NU 578 Unit 2 Exam (PDF) | Updated Exam
Questions | University of South Alabama
1. A patient with a urinary tract infection is prescribed
nitrofurantoin. Which instruction is most important to
include?
A. Take with orange juice to enhance absorption
B. Take with food to reduce GI upset
C. Avoid dairy products for 2 hours after dosing
D. Increase fluid intake to 3 L/day
Answer: B
Rationale: Nitrofurantoin is best absorbed with food,
which also reduces nausea and GI distress. Orange juice
(A) may alter urine pH. Dairy avoidance (C) is irrelevant.
Excessive fluids (D) can reduce drug concentration in the
urinary tract.
2. A patient on vancomycin develops flushing, rash, and
hypotension during infusion. What is the priority action?
1
,A. Stop the infusion immediately
B. Administer diphenhydramine
C. Slow the infusion rate
D. Apply topical steroids
Answer: A
Rationale: This describes red man syndrome, caused by
rapid vancomycin infusion. The priority is to stop the
infusion to prevent progression. Slowing the rate (C) is
done after stopping and restarting cautiously.
Antihistamines (B) help symptoms but are not the first step.
3. Which antibiotic requires therapeutic drug monitoring
to prevent ototoxicity and nephrotoxicity?
A. Azithromycin
B. Gentamicin
C. Doxycycline
D. Metronidazole
2
,Answer: B
Rationale: Gentamicin (aminoglycoside) has a narrow
therapeutic index. Peak and trough levels are monitored
to avoid toxicity. The others do not require routine
monitoring.
4. A patient with C. difficile infection is started on oral
vancomycin. Which finding indicates a therapeutic
response?
A. Decreased serum vancomycin trough
B. Reduced frequency of watery stools
C. Elevated white blood cell count
D. Increased fever
Answer: B
Rationale: Clinical improvement in C. difficile is marked
by decreased diarrhea, fever, and leukocytosis.
Vancomycin is poorly absorbed orally, so serum levels (A)
are not therapeutic indicators.
3
, 5. A nurse is teaching about fluoroquinolones. Which
adverse effect requires immediate discontinuation?
A. Nausea
B. Headache
C. Achilles tendon pain
D. Diarrhea
Answer: C
Rationale: Fluoroquinolones increase risk of tendonitis and
tendon rupture, especially Achilles. Pain or swelling
warrants immediate cessation. Nausea (A), headache (B),
and mild diarrhea (D) are common but not emergent.
6. Which drug is first-line for acute uncomplicated
pyelonephritis in an outpatient?
A. Cephalexin
B. Ciprofloxacin
4
Questions | University of South Alabama
1. A patient with a urinary tract infection is prescribed
nitrofurantoin. Which instruction is most important to
include?
A. Take with orange juice to enhance absorption
B. Take with food to reduce GI upset
C. Avoid dairy products for 2 hours after dosing
D. Increase fluid intake to 3 L/day
Answer: B
Rationale: Nitrofurantoin is best absorbed with food,
which also reduces nausea and GI distress. Orange juice
(A) may alter urine pH. Dairy avoidance (C) is irrelevant.
Excessive fluids (D) can reduce drug concentration in the
urinary tract.
2. A patient on vancomycin develops flushing, rash, and
hypotension during infusion. What is the priority action?
1
,A. Stop the infusion immediately
B. Administer diphenhydramine
C. Slow the infusion rate
D. Apply topical steroids
Answer: A
Rationale: This describes red man syndrome, caused by
rapid vancomycin infusion. The priority is to stop the
infusion to prevent progression. Slowing the rate (C) is
done after stopping and restarting cautiously.
Antihistamines (B) help symptoms but are not the first step.
3. Which antibiotic requires therapeutic drug monitoring
to prevent ototoxicity and nephrotoxicity?
A. Azithromycin
B. Gentamicin
C. Doxycycline
D. Metronidazole
2
,Answer: B
Rationale: Gentamicin (aminoglycoside) has a narrow
therapeutic index. Peak and trough levels are monitored
to avoid toxicity. The others do not require routine
monitoring.
4. A patient with C. difficile infection is started on oral
vancomycin. Which finding indicates a therapeutic
response?
A. Decreased serum vancomycin trough
B. Reduced frequency of watery stools
C. Elevated white blood cell count
D. Increased fever
Answer: B
Rationale: Clinical improvement in C. difficile is marked
by decreased diarrhea, fever, and leukocytosis.
Vancomycin is poorly absorbed orally, so serum levels (A)
are not therapeutic indicators.
3
, 5. A nurse is teaching about fluoroquinolones. Which
adverse effect requires immediate discontinuation?
A. Nausea
B. Headache
C. Achilles tendon pain
D. Diarrhea
Answer: C
Rationale: Fluoroquinolones increase risk of tendonitis and
tendon rupture, especially Achilles. Pain or swelling
warrants immediate cessation. Nausea (A), headache (B),
and mild diarrhea (D) are common but not emergent.
6. Which drug is first-line for acute uncomplicated
pyelonephritis in an outpatient?
A. Cephalexin
B. Ciprofloxacin
4
