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NCLEX-Style Quiz: Sulfonamides and Penicillins

Total questions: 49

Worksheet time: 25mins

Name
Class
Date
1.

A patient prescribed sulfamethoxazole-trimethoprim reports a new rash and fever. What is the nurse’s priority action?

a)

Reassure the patient this is a normal side effect

b)

Discontinue the medication and notify the provider

c)

Administer diphenhydramine and continue therapy

d)

Increase fluid intake

2.

The nurse instructs a patient on trimethoprim-sulfamethoxazole therapy to:

a)

Limit water intake to prevent hyponatremia

b)

Use additional contraception methods

c)

Avoid taking with food

d)

Stop medication if urine turns dark

3.

Which medication increases the effect of penicillin G?

a)

Warfarin

b)

Probenecid

c)

Furosemide

d)

Acetaminophen

4.

A patient develops shortness of breath and wheezing after receiving IV penicillin. What should the nurse do first?

a)

Administer diphenhydramine

b)

Stop the infusion and notify the provider

c)

Document the reaction

d)

Give oxygen and continue the infusion

5.

Teaching for oral amoxicillin includes:

a)

Take on an empty stomach only

b)

Stop if stools become loose

c)

May take with food if GI upset occurs

d)

Avoid dairy products

6.

Which cephalosporin generation is most effective against MRSA?

a)

First

b)

Third

c)

Fourth

d)

Fifth

7.

Which instruction is appropriate for a patient taking ceftriaxone?

a)

Avoid alcohol during therapy

b)

Limit fluid intake

c)

Expect orange urine

d)

Stop drug if mild diarrhea occurs

8.

Which finding indicates a potential complication from cephalosporin use?

a)

Metallic taste

b)

Sore throat and fatigue

c)

Dry mouth

d)

Constipation

9.

The nurse should monitor a patient on imipenem/cilastatin for which serious adverse effect?

a)

Hepatotoxicity

b)

Seizures

c)

Alopecia

d)

Hypotension

10.

Which statement indicates correct patient teaching?

a)

“If I feel dizzy, I should skip my next dose.”

b)

“I’ll report confusion or tremors right away.”

11.

Which organism is aztreonam most active against?

a)

Streptococcus pneumoniae

b)

Clostridium difficile

c)

Escherichia coli

d)

Staphylococcus aureus

12.

Which teaching is essential for a patient receiving aztreonam IM?

a)

Expect a disulfiram-like reaction

b)

Report rash or shortness of breath

c)

Take with antacids

d)

Increase dairy intake

13.

Which lab value should the nurse monitor for a patient on erythromycin?

a)

ALT/AST

b)

Sodium

c)

Calcium

d)

Platelets

14.

A nurse knows macrolides are contraindicated in:

a)

QT prolongation

b)

Asthma

c)

Pregnancy

d)

Hypotension

15.

What should the nurse include in teaching for azithromycin?

a)

Take with aluminum antacids

b)

Complete entire course even if feeling better

c)

Take with milk for absorption

d)

Double the dose if missed

16.

The nurse should question which order?

a)

Doxycycline for acne

b)

Tetracycline for a pregnant patient

c)

Minocycline for chlamydia

d)

Tigecycline for pneumonia

17.

Which adverse effect is associated with tetracyclines?

a)

Photosensitivity

b)

Constipation

c)

Hypoglycemia

d)

Hypertension

18.

Which instruction is correct?

a)

Take with milk to reduce GI upset

b)

Take on an empty stomach with water

c)

Take with antacids to prevent gastritis

d)

Take before bed

19.

Which finding requires immediate action in a patient on gentamicin?

a)

Dry mouth

b)

Tinnitus

c)

Nausea

d)

Drowsiness

20.

Which lab should the nurse monitor for a patient on sulfonamides?

a)

Potassium

b)

Creatinine

c)

Hemoglobin

d)

Glucose

21.

To prevent toxicity, the nurse ensures:

a)

Peak levels remain below 2 mcg/mL

b)

Trough levels remain below 2 mcg/mL

c)

Doses are spaced every 2 hours

d)

The drug is given PO

22.

What is a serious adverse effect of levofloxacin?

a)

Alopecia

b)

Tendon rupture

c)

Tooth discoloration

d)

Photosensitivity

23.

Which statement indicates correct teaching?

a)

“I can take my antacid right after my antibiotic.”

b)

“I’ll avoid sunlight and report tendon pain.”

c)

“I’ll drink grapefruit juice with my medication.”

d)

“If I feel dizzy, I’ll double the dose.”

24.

