Pharm Final- Test Bank (2026-2027 Exam
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A 28-year-old patient has been prescribed penicillin for the first
time. What nursing diagnosis would be most appropriate for this
patient?
A. Acute pain related to gastrointestinal (GI) effects of the drug
B. Deficient knowledge regarding drug therapy
C. Imbalance nutrition: less than body requirements related to
multiple GI effects of the drug
D. Constipation
B.
Because this is the first time the patient has taken penicillin, she is
likely to have limited knowledge about the drug. She may not
understand the importance of taking the medication as ordered to
increase effectiveness of the drug or to report adverse effects.
because the patient has not started the drug yet, there is no way to
know what adverse effects, if any, she will experience. Only if she
develops acute pain related to GI effects of the drug would this be
appropriate. If GI symptoms develop it may lead to imbalanced
nutrition, but that remains to be seen. No indication about
constipation exists.
he mother of a 5-year-old asks the nurse why it seems amoxicillin
is always prescribed when her child needs an antibiotic. What is
the priority rationale the nurse should give the mother?
A) It is better absorbed.
B) It is less costly.
C) It has a less frequent dosing schedule.
D) It tastes better in oral form.
,Ans: A
Feedback:
Most penicillins are rapidly absorbed from the GI tract, reaching
peak levels in 1 hour. Although amoxicillin is less expensive, that
fact has far less impact on choosing the proper antibiotic than the
effectiveness of the drug. Most oral antibiotics for children are
available in pleasant tasting syrups so taste would not be a factor.
Ampicillin is often given up to 4 times a day so it actually has a
frequent dosing schedule.
25. The nurse is teaching the patient about amoxicillin prior to
discharge and includes what important teaching point?
A) Blackening of the tongue may occur but will subside when the
drug is discontinued.
B) Even if it seems like the infection is not improving, the drug is
still working.
C) Yeast infections are unlikely to occur with this medication
because it is narrow spectrum.
D) Appearance of a rash is common and does not indicate an
allergic reaction.
Ans: A
Feedback:
One of the adverse effects of ampicillin is blackening of the tongue
but the discoloration goes away after stopping the drug. If it is
accompanied by swelling, the patient should be instructed to call
the prescribing health care provider immediately. Many penicillin-
resistant pathogens exist, so if the infection does not seem to be
responding to the drug, the patient should notify the health care
provider because a different antibiotic may be required. Yeast
infections are very likely after taking ampicillin because it is a
broad-spectrum antibiotic. Appearance of a rash should be
evaluated by a health care professional because allergic reactions
to this class of antibiotic are very common.
A local bioterrorism medical team is learning about germ warfare.
The team is instructed that a fluoroquinolone may be used to
prevent an outbreak of anthrax infection. What fluoroquinolone
would the nurse be most likely to administer for this purpose?
A) Ciprofloxacin (Cipro)
B) Gemifloxacin (Factive)
C) Norfloxacin (Noroxin)
D) Sparfloxacin (Zagam)
,Ans: A
Feedback:
Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and
is indicated for the prevention of anthrax infection. Gemifloxacin
and sparfloxacin are most useful in treating acute episodes of
chronic bronchitis and community-acquired pneumonia.
Norfloxacin is recommended only for certain types of urinary tract
infections.
The nurse is providing patient teaching before discharging a
patient home. The patient is taking ciprofloxacin (Cipro). What
would the nurse teach this patient is the best way to prevent
crystalluria caused by ciprofloxacin (Cipro)?
A. Eliminate red meat and seafood from the diet.
B. Encourage at least 2 liters of fluid per day.
C. Avoid caffeine and alcohol.
D. Spend time in the sun each day to optimize vitamin D levels.
B. Encourage at least 2L of fluid per day
Provide the following patient teaching: Avoid driving or operating
dangerous machinery because dizziness, lethargy, and ataxia may
occur; try to drink a lot of fluids and maintain nutrition (very
important), even though nausea, vomiting, and diarrhea may occur.
There is no need to eliminate red meat, seafood, caffeine, or
alcohol from the diet, although alcohol may increase the risk of GI
irritation. Patients should be taught to avoid the sun due to
possible photosensitivity.
What is the priority reason for the nurse to consider questioning an
order for tetracycline in a child younger than 8 years of age?
A. Children younger than 8 years of age cannot take tetracyclines.
B. Weight-bearing joints have been impaired in young animals
given the drugs.
