Final Exam
Study Guide and Blueprint
Types of Questions: Multiple Choice (49), 1 select all that apply
2 Points Per Question
Please refer to Chapter objectives
Chapter Chapter Number of Client Blooms Integrated
Objectives Questions Needs Process
17 3,4,5 &6 5 5-PHI 2-AN NP-5
2-UD
1 AP
41 1,5,6,7,9 7 5-PHI 1-UD NP-5
4-AP T/L-2
42 2,4, 5, 6 6 8- PHI 4-AP NP-4
1-AN T/L-2
1-UD
43 3, 4, 5, 6, 6 5-PHI 4-AP NP-5
1-UD T/L-1
44 1, 2,3, 4,5 5 4-PHI 4-AP NP-4
T/L-1
45 1,2, 3,5,6 8 9- PHI 6-AP NP-7
1-UD T/L-1
1-AN
23 1,2,3,4,5 3 PHI-3 2- APP NP-3
1-UD
24 2,3,4,5, 2 PHI-1 1-APP NP-1
1-UD T/L-1
25 2,3,4 2 PHI 1 AN NP-2
1UD
39 1,2,3 3 PHI 1UD NP-3
2 APP
40 4,5,6 3 PHI APP-3 NP-3
Total Questions 50
Client Needs
, 1. SE- Safe and Effective Care Environment Blooms Taxonomy
2. PHI-Physiological Integrity AP-Apply
3. HP-Health Promotion UD- Understanding
AN-Analyze
Integrated Process
NP- Nursing Process
T/L -Teaching Learning
Know the following medications: Indications, Side Effects, Nursing Implications, labs,
and Patient Education for the following drug classes (Prototypes)- Refer to the boxes for
Pt. teaching guidelines for these medications.
Amphotericin B
- Drug class: polyene; acts against most types of pathogenic fungi and is fungicidal
or fungistatic, depending on the concentration in body fluids and the susceptibility
of the causative fungus. ONLY for serious systemic fungal infections
(candidiasis, histoplasmosis, cutaneous/oral candidiasis). Given for 4-12 weeks.
- Uses: for patients with progressive and potentially fatal infections resulting from
cryptococcosis, North American blastomycosis, systemic candidiasis,
disseminated moniliasis, coccidioidomycosis, and histoplasmosis. ALSO
mucormycosis caused by the species of Mucor, Rhizopus, Absidia, Conidiobolus,
and Basidiobolus; sporotrichosis; and aspergillosis. The drug is also given as an
adjunctive agent in the treatment of American mucocutaneous leishmaniasis.
- Adverse effects: multiple organ failure, respiratory arrest, and cardiac arrest;
nausea, vomiting, dyspepsia, bleeding; hypokalemia azotemia, kidney failure;
leukopenia, thrombocytopenia; hyperkalemia, hypomagnesemia, hyponatremia.
- Nursing implications: preventing drug interactions (antibiotics bc of
nephrotoxicity; antineoplastic agents bc of kidney toxicity, bronchospasm, and
hypotension; cardiac glycosides bc of the increase risk of digitalis toxicity),
Administering the drug (infuse within 8 hrs of reconstitution, give pt a test dose to
assess tolerance for the drug; IV form: give in 5% dextrose in water over 2 to 6
hours with the use of in-line filter, DO NOT mix with other meds; Abelcet: give
over 2 hrs w/out an in-line filter. Cream/lotion: apply liberally to skin lesions and
rub in gently. PRIOR: obtain culture of infection and administer aspirin,
antihistamines, and antiemetics to manage adverse effects. MONITOR injection
sites for phlebitis. ASSESS sodium balance throughout treatment), Assessing for
therapeutic effects (assess for decrease in symptoms of fungal infections),
Assessing for AE (ASSESS for severe chilling, headaches, malaise, nausea,
vomiting, and generalized pain; MONITOR for hypokalemia and hyponatremia;
ASSESS for phlebitis and thrombophlebitis)
- Pt Teaching: effects takes several weeks; use good hygiene to prevent reinfection
or spread of infection; the home should be kept meticulously clean and free of
mold-producing substances, such as potted plants, fresh flowers, and adhesive
nonslip bathtub appliques; the bathroom should be cleaned daily with bleach, and
air conditioning and air filtration systems should be kept clean; eat small frequent
meals; topical may cause staining of clothes, report skin irritations; report fever
chills, muscle aches, and headache
Nystatin
- Drug class: polyenes
- Uses: ONLY for candidiasis of skin, mucous membrane, and intestinal tract (PO,
topical, intravaginally) because it is too toxic for systemic use.