1. A nurse needs to administer a cephalosporin to a patient.

The patient informs the

nurse that he is allergic to penicillin. Which of the following actions is the nurse
most likely to take in such a situation?
a) Inform the primary health care provider.
b) Suggest kidney function tests.
c) Obtain patient's occupational history.
d) Administer an antipyretic drug.

2. The physician has ordered penicillin V for your patient. Which of the following
should you instruct the patient to take with the medication?
a) A full glass of orange juice
b) An antacid
c) A full glass of water
d) A diuretic

3. Penicillins may trigger an anaphylactic reaction in some patients. During what

period following injection of a penicillin is anaphylaxis most likely to occur?
a) 8 hours
b) 12 hours
c) 2 hours
d) 30 minutes

4. Cephalosporins are structurally and chemically related to which classes of

antibiotics? (Choose one)
a) Tetracyclines
b) Aminoglycosides
c) Penicillins
d) Fluoroquinolones

5. A nurse is preparing the medical history report of a patient with a urinary tract
infection. Which of the following conditions should the nurse identify as one in which
the use of cephalosporins is restricted?

a) Headache
b) Abdominal cramps
c) Renal disease
d) Aplastic anemia

6. Your client is being treated for streptococcal pharyngitis and is NPO. Her health
care provider has ordered Penicillin G to be given IM. She wants to know why she
cannot take her medications via an oral route. Your best response is:
a) Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.
b) Penicillin G is inactivated by gastric acid, therefore it is only given IM.
c) Penicillin G is no longer used for this problem.
d) Penicillin G can be given orally but requires higher doses.

7. You are doing patient teaching prior to discharging a patient home. The patient is
taking ciprofloxacin (Cipro). What would you teach this patient is the best way to
prevent crystalluria caused by ciprofloxacin (Cipro)?
a) Encourage at least 2 L of fluid per day
b) Give phenazopyridine (Pyridium) qid
c) Limit fluids to 500 cc per day
d) Offer the bed pan or commode every 2 hours

8. A client is receiving ciprofloxacin for a urinary tract infection. This drug is

administered IV. During an infusion, the nurse notes fluid leaking into the tissue
around the IV site. What is the best response of the nurse?
a) Discontinue the IV.
b) Elevate the extremity.
c) Administer pain medication.
d) Increase the IV drip rate.

9. The nurse is caring for a 62-year-old patient who has been prescribed gentamicin.
The patient complains of difficulty hearing. What should the nurse do?

a) Administer the dose and document the observation in the nursing notes.
b) Administer the dose and report this information to the oncoming nurse at shift
change.
c) Hold the dose and notify the physician immediately.
d) Administer the dose and then notify the physician.

10. You are a critical care nurse caring for a patient taking aminoglycosides. Which
of the following should you monitor closely to determine whether dosage
adjustment is required?
a) Cardiac function
b) Renal function
c) Lung function
d) Intestinal function

11. When administering aminoglycosides, the nurse must be aware of which of the
following adverse reactions?
a) Glaucoma and renal failure
b) Hypoglycemia and hyperglycemia
c) Ototoxicity and nephrotoxicity
d) Liver necrosis, or hepatic failure

12. The nurse should advise the client which of the following in regards to the
administration of fluoroquinolones? (Choose one)
a) Do not take blood pressure medications while taking fluoroquinolones
b) Do not take antacids while taking fluoroquinolones
c) Do not take diabetes medications while taking fluoroquinolones
d) Do not take oral contraceptives while taking fluoroquinolones

13. The nurse understands that an infection caused by a secondary pathogen,

which can occur during prolonged antibiotic therapy, is known as which of the
following?

a) Acquired resistance
b) Cross-sensitivity
c) Superinfection
d) Primary infection

14. A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client
complains of pain and the nurse notes a reddened area along the vein. What does
the nurse suspect?

a) Extravasation
b) Phlebitis
c) Allergic reaction
d) Adverse reaction

15. The nurse knows that pseudomembranous colitis is a superinfection of

fluoroquinolones, especially when they are administered in high doses, because
these medications have what effect in the body?

a) They decrease the infectious process of the existing bacteria.

b) They increase the infectious process of the existing bacteria.
c) They disrupt the microbial flora of the body.
d) They disrupt the existing bacterial infection.