C. Tetracyclines can damage developing teeth and bone in children
younger than 8 years of age.
D. Liver and kidney function may be damaged when it is given to
children under 8 years of age.
ANS: C
Use tetracyclines with caution in children younger than 8 years of
age because they can potentially damage developing bones and
teeth. Although the drug does not cause damage to liver and
kidneys, it may be contraindicated in patients with hepatic or renal
dysfunction because it is concentrated in the bile and excreted in
, the urine. Fluoroquinolones, not tetracyclines, are generally
contraindicated for use in children (i.e., those younger than 18
years of age) because weight-bearing joints have been impaired in
young animals given the drugs. Clindamycin (Dalacin C) warrants
monitoring hepatic and renal function when it is given to neonates
and infants. Trimethoprimsulfamethoxazole (Nu-Cotrimox) is used
in children, although children younger than 2 months of age have
not been evaluated. Children under 8 years of age can take
tetracycline, but it should be used with caution.
The nurse is providing discharge teaching to a patient who is being
sent home on oral tetracycline (Sumycin). What instructions should
the nurse include?
A. Take the medication only once a day.
B. Check pulse rate and hold the drug if lower than 60 beats per
minute (bpm).
C. Take the drug on an empty stomach.
D. Take the medication with 2 ounces of water.
ANS: C
Tetracycline should be taken on an empty stomach 1 hour before or
2 hours after meals with a full 8 ounces of water to ensure full
absorption. Tetracycline is usually taken at least once every 12
hours. Checking the pulse and holding the dose if below 60 bpm is
an action specific to the use of cardiac glycosides.
The nurse is admitting a 12-year-old girl to the acute care facility
and notices discolored secondary teeth. The mother says she
doesn't know why the teeth are discolored because the child is
very good about brushing and flossing and sees the dentist
regularly. What question would the nurse ask?
A. Has she ever received tetracycline?
B. Has she ever received gentamicin?
C. Has she ever received ampicillin?
D. Has she ever received cephalexin?
ANS: A
The nurse would question whether the child was ever given
tetracycline because this drug is commonly associated with
discoloration of secondary teeth when it is administered to children
who still have their primary teeth. Gentamicin, ampicillin, and
cephalexin are not associated with discoloration of the teeth.
Update) Premium Questions Bank and
Verified Solutions / Fully Solved / Just
Released
A 28-year-old patient has been prescribed penicillin for the first
time. What nursing diagnosis would be most appropriate for this
patient?
A. Acute pain related to gastrointestinal (GI) effects of the drug
B. Deficient knowledge regarding drug therapy
C. Imbalance nutrition: less than body requirements related to
multiple GI effects of the drug
D. Constipation
B.
Because this is the first time the patient has taken penicillin, she is
likely to have limited knowledge about the drug. She may not
understand the importance of taking the medication as ordered to
increase effectiveness of the drug or to report adverse effects.
because the patient has not started the drug yet, there is no way to
know what adverse effects, if any, she will experience. Only if she
develops acute pain related to GI effects of the drug would this be
appropriate. If GI symptoms develop it may lead to imbalanced
nutrition, but that remains to be seen. No indication about
constipation exists.
he mother of a 5-year-old asks the nurse why it seems amoxicillin
is always prescribed when her child needs an antibiotic. What is
the priority rationale the nurse should give the mother?
A) It is better absorbed.
B) It is less costly.
C) It has a less frequent dosing schedule.
D) It tastes better in oral form.
,Ans: A
Feedback:
Most penicillins are rapidly absorbed from the GI tract, reaching
peak levels in 1 hour. Although amoxicillin is less expensive, that
fact has far less impact on choosing the proper antibiotic than the
effectiveness of the drug. Most oral antibiotics for children are
available in pleasant tasting syrups so taste would not be a factor.
Ampicillin is often given up to 4 times a day so it actually has a
frequent dosing schedule.
25. The nurse is teaching the patient about amoxicillin prior to
discharge and includes what important teaching point?
A) Blackening of the tongue may occur but will subside when the
drug is discontinued.
B) Even if it seems like the infection is not improving, the drug is
still working.
C) Yeast infections are unlikely to occur with this medication
because it is narrow spectrum.
D) Appearance of a rash is common and does not indicate an
allergic reaction.
