NSG 318 LATEST 2026/2027 TEST PAPER QUESTIONS
AND ANSWERS RATED A+
✔✔Antifungal Antibiotic - ✔✔Binds to sterols (ergosterol) causing the loss of
intracellular potassium and other cellular contents
✔✔Prototype of Antifungal Antibiotic - ✔✔nystatin
✔✔Indications for Antifungal Antibiotic - ✔✔Treatment of oral and skin fungal infections
✔✔Side Effects of Antifungal Antibiotic - ✔✔Nausea, vomiting, diarrhea (especially with
oral suspension), mild skin irritation with topical use.
✔✔Adverse Reactions - ✔✔Rare-well tolerated; topical: prutitus, urticaria, rash,
hyperglycemia
✔✔Contraindications - ✔✔Diabetes mellitus, paraben hypersensitivity, breastfeeding
✔✔Nursing Considerations for Oral Suspension - ✔✔Used for oral thrush. Swish in the
mouth for several minutes before swallowing. Continue treatment 48 hours after
symptoms resolve.
✔✔Lozenges (troches) - ✔✔Dissolve slowly in the mouth for oral fungal infections
✔✔Topical cream/ointment/powder - ✔✔Used for cutaneous fungal infections
✔✔Tablets - ✔✔For intestinal candidiasis, but not commonly used
✔✔Vaginal suppositories - ✔✔For vaginal candidiasis (less common since azoles are
preferred)
✔✔CLASS: Azole Antifungal - ✔✔Prototype: fluconazole
✔✔MOA of Fluconazole - ✔✔Increases permeability of the fungal cell membrane by
inhibiting ergosterol synthesis
✔✔Indications for Fluconazole - ✔✔Candida infections, Cryptococcal meningitis, Bone
marrow transplant and radiation therapy prophylaxis
✔✔Side Effects of Fluconazole - ✔✔Nausea, vomiting, abdominal pain, rash
✔✔Adverse Reactions of Fluconazole - ✔✔Serious skin reactions, liver toxicity, QT
prolongation. Respiratory effects with fluconazole are rare but can include an allergic
reaction that may lead to bronchospasm or difficulty breathing.
,✔✔Contraindications for Fluconazole - ✔✔Pregnancy, liver dysfunction, renal
impairment
✔✔CAMS for Fluconazole - ✔✔St. John's Wort, Garlic - Increased liver toxicity, reduced
antifungal effects
✔✔Nursing Considerations for Fluconazole - ✔✔Monitor liver and renal function, assess
for signs of allergic reactions, and educate patients on potential drug interactions,
especially with other antifungals.
✔✔CLASS: Antiviral - ✔✔Prototype: acyclovir
✔✔MOA of Acyclovir - ✔✔Inhibits viral DNA synthesis and inhibits viral DNA
polymerase and viral DNA chain; inactivates viral DNA polymerase
✔✔Indications for Acyclovir - ✔✔Herpes simplex virus, Varicella-zoster viruses
✔✔Side Effects of Acyclovir - ✔✔Nausea, vomiting, headache, rash, IV site irritation
(regularly check)
✔✔Adverse Reactions of Acyclovir - ✔✔Seizures, CNS effects
✔✔Contraindications for Acyclovir - ✔✔Renal impairment (dose adjustment needed),
pregnancy (use with caution), neurological side effects in elderly
✔✔CAMS for Acyclovir - ✔✔St. John's Wort, Alcohol - CNS effects, liver damage,
disulfiram-like reaction with alcohol
✔✔Nursing Considerations for Acyclovir - ✔✔Monitor renal function, assess for signs of
CNS effects, and educate patients on the risk of dizziness and sedation. Use caution in
elderly patients.
✔✔CLASS: Anthelmintic - ✔✔Prototype: ivermectin
✔✔MOA of Ivermectin - ✔✔Diffuses into organism, interacting with DNA and causing a
loss of helical DNA structure and strand breakage, inhibiting protein synthesis.
✔✔Indications for Ivermectin - ✔✔Parasitic worms (roundworms)
✔✔Side Effects of Ivermectin - ✔✔Diarrhea, nausea, dizziness, rash
✔✔Adverse Reactions of Ivermectin - ✔✔Neuropathy, seizures, dizziness
, ✔✔Contraindications for Ivermectin - ✔✔Pregnancy, children under 2 years old (unless
prescribed by a doctor), liver impairment.
