N316B Final Exam 2025 Questions and
Answers
Vincristine "vine to wine for my crabs/cancer" - ANS 1.Constipation - Slows peristalsis
(unique to vincr.)
2.Peripheral paresthesia - Must monitor for...
3. Push Fluids to help prevent constipation
Acetaminophen - ANS - It is for pain only, it has NO anti-inflammatory qualities
- Be careful w/ taking OTC that have Tyenol you can overdose
- Safe alternatives to NSAIDs
NSAIDs - ANS - Will tear your gut up, take w/ food
- Can cause bleeding everywhere
- Good for anti-inflammatory conditions (i.e. rheumatoid arthritis)
Aspirin (NSAID) - ANS - Hearing disturbances and tinnitus #1 sign w/ toxicity
- Same issue as NSAIDs (w/ bleeding, will slice up your gut but than other NSAIDs)
NSAID - Ibuprofen, naproxen, indomethacin - ANS - Gut issues (bleeding)
- Stop before surgery (bleeding)
- Great for inflammatory joint conditions
Pg. 1 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,PCAs & narcotic handling - ANS •ONLY the patient pushes the button
•Monitor for Respiratory Depression
•PCA & Narcotics:
•Two Nurses Always for wasting, and crosschecking
•Count not correct? STOP bring attention to Charge Nurse/Leadership
Morphine and all Narcotics - ANS •Monitor for decrease LOC & Respiration Rate, also do not
give if patient hypotensive
•Constipation a HUGE side effect, make sure they are on a GI bowel protocol.
•Specifically, Morphine is used for Chest Pain Angina
Hospice - ANS •Morphine/narcotics give at regular intervals NOT prn
•Hospice ok to give to unresponsive patients
•Reduce their pain during their final exit
Methadone - ANS •Used in inpatient wards when have known heroin user. Switches them
from illegal street drug to controlled legal narcotic.
•Still a narcotic but has longer duration than other opioids and does not produce same "high."
Thus used for those on Medicated Assisted Treatment (MAT) of opioid addiction.
•Controversial subject is whether opioid addicts should be completely off opioids or remain on
more controlled/safer opioid such as methadone or buprenorphine.
Nalaxone (Narcan) - ANS •Know its working when respiration rate increases.
•It wears off in an hour, so closely monitor patient for opioid relapse.
•It's available OTC, the "new epi pen", given to patients often who are just getting a couple of
percocets on discharge.
-cillin/ cef- - ANS ampicillin, penicillin, cephalosporin
Pg. 2 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
, purpose -cillin/cef- - ANS infection
classification -cillin/cef- - ANS beta lactam
"Anti-B"-cillins, Cef's- "Anti-B" - ANS 1.ALLERGIC!! Hives, edema, SOB, N/V, diarrhea...STOP
MED
2.Nephrotoxicity: can be dangerous for those w/ kidney dz; Monitor Creatinine & GFR, push
fluids (drink plenty of fluids)
3. Great for syphillis, drug probenecid aids PCN excretion, causing higher PCN levels kill syphilis
"Anti-B" - mycin & -micin - ANS 1.Nephrotoxicity: Above but worse, check BUN too, normal
10-20. Don't give with CKD
•The client has a history of chronic kidney disease? Consult with provider, before giving..
•"I need to call my provider if my urine changes."..Nephrotoxicity is the main adverse reaction
with Vancomycin, it's why we do peaks and troughs to make sure it is at the right level...
2.Peaks and Troughs Know it!
•Nephrotoxicity is associated with a trough level above 10 mcg/dl..
•Due to nephrotoxicity watch for Serum creatinine level..
•Any toxicity related to gentamicin be sure to follow serum creatinine..
•High serum creatinine? Call doc
•Also focus on BUN, Have Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)? Normal is 10-
20, Call Doc, mycin's effecting kidneys
3.Ototoxicity - Unique to the -mycin/-micin
•Ringing both ears? Stop infusion
•TB patient, hearing loss, probably a -mycin
•Risk for hearing impairment? -micin
Pg. 3 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
Answers
Vincristine "vine to wine for my crabs/cancer" - ANS 1.Constipation - Slows peristalsis
(unique to vincr.)
