NSG 251 Final Exam UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

NSG 251 Final Exam UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Rank speed of absorption: Po, IM, IV - CORRECT ANSWER Po slowest, then IM, IV
fastest



Describe drug distribution in relation to protein binding - CORRECT
ANSWER Protein binding- Most drugs form a compound and bind with plasma
proteins. Drug molecules bound to plasma proteins are pharmacologically inactive. Only the
free or unbound portions of the drug acts on the cells. Protein binding allows for some of the
drug to be stored and others to be released as needed. This gives the constant blood level and
decreased risk for toxicity.

High binding=high duration of action.



First pass effect - CORRECT ANSWER a phenomenon of drug metabolism whereby
the concentration of a drug is greatly reduced before it reaches the systemic circulation. It is
the fraction of drug lost during the process of absorption which is generally related to the
liver and gut wall.



Does liver failure affect drug metabolism? - CORRECT ANSWER Liver failure does
affect metabolism of drugs



Drug excretion - CORRECT ANSWER elimination of drug from the body by kidneys
or bowel



What are the nurse's responsibilities for drug administration? - CORRECT
ANSWER Right drug, dose, route, patient, time, documentation (response or refusal),
reason



Prototype - CORRECT ANSWER The "lead agent" in the drug class. Ex. metoprolol is
prototype of beta-1 blockers



Federal Food and Drug Act - CORRECT ANSWER accurate labeling

,Durham-Humphrey Amendment - CORRECT ANSWER designated drugs that must be
prescribed by a physician and administered by a pharmacist



The comprehensive abuse and control act - CORRECT ANSWER regulated narcotics
and categorized



Orphan Drug Act - CORRECT ANSWER decreased taxes and competition that
affected drugs associated with rare diseases



Drug Approval - CORRECT ANSWER FDA regulates the process by which drugs are
researched and released to population.



Clinical trial phases - CORRECT ANSWER Phase I-a few doses are given to healthy
volunteers
Phase II-small doses are given to people with disease

Phase III-larger and more representative group of patients-- drug and placebo groups

Phase IV-allows drug to be marketed, company has to monitor and report adverse effects



Gram positive antibiotics - CORRECT ANSWER Penicillian, Cephalosporins



Gram negative antibiotics - CORRECT ANSWER Aminoglycosides



Broad spectrum antibiotics - CORRECT ANSWER Cephalosporins, Carbapenems,
Tetracyclines



Sulfonamide contraindications - CORRECT ANSWER Patients with a sulfa allergy



Sulfonamides uses - CORRECT ANSWER Inhibit bacteria; UTI, 2nd and 3rd degree
burns

,Sulfonamide drugs - CORRECT ANSWER trimethprim/sulfamethoxazole (Bactrim),

silver sulfadiazine (Silvadene) ointment



Sulfonamide adverse - CORRECT ANSWER N/V/D, allergic reaction



Penicillin uses - CORRECT ANSWER Works on Gram+ bacteria; strep, pneumococcal
pneumonia, endocarditis, meningitis, prevent endocarditis



Penicillin adverse - CORRECT ANSWER rash, anaphylaxis, neurotoxicity, GI
symptoms



Penicillin nursing - CORRECT ANSWER watch for Allergic reaction(rash), take on an
Empty stomach



Penicillin drugs - CORRECT ANSWER penicillin G

Amoxicillin
Ampicillin

tazobactam (Zosyn)



Cephalosporin uses - CORRECT ANSWER Bactericidal(kills bacteria), Inhibit cell
wall synthesis, Broad spectrum, Gram + /-(depending on generation) 5 generations of drugs(
as the go up in number they become more Gram- effective)

--surgical prophylaxis- SCIP, UTI, PCN resistant gonorrhea



Cephalosporin adverse - CORRECT ANSWER cross sensitivity w/ PCN, GI symptoms

-->Take most w/ food



Cephalosporin drugs + uses for specific ones - CORRECT ANSWER cefazolin
(Kefzol) - IV, 1st generation,

, cephalexin (Keflex) po

cefuroxime (Zinacef), 2nd generation

ceftriaxone (Rocephin), 3rd generation- ghonorrhea use

cefepime (Maxipime) 4th generation

ceftaroline (Teflaro) 5th generation: used for MRSA and Gram (-) infections



Carbapenem uses - CORRECT ANSWER Broad spectrum, bactericidal, Inhibit cell
wall synthesis

-- used in staph, E. coli (complicated body cavity/connective tissue infections)



Carbapenem adverse - CORRECT ANSWER Drug induced seizures( in children, rare),
related to PCN so check allergies



Carbapenem drug - CORRECT ANSWER imipenem cilastatin (Primaxin), IV



Macrolides uses - CORRECT ANSWER Bacteriostatic, bactericidal in large doses,
Inhibit protein synthesis

-- used in staph, strep, gonorrhea and chlamydia, URI



Macrolides adverse - CORRECT ANSWER GI, N/V, GI bleed



Macrolides drugs - CORRECT ANSWER erythromycin (E-mycin)

azithromycin (Zithromax)



Tetracycline uses - CORRECT ANSWER Broad spectrum, bacteriostatic, Gram +/-
organisms

-- Used for H pylori, chlamydia, PID, acne, syphilis



Tetracycline contra - CORRECT ANSWER renal failure, no use children <8yrs,
pregnancy