16. Prior to administration of fluoroquinolones, which laboratory test should be

obtained?
a) Renal function
b) Complete blood counts
c) Hepatic function
d) Culture and sensitivity

17. The client has been taking her antibiotic for five days. She tells the nurse that
she is now experiencing vaginal itching and discharge. The nurse suspects what has
occurred?
a) The client has developed a superinfection.
b) The client is not taking her medications.
c) The client is experiencing an adverse reaction.
d) The client has developed sepsis.

18. A 72-year-old female clinic patient is started on trimethoprim-sulfamethoxazole

for treatment of a urinary tract infection. Prior to administering this drug, the nurse
should assess the patient for which of the following conditions?
a) Diabetes mellitus
b) Renal impairment
c) Hypertension
d) Asthma
19. A patient has been prescribed a tetracycline drug for Rocky Mountain spotted
fever. The patient also takes antacids. Which of the following effects is likely to
occur due to an interaction between the two drugs?
a) Increased action of neuromuscular-blocking drugs
b) Increased profound respiratory depression
c) Increased risk of bleeding
d) Decreased absorption of tetracycline

20. Your client developed a pressure area on her hip which has become infected. If
the wound culture reveals methicillin-resistant Staphylococcus aureus, which of the
following medications will you expect to be ordered?
a) Penicillin
b) Erythromycin
c) Vancomycin
d) Flagyl

21. You are administering erythromycin to one of your patients. For what common
side effects should you monitor the patient?

a) Shortness of breath
b) Urticaria and colitis
c) Headache, fever, and itching
d) Nausea, vomiting, and diarrhea

22. A 78-year-old female, who lives alone and is forgetful, is being seen by her
home health nurse. In reviewing the patient's medication the nurse discovers that
the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a
good choice of antibiotics for this patient?
a) It is taken only once a day.
b) It has very few adverse effects.
c) The half-life of the drug is 3 to 7 hours.
d) It can be given without consideration to drug-drug- interactions.

23. A patient is diagnosed with peptic ulcer disease. He has been prescribed
clarithromycin (Biaxin). Which of the following organisms is this medication used to
treat?
a) Haemophilus influenzae
b) Helicobacter pylori
c) Mycobacterium avium complex
d) Streptococcus pneumoniae

24. Your client states that she has frequent sinus infections, for which she takes a
medication for 3 days. The most likely medication she takes is:
a) Tetracycline.
b) Pyridium.
c) Azithromycin.
d) Bactrim.

25. The nursing instructor is discussing the administration of azithromycin, a

macrolide, with her clinical group. The instructor asks her students to identify the
medication that will decrease the effects of azithromycin when administered

concurrently. Which of the following medications would the students identify?

a) Calcium-channel blockers
b) Beta-adrenergic blockers
c) Antacids
d) Antidepressants

26. How is tuberculosis transmitted from person to person? (Choose 0ne)

a) Inhalation of infected aerosolized droplets
b) Contact with infected blood
c) Fecal oral transmission
d) Contact with sweat

27. Medical treatment for tuberculosis (TB) consists of a combination of drugs to get
the best results. This statement is:
a) False
b) True

28. A patient is taking rifampin (Rifadin) for active TB. When discussing this drug
with the patient, the nurse should stress that
a) the drug usually causes cardiac arrhythmias.
b) body fluids such as urine, saliva, tears, and sputum may become discolored.
c) facial flushing may appear but will go away once therapy is concluded.
d) the drug frequently causes seizure activity.

