Practice quiz · by a Quizcard user

Nursing Pharmacology: Antimicrobials and Infection — quiz

20 multiple-choice questions covering Penicillins, Cephalosporins, Carbapenems, Vancomycin, Aminoglycosides. One answer each; you get a score at the end and the explanation for every question. No account needed.

Updated 2026-11-03. Keys 1–4 pick an answer, Enter moves on. Redo it any time, in order or shuffled.

The questions

Answers and explanations are shown after you finish.

1. Penicillins

   A nursing student explains how penicillin kills bacteria. Which mechanism is correct?

   • Inhibits DNA gyrase preventing DNA replication
   • Disrupts fungal cell membrane ergosterol
   • Inhibits bacterial protein synthesis at the 50S ribosome
   • Binds penicillin-binding proteins to inhibit cell wall synthesis, causing lysis
2. Penicillins

   A patient being treated for syphilis reports a history of severe penicillin allergy with anaphylaxis. What is the priority nursing action before giving benzathine penicillin G?

   • Substitute a cephalosporin without further assessment since cross-reactivity is rare
   • Withhold the drug and notify the provider; further assess the allergy history
   • Give the first dose as scheduled since syphilis requires penicillin regardless of allergy
   • Administer diphenhydramine prophylactically and proceed with penicillin
3. Cephalosporins

   A student compares first-generation and fourth-generation cephalosporins. Which statement about this generational trend is accurate?

   • Gram-positive coverage and CNS penetration both increase progressively
   • Gram-negative coverage and CNS penetration increase while gram-positive coverage generally decreases
   • All generations provide identical MRSA coverage
   • Gram-negative coverage decreases while gram-positive coverage increases
4. Cephalosporins

   A patient with bacterial meningitis also has gonorrhea. Which cephalosporin is appropriate because it penetrates the CNS well and covers both infections?

   • Ceftriaxone
   • Cefuroxime
   • Cefepime
   • Cefazolin
5. Cephalosporins

   Which cephalosporin would be most appropriate for a hospital-acquired Pseudomonas aeruginosa infection?

   • Cefepime
   • Cefuroxime
   • Ceftaroline
   • Cefazolin
6. Carbapenems

   A patient with renal impairment is started on imipenem for a multidrug-resistant infection. What adverse effect requires the nurse's close monitoring?

   • Optic neuritis
   • Tendon rupture
   • Seizures
   • Red man syndrome
7. Vancomycin

   One patient has C. difficile colitis and another has MRSA bacteremia. How should vancomycin be administered differently for each?

   • Both should receive oral vancomycin since it treats systemic and GI infections equally
   • IV vancomycin for both since oral forms are not absorbed
   • Oral vancomycin for C. diff (local GI effect) and IV vancomycin for MRSA bacteremia (systemic)
   • Oral vancomycin for MRSA and IV for C. diff
8. Vancomycin

   A patient receiving IV vancomycin develops flushing and itching of the face and trunk shortly after a rapid infusion. What is the best nursing response?

   • Slow the infusion rate, since this is a histamine-mediated reaction and not a true allergy
   • Increase the infusion rate to finish dosing quickly
   • Administer epinephrine for anaphylaxis
   • Stop the drug permanently and document a severe allergic reaction
9. Aminoglycosides

   A patient on gentamicin reports ringing in the ears. Which monitoring finding would most concern the nurse regarding toxicity risk?

   • Elevated trough level
   • Decreased BUN/creatinine
   • Low peak level
   • Elevated liver enzymes
10. Macrolides

    A patient allergic to penicillin needs treatment for atypical pneumonia caused by Mycoplasma. Which drug class binds the 50S ribosomal subunit and is a suitable alternative?

    • Macrolides
    • Aminoglycosides
    • Tetracyclines
    • Fluoroquinolones
11. Macrolides

    A patient taking warfarin is prescribed azithromycin for a respiratory infection. What should the nurse monitor for due to a drug interaction?

    • Decreased INR and risk of clot formation
    • Increased INR and risk of bleeding
    • Hypoglycemia
    • Hypertension
12. Tetracyclines

    A pregnant patient asks why she cannot take doxycycline for her infection. What is the best explanation?

    • It can discolor developing teeth and inhibit bone growth in the fetus/child
    • It increases risk of tendon rupture in the fetus
    • It causes fetal neural tube defects
    • It is hepatotoxic to the fetus specifically
13. Fluoroquinolones

    Ciprofloxacin kills bacteria by which mechanism?

    • Inhibiting folic acid synthesis
    • Binding the 30S ribosomal subunit
    • Binding penicillin-binding proteins to inhibit cell wall synthesis
    • Inhibiting DNA gyrase and topoisomerase IV
14. Fluoroquinolones

    An older adult taking levofloxacin along with a corticosteroid reports sudden heel pain and swelling. What should the nurse suspect?

    • Peripheral neuropathy from isoniazid
    • Tendinitis or tendon rupture
    • Red man syndrome
    • Optic neuritis
15. Sulfonamides

    A patient on sulfamethoxazole-trimethoprim is instructed to increase fluid intake. What adverse effect is this teaching meant to prevent?

    • Crystalluria and kidney stone formation
    • Photosensitivity
    • Red man syndrome
    • Tendon rupture
16. Metronidazole

    A patient prescribed metronidazole for trichomoniasis asks if she can have a glass of wine during treatment. What is the nurse's best response?

    • "Alcohol will reduce the effectiveness of the drug but won't cause harm."
    • "Alcohol is fine as long as it's in moderation."
    • "You should avoid alcohol during treatment and for 48-72 hours after finishing because it can cause a severe reaction."
    • "Only avoid alcohol if you also have liver disease."
17. Antituberculars

    A patient newly diagnosed with active TB is started on four-drug therapy. Which combination represents the standard first-line regimen?

    • Rifampin, Isoniazid, Penicillin, Ethambutol
    • Rifampin, Isoniazid, Pyrazinamide, Ethambutol
    • Rifampin, Isoniazid, Pyrazinamide, Erythromycin
    • Rifampin, Imipenem, Pyrazinamide, Erythromycin
18. Antituberculars

    Why is vitamin B6 (pyridoxine) often co-administered with isoniazid?

    • To prevent hyperuricemia
    • To prevent optic neuritis
    • To prevent hepatotoxicity
    • To prevent peripheral neuropathy
19. Antifungals

    A patient receiving IV amphotericin B develops fever, chills, and myalgia during infusion ("shake and bake"), while another patient on fluconazole develops elevated liver enzymes. What best explains this difference in toxicity?

    • Amphotericin B binds ergosterol causing infusion reactions/nephrotoxicity, while azoles inhibit ergosterol synthesis causing hepatotoxicity
    • Both drugs work identically and share the same toxicity profile
    • Fluconazole causes infusion reactions and amphotericin B causes CYP450 interactions
    • Amphotericin B is hepatotoxic and fluconazole is nephrotoxic
20. Antivirals/Antiretrovirals

    A patient with HIV is prescribed a combination regimen including an NRTI, an NNRTI, and an integrase inhibitor. What is the most important teaching point for this regimen?

    • The regimen can be stopped once viral load is undetectable
    • Take doses only when symptoms occur
    • Strict adherence to the exact dosing schedule prevents resistance and treatment failure
    • Only one drug class is necessary long-term