Ans: A
Feedback:
One of the adverse effects of ampicillin is blackening of the tongue
but the discoloration goes away after stopping the drug. If it is
accompanied by swelling, the patient should be instructed to call
the prescribing health care provider immediately. Many penicillin-
resistant pathogens exist, so if the infection does not seem to be
responding to the drug, the patient should notify the health care
provider because a different antibiotic may be required. Yeast
infections are very likely after taking ampicillin because it is a
broad-spectrum antibiotic. Appearance of a rash should be
evaluated by a health care professional because allergic reactions
to this class of antibiotic are very common.
A local bioterrorism medical team is learning about germ warfare.
The team is instructed that a fluoroquinolone may be used to
prevent an outbreak of anthrax infection. What fluoroquinolone
would the nurse be most likely to administer for this purpose?
A) Ciprofloxacin (Cipro)
B) Gemifloxacin (Factive)
C) Norfloxacin (Noroxin)
D) Sparfloxacin (Zagam)
,Ans: A
Feedback:
Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and
is indicated for the prevention of anthrax infection. Gemifloxacin
and sparfloxacin are most useful in treating acute episodes of
chronic bronchitis and community-acquired pneumonia.
Norfloxacin is recommended only for certain types of urinary tract
infections.
The nurse is providing patient teaching before discharging a
patient home. The patient is taking ciprofloxacin (Cipro). What
would the nurse teach this patient is the best way to prevent
crystalluria caused by ciprofloxacin (Cipro)?
A. Eliminate red meat and seafood from the diet.
B. Encourage at least 2 liters of fluid per day.
C. Avoid caffeine and alcohol.
D. Spend time in the sun each day to optimize vitamin D levels.
B. Encourage at least 2L of fluid per day
Provide the following patient teaching: Avoid driving or operating
dangerous machinery because dizziness, lethargy, and ataxia may
occur; try to drink a lot of fluids and maintain nutrition (very
important), even though nausea, vomiting, and diarrhea may occur.
There is no need to eliminate red meat, seafood, caffeine, or
alcohol from the diet, although alcohol may increase the risk of GI
irritation. Patients should be taught to avoid the sun due to
possible photosensitivity.
What is the priority reason for the nurse to consider questioning an
order for tetracycline in a child younger than 8 years of age?
A. Children younger than 8 years of age cannot take tetracyclines.
B. Weight-bearing joints have been impaired in young animals
given the drugs.
C. Tetracyclines can damage developing teeth and bone in children
younger than 8 years of age.
D. Liver and kidney function may be damaged when it is given to
children under 8 years of age.
ANS: C
Use tetracyclines with caution in children younger than 8 years of
age because they can potentially damage developing bones and
teeth. Although the drug does not cause damage to liver and
kidneys, it may be contraindicated in patients with hepatic or renal
dysfunction because it is concentrated in the bile and excreted in
, the urine. Fluoroquinolones, not tetracyclines, are generally
contraindicated for use in children (i.e., those younger than 18
years of age) because weight-bearing joints have been impaired in
young animals given the drugs. Clindamycin (Dalacin C) warrants
monitoring hepatic and renal function when it is given to neonates
and infants. Trimethoprimsulfamethoxazole (Nu-Cotrimox) is used
in children, although children younger than 2 months of age have
not been evaluated. Children under 8 years of age can take
tetracycline, but it should be used with caution.
The nurse is providing discharge teaching to a patient who is being
sent home on oral tetracycline (Sumycin). What instructions should
the nurse include?
A. Take the medication only once a day.
B. Check pulse rate and hold the drug if lower than 60 beats per
minute (bpm).
C. Take the drug on an empty stomach.
D. Take the medication with 2 ounces of water.
ANS: C
Tetracycline should be taken on an empty stomach 1 hour before or
2 hours after meals with a full 8 ounces of water to ensure full
absorption. Tetracycline is usually taken at least once every 12
hours. Checking the pulse and holding the dose if below 60 bpm is
an action specific to the use of cardiac glycosides.
The nurse is admitting a 12-year-old girl to the acute care facility
and notices discolored secondary teeth. The mother says she
doesn't know why the teeth are discolored because the child is
very good about brushing and flossing and sees the dentist
regularly. What question would the nurse ask?
A. Has she ever received tetracycline?
B. Has she ever received gentamicin?
C. Has she ever received ampicillin?
D. Has she ever received cephalexin?
ANS: A
The nurse would question whether the child was ever given
tetracycline because this drug is commonly associated with
discoloration of secondary teeth when it is administered to children
who still have their primary teeth. Gentamicin, ampicillin, and
cephalexin are not associated with discoloration of the teeth.