✔✔CAMS for Ivermectin - ✔✔St. John's Wort, Garlic - Neurotoxic effects, dizziness,
reduced effectiveness
✔✔Nursing Considerations for Ivermectin - ✔✔Monitor for GI side effects, neurological
symptoms, and educate patients on avoiding alcohol use. Monitor liver and renal
function.
✔✔CLASS: Antibacterial: Peptide, Amebicide - ✔✔Prototype: metronidazole
✔✔MOA of Metronidazole - ✔✔Diffuses into organism, interacting with DNA and
causing a loss of helical DNA structure and strand breakage, inhibiting protein
synthesis.
✔✔Indications for Metronidazole - ✔✔Anaerobic infections
✔✔Side Effects of Metronidazole - ✔✔Nausea, vomiting, diarrhea, metallic taste
✔✔Adverse Reactions of Metronidazole - ✔✔Neuropathy, eye damage
✔✔Contraindications for Metronidazole - ✔✔Caution with liver dysfunction, pregnancy.
Disulfiram-like reaction: Can cause nausea, vomiting, flushing, headache, and
abdominal cramps when alcohol is consumed during treatment.
✔✔CAMS for Metronidazole - ✔✔Garlic, Echinacea - Reduced effectiveness, immune
system modulation
✔✔Nursing Considerations for Metronidazole - ✔✔Monitor for neurological side effects
(headache, dizziness), assess liver function, and educate patients to avoid alcohol due
to the risk of a disulfiram-like reaction.
✔✔Non-steroidal Anti-inflammatory Drugs - ✔✔Medications that provide relief from pain
and inflammation without the use of steroids.
✔✔Salicylate - ✔✔A class of drugs that includes aspirin, which inhibits prostaglandin
synthesis.
✔✔Aspirin - ✔✔The prototype drug of the salicylate class, used for relief of moderate to
severe pain.
✔✔MOA (Mechanism of Action) - ✔✔Inhibits prostaglandin synthesis, hypothalamic
heat regulator center, and platelet aggregation.
AND ANSWERS RATED A+
✔✔Antifungal Antibiotic - ✔✔Binds to sterols (ergosterol) causing the loss of
intracellular potassium and other cellular contents
✔✔Prototype of Antifungal Antibiotic - ✔✔nystatin
✔✔Indications for Antifungal Antibiotic - ✔✔Treatment of oral and skin fungal infections
✔✔Side Effects of Antifungal Antibiotic - ✔✔Nausea, vomiting, diarrhea (especially with
oral suspension), mild skin irritation with topical use.
✔✔Adverse Reactions - ✔✔Rare-well tolerated; topical: prutitus, urticaria, rash,
hyperglycemia
✔✔Contraindications - ✔✔Diabetes mellitus, paraben hypersensitivity, breastfeeding
✔✔Nursing Considerations for Oral Suspension - ✔✔Used for oral thrush. Swish in the
mouth for several minutes before swallowing. Continue treatment 48 hours after
symptoms resolve.
✔✔Lozenges (troches) - ✔✔Dissolve slowly in the mouth for oral fungal infections
✔✔Topical cream/ointment/powder - ✔✔Used for cutaneous fungal infections
✔✔Tablets - ✔✔For intestinal candidiasis, but not commonly used
✔✔Vaginal suppositories - ✔✔For vaginal candidiasis (less common since azoles are
preferred)
✔✔CLASS: Azole Antifungal - ✔✔Prototype: fluconazole
✔✔MOA of Fluconazole - ✔✔Increases permeability of the fungal cell membrane by
inhibiting ergosterol synthesis
✔✔Indications for Fluconazole - ✔✔Candida infections, Cryptococcal meningitis, Bone
marrow transplant and radiation therapy prophylaxis
✔✔Side Effects of Fluconazole - ✔✔Nausea, vomiting, abdominal pain, rash
✔✔Adverse Reactions of Fluconazole - ✔✔Serious skin reactions, liver toxicity, QT
prolongation. Respiratory effects with fluconazole are rare but can include an allergic
reaction that may lead to bronchospasm or difficulty breathing.
