MSN 571 PHARM FINAL EXAM EXAM 2024-2025 QUESTIONS
and ANSWERS WITH RATIONALE
A patient was diagnosed as having health care-associated methicillin-resistant Staphylococcus
aureus (HCA-MRSA). Which medication is most likely to be ordered for treatment?
A. Amo
B. Clindamycin
C. Tetracycline
D. Vancomycin - ANSWER-D
Vancomycin is effective in treating HCA-MRSA. MRSA is resistant to all penicillins and
cephalosporins. The bacteria are resistant to tetracycline and clindamycin as well
Which action should the nurse take before administering intravenous (IV) penicillin?
A. Assess the patient for allergies
B. Flush the IV site with normal saline
C. Review the patient's intake and output record
D. Determine the latest creatinine clearance results - ANSWER-A
The principle adverse effect of penicillins is allergic reaction. Penicillins are contraindicated in
pts with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems.
IV patency is important, as is monitoring renal function, because impairment can cause
penicillins to reach toxic levels; however these are not as important as determining allergy
status
The nurse is monitoring a patient on vancomycin for indications of major toxicity. Which test
should be monitored closely?
A. Creatinine level
B. Alkaline phosphatase
C. Electroencephalogram
D. Creatine phosphokinase (CPK) - ANSWER-A
The creatinine level and other indicators of kidney function should be monitored closely
because of the risk of renal failure when a patient is taking vancomycin.
,Electroencephalogram is used to check brain waves, alkaline phosphatase is a liver function
test and CPK is an enzyme in the heart, brain and skeletal muscle. Abnormal results of those
tests or labratory results are not indicative of kidney failure as are creatinine levels,
representing the major toxicity of vancomycin
Which is considered the most widely used group of antibiotics because of their bactericidal
nature, resistance to betalactamases, and activity against a broad spectrum of pathogens?
A. Penicillins
B. Tetracyclines
C. Cephalosporins
D. Aminoglycosides - ANSWER-C
Cephalosporins are considered the most widely used antibiotics because of their bactericidal
nature, their resistance to beta-lactamases, and their activity against a broad spectrum of
pathogens.
Aminoglycosides and penicillins are bactericillins, aminoglycosides and tetracyclines are
considered narrow spectrum antibiotics
Which increases as cephalosporins progress from firstgeneration agents to fifth-generation
agents? Select all that apply.
A. Ability to contain a beta-lactam ring
B. Ability to reach the cerebrospinal fluid (CSF)
C. Resistance to destruction by beta-lactamases
D. Activity against gram-positive bacteria and anaerobes
E. Activity against gram-negative bacteria and anerobes - ANSWER-B, C, E
As cephalosporins progress from first-generation agents to fifth-generation agents, the
activity against gram negative bacteria and anaerobes is higher, resistance to destruction by
beta-lactamases is higher, and ability to reach the CSF is greater. All cephalosporins contain a
beta-lactam ring and do not increase activity against gram-positive bacteria and anaerobes
as the generations progress
, The nurse teaches a patient to promptly report any diarrhea to the health care provider. Which
drug is the patient likely being prescribed?
A. Linezolid
B. Minocycline
C. Clindamycin
D. Doxcycline - ANSWER-C
Patients on clindamycin should promptly report any diarrhea to their health care provider
because clinadmycin can cause potentially fatal Clostridium difficile diarrhea. Diarrhea can be
a side effect of most antibiotics such as linezolid, doxycycline and minocycline but does nto
have the same risk as clindamycin for C. Diff
A certain group of patients should not be given tetracyclines. Which patients are of most
concern? Select all that apply.
A. Hearing impaired
B. Pregnant women
C. Mentally impaired
D. Breastfeeding women
E. children younger than 8 years - ANSWER-B, D, E
Because they can cause permanent tooth discoloration, tetracyclines should not be given to
pregnant women, breastfeeding women, or children younger than 8 years. The hearing
impaired or mentally impaired are not groups directly affected by this drug unless they also
are part of the other groups
Which instruction should a nurse include in the discharge teaching for a patient who is to start
taking tetracycline?