2.Peripheral paresthesia - Must monitor for...
3. Push Fluids to help prevent constipation
Acetaminophen - ANS - It is for pain only, it has NO anti-inflammatory qualities
- Be careful w/ taking OTC that have Tyenol you can overdose
- Safe alternatives to NSAIDs
NSAIDs - ANS - Will tear your gut up, take w/ food
- Can cause bleeding everywhere
- Good for anti-inflammatory conditions (i.e. rheumatoid arthritis)
Aspirin (NSAID) - ANS - Hearing disturbances and tinnitus #1 sign w/ toxicity
- Same issue as NSAIDs (w/ bleeding, will slice up your gut but than other NSAIDs)
NSAID - Ibuprofen, naproxen, indomethacin - ANS - Gut issues (bleeding)
- Stop before surgery (bleeding)
- Great for inflammatory joint conditions
Pg. 1 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,PCAs & narcotic handling - ANS •ONLY the patient pushes the button
•Monitor for Respiratory Depression
•PCA & Narcotics:
•Two Nurses Always for wasting, and crosschecking
•Count not correct? STOP bring attention to Charge Nurse/Leadership
Morphine and all Narcotics - ANS •Monitor for decrease LOC & Respiration Rate, also do not
give if patient hypotensive
•Constipation a HUGE side effect, make sure they are on a GI bowel protocol.
•Specifically, Morphine is used for Chest Pain Angina
Hospice - ANS •Morphine/narcotics give at regular intervals NOT prn
•Hospice ok to give to unresponsive patients
•Reduce their pain during their final exit
Methadone - ANS •Used in inpatient wards when have known heroin user. Switches them
from illegal street drug to controlled legal narcotic.
•Still a narcotic but has longer duration than other opioids and does not produce same "high."
Thus used for those on Medicated Assisted Treatment (MAT) of opioid addiction.
•Controversial subject is whether opioid addicts should be completely off opioids or remain on
more controlled/safer opioid such as methadone or buprenorphine.
Nalaxone (Narcan) - ANS •Know its working when respiration rate increases.
•It wears off in an hour, so closely monitor patient for opioid relapse.
•It's available OTC, the "new epi pen", given to patients often who are just getting a couple of
percocets on discharge.
-cillin/ cef- - ANS ampicillin, penicillin, cephalosporin
Pg. 2 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
, purpose -cillin/cef- - ANS infection
classification -cillin/cef- - ANS beta lactam
"Anti-B"-cillins, Cef's- "Anti-B" - ANS 1.ALLERGIC!! Hives, edema, SOB, N/V, diarrhea...STOP
MED
2.Nephrotoxicity: can be dangerous for those w/ kidney dz; Monitor Creatinine & GFR, push
fluids (drink plenty of fluids)
3. Great for syphillis, drug probenecid aids PCN excretion, causing higher PCN levels kill syphilis
"Anti-B" - mycin & -micin - ANS 1.Nephrotoxicity: Above but worse, check BUN too, normal
10-20. Don't give with CKD
•The client has a history of chronic kidney disease? Consult with provider, before giving..
•"I need to call my provider if my urine changes."..Nephrotoxicity is the main adverse reaction
with Vancomycin, it's why we do peaks and troughs to make sure it is at the right level...
2.Peaks and Troughs Know it!
•Nephrotoxicity is associated with a trough level above 10 mcg/dl..
•Due to nephrotoxicity watch for Serum creatinine level..
•Any toxicity related to gentamicin be sure to follow serum creatinine..
•High serum creatinine? Call doc
•Also focus on BUN, Have Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)? Normal is 10-
20, Call Doc, mycin's effecting kidneys
3.Ototoxicity - Unique to the -mycin/-micin
•Ringing both ears? Stop infusion
•TB patient, hearing loss, probably a -mycin
•Risk for hearing impairment? -micin
Pg. 3 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