29. You are caring for a 52-year-old client who has been diagnosed with a latent
tuberculosis infection. The physician is considering ordering isoniazid (INH). The preexistence of what condition would require cautious use of INH in this client?
a) Cirrhosis of the liver
b) Glaucoma
c) Folic acid deficiency
d) Hypertension

30. The client is taking isoniazid (INH). It is important that the client understand INH
can affect which vitamin?
a) B9
b) B1
c) B6
d) B2

31. A patient is hospitalized due to noncompliance with an antitubercular drug

treatment. Which of the following is most important for the nurse to do?
a) Instruct the family on the medication regime
b) Count the number of tablets in the bottle daily
c) Observe the patient taking the medications
d) Administer the medications parenterally

32. A patient for whom antiretroviral therapy has been prescribed informs the nurse
that she is taking oral contraceptives. Which of the following should the nurse
inform the patient is one of the effects of combining birth control pills with
antiretroviral therapy?
a) Decreases effectiveness of birth control pills
b) Decreases effectiveness of antiviral therapy
c) Increases serum level of the antiretroviral
d) Increases risk of vaginal bleeding

33. The nursing instructor is giving memory aids to the students to help them to
better remember the different drug classifications. Which of the following syllables
would the nurse instruct the students to look for when learning the antivirals?
a) -vir
b) -floxacin
c) -cillin
d) -azole

34. The nurse is reviewing the medication instruction for the patient taking
acyclovir. Which of the following would indicate the need for additional teaching?
a) "I need to contact my physician if the lesion turns red."
b) "This medication will cure my disease."
c) "I need to complete the full course of therapy as prescribed."
d) "I need to report any rash or itching while taking the medication."

35. Which drug is most commonly used orally to treat infections caused by Candida
albicans?
a) Acrisorcin (Akrinol)
b) Fluconazole (Diflucan)
c) Tolnaftate (Tinactin)
d) Griseofulvin (Fulvicin)

36. A patient is being treated with amphotericin B. Which of the following

statements indicates that the patient has understood the patient teaching?
a) The medication will cause liver necrosis.
b) The medication may cause kidney damage.
c) The medication may cause diabetes.
d) The medication will cause pancreatitis.

37. The following statement by 82-year-old Mr. B. leads you to believe that he has
understood the teaching that you have done regarding amphotericin B (Fungizone).
He says he could develop which of the following?
a) Diabetes
b) Pancreatitis
c) Damage to his kidneys
d) Liver necrosis

38. The client has a helminth infection. The nurse understands that it is important to

prevent recurrent infections. Which of the following is the best method to prevent
reinfection?
a) Hand washing
b) Washing undergarments
c) Washing bed linens
d) Changing bed linens

39. Amphotericin B is given by which route?

a) IV
b) SQ
c) IM
d) PO

40. You are caring a client who has been prescribed an oral suspension of nystatin
for treatment of mouth lesions. How would you explain self-administration of the
medication to the client?
a) "Swallow the medication."
b) "Swish the medication around in your mouth and then swallow it."
c) "Dilute the medication in a glass of water and then swallow it."
d) None of the above statements accurately describe self-administration of the
medication.

41. A patient comes to the clinic and is diagnosed with a vaginal fungal infection.
The nurse provides patient information for self administration of a vaginal antifungal
medication. What will the nurse include in her instructions?
a) Insert low into the opening of the vagina
b) Use a tampon to avoid staining undergarments
c) Discontinue use during menstruation
d) Remain recumbent for at least 15 minutes after insertion

42. Your client has a history of deep vein thrombosis, for which he is taking
Coumadin. When providing patient education for this client, who is now taking

fluconazole to treat a localized candidal infection, you would include which of the
following instructions?
a) Fluconazole increases the effects of warfarin. Have routine lab tests done.
b) Fluconazole decreases the effects of warfarin.
c) Fluconazole has no effect on warfarin.
d) Drink at least five 8-oz glasses of water daily while taking this medication.

43. You are caring for a patient who is receiving amphotericin B. Which of the
following medications could you administer concomitantly to promote patient
comfort?
a) Beta-adrenergic blockers
b) Antipyretics
c) Sedatives
d) Diuretics

44. A patient taking metronidazole should avoid alcohol intake.

a) True
b) False

45. A patient with a severe stomach ache visits the health care facility. Which of the
following interventions should the nurse perform if a pinworm infection is
suspected?
a) Obtain stool samples.
b) Obtain sample of saliva.
c) Obtain urine sample.
d) Obtain blood sample.