The nurse should monitor for which cardiac complication?

a)

QT prolongation

b)

Bradycardia

c)

Heart block

d)

Hypotension

25.

What is the most serious adverse effect of clindamycin?

a)

Constipation

b)

Pseudomembranous colitis

c)

Anemia

d)

Rash

26.

What should the nurse include in teaching?

a)

Report diarrhea immediately

b)

Take with iron supplements

c)

Avoid dairy products

d)

Take with grapefruit juice

27.

Which adverse effect is expected with metronidazole?

a)

Orange urine

b)

Metallic taste

c)

Photosensitivity

d)

Tinnitus

28.

Which statement indicates a need for more teaching?

a)

“I’ll avoid alcohol for two days after finishing this medicine.”

b)

“I might have a metallic taste.”

c)

“I should take this with milk.”

d)

“I’ll finish all doses, even if I feel better.”

29.

What is the primary dietary teaching for a patient on linezolid?

a)

Avoid high-fat foods

b)

Avoid aged cheeses and wine

c)

Limit protein intake

d)

Increase caffeine intake

30.

Linezolid has drug interactions with:

a)

SSRIs

b)

Beta blockers

c)

NSAIDs

d)

ACE inhibitors

31.

What is the most important nursing action during vancomycin infusion?

a)

Administer IV push

b)

Infuse over at least 60 minutes

c)

Use a small-gauge needle

d)

Give with food

32.

Which sign indicates Red Man Syndrome?

a)
Wheezing
b)

Diarrhea

c)

hearing loss

d)

leg cramps

33.

Which lab finding indicates vancomycin toxicity?

a)

Elevated BUN/creatinine

b)

Low potassium

c)

Elevated calcium

d)

Low hematocrit

34.

A patient on warfarin is prescribed trimethoprim-sulfamethoxazole. The nurse expects:

a)

No interaction

b)

Increased bleeding risk

c)

Decreased INR

d)

Reduced anticoagulant effect

35.

A nurse notes a patient on ceftriaxone complains of diarrhea and abdominal pain. What should be suspected?

a)

C. difficile infection

b)

Viral gastroenteritis

c)

Constipation

d)

Medication allergy

36.

Which antibiotic class requires avoiding calcium, iron, and magnesium during therapy?

a)

Fluoroquinolones

b)

Penicillins

c)

Sulfonamides

d)

Macrolides

37.

Which antibiotic is safest for a patient with a penicillin allergy?

a)

Azithromycin

b)

Amoxicillin

c)

Cefazolin

d)

Piperacillin

38.

Which antibiotic requires monitoring for serotonin syndrome?

a)

Linezolid

b)

Ciprofloxacin

c)

Clindamycin

d)

Gentamicin

39.

Which antibiotic should not be used in children under 8 years old?

a)

Doxycycline

b)

Azithromycin

c)

Amoxicillin

d)

Vancomycin

40.

Which antibiotic can cause a disulfiram-like reaction?

a)

Metronidazole

b)

Gentamicin

c)

Tetracycline

d)

Cefazolin

41.

What is a nursing priority when administering IV aminoglycosides?

a)

Assess urine output and hearing daily

b)

Encourage fluids only

c)

Avoid peak and trough monitoring

d)

Administer rapidly to reduce irritation

42.

What adverse effect is shared by both vancomycin and aminoglycosides?

a)

Ototoxicity

b)

Tendon rupture

c)

Photosensitivity

d)

Seizures

43.

A patient reports a metallic taste and dark urine while on metronidazole. The nurse should:

a)

Discontinue the medication

b)

Reassure the patient this is normal

c)

Reduce the dose

d)

Give diphenhydramine

44.

Which antibiotic can prolong the QT interval?

a)

Azithromycin

b)

Amoxicillin

45.

The nurse is preparing to administer cefazolin IM. What should be done first?

a)

Check for penicillin allergy

b)

Mix with lidocaine

c)

Heat the injection site

d)

Draw trough level

46.

Which class requires slow IV infusion to prevent hypotension?

a)

Vancomycin

b)

Tetracyclines

c)

Macrolides

d)

Penicillins

47.

What should the nurse do if a patient develops watery diarrhea while on clindamycin?

a)

Encourage fluids only

b)

Discontinue the medication

c)

Give antidiarrheal medication

d)

Monitor for constipation

48.

Which antibiotic can cause photosensitivity?

a)

Tetracyclines

b)

Clindamycin

c)

Gentamicin

d)

Vancomycin

49.

Which antibiotic can cross the blood-brain barrier and treat meningitis?

a)

Ceftriaxone

b)

Piperacillin

c)

Gentamicin

d)

Clindamycin

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