1141 Exam 3 EAQ's

Which antiprotozoal drug is effective for the treatment of trichomoniasis? 1 Iodoquinol 2 Atovaquone 3 Pentamidine 4 Metronidazole

4 Metronidazole Metronidazole is the antiprotozoal drug that is effective for the treatment of trichomoniasis. Iodoquinol is effective for the treatment of amebiasis. Atovaquone is effective for the treatment of pneumocystosis. Pentamidine is effective for the treatment of pneumocystosis.

A patient with TB has been taking antitubercular drugs. A sputum culture is ordered to test for acid-fast bacilli. When is the best time for the nurse to obtain the sputum culture? In the morning Noon 5 pm 10 pm

In the morning

A patient with gout asks the nurse about the mechanism of action of the antigout drugs. What should the nurse tell the patient? 1 "It increases the red blood cells." 2 "It decreases the fatty acid level." 3 "It increases the blood oxygen level." 4 "It decreases the serum uric acid level."

4 "It decreases the serum uric acid level."

Before administration of primaquine, it is most important for the nurse to assess the patient for a history of which condition? Asthma Diabetes mellitus Hypertension Rheumatoid arthritis

Rheumatoid arthritis

What is the MOST common drug used to treat oral candidiasis? A. Oseltamivir (Tamiflu) B. Nystatin (Mycostatin) C. Amantadine (Symmetrel) D. Griseofulvin (Fulvicin P/G)

B. Nystatin (Mycostatin) Nystatin is an antifungal drug that is used for a variety of candidal infections. It is applied topically as a cream, ointment, or powder. It is also available as a troche and an oral liquid or tablet.

The nurse would question a prescription for voriconazole (Vfend) if the client was taking which medication? U. Quinidine V. Prednisone (Deltasone) W. Captopril (Capoten) X. Clindamycin (Cleocin)

U. Quinidine The nurse would question a prescription for quinidine because both voriconazole and quinidine are metabolized by the cytochrome P-450 enzyme system. The drugs will compete for the limited number of enzymes, and one of the drugs will end up accumulating.

When assessing for adverse effects to Rifamate (combination isoniazid and rifampin), the nurse would monitor which laboratory values? (Select all that apply.) U. Cholesterol V. Uric acid levels W. Sputum cultures X. Liver function tests Y. Complete blood cell count

X. Liver function tests Y. Complete blood cell count

The nurse is teaching a client who is preparing to travel to a malarious country about the prophylactic medication chloroquine (Aralen). The nurse would instruct the client to take this drug for how long after leaving the affected area? A. 2 weeks B. 4 weeks C. 8 weeks D. 12 weeks

C. 8 weeks Treatment for malaria prophylaxis is usually started 2 weeks before travel and continues for 8 weeks after travel is completed.

The nurse anticipates the patient with giardiasis to exhibit which of the following manifestations? Difficulty breathing Foul smelling vaginal discharge Red rash on the skin Diarrhea, bloating, and foul-smelling stools

Diarrhea, bloating, and foul-smelling stools

A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? Increased bleeding tendencies Increased chance for GI bleeding Increased nephrotoxic effects Reduced anti-inflammatory effects of the NSAID

Increased chance for GI bleeding

A patient with a diagnosis of TB will be taking INH as part of the anti-TB therapy. When reviewing the patient's chart, the nurse finds documentation that the patient is a "slow acetylator." This means that: the dosage of INH may need to be lower to prevent INH accumulation. the dosage of INH may need to be higher because of the slow acetylation process. he should not take INH. he will need to take a combination of anti-TB drugs for successful therapy.

the dosage of INH may need to be lower to prevent INH accumulation.

The patient's wife is taking rifampin to prevent her from developing a TB infection. Which statement by the wife indicates that further teaching is needed? "Because my oral contraceptives will not work while I am taking rifampin, I will use another form of birth control." "I will take the medication for 1 week and then stop." "I will avoid prolonged exposure to the sun." "My urine may turn a reddish color when taking rifampin."

"I will take the medication for 1 week and then stop."