46. A nurse is preparing a presentation for a local parent group about helminthic
infections. Which of the following would the nurse include as the most frequent type
of helminthic infection in the United States?
a) Whipworm

b) Hookworm
c) Pinworm
d) Threadworm

47. You are conducting patient teaching with a patient has just been prescribed
lansoprazole (Prevacid). What statement would indicate that the patient correctly
understands the action of this medication?
a) The medication inhibits acid secretions.
b) The medication will repair my ulcer.
c) The medication is an analgesic.
d) The medication is an antibiotic.

48. A patient has been prescribed esomeprazole (Nexuim). What statement by the
patient indicates that he has a good understanding of his newly prescribed drug?
a) I should open the capsules and crush the drug into applesauce.
b) It is important that I take the drug after each meal.
c) I need to swallow the drug whole and not chew the capsules.
d) I should always take the drug with an antacid.

49. A patient's GI discomfort is prescribed antacids. Nursing interventions

associated with this prescription should include what?
a) Have the patient swallow the antacid whole and do not crush or chew the tablet
b) Administer this drug with other drugs or food
c) Administer the antacid 1 hour before or 2 hours after other oral medications
d) Limit fluid intake to decrease fluid retention

50. Your patient will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to
administration, you should inform the patient that common side effects related to
this medication include what?
a) Anxiety
b) Visual disturbances
c) Tremors

d) Headache

51. A patient has been prescribed rabeprazole (Aciphex). It will be important for the
nurse to assess the patient's drug history to determine if the patient is taking which
of the following drugs?
a) Morphine
b) Dicyclomine hydrochloride
c) Digoxin
d) Levodopa

52. The nurse is about to administer a laxative to a client for the first time. Which of
the following should be included in client education?
a) "Laxatives may cause diarrhea, abdominal discomfort, nausea, vomiting, perianal
irritation, and flatulence."
b) "If you are allergic to red dye number 5 you may have an allergic reaction to this
medication."
c) "It is important to avoid a large intake of fluids when taking this medication."
d) "It is good to take this medication daily. It is safe and non-habit forming."

53. Your patient is taking psyllium hydrophilic mucilloid (Metamucil) daily. What
information should be included in the discharge plan?
a) Discontinue the mucilloid if you do not have a bowel movement daily.
b) Mix the medication with your food at the evening meal.
c) Drink at least 8 ounces of fluid with the medication.
d) Combine all of your medications with the mucilloid.

54. Older adults who are unable or unwilling to eat an adequate diet or who are
debilitated may benefit from using bulk-forming laxatives. What is an important
teaching regarding intake for anyone using bulk-forming laxatives?
a) Assure adequate roughage intake
b) Assure adequate fluid intake
c) Assure adequate fat intake

d) Assure adequate protein intake

55. Your patient is being sent home with orders for a laxative PRN. You are doing
patient teaching on the use of a laxative. What will you inform the patient is one of
the most common adverse effects of a laxative?
a) Abdominal cramping
b) Headache
c) Weakness
d) Dizziness

56. Which of the following is the correct rationale for why the nurse would
administer a laxative at a separate time from the client's other medications?
a) Often laxatives make the client nauseated, which interferes with the ability to
take medications.
b) Laxatives may reduce absorption of other drugs present in the GI tract.
c) They often taste bad and clients are less likely to take other medications.
d) Because a laxative may stimulate a bowel movement, it can interfere with
medication administration.

57. You are a home health nurse caring for a 72-year-old male in his home. He
complains to you about diarrhea on an almost daily basis. What would you explain
to this patient is a common cause of diarrhea in older adults?
a) Diabetes
b) Hypertensive medications
c) Laxative overuse
d) Glaucoma

58. Which of the following patients are at highest risk for alteration in bowel
elimination?
a) Triathlete
b) Diabetic
c) Paraplegic

d) Hypertensive patient

59. The nurse may advise a patient to get which of the following after a myocardial
infarction to prevent straining during defecation? (Choose one)
a) Lactulose (Cephulac)
b) Lubiprostone (Amitiza)
c) Docusate (Colace)
d) Psyllium (Metamucil)

