NURS 5663 BUNDLE COMPREHENSIVE
STUDY GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ Reactions may be caused by overdose: Digoxin.
Answer: 1. Symptoms: GI: N/V/D; Xanthopsia: blurry, objects appear
yellow; Cardiovascular: arrhythmias, AV blocks; Blood test: Hyperkalemia
(poor prognosis)
◍ General characteristics of Insulin.
Answer: - small protein that contains 51 amino acids arranged in 2 chains (A
& B) linked by disulfide bridges.- stored in beta cells of pancreas in form of
hexameric crystals1. Entire human pancreas stores up to 8mg (200 units) of
insulin.- Insulin is released from pancreatic beta cells at a low BASAL rate
--> plus with stimulation releases at a much higher rate
◍ Contraindications of Glucagon.
Answer: a. Pheochromocytoma → can cause release of catecholamines and
increase BPb. Patients with insulinoma→ can cause rebound hypoglycemia
◍ Insulin Inhibitory drugs:.
Answer: diazoxide, phenytoin, vinblastine, clonidine, verapamil, and
colchicine
◍ Antifungals: Flucytosine.
Answer: Characteristics: Water soluble pyrimidine analog rt the
chemotherapeutic agent 5-fluorouracil (5-FU) Narrow spectrum; Narrow
therapeutic windowMOA: Enters fungal cell via cytosine permeaseClinical
Use: Treat severe candida & cryptococcus infectionsAdverse
Reactions:Result from metabolism to the toxic antienoplastic compound.
Bone marrow toxicity → anemia, leukopenia, & thrombocytopenia
, (common). Derangement of liver enzymes (less frequently). Enterocolitis.
◍ What are the steps to resolving ethical dilemmas?.
Answer: Validate feelings, conduct case analysis, consider options, identify
outcomes, clarify accountabilities, follow through, and evaluate impact.
◍ What does beneficence mean in healthcare ethics?.
Answer: Acting in ways that benefit the patient, such as providing pain relief
and emotional support.
◍ What is a sentinel event?.
Answer: A serious injury or death caused by an error that must be reported
to TJC and state agencies.
◍ What is the focus of Doctor of Nursing Practice (DNP) programs?.
Answer: Advanced clinical practice, leadership, and research application
◍ Why is patient safety important?.
Answer: Preventable medical errors were the 4th highest cause of death in
hospitals in 2020.
◍ Antifungals: Azoles.
Answer: Characteristics: Broad spectrum. Divided into two groups:
Imidazoles with two nitrogens in azole ring & Triazoles with three
nitrogrens in ringTriazoles have fewer side effects, better drug distribution
& fewer drug interactionsMAO: inhibit synthesis of ergosterol by inhibiting
the 14-a-demethylase enzymeClinical Use: Used in treatment of intrinsically
amphotericin-resistant organisms (P. boydii) Itraconazole - treatment of
dermatophytoses & onychomycosis. Fluconazole - treatment & secondary
prophylaxis of cryptococcal meningitisAdverse Reactions:Minor GI upset
(common). Abnormalities in liver enzymes. Hepatitis (rarely). Itraconazole
taken with Rifamycins to reduce drug interactions. Voriconazole: rash,
elevated hepatic enzymes, visual disturbances (common), photosensitivit
dermatitis (common), skin cancers. Fluorosis (rare). Posaconazole -
hyperaldosteronism → cause HTN & Hypokalemia (rare)
◍ What are common patient safety risks?.
, Answer: Medication errors, bloodborne exposures, back injuries, and unsafe
equipment.
◍ What is Evidence-Based Practice (EBP) in nursing?.
Answer: Using the best available evidence combined with clinical expertise
and patient preferences to guide care.
◍ What are examples of behaviors that can lead to Board of Nursing action?.
Answer: Drug diversion, abuse, and sexual contact with a patient.
◍ One mechanism of stimulated insulin release.
Answer: 1. in resting cell: normal (low) ATP levels→ K+ diffuses down its
concentration gradient through ATP-gated K+ channels, maintaining the
intracellular potential @fully polarized, negative level→ insulin release is
minimal2. if glucose concentration rises → ATP production increases → K+
channels close --> depolarization results → in muscle/nerve voltage-gated
Ca2+ channels open in response to depolarization --> allows more Ca2+ to
enter cell --> increased intracellular Ca2+ results in increased insulin
secretion → insulin secretagugues close the ATP-dependent K+ channel→
depolarizes membrane→ increased insulin release by same mechanism
◍ Insulin Definition.
Answer: the storage and anabolic hormone of the body
◍ Adverse Effects of Glucocorticoids: Infections.
Answer: - D/t immune suppression
◍ What is a near miss in healthcare?.
