ATI Pharmacology: Anti-Infectives Study Guide 2026
UPDATED ACTUAL Exam Questions and CORRECT Answers
1. A nurse is preparing to administer the first dose of an antibiotic to a client
with a suspected infection. Which action should the nurse take first?
A. Administer the antibiotic immediately.
B. Check the client’s temperature.
C. Obtain ordered cultures.
D. Educate the client on side effects.
Answer: C
Rationale: Cultures must be obtained before starting antibiotic therapy to ensure the
organism is correctly identified without interference from the medication.
2. A client is prescribed Penicillin G. The nurse should monitor for which of the
following as a primary sign of an immediate allergic reaction?
A. Joint pain
B. Black hairy tongue
C. Nausea and vomiting
D. Wheezing and dyspnea
Answer: D
Rationale: Immediate hypersensitivity reactions to penicillin occur within 2 to 30 minutes
and are characterized by anaphylaxis, including respiratory distress/wheezing.
,3. A client taking Cefazolin reports a history of a severe anaphylactic reaction to
Penicillin. What is the priority nursing action?
A. Withhold the medication and notify the provider.
B. Administer the medication as ordered.
C. Administer diphenhydramine before the dose.
D. Monitor the client closely for 30 minutes after administration.
Answer: A
Rationale: There is a cross-sensitivity between penicillins and cephalosporins. If the
reaction to penicillin was severe (anaphylaxis), cephalosporins should be avoided.
4. Which lab value is most critical to monitor for a client receiving Vancomycin?
A. Prothrombin time (PT)
B. Serum Creatinine
C. Serum Potassium
D. White blood cell count
Answer: B
Rationale: Vancomycin is nephrotoxic. Monitoring serum creatinine and trough levels is
essential to prevent kidney damage.
5. A nurse is infusing Vancomycin IV and notes the client’s face and neck have
become bright red and itchy. What is the nurse’s first action?
A. Stop the infusion immediately.
B. Slow the infusion rate.
C. Apply cold compresses to the neck.
D. Administer epinephrine.
Answer: B
Rationale: Red Man Syndrome is a rate-dependent infusion reaction, not a true allergy. It is
managed by slowing the infusion rate to at least 60 minutes.
, 6. A client is prescribed Tetracycline for acne. Which instruction should the
nurse include in the teaching?
A. Take the medication with a glass of milk.
B. Stop taking the drug once the acne clears.
C. Expect urine to turn bright orange.
D. Avoid sun exposure and use sunscreen.
Answer: D
Rationale: Tetracyclines cause photosensitivity. They should not be taken with
dairy/calcium as it decreases absorption.
7. A nurse is teaching a client about Gentamicin. Which symptom should the
nurse tell the client to report immediately?
A. Constipation
B. Tinnitus or hearing loss
C. Increased appetite
D. Muscle aches
Answer: B
Rationale: Aminoglycosides like Gentamicin are ototoxic and can cause permanent hearing
loss and vestibular damage.
8. A client taking Ciprofloxacin for a UTI reports pain and swelling in the back of
the ankle. What is the nurse’s priority action?
A. Advise the client to perform range-of-motion exercises.
B. Instruct the client to stop the medication and avoid exercise.
C. Tell the client this is a normal side effect.
D. Suggest the use of a heating pad.
Answer: B
Rationale: Fluoroquinolones like Ciprofloxacin carry a black box warning for tendon
rupture, most commonly the Achilles tendon.
UPDATED ACTUAL Exam Questions and CORRECT Answers
1. A nurse is preparing to administer the first dose of an antibiotic to a client
with a suspected infection. Which action should the nurse take first?
A. Administer the antibiotic immediately.
B. Check the client’s temperature.
C. Obtain ordered cultures.
D. Educate the client on side effects.
Answer: C
Rationale: Cultures must be obtained before starting antibiotic therapy to ensure the
organism is correctly identified without interference from the medication.
2. A client is prescribed Penicillin G. The nurse should monitor for which of the
following as a primary sign of an immediate allergic reaction?
A. Joint pain
B. Black hairy tongue
C. Nausea and vomiting
D. Wheezing and dyspnea
Answer: D
Rationale: Immediate hypersensitivity reactions to penicillin occur within 2 to 30 minutes
and are characterized by anaphylaxis, including respiratory distress/wheezing.
,3. A client taking Cefazolin reports a history of a severe anaphylactic reaction to
Penicillin. What is the priority nursing action?
A. Withhold the medication and notify the provider.
B. Administer the medication as ordered.
C. Administer diphenhydramine before the dose.
D. Monitor the client closely for 30 minutes after administration.
Answer: A
Rationale: There is a cross-sensitivity between penicillins and cephalosporins. If the
reaction to penicillin was severe (anaphylaxis), cephalosporins should be avoided.
4. Which lab value is most critical to monitor for a client receiving Vancomycin?
A. Prothrombin time (PT)
B. Serum Creatinine
C. Serum Potassium
D. White blood cell count
Answer: B
Rationale: Vancomycin is nephrotoxic. Monitoring serum creatinine and trough levels is
essential to prevent kidney damage.
5. A nurse is infusing Vancomycin IV and notes the client’s face and neck have
become bright red and itchy. What is the nurse’s first action?
A. Stop the infusion immediately.
B. Slow the infusion rate.
C. Apply cold compresses to the neck.
D. Administer epinephrine.
Answer: B
Rationale: Red Man Syndrome is a rate-dependent infusion reaction, not a true allergy. It is
managed by slowing the infusion rate to at least 60 minutes.
, 6. A client is prescribed Tetracycline for acne. Which instruction should the
nurse include in the teaching?
A. Take the medication with a glass of milk.
B. Stop taking the drug once the acne clears.
C. Expect urine to turn bright orange.
D. Avoid sun exposure and use sunscreen.
Answer: D
Rationale: Tetracyclines cause photosensitivity. They should not be taken with
dairy/calcium as it decreases absorption.
7. A nurse is teaching a client about Gentamicin. Which symptom should the
nurse tell the client to report immediately?
A. Constipation
B. Tinnitus or hearing loss
C. Increased appetite
D. Muscle aches
Answer: B
Rationale: Aminoglycosides like Gentamicin are ototoxic and can cause permanent hearing
loss and vestibular damage.
8. A client taking Ciprofloxacin for a UTI reports pain and swelling in the back of
the ankle. What is the nurse’s priority action?
A. Advise the client to perform range-of-motion exercises.
B. Instruct the client to stop the medication and avoid exercise.
C. Tell the client this is a normal side effect.
D. Suggest the use of a heating pad.
Answer: B
Rationale: Fluoroquinolones like Ciprofloxacin carry a black box warning for tendon
rupture, most commonly the Achilles tendon.
