NSG 251 Final Exam Questions and
Complete Solutions Graded A+
Rank speed of absorption: Po, IM, IV - Answer: Po slowest, then IM, IV fastest
Describe drug distribution in relation to protein binding - 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 - 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? - Answer: Liver failure does affect metabolism of drugs
Drug excretion - Answer: elimination of drug from the body by kidneys or bowel
What are the nurse's responsibilities for drug administration? - Answer: Right drug, dose, route, patient,
time, documentation (response or refusal), reason
Prototype - Answer: The "lead agent" in the drug class. Ex. metoprolol is prototype of beta-1 blockers
Federal Food and Drug Act - Answer: accurate labeling
Durham-Humphrey Amendment - Answer: designated drugs that must be prescribed by a physician and
administered by a pharmacist
The comprehensive abuse and control act - Answer: regulated narcotics and categorized
,Orphan Drug Act - Answer: decreased taxes and competition that affected drugs associated with rare
diseases
Drug Approval - Answer: FDA regulates the process by which drugs are researched and released to
population.
Clinical trial phases - 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 - Answer: Penicillian, Cephalosporins
Gram negative antibiotics - Answer: Aminoglycosides
Broad spectrum antibiotics - Answer: Cephalosporins, Carbapenems, Tetracyclines
Sulfonamide contraindications - Answer: Patients with a sulfa allergy
Sulfonamides uses - Answer: Inhibit bacteria; UTI, 2nd and 3rd degree burns
Sulfonamide drugs - Answer: trimethprim/sulfamethoxazole (Bactrim),
silver sulfadiazine (Silvadene) ointment
Sulfonamide adverse - Answer: N/V/D, allergic reaction
Penicillin uses - Answer: Works on Gram+ bacteria; strep, pneumococcal pneumonia, endocarditis,
meningitis, prevent endocarditis
,Penicillin adverse - Answer: rash, anaphylaxis, neurotoxicity, GI symptoms
Penicillin nursing - Answer: watch for Allergic reaction(rash), take on an Empty stomach
Penicillin drugs - Answer: penicillin G
Amoxicillin
Ampicillin
tazobactam (Zosyn)
Cephalosporin uses - 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 - Answer: cross sensitivity w/ PCN, GI symptoms
-->Take most w/ food
Cephalosporin drugs + uses for specific ones - 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 - Answer: Broad spectrum, bactericidal, Inhibit cell wall synthesis
-- used in staph, E. coli (complicated body cavity/connective tissue infections)
Carbapenem adverse - Answer: Drug induced seizures( in children, rare), related to PCN so check
allergies
, Carbapenem drug - Answer: imipenem cilastatin (Primaxin), IV
Macrolides uses - Answer: Bacteriostatic, bactericidal in large doses, Inhibit protein synthesis
-- used in staph, strep, gonorrhea and chlamydia, URI
Macrolides adverse - Answer: GI, N/V, GI bleed
Macrolides drugs - Answer: erythromycin (E-mycin)
azithromycin (Zithromax)
Tetracycline uses - Answer: Broad spectrum, bacteriostatic, Gram +/- organisms
-- Used for H pylori, chlamydia, PID, acne, syphilis
Tetracycline contra - Answer: renal failure, no use children <8yrs, pregnancy
Tetracycline adverse - Answer: Discoloration of permanent teeth, GI, rashes
Tetracycline drugs - Answer: doxycycline (Vibramycin)
**increase resistance of this drug so decreased use
**related to PCN so watch for allergic reactions
Aminoglycoside uses - Answer: Bactericidals, Inhibit protein synthesis
--used for serious gram neg. infections, preoperatively for GI/GU tract surgeries
Aminoglycoside contra - Answer: pregnancy
Aminoglycoside adverse - Answer: nephrotoxic and ototoxic