Answer: An error that almost happened but did not reach the patient.
◍ What are the five core competencies of nursing?.
Answer: Person-centered care, interprofessional collaboration,
evidence-based practice (EBP), quality and safety, informatics and
technology.
◍ Hepatitis C virus (HCV) & Hepatitis B (HBV).
Answer: Characteristics: Proteins that target drug therapy → NS5A: viral
, protein essential for replication & new virus assembly; NS3/4A protease:
essential for life cycle of virus; NS5b: RNA-dependent RNA
polymeraseHep B acute treatment - no specific, most often resolve
spontaneously.MOA: Hepetitis C - NS5A inhibitors: NS5A protein plays a
role in both viral replication and the assembly of HCV; MOA remains
unclear.Adverse Reactions:Preferred drugs for chronic Hep BEntecavir -
HA, fatigue, upper abdominal pain, lactic acidosisTenofovir alafenamide
fumarate - N/D, abdominal pain, dizziness, fatigue, nephropathy, lactic
acidosisTenofovir disoproxil - N/D, abdominal pain, nephropathy, Fanconi
syndrome, osteomalacia, lactic acidosisPegylated interferon alfa-2a -
Flu-like sx, fatigue, mood disturbances, cytopenias, autoimmune disorders.
◍ What organization did Clara Barton organize in 1882?.
Answer: The National Red Cross
◍ How does Maslow's Hierarchy of Human Needs apply to nursing?.
Answer: It helps prioritize patient needs from basic survival to fullest
potential.
◍ What is safety science?.
Answer: It examines the nature of safety, causes of errors, and systems that
keep patients safe.
◍ Considerations in drug administration of the Elderly.
Answer: Absorption - Conditions associated with age may alter the rate at
which some drugs are absorbed. Including: altered nutritional habits, greater
consumption of nonprescription drugs (antacids & laxatives), & changes in
gastric emptying (slower in older people, esp in DM)Distribution - reduced
lean body mass, reduced body water, & increased fat as a percentage of
body mass. Decrease in serum albumin (binds many drugs). Increase in
serum orosomucoid (binds basic drugs). Ex: loading dose of digoxin in
elderly with heart failure should be reduced (if used at all) bc of decreased
apparent volume of distribution. The maintenance dose may need to be
reduced bc of reduced clearance of drugMetabolism - Capacity of liver to
metabolize drugs declines with age for some drugs. Greatest changes are in
STUDY GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ Reactions may be caused by overdose: Digoxin.
Answer: 1. Symptoms: GI: N/V/D; Xanthopsia: blurry, objects appear
yellow; Cardiovascular: arrhythmias, AV blocks; Blood test: Hyperkalemia
(poor prognosis)
◍ General characteristics of Insulin.
Answer: - small protein that contains 51 amino acids arranged in 2 chains (A
& B) linked by disulfide bridges.- stored in beta cells of pancreas in form of
hexameric crystals1. Entire human pancreas stores up to 8mg (200 units) of
insulin.- Insulin is released from pancreatic beta cells at a low BASAL rate
--> plus with stimulation releases at a much higher rate
◍ Contraindications of Glucagon.
Answer: a. Pheochromocytoma → can cause release of catecholamines and
increase BPb. Patients with insulinoma→ can cause rebound hypoglycemia
◍ Insulin Inhibitory drugs:.
Answer: diazoxide, phenytoin, vinblastine, clonidine, verapamil, and
colchicine
◍ Antifungals: Flucytosine.
Answer: Characteristics: Water soluble pyrimidine analog rt the
chemotherapeutic agent 5-fluorouracil (5-FU) Narrow spectrum; Narrow
therapeutic windowMOA: Enters fungal cell via cytosine permeaseClinical
Use: Treat severe candida & cryptococcus infectionsAdverse
Reactions:Result from metabolism to the toxic antienoplastic compound.
Bone marrow toxicity → anemia, leukopenia, & thrombocytopenia
, (common). Derangement of liver enzymes (less frequently). Enterocolitis.
◍ What are the steps to resolving ethical dilemmas?.
Answer: Validate feelings, conduct case analysis, consider options, identify
outcomes, clarify accountabilities, follow through, and evaluate impact.
◍ What does beneficence mean in healthcare ethics?.
Answer: Acting in ways that benefit the patient, such as providing pain relief
and emotional support.
◍ What is a sentinel event?.
Answer: A serious injury or death caused by an error that must be reported
to TJC and state agencies.
◍ What is the focus of Doctor of Nursing Practice (DNP) programs?.
Answer: Advanced clinical practice, leadership, and research application
◍ Why is patient safety important?.
Answer: Preventable medical errors were the 4th highest cause of death in
hospitals in 2020.
◍ Antifungals: Azoles.