,✔✔Contraindications for Fluconazole - ✔✔Pregnancy, liver dysfunction, renal
impairment
✔✔CAMS for Fluconazole - ✔✔St. John's Wort, Garlic - Increased liver toxicity, reduced
antifungal effects
✔✔Nursing Considerations for Fluconazole - ✔✔Monitor liver and renal function, assess
for signs of allergic reactions, and educate patients on potential drug interactions,
especially with other antifungals.
✔✔CLASS: Antiviral - ✔✔Prototype: acyclovir
✔✔MOA of Acyclovir - ✔✔Inhibits viral DNA synthesis and inhibits viral DNA
polymerase and viral DNA chain; inactivates viral DNA polymerase
✔✔Indications for Acyclovir - ✔✔Herpes simplex virus, Varicella-zoster viruses
✔✔Side Effects of Acyclovir - ✔✔Nausea, vomiting, headache, rash, IV site irritation
(regularly check)
✔✔Adverse Reactions of Acyclovir - ✔✔Seizures, CNS effects
✔✔Contraindications for Acyclovir - ✔✔Renal impairment (dose adjustment needed),
pregnancy (use with caution), neurological side effects in elderly
✔✔CAMS for Acyclovir - ✔✔St. John's Wort, Alcohol - CNS effects, liver damage,
disulfiram-like reaction with alcohol
✔✔Nursing Considerations for Acyclovir - ✔✔Monitor renal function, assess for signs of
CNS effects, and educate patients on the risk of dizziness and sedation. Use caution in
elderly patients.
✔✔CLASS: Anthelmintic - ✔✔Prototype: ivermectin
✔✔MOA of Ivermectin - ✔✔Diffuses into organism, interacting with DNA and causing a
loss of helical DNA structure and strand breakage, inhibiting protein synthesis.
✔✔Indications for Ivermectin - ✔✔Parasitic worms (roundworms)
✔✔Side Effects of Ivermectin - ✔✔Diarrhea, nausea, dizziness, rash
✔✔Adverse Reactions of Ivermectin - ✔✔Neuropathy, seizures, dizziness
, ✔✔Contraindications for Ivermectin - ✔✔Pregnancy, children under 2 years old (unless
prescribed by a doctor), liver impairment.
✔✔CAMS for Ivermectin - ✔✔St. John's Wort, Garlic - Neurotoxic effects, dizziness,
reduced effectiveness
✔✔Nursing Considerations for Ivermectin - ✔✔Monitor for GI side effects, neurological
symptoms, and educate patients on avoiding alcohol use. Monitor liver and renal
function.
✔✔CLASS: Antibacterial: Peptide, Amebicide - ✔✔Prototype: metronidazole
✔✔MOA of Metronidazole - ✔✔Diffuses into organism, interacting with DNA and
causing a loss of helical DNA structure and strand breakage, inhibiting protein
synthesis.
✔✔Indications for Metronidazole - ✔✔Anaerobic infections
✔✔Side Effects of Metronidazole - ✔✔Nausea, vomiting, diarrhea, metallic taste
✔✔Adverse Reactions of Metronidazole - ✔✔Neuropathy, eye damage
✔✔Contraindications for Metronidazole - ✔✔Caution with liver dysfunction, pregnancy.
Disulfiram-like reaction: Can cause nausea, vomiting, flushing, headache, and
abdominal cramps when alcohol is consumed during treatment.
✔✔CAMS for Metronidazole - ✔✔Garlic, Echinacea - Reduced effectiveness, immune
system modulation
✔✔Nursing Considerations for Metronidazole - ✔✔Monitor for neurological side effects
(headache, dizziness), assess liver function, and educate patients to avoid alcohol due
to the risk of a disulfiram-like reaction.
✔✔Non-steroidal Anti-inflammatory Drugs - ✔✔Medications that provide relief from pain
and inflammation without the use of steroids.
✔✔Salicylate - ✔✔A class of drugs that includes aspirin, which inhibits prostaglandin
synthesis.
✔✔Aspirin - ✔✔The prototype drug of the salicylate class, used for relief of moderate to
severe pain.
✔✔MOA (Mechanism of Action) - ✔✔Inhibits prostaglandin synthesis, hypothalamic
heat regulator center, and platelet aggregation.
