1087
A hospitalized patient is receiving gentamicin (Garamycin) 80 mg IV twice daily
for acute osteomyelitis. Which data about the patient is most important for the
nurse to obtain before administering the gentamicin?
a.) oral temperature
b.) reports of nausea
,c.) BUN and creatinine levels
d.) when an antacid was administered - ANSWER-Answer: C
Rationale: Although the patient's temperature will be monitored on a regular basis
in the hospital, gentamicin is nephrotoxic and can cause renal failure. Therefore
monitoring renal function is critical. Nausea is not a common side effect of IV
gentamicin. Because the drug is administered IV, an antacid will not affect
absorption of the gentamicin.
A patient has acquired hospital-associated MRSA. Which drug does the nurse
anticipate will be ordered to treat this infection?
vancomycin (Vancocin)
TMP/SMZ (Bactrim)
imipenem (Primaxin)
azithromycin (Zithromax) - ANSWER-Answer: Vancomycin
Rationale: MRSA is resistant to all penicillins and cephalosporins. These include
beta lactam antibiotics such as imipenem. Most strains of MRSA are also resistant
to many other antibiotics. The drug of choice is vancomycin although there are
others that may be used. TMP/SMZ is a preferred drug for community-acquired
MRSA. Azithromycin is a macrolide used for respiratory and skin infections as
well as other infections such as mycobacterium avium and chlamydia.
A patient who is receiving penicillin begins to wheeze and reports a feeling of
impending doom. Upon assessing the patient, the nurse finds a blood pressure of
88/47 mm Hg. and a weak pulse of 120 beats per minute. Which order will the
nurse implement first?
A.) administer 500 mL IV fluid bolus
B.) apply oxygen at 3L per nasal cannula
, C.) administer epinephrine
D.) obtain an oropharyngeal airway device - ANSWER-Answer: C
Rationale: The priority is to reverse the allergic reaction. This can be done by
administering epinephrine, which is used to treat anaphylaxis (which the patient is
manifesting). If the reaction is not reversed, an airway may be necessary. Oxygen
is applied after the epinephrine is administered or a second nurse may apply the
oxygen as the epinephrine is being given. IV fluids may be a consideration if the
blood pressure does not rise after administration of epinephrine, but epinephrine is
the priority. See Lehne, p. 1020
The nurse is reviewing laboratory test results for a patient who is starting penicillin
G. Which test result, if elevated, would suggest a contraindication to penicillin G?
hematocrit and hemoglobin
BUN and creatinine
liver enzymes SGOT and ALT
PT/INR - ANSWER-BUN and creatinine
Rationale: Treatment with penicillin drugs requires normal kidney function. The
BUN and creatinine level are indicators of kidney function. PT/INR is indicted for
warfarin, not pencillin. Penicillin does not affect red cell production or cause
bleeding so hematocrit and hemoglobin are not needed. SGOT and ALT are
indicated for drugs that are hepatotoxic, which penicillin is not. See Lehne, p. 1062
Which of the following would be classified as a suprainfection?
A.) peritonitis that developed after surgery for a ruptured appendix
B.) monilial vaginal infection that developed during antibiotic therapy
C.) pneumonia in a patient with chronic obstructive pulmonary disease
ANSWERS LATEST 2025
A nurse is preparing to administer the antibiotic for a hospitalized patient who
acquired a Methicillin-resistant Staph. aureus (MRSA) infection. Based on the
nurses' knowledge of antibiotics for the treatment of MRSA, which medication
may be ordered?
Vancomycin
Neomycin
Cefazolin
Ceftaroline
Metronidazole
Piperacillin - ANSWER-Answer: Vancomycin and ceftaroline
Rationale: Methicillin-resistant Staph. aureus(MRSA), highly resistant bacteria, are
resistant to all penicillins and all cephalosporins. Because most strains of MRSA
are multidrug resistant, many other antibiotics are ineffective, including
tetracyclines, clindamycin, trimethoprim/sulfamethoxazole, and beta-lactam agents
(except ceftaroline). Preferred drugs are IV vancomycin, linezolid [Zyvox],
daptomycin [Cubicin], telavancin [Vibativ], clindamycin, and ceftaroline. See
Lehne p. 1017
A nurse transcribes a new prescription for potassium penicillin G given
intravenously (IV) q 8 hours and gentamicin IV q 12 hours. Which plan is the best
schedule for administering these drugs?
a.) penicillin at 0800, 1600, and 2400; gentamicin at 1200 and 2400
b.) penicillin at 0600, 1400, and 2200; gentamicin at 0600 and 1800
,c.) penicillin at 0800, 1600, and 2400; gentamicin at 0600 and 1800
d.) penicillin at 0100, 0900, and 1700; gentamicin at 0900 and 1800 - ANSWER-
Answer: C Rationale: Gentamicin should never be administered concurrently with
penicillin, because they will interact, and the penicillin may inactivate the
aminoglycoside. All options except A show concurrent administration. See Lehne
p. 1064
A patient who works as a landscaper is preparing to be discharged home.
