NSG 318 EXAM 4 2026 PRACTICE TEST PACK
COMPLETE SOLUTIONS VERIFIED INSIGHTS
◉ Fluconazole (Diflucan).
Answer: ↑ fungal membrane permeability; used for Candida
infections, cryptococcal meningitis, BMT 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).
◉ 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.
◉ Metronidazole (Flagyl).
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.
,◉ 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.
◉ 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).
◉ 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.
◉ 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.
, ◉ Metronidazole and Alcohol.
Answer: Alcohol must be avoided — combining alcohol with this
drug causes a disulfiram-like reaction (flushing, nausea, cramps).
◉ Fluconazole and Caffeine.
Answer: Avoid caffeine (e.g., coffee, green tea, energy drinks) due to
increased serum caffeine levels.
◉ Azithromycin and Grapefruit Juice.
Answer: Grapefruit juice and herbal CYP3A4 inhibitors may raise
risk of QT prolongation.
◉ General CAM Consideration.
Answer: Advise clients to inform healthcare providers of any herbal
or CAM use before starting antibiotics to avoid interactions or
hepatotoxicity.
◉ Age and Drug Effects.
Answer: Older adults = higher risk of hepatotoxicity/nephrotoxicity.
◉ Liver/Renal Function.
COMPLETE SOLUTIONS VERIFIED INSIGHTS
◉ Fluconazole (Diflucan).
Answer: ↑ fungal membrane permeability; used for Candida
infections, cryptococcal meningitis, BMT 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).
◉ 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.
◉ Metronidazole (Flagyl).
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.
,◉ 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.
◉ 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).
◉ 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.
◉ 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.
, ◉ Metronidazole and Alcohol.
Answer: Alcohol must be avoided — combining alcohol with this
drug causes a disulfiram-like reaction (flushing, nausea, cramps).
◉ Fluconazole and Caffeine.
Answer: Avoid caffeine (e.g., coffee, green tea, energy drinks) due to
increased serum caffeine levels.
◉ Azithromycin and Grapefruit Juice.
Answer: Grapefruit juice and herbal CYP3A4 inhibitors may raise
risk of QT prolongation.
◉ General CAM Consideration.
Answer: Advise clients to inform healthcare providers of any herbal
or CAM use before starting antibiotics to avoid interactions or
hepatotoxicity.
◉ Age and Drug Effects.
Answer: Older adults = higher risk of hepatotoxicity/nephrotoxicity.
◉ Liver/Renal Function.