Answer: Characteristics: Broad spectrum. Divided into two groups:
Imidazoles with two nitrogens in azole ring & Triazoles with three
nitrogrens in ringTriazoles have fewer side effects, better drug distribution
& fewer drug interactionsMAO: inhibit synthesis of ergosterol by inhibiting
the 14-a-demethylase enzymeClinical Use: Used in treatment of intrinsically
amphotericin-resistant organisms (P. boydii) Itraconazole - treatment of
dermatophytoses & onychomycosis. Fluconazole - treatment & secondary
prophylaxis of cryptococcal meningitisAdverse Reactions:Minor GI upset
(common). Abnormalities in liver enzymes. Hepatitis (rarely). Itraconazole
taken with Rifamycins to reduce drug interactions. Voriconazole: rash,
elevated hepatic enzymes, visual disturbances (common), photosensitivit
dermatitis (common), skin cancers. Fluorosis (rare). Posaconazole -
hyperaldosteronism → cause HTN & Hypokalemia (rare)
◍ What are common patient safety risks?.
, Answer: Medication errors, bloodborne exposures, back injuries, and unsafe
equipment.
◍ What is Evidence-Based Practice (EBP) in nursing?.
Answer: Using the best available evidence combined with clinical expertise
and patient preferences to guide care.
◍ What are examples of behaviors that can lead to Board of Nursing action?.
Answer: Drug diversion, abuse, and sexual contact with a patient.
◍ One mechanism of stimulated insulin release.
Answer: 1. in resting cell: normal (low) ATP levels→ K+ diffuses down its
concentration gradient through ATP-gated K+ channels, maintaining the
intracellular potential @fully polarized, negative level→ insulin release is
minimal2. if glucose concentration rises → ATP production increases → K+
channels close --> depolarization results → in muscle/nerve voltage-gated
Ca2+ channels open in response to depolarization --> allows more Ca2+ to
enter cell --> increased intracellular Ca2+ results in increased insulin
secretion → insulin secretagugues close the ATP-dependent K+ channel→
depolarizes membrane→ increased insulin release by same mechanism
◍ Insulin Definition.
Answer: the storage and anabolic hormone of the body
◍ Adverse Effects of Glucocorticoids: Infections.
Answer: - D/t immune suppression
◍ What is a near miss in healthcare?.
Answer: An error that almost happened but did not reach the patient.
◍ What are the five core competencies of nursing?.
Answer: Person-centered care, interprofessional collaboration,
evidence-based practice (EBP), quality and safety, informatics and
technology.
◍ Hepatitis C virus (HCV) & Hepatitis B (HBV).
Answer: Characteristics: Proteins that target drug therapy → NS5A: viral
, protein essential for replication & new virus assembly; NS3/4A protease:
essential for life cycle of virus; NS5b: RNA-dependent RNA
polymeraseHep B acute treatment - no specific, most often resolve
spontaneously.MOA: Hepetitis C - NS5A inhibitors: NS5A protein plays a
role in both viral replication and the assembly of HCV; MOA remains
unclear.Adverse Reactions:Preferred drugs for chronic Hep BEntecavir -
HA, fatigue, upper abdominal pain, lactic acidosisTenofovir alafenamide
fumarate - N/D, abdominal pain, dizziness, fatigue, nephropathy, lactic
acidosisTenofovir disoproxil - N/D, abdominal pain, nephropathy, Fanconi
syndrome, osteomalacia, lactic acidosisPegylated interferon alfa-2a -
Flu-like sx, fatigue, mood disturbances, cytopenias, autoimmune disorders.
◍ What organization did Clara Barton organize in 1882?.
Answer: The National Red Cross
◍ How does Maslow's Hierarchy of Human Needs apply to nursing?.
Answer: It helps prioritize patient needs from basic survival to fullest
potential.
◍ What is safety science?.
Answer: It examines the nature of safety, causes of errors, and systems that
keep patients safe.
◍ Considerations in drug administration of the Elderly.
Answer: Absorption - Conditions associated with age may alter the rate at
which some drugs are absorbed. Including: altered nutritional habits, greater
consumption of nonprescription drugs (antacids & laxatives), & changes in
gastric emptying (slower in older people, esp in DM)Distribution - reduced
lean body mass, reduced body water, & increased fat as a percentage of
body mass. Decrease in serum albumin (binds many drugs). Increase in
serum orosomucoid (binds basic drugs). Ex: loading dose of digoxin in
elderly with heart failure should be reduced (if used at all) bc of decreased
apparent volume of distribution. The maintenance dose may need to be
reduced bc of reduced clearance of drugMetabolism - Capacity of liver to
metabolize drugs declines with age for some drugs. Greatest changes are in