A. Use sunscreen and protective clothing when outdoors
B. You'll need to return to the clinic for weekly blood work
C. You may stop taking the pills when you begin to feel better
and ANSWERS WITH RATIONALE
A patient was diagnosed as having health care-associated methicillin-resistant Staphylococcus
aureus (HCA-MRSA). Which medication is most likely to be ordered for treatment?
A. Amo
B. Clindamycin
C. Tetracycline
D. Vancomycin - ANSWER-D
Vancomycin is effective in treating HCA-MRSA. MRSA is resistant to all penicillins and
cephalosporins. The bacteria are resistant to tetracycline and clindamycin as well
Which action should the nurse take before administering intravenous (IV) penicillin?
A. Assess the patient for allergies
B. Flush the IV site with normal saline
C. Review the patient's intake and output record
D. Determine the latest creatinine clearance results - ANSWER-A
The principle adverse effect of penicillins is allergic reaction. Penicillins are contraindicated in
pts with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems.
IV patency is important, as is monitoring renal function, because impairment can cause
penicillins to reach toxic levels; however these are not as important as determining allergy
status
The nurse is monitoring a patient on vancomycin for indications of major toxicity. Which test
should be monitored closely?
A. Creatinine level
B. Alkaline phosphatase
C. Electroencephalogram
D. Creatine phosphokinase (CPK) - ANSWER-A
The creatinine level and other indicators of kidney function should be monitored closely
because of the risk of renal failure when a patient is taking vancomycin.
,Electroencephalogram is used to check brain waves, alkaline phosphatase is a liver function
test and CPK is an enzyme in the heart, brain and skeletal muscle. Abnormal results of those
tests or labratory results are not indicative of kidney failure as are creatinine levels,
representing the major toxicity of vancomycin
Which is considered the most widely used group of antibiotics because of their bactericidal
nature, resistance to betalactamases, and activity against a broad spectrum of pathogens?
A. Penicillins
B. Tetracyclines
C. Cephalosporins
D. Aminoglycosides - ANSWER-C
Cephalosporins are considered the most widely used antibiotics because of their bactericidal
nature, their resistance to beta-lactamases, and their activity against a broad spectrum of
pathogens.
Aminoglycosides and penicillins are bactericillins, aminoglycosides and tetracyclines are
considered narrow spectrum antibiotics
Which increases as cephalosporins progress from firstgeneration agents to fifth-generation
agents? Select all that apply.
A. Ability to contain a beta-lactam ring
B. Ability to reach the cerebrospinal fluid (CSF)
C. Resistance to destruction by beta-lactamases
D. Activity against gram-positive bacteria and anaerobes
E. Activity against gram-negative bacteria and anerobes - ANSWER-B, C, E
As cephalosporins progress from first-generation agents to fifth-generation agents, the
activity against gram negative bacteria and anaerobes is higher, resistance to destruction by
beta-lactamases is higher, and ability to reach the CSF is greater. All cephalosporins contain a
beta-lactam ring and do not increase activity against gram-positive bacteria and anaerobes
as the generations progress
, The nurse teaches a patient to promptly report any diarrhea to the health care provider. Which
drug is the patient likely being prescribed?
A. Linezolid
B. Minocycline
C. Clindamycin
D. Doxcycline - ANSWER-C
Patients on clindamycin should promptly report any diarrhea to their health care provider
because clinadmycin can cause potentially fatal Clostridium difficile diarrhea. Diarrhea can be
a side effect of most antibiotics such as linezolid, doxycycline and minocycline but does nto
have the same risk as clindamycin for C. Diff
A certain group of patients should not be given tetracyclines. Which patients are of most
concern? Select all that apply.
A. Hearing impaired
B. Pregnant women
C. Mentally impaired
D. Breastfeeding women
E. children younger than 8 years - ANSWER-B, D, E
Because they can cause permanent tooth discoloration, tetracyclines should not be given to
pregnant women, breastfeeding women, or children younger than 8 years. The hearing
impaired or mentally impaired are not groups directly affected by this drug unless they also
are part of the other groups
Which instruction should a nurse include in the discharge teaching for a patient who is to start
taking tetracycline?
A. Use sunscreen and protective clothing when outdoors
B. You'll need to return to the clinic for weekly blood work
C. You may stop taking the pills when you begin to feel better