What is advantage of COX-2 inhibitors over other NSAIDs? M. Maintain GI mucosa N. Have a longer duration of action O. Have a more rapid onset of action P. Are less likely to cause hepatic toxicity

M. Maintain GI mucosa By not inhibiting the COX-1 enzyme to maintain an intact gastric mucosal barrier by increasing secretion of mucus, the risks of GI adverse effects are decreased.

What is the common drug-induced adverse effect of caspofungin? 1 Leukopenia 2 Bradycardia 3 Hypertension 4 Nephrotoxicity

1 Leukopenia Caspofungin has potential drug-induced adverse effects, such as leukopenia. It also causes tachycardia and hypotension, but not bradycardia or hypertension. Nephrotoxicity is an adverse effect of amphotericin B.

A patient who is receiving an oral anticoagulant is started on fluconazole to treat a fungal infection. What possible drug interaction could occur in this patient? 1 Risk of bleeding 2 Risk of thrombosis 3 No drug interaction 4 Fluconazole toxicity

1 Risk of bleeding Fluconazole increases the effects of anticoagulants, and thus the patient is at risk of bleeding. Fluconazole does not increase the risk of thrombosis. The interaction of fluconazole and anticoagulants does not cause fluconazole toxicity.

Which assessment finding indicates that the nonsteroidal antiinflammatory drug has been effective? 1 PTT is 100 seconds. 2 Patient's bleeding time is prolonged. 3 Patient has increased circulation to his legs. 4 Pain has decreased from a "6" to a "1" on a scale of 10.

4 Pain has decreased from a "6" to a "1" on a scale of 10. Prostaglandins are produced in response to activation of the arachidonic acid pathway. Nonsteroidal antiinflammatory drugs (NSAIDs) work by blocking cyclooxygenase, the enzyme responsible for conversion of arachidonic acid into prostaglandins. Decreasing the synthesis of prostaglandins results in decreased pain and inflammation. The length of the PTT, the bleeding time, and the increased extremity circulation will not necessarily be correlated with the effectiveness of the NSAID medication.

Which precaution should the nurse follow while administering caspofungin to a patient with impaired liver function? 1 Injecting the caspofungin slowly 2 Reducing the dose of caspofungin 3 Replacing caspofungin with another drug 4 Administering caspofungin along with antihistamines

2 Reducing the dose of caspofungin Caspofungin is an echinocandin antifungal drug that is used for the treatment of severe Aspergillus infection. The dose of caspofungin is reduced in a patient who has impaired liver function to prevent further liver damage. The dose does not need to be injected slowly. The best precaution is to reduce the dose of caspofungin and not to replace it or give another drug along with it.

What will the nurse teach patients taking rifampin and isoniazid prophylactically secondary to tuberculosis exposure? 1 These drugs will only need to be taken for 7 to 10 days. 2 Isoniazid may decrease serum glucose in susceptible people. 3Oral contraceptives become ineffective when given with rifampin. 4 Tanning beds may be used to counteract the pale skin tone caused by these medications.

3 Oral contraceptives become ineffective when given with rifampin. Women taking oral contraceptives who are prescribed rifampin must be switched to another form of birth control because oral contraceptives become ineffective when given with rifampin. These medications must be taken long term because the mycobacterium is slow growing. Isoniazid may increase, not decrease, serum glucose levels. They can cause photosensitivity, necessitating the use of sunscreen, not tanning beds.

A nurse is caring for a client diagnosed with malaria. What drug would the nurse expect to be prescribed? M. Chloroquine (Aralen) N. Penicillin O. Metronidazole (Flagyl) P. Pentamidine (Pentam)

Chloroquine (Aralen) Chloroquine is a standard drug used for the treatment of malaria in an acute stage.

A patient has an extremely severe infection with a Mycobacterium that is resistant to all but one antitubercular drug; however, the patient has had an allergic reaction to that drug in the past. What does the nurse anticipate as being ordered for this patient? A combination of antitubercular drugs will be chosen to fight the infection. The patient will receive the drug and supportive care to help him tolerate the antitubercular therapy. The patient will remain on isolation precautions until his cough clears. There is nothing that can be done for this patient.

The patient will receive the drug and supportive care to help him tolerate the antitubercular therapy.

