NUR 334 Exam 2: Pharmacology I V3 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed Vancomycin for a MRSA infection. Which assessment finding should the nurse
prioritize during the infusion?
A. Blood pressure of 140/90 mmHg
B. Flushing and rash on the face and neck
C. Increased urinary output
D. A heart rate of 70 beats per minute
Ans: B
Explanation: Vancomycin can cause Red Man Syndrome if infused too rapidly. This reaction is
characterized by flushing, rash, and pruritus of the upper body. The nurse should immediately slow the
infusion and notify the provider if these symptoms occur. It is not an allergic reaction but a rate-
dependent histamine release. Ensuring an infusion duration of at least 60 minutes minimizes this specific
risk.
2. Which lab value is most critical for a nurse to monitor in a patient receiving Gentamicin?
A. Serum creatinine
B. Serum glucose
C. Prothrombin time (PT)
D. Hemoglobin levels
Ans: A
,Explanation: Gentamicin is an aminoglycoside known for its potential to cause severe nephrotoxicity.
Monitoring serum creatinine and BUN is essential to detect early signs of kidney damage. The nurse
should also assess for ototoxicity, which can be irreversible in some cases. This drug requires therapeutic
drug monitoring of peak and trough levels to ensure safety. Maintaining adequate hydration is a key
teaching point for patients on this therapy.
3. A patient taking Tetracycline should be instructed to avoid which of the following substances?
A. Dairy products
B. Grapefruit juice
C. Leafy green vegetables
D. Red meat
Ans: A
Explanation: Tetracycline binds with calcium, iron, and magnesium, which prevents its absorption in the
GI tract. Patients should avoid dairy products, antacids, and iron supplements while taking this
medication. This drug can also cause permanent tooth discoloration in children and developing fetuses.
The nurse should advise the patient to take the medication on an empty stomach. Photosensitivity is
another common side effect that requires sun protection measures.
4. A nurse is preparing to administer Ciprofloxacin. Which adverse effect is a black box warning for this drug
class?
A. Tendon rupture
B. Nephrotoxicity
C. Ototoxicity
D. Bone marrow suppression
, Ans: A
Explanation: Fluoroquinolones like Ciprofloxacin carry a black box warning for tendonitis and tendon
rupture. This risk is highest in older adults, patients with renal failure, and those taking corticosteroids.
Patients should be instructed to stop exercise and report any new joint or tendon pain immediately. The
drug can also cause CNS effects like dizziness and confusion in certain populations. Educating the patient
on these risks is a priority for the prescribing nurse.
5. A patient with a history of a severe anaphylactic reaction to Penicillin is prescribed Cephalexin. What is
the nurse’s priority action?
A. Administer the dose as ordered
B. Monitor for a rash after administration
C. Administer an antihistamine before the dose
D. Withhold the dose and contact the provider
Ans: D
Explanation: There is a 1% to 10% cross-sensitivity between penicillins and cephalosporins due to their
similar beta-lactam structure. If a patient has a history of severe anaphylaxis to penicillin, cephalosporins
should be avoided. The nurse must verify the severity of the previous reaction before continuing care.
Giving the medication could result in a life-threatening allergic reaction. Safety protocols dictate that the
provider must be notified to find an alternative antibiotic.
6. When administering Amphotericin B intravenously, which nursing intervention is essential to prevent
infusion-related reactions?
A. Administer the drug over 15 minutes
B. Premedicate with acetaminophen and diphenhydramine
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed Vancomycin for a MRSA infection. Which assessment finding should the nurse
prioritize during the infusion?
A. Blood pressure of 140/90 mmHg
B. Flushing and rash on the face and neck
C. Increased urinary output
D. A heart rate of 70 beats per minute
Ans: B
Explanation: Vancomycin can cause Red Man Syndrome if infused too rapidly. This reaction is
characterized by flushing, rash, and pruritus of the upper body. The nurse should immediately slow the
infusion and notify the provider if these symptoms occur. It is not an allergic reaction but a rate-
dependent histamine release. Ensuring an infusion duration of at least 60 minutes minimizes this specific
risk.
2. Which lab value is most critical for a nurse to monitor in a patient receiving Gentamicin?
A. Serum creatinine
B. Serum glucose
C. Prothrombin time (PT)
D. Hemoglobin levels
Ans: A
,Explanation: Gentamicin is an aminoglycoside known for its potential to cause severe nephrotoxicity.
Monitoring serum creatinine and BUN is essential to detect early signs of kidney damage. The nurse
should also assess for ototoxicity, which can be irreversible in some cases. This drug requires therapeutic
drug monitoring of peak and trough levels to ensure safety. Maintaining adequate hydration is a key
teaching point for patients on this therapy.
3. A patient taking Tetracycline should be instructed to avoid which of the following substances?
A. Dairy products
B. Grapefruit juice
C. Leafy green vegetables
D. Red meat
Ans: A
Explanation: Tetracycline binds with calcium, iron, and magnesium, which prevents its absorption in the
GI tract. Patients should avoid dairy products, antacids, and iron supplements while taking this
medication. This drug can also cause permanent tooth discoloration in children and developing fetuses.
The nurse should advise the patient to take the medication on an empty stomach. Photosensitivity is
another common side effect that requires sun protection measures.
4. A nurse is preparing to administer Ciprofloxacin. Which adverse effect is a black box warning for this drug
class?
A. Tendon rupture
B. Nephrotoxicity
C. Ototoxicity
D. Bone marrow suppression
, Ans: A
Explanation: Fluoroquinolones like Ciprofloxacin carry a black box warning for tendonitis and tendon
rupture. This risk is highest in older adults, patients with renal failure, and those taking corticosteroids.
Patients should be instructed to stop exercise and report any new joint or tendon pain immediately. The
drug can also cause CNS effects like dizziness and confusion in certain populations. Educating the patient
on these risks is a priority for the prescribing nurse.
5. A patient with a history of a severe anaphylactic reaction to Penicillin is prescribed Cephalexin. What is
the nurse’s priority action?
A. Administer the dose as ordered
B. Monitor for a rash after administration
C. Administer an antihistamine before the dose
D. Withhold the dose and contact the provider
Ans: D
Explanation: There is a 1% to 10% cross-sensitivity between penicillins and cephalosporins due to their
similar beta-lactam structure. If a patient has a history of severe anaphylaxis to penicillin, cephalosporins
should be avoided. The nurse must verify the severity of the previous reaction before continuing care.
Giving the medication could result in a life-threatening allergic reaction. Safety protocols dictate that the
provider must be notified to find an alternative antibiotic.
6. When administering Amphotericin B intravenously, which nursing intervention is essential to prevent
infusion-related reactions?
A. Administer the drug over 15 minutes
B. Premedicate with acetaminophen and diphenhydramine
