NSG 318 Exam 4- Pharmacology|
Reviewed 2026/2027| 174 Real Questions
and Correct Detailed Answers with
Clinical Rationales| Guaranteed Pass
1. Nystatin (myostatin) - Answer✔️-binds sterols, causing cell leakage; used
for candidiasis (oral, vaginal, skin); side effects include gi upset (oral), skin
irritation (topical); adverse effects include, tachycardia, bronchospasm;
nursing considerations include swish/swallow or apply thin layer.
2. Fluconazole (Diflucan) - Answer✔️-↑ fungal membrane permeability; used
for candida infections, cryptococcal meningitis, prophylaxis; side effects
include gi upset, headache, rash, hypokalemia; adverse effects include
hepatic/renal failure, sjs, fatal arrhythmias; nursing considerations include
monitoring lfts and avoiding alcohol and caffeine (↑ levels).
3. Acyclovir (Zovirax) - Answer✔️-inhibits viral dna polymerase; used for
herpes simplex, varicella; side effects include gi upset, pruritus, tremors;
adverse effects include nephrotoxicity, blood dyscrasias, seizures; nursing
considerations include increasing fluids and monitoring kidney function.
4. Metronidazole (flaggy) - Answer✔️-disrupts dna synthesis (anaerobes);
used for gi infections, h. Pylori, c. Diff, vaginitis; side effects include
metallic taste, dizziness, flushing; adverse effects include neuropathy,
seizures; nursing considerations include no alcohol (disulfiram reaction) and
monitoring lfts, bun, platelets.
5. Ivermectin (Stromectol) - Answer✔️-destroys parasitic worms; used for
roundworms, scabies, strongyloidiasis; side effects include pruritus,
dizziness, gi upset; adverse effects are rare - seizures, hypotension; nursing
considerations include assessing travel and food history and teaching hand
hygiene and safe food prep.
6. Ceftriaxone - Answer✔️-3rd-generation cephalosporin; inhibits cell wall
synthesis → cell lysis (bactericidal); used for om, meningitis, gonorrhea,
, surgical prophylaxis, uti, skin & bone infections; major adverse effects
include seizures, sjs, nephrotoxicity, superinfection (c. Diff).
7. Levofloxacin - Answer✔️-fluoroquinolone; inhibits dna gyrase → prevents
dna replication (bactericidal); used for skin, bone, respiratory, urinary,
gynecologic infections; anthrax, plague; major adverse effects include
seizures, sjs, dysrhythmias, hepatotoxicity, suicidal ideation.
8. Metronidazole (peptide/antiprotozoal) - Answer✔️-disrupts dna synthesis in
anaerobic bacteria → cell death; used for h. Pylori, anaerobic gi infections,
c. Diff, vaginitis; major adverse effects include seizures, peripheral
neuropathy, optic nerve damage.
9. Metronidazole and alcohol - Answer✔️-alcohol must be avoided —
combining alcohol with this drug causes a disulfiram-like reaction (flushing,
nausea, cramps).
10.Fluconazole and caffeine - Answer✔️-avoid caffeine (e.g., coffee, green tea,
energy drinks) due to increased serum caffeine levels.
11.Azithromycin and grapefruit juice - Answer✔️-grapefruit juice and herbal
cyp3a4 inhibitors may raise risk of qt prolongation.
12.General cam consideration - Answer✔️-advise clients to inform healthcare
providers of any herbal or cam use before starting antibiotics to avoid
interactions or hepatotoxicity.
13.Assessment in nursing process - Answer✔️-bowel/bladder patterns, history
of ulcers, Gerd, fertility, or prostate issues
14.Diagnosis examples - Answer✔️-risk for constipation/diarrhea, risk for fluid
volume deficit, imbalanced nutrition, ineffective coping (infertility)
15.Planning/implementation - Answer✔️-give sucralfate on empty stomach,
increase fluids/fiber with laxatives or antispasmodics, monitor qt interval
(Solifenacin), educate on drug timing, side effects, non-pharm options
Reviewed 2026/2027| 174 Real Questions
and Correct Detailed Answers with
Clinical Rationales| Guaranteed Pass
1. Nystatin (myostatin) - Answer✔️-binds sterols, causing cell leakage; used
for candidiasis (oral, vaginal, skin); side effects include gi upset (oral), skin
irritation (topical); adverse effects include, tachycardia, bronchospasm;
nursing considerations include swish/swallow or apply thin layer.
