NSG 318 EXAM 2 NEWEST 2025 ACTUAL EXAM TEST
BANK| NSG 318 INTRODUCTION TO
PHARMACOLOGY EXAM 2 WITH COMPLETE 500 REAL
EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS/
GRADED A+ (MOST RECENT!!)
1. A patient is prescribed amoxicillin for otitis media. The
nurse knows that penicillins exert their effect by:
a) Inhibiting protein synthesis at the 30S ribosome
b) Disrupting bacterial cell wall synthesis
c) Inhibiting folic acid synthesis
d) Increasing bacterial cell membrane permeability
Answer: b
Rationale: Penicillins inhibit bacterial cell wall synthesis by binding
to penicillin-binding proteins (PBPs), leading to cell lysis. This is
bactericidal .
2. A patient with a penicillin allergy reports a previous rash
and hives. Which cephalosporin is most likely to cause cross-
reactivity?
a) Cephalexin (first-generation)
b) Ceftriaxone (third-generation)
1
,c) Cefepime (fourth-generation)
d) Ceftaroline (fifth-generation)
Answer: a
*Rationale: Cross-reactivity between penicillins and
cephalosporins is highest with first-generation cephalosporins
(≈1-3% risk). Later generations have lower risk, but caution is
still needed .*
3. The nurse is administering IV ampicillin. Which adverse
effect requires immediate discontinuation?
a) Nausea and mild diarrhea
b) Pain at the IV site
c) Sudden wheezing and hypotension
d) Oral candidiasis (thrush)
Answer: c
Rationale: Sudden wheezing and hypotension indicate anaphylaxis,
a life-threatening allergic reaction. The drug must be stopped, and
epinephrine administered immediately .
4. A patient taking amoxicillin reports watery diarrhea 6 times
per day. The nurse suspects:
a) Normal adverse effect
b) Clostridioides difficile infection
2
,c) Allergic reaction
d) Viral gastroenteritis
Answer: b
*Rationale: Antibiotic-associated diarrhea with ≥3 watery
stools/day, especially after broad-spectrum penicillins, raises
concern for C. diff infection. Testing is indicated; do not treat
with antidiarrheals initially .*
5. Which laboratory value should be monitored in a patient
receiving high-dose IV penicillin?
a) Serum potassium
b) Serum calcium
c) Hemoglobin
d) Platelet count
Answer: a
Rationale: High-dose IV penicillin (especially ticarcillin, piperacillin)
can cause hypokalemia due to non-reabsorbable anion effect,
leading to renal potassium wasting. Monitor potassium and replace
as needed .
6. A patient with endocarditis is receiving IV penicillin G
every 4 hours. The nurse should schedule the dose:
a) At 0600, 1400, 2200
3
, b) At 0800, 1200, 1600, 2000, 2400, 0400
c) Once daily
d) Continuous infusion
Answer: b
*Rationale: Penicillin G has a short half-life (30-60 min) and must
be administered every 4-6 hours for severe infections. Q4H
dosing = 6 doses/day around the clock .*
7. Which medication should the nurse administer at least 1
hour before or 2 hours after amoxicillin?
a) Acetaminophen
b) Sucralfate
c) Ferrous sulfate
d) Both b and c
Answer: d
*Rationale: Divalent/trivalent cations (calcium, magnesium,
aluminum, iron, zinc) bind to penicillins and reduce absorption.
Sucralfate (aluminum) and ferrous sulfate (iron) should be
separated by 2 hours .*
8. A patient with a penicillin allergy receives cefazolin
preoperatively. The nurse should monitor for:
a) Rash, hives, or hypotension
4
BANK| NSG 318 INTRODUCTION TO
PHARMACOLOGY EXAM 2 WITH COMPLETE 500 REAL
EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS/
GRADED A+ (MOST RECENT!!)
1. A patient is prescribed amoxicillin for otitis media. The
nurse knows that penicillins exert their effect by:
a) Inhibiting protein synthesis at the 30S ribosome
b) Disrupting bacterial cell wall synthesis
c) Inhibiting folic acid synthesis
d) Increasing bacterial cell membrane permeability
Answer: b
Rationale: Penicillins inhibit bacterial cell wall synthesis by binding
to penicillin-binding proteins (PBPs), leading to cell lysis. This is
bactericidal .
2. A patient with a penicillin allergy reports a previous rash
and hives. Which cephalosporin is most likely to cause cross-
reactivity?
a) Cephalexin (first-generation)
b) Ceftriaxone (third-generation)
1
,c) Cefepime (fourth-generation)
d) Ceftaroline (fifth-generation)
Answer: a
*Rationale: Cross-reactivity between penicillins and
cephalosporins is highest with first-generation cephalosporins
(≈1-3% risk). Later generations have lower risk, but caution is
still needed .*
3. The nurse is administering IV ampicillin. Which adverse
effect requires immediate discontinuation?
a) Nausea and mild diarrhea
b) Pain at the IV site
c) Sudden wheezing and hypotension
d) Oral candidiasis (thrush)
Answer: c
Rationale: Sudden wheezing and hypotension indicate anaphylaxis,
a life-threatening allergic reaction. The drug must be stopped, and
epinephrine administered immediately .
4. A patient taking amoxicillin reports watery diarrhea 6 times
per day. The nurse suspects:
a) Normal adverse effect
b) Clostridioides difficile infection
2
,c) Allergic reaction
d) Viral gastroenteritis
Answer: b
*Rationale: Antibiotic-associated diarrhea with ≥3 watery
stools/day, especially after broad-spectrum penicillins, raises
concern for C. diff infection. Testing is indicated; do not treat
with antidiarrheals initially .*
5. Which laboratory value should be monitored in a patient
receiving high-dose IV penicillin?
a) Serum potassium
b) Serum calcium
c) Hemoglobin
d) Platelet count
Answer: a
Rationale: High-dose IV penicillin (especially ticarcillin, piperacillin)
can cause hypokalemia due to non-reabsorbable anion effect,
leading to renal potassium wasting. Monitor potassium and replace
as needed .
6. A patient with endocarditis is receiving IV penicillin G
every 4 hours. The nurse should schedule the dose:
a) At 0600, 1400, 2200
3
, b) At 0800, 1200, 1600, 2000, 2400, 0400
c) Once daily
d) Continuous infusion
Answer: b
*Rationale: Penicillin G has a short half-life (30-60 min) and must
be administered every 4-6 hours for severe infections. Q4H
dosing = 6 doses/day around the clock .*
7. Which medication should the nurse administer at least 1
hour before or 2 hours after amoxicillin?
a) Acetaminophen
b) Sucralfate
c) Ferrous sulfate
d) Both b and c
Answer: d
*Rationale: Divalent/trivalent cations (calcium, magnesium,
aluminum, iron, zinc) bind to penicillins and reduce absorption.
Sucralfate (aluminum) and ferrous sulfate (iron) should be
separated by 2 hours .*
8. A patient with a penicillin allergy receives cefazolin
preoperatively. The nurse should monitor for:
a) Rash, hives, or hypotension
4