60. You are preparing to administer a saline cathartic when the patient mentions
that they have CHF. You know that saline cathartics are contraindicated for clients
with congestive heart failure due to what adverse effect?
a) Hypomagnesemia
b) Hyperphosphatemia
c) Hypochloremia
d) Hypernatremia

61. It is determined that a patient, who is in a hepatic coma, needs a laxative.

Lactulose is prescribed. Which of the following should the nurse monitor to assess
the efficacy of the lactulose therapy?
a) Oncotic pressure in the colon
b) Relief from symptoms
c) Blood ammonia levels
d) Water levels in the colon

62. A 76-year-old woman who resides in a long-term care facility is your newest
admission, presenting with dehydration, explosive diarrhea, abdominal pain,
elevated temperature, and dementia. She just completed a course of antibiotics for
a lower respiratory infection. What do you think is causing her diarrhea?
a) Rotavirus
b) Clostridium difficile
c) Inflammatory bowel disorder

d) Irritable bowel syndrome

63. A patient develops diarrhea secondary to antibiotic therapy. He is to receive two

tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for
each loose stool. The nurse should inform him that he may experience
a) increase in appetite.
b) dizziness.
c) muscle aches.
d) bradycardia.

64. The nurse is about to administer diphenoxylate (Lomotil) to a client for the first
time. Which of the following side effects should be included in the teaching about
this medication?
a) "This medication may make you feel lightheaded or drowsy."
b) "You can expect to feel an increase in energy on this medication."
c) "Perianal irritation is a side effect of this medication."
d) "This medication has few side effects so you may not notice any."

65. Which of the following drugs must the nurse question when it is given with an
anti-diarrheal medication, because it can lead to a hypertensive crisis?
a) An antiflatulent medication
b) Antihistamines for allergy
c) Monoamine oxidase inhibitor (MAOI) antidepressants
d) Mineral oil laxative

66. The physician orders bismuth subsalicylate (Pepto-Bismol) for your patient.
What assessment is most important to make before administering this medication?
a) Assess for allergy to aspirin
b) Assess electrolytes
c) Assess for pain
d) Assess for allergy to opioids

67. A nurse administers dronabinol to a patient just prior to starting an infusion of

chemotherapy drugs. Before allowing the patient to leave the facility, what should
the nurse instruct the patient to avoid?
a) Fluids
b) Sleeping
c) Driving
d) All the above

68. A patient is administered an antihistamine for nausea. Which of the following is

an adverse effect of this classification of medication?
a) Urinary incontinence
b) Inverted T wave
c) Prolonged QRS complex
d) Urinary retention

69. Different medications are used to treat the differing causes of nausea and
vomiting. Antihistamines may be effective in the treatment of nausea and vomiting
created by:
a) Surgery.
b) Radiation therapy.
c) Motion sickness.
d) Drugs.

70. Your 54-year-old client, who is preparing to go on an ocean cruise, asks for a
medication to relieve the symptoms of seasickness. What medication would a
physician most likely prescribe?
a) Palonosetron
b) Odansetron
c) Scopolamine
d) Dronabinol

71. A 54-year-old patient is going on an ocean cruise. What medication would be

most effective for motion sickness?
a) Hydroxyzine (Atarax)
b) Meclizine (Antivert)
c) Metoclopramide (Reglan)
d) Diphenhydramine (Benadryl)

72. Which of the following would increase the risk of sedation in a patient receiving
meclizine? Select all that apply.
a) Caffeine
b) Alcohol
c) Codeine
d) Diazepam
e) Hydrocodone

-------------------Key:
1. a
2. c
3. d
4. c
5. c
6. a
7. a
8. a
9. c
10. b
11. c
12. b
13. c
14. b
15. c
16. d
17. a
18. b

19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.

d
c
d
a
b
c
c
a
b
b
a
c
c
a
a
b
b
b
c
a
a
b
d
a
b
a
a
c
a
c
c
d
c
a
c
b
a
b
c
c
c
d
c
b

63.
64.
65.
66.
67.
68.
69.
70.
71.
72.

b
a
c
a
c
d
c
c
b
b,c,d,e