2. Fluconazole (Diflucan) - Answer✔️-↑ fungal membrane permeability; used
for candida infections, cryptococcal meningitis, prophylaxis; side effects
include gi upset, headache, rash, hypokalemia; adverse effects include
hepatic/renal failure, sjs, fatal arrhythmias; nursing considerations include
monitoring lfts and avoiding alcohol and caffeine (↑ levels).
3. Acyclovir (Zovirax) - Answer✔️-inhibits viral dna polymerase; used for
herpes simplex, varicella; side effects include gi upset, pruritus, tremors;
adverse effects include nephrotoxicity, blood dyscrasias, seizures; nursing
considerations include increasing fluids and monitoring kidney function.
4. Metronidazole (flaggy) - Answer✔️-disrupts dna synthesis (anaerobes);
used for gi infections, h. Pylori, c. Diff, vaginitis; side effects include
metallic taste, dizziness, flushing; adverse effects include neuropathy,
seizures; nursing considerations include no alcohol (disulfiram reaction) and
monitoring lfts, bun, platelets.
5. Ivermectin (Stromectol) - Answer✔️-destroys parasitic worms; used for
roundworms, scabies, strongyloidiasis; side effects include pruritus,
dizziness, gi upset; adverse effects are rare - seizures, hypotension; nursing
considerations include assessing travel and food history and teaching hand
hygiene and safe food prep.
6. Ceftriaxone - Answer✔️-3rd-generation cephalosporin; inhibits cell wall
synthesis → cell lysis (bactericidal); used for om, meningitis, gonorrhea,
, surgical prophylaxis, uti, skin & bone infections; major adverse effects
include seizures, sjs, nephrotoxicity, superinfection (c. Diff).
7. Levofloxacin - Answer✔️-fluoroquinolone; inhibits dna gyrase → prevents
dna replication (bactericidal); used for skin, bone, respiratory, urinary,
gynecologic infections; anthrax, plague; major adverse effects include
seizures, sjs, dysrhythmias, hepatotoxicity, suicidal ideation.
8. Metronidazole (peptide/antiprotozoal) - Answer✔️-disrupts dna synthesis in
anaerobic bacteria → cell death; used for h. Pylori, anaerobic gi infections,
c. Diff, vaginitis; major adverse effects include seizures, peripheral
neuropathy, optic nerve damage.
9. Metronidazole and alcohol - Answer✔️-alcohol must be avoided —
combining alcohol with this drug causes a disulfiram-like reaction (flushing,
nausea, cramps).
10.Fluconazole and caffeine - Answer✔️-avoid caffeine (e.g., coffee, green tea,
energy drinks) due to increased serum caffeine levels.
11.Azithromycin and grapefruit juice - Answer✔️-grapefruit juice and herbal
cyp3a4 inhibitors may raise risk of qt prolongation.
12.General cam consideration - Answer✔️-advise clients to inform healthcare
providers of any herbal or cam use before starting antibiotics to avoid
interactions or hepatotoxicity.
13.Assessment in nursing process - Answer✔️-bowel/bladder patterns, history
of ulcers, Gerd, fertility, or prostate issues
14.Diagnosis examples - Answer✔️-risk for constipation/diarrhea, risk for fluid
volume deficit, imbalanced nutrition, ineffective coping (infertility)
15.Planning/implementation - Answer✔️-give sucralfate on empty stomach,
increase fluids/fiber with laxatives or antispasmodics, monitor qt interval
(Solifenacin), educate on drug timing, side effects, non-pharm options