Ciprofloxacin (Cipro) has been prescribed for outpatient therapy. Which of the
following will the nurse include in the discharge teaching for this patient?
"You may take the medication with milk of magnesia."
"Use sunscreen and protective clothing when outdoors."
"Take the medication with crackers and cheese."
"Take the medication until all symptoms subside." - ANSWER-"Use sunscreen
and protective clothing when outdoors."
Rationale: The patient, a landscaper, should be advised to wear sunscreen and
protective clothing when outdoors, because the medication may cause
phototoxicity. The medication should be taken until it is gone, not just until the
patient's symptoms are improved. Absorption of fluoroquinolones is reduced when
taken with a number of products including aluminum or magnesium containing
antacids and milk or other dairy products. See Lehne p. 1087
A hospitalized patient is receiving gentamicin (Garamycin) 80 mg IV twice daily
for acute osteomyelitis. Which data about the patient is most important for the
nurse to obtain before administering the gentamicin?
a.) oral temperature
b.) reports of nausea
,c.) BUN and creatinine levels
d.) when an antacid was administered - ANSWER-Answer: C
Rationale: Although the patient's temperature will be monitored on a regular basis
in the hospital, gentamicin is nephrotoxic and can cause renal failure. Therefore
monitoring renal function is critical. Nausea is not a common side effect of IV
gentamicin. Because the drug is administered IV, an antacid will not affect
absorption of the gentamicin.
A patient has acquired hospital-associated MRSA. Which drug does the nurse
anticipate will be ordered to treat this infection?
vancomycin (Vancocin)
TMP/SMZ (Bactrim)
imipenem (Primaxin)
azithromycin (Zithromax) - ANSWER-Answer: Vancomycin
Rationale: MRSA is resistant to all penicillins and cephalosporins. These include
beta lactam antibiotics such as imipenem. Most strains of MRSA are also resistant
to many other antibiotics. The drug of choice is vancomycin although there are
others that may be used. TMP/SMZ is a preferred drug for community-acquired
MRSA. Azithromycin is a macrolide used for respiratory and skin infections as
well as other infections such as mycobacterium avium and chlamydia.
A patient who is receiving penicillin begins to wheeze and reports a feeling of
impending doom. Upon assessing the patient, the nurse finds a blood pressure of
88/47 mm Hg. and a weak pulse of 120 beats per minute. Which order will the
nurse implement first?
A.) administer 500 mL IV fluid bolus
B.) apply oxygen at 3L per nasal cannula
, C.) administer epinephrine
D.) obtain an oropharyngeal airway device - ANSWER-Answer: C
Rationale: The priority is to reverse the allergic reaction. This can be done by
administering epinephrine, which is used to treat anaphylaxis (which the patient is
manifesting). If the reaction is not reversed, an airway may be necessary. Oxygen
is applied after the epinephrine is administered or a second nurse may apply the
oxygen as the epinephrine is being given. IV fluids may be a consideration if the
blood pressure does not rise after administration of epinephrine, but epinephrine is
the priority. See Lehne, p. 1020
The nurse is reviewing laboratory test results for a patient who is starting penicillin
G. Which test result, if elevated, would suggest a contraindication to penicillin G?
hematocrit and hemoglobin
BUN and creatinine
liver enzymes SGOT and ALT
PT/INR - ANSWER-BUN and creatinine
Rationale: Treatment with penicillin drugs requires normal kidney function. The
BUN and creatinine level are indicators of kidney function. PT/INR is indicted for
warfarin, not pencillin. Penicillin does not affect red cell production or cause
bleeding so hematocrit and hemoglobin are not needed. SGOT and ALT are
indicated for drugs that are hepatotoxic, which penicillin is not. See Lehne, p. 1062
Which of the following would be classified as a suprainfection?
A.) peritonitis that developed after surgery for a ruptured appendix
B.) monilial vaginal infection that developed during antibiotic therapy
C.) pneumonia in a patient with chronic obstructive pulmonary disease