The clinical coordinator is teaching a nursing student about the safe administration of antimalarial drugs. Which statement by the nursing student indicates effective teaching? 1 "Antimalarial medications can also be administered as prophylactic treatment." 2 "Antimalarial medications cannot be administered in combination with antibiotics." 3 "Antimalarial medications must be administered to the patient on an empty stomach." 4 "Antimalarial medications must not be administered if the patient has abdominal pain."

1 "Antimalarial medications can also be administered as prophylactic treatment." Antimalarial medications can be prescribed to patients living in areas having an epidemic spread of malaria. They can be administered for prophylactic treatment to prevent malarial infection. Antimalarial drugs can be administered in combination with antibiotics for synergistic action. Antimalarial medications cause gastrointestinal upset, so they must not be administered on an empty stomach. If the patient has abdominal pain, it must be reported to the primary health care provider instead of discontinuing the medication.

Which assessment finding in a patient taking NSAIDs requires immediate intervention? 1 Black, tarry stools 2 Palpitations 3 Nonproductive cough 4 Headache

1 Black, tarry stools A major side effect of NSAID therapy is gastrointestinal (GI) distress with potential GI bleeding. Black, tarry stools are indicative of a GI bleed. Headaches, palpitations, and cough should not result from the use of NSAID medications.

A patient is prescribed allopurinol to treat gout. The nurse is educating the patient about administration of the drug. Which intervention does the nurse suggest to the patient to ensure safe administration of the drug? 1Take the drug after a meal. 2 Take the drug with caffeine. 3 Reduce the amount of fluid intake. 4Take the drug on an empty stomach.

1 Take the drug after a meal. The nurse should advise the patient to take the drug after meals to minimize gastrointestinal symptoms. Caffeine increases uric acid levels and decreases the level of allopurinol, so the nurse should advise the patient to avoid taking the drug with caffeine. The fluid intake should be increased to 3 liters a day. If the drug is administered on an empty stomach, it produces gastrointestinal symptoms. Therefore, the nurse should advise the patient to avoid taking the drug on an empty stomach.

A patient is prescribed celecoxib for the treatment of rheumatoid arthritis. Which instruction does the nurse give to the patient for safe administration of the drug? 1"Take the drug after a meal." 2 "Take the drug with caffeine." 3 "Avoid taking the drug with fluid." 4 "Take the drug on an empty stomach."

1"Take the drug after a meal." Taking celecoxib after a meal decreases gastrointestinal upset, so the nurse should advise the patient to take the drug after meals. Administration of the drug with caffeine should be avoided, because it may interfere with absorption of the drug. When the drug is taken with fluid, the risk of gastrointestinal upset is decreased. Administration of the drug on an empty stomach may cause gastrointestinal upset; therefore, it should be avoided.

A patient has a positive Mantoux test. Which test will the provider order next? 1 Sputum culture 2 Chest radiography 3 Tuberculin skin test 4 Stomach secretion culture

2 Chest radiography Tuberculosis is diagnosed by following three steps. In the first step the Mantoux test is conducted. If the results of the Mantoux test are positive, then the second step of diagnosis can be carried out. Sometimes the Mycobacterium becomes dormant and does not cause infection, but the patient still shows positive results to the Mantoux test. In the second step, chest radiography is conducted. If the results of chest radiography are positive, the third step is followed. In the third step, a culture of sputum and stomach secretions is done to detect the presence of Mycobacterium tuberculosis. The Mantoux test is also called a tuberculin skin test.

The nurse has administered ethambutol to a patient for the treatment of tuberculosis. For which side effect associated with ethambutol use will the nurse assess in the patient? 1 Neutropenia 2Optic neuritis 3 Hyperuricemia 4 Hyperglycemia

2Optic neuritis Ethambutol is a first-line bacteriostatic drug used in the treatment of tuberculosis. It is associated with side effects such as optic neuritis, a condition in which inflammation of the optic nerve occurs. It may cause a complete or partial loss of vision. Neutropenia, hyperuricemia, and hyperglycemia are not side effects of ethambutol. Neutropenia is a side effect of rifabutin. Hyperuricemia is a side effect of pyrazinamide. Hyperglycemia is a side effect of isoniazid.

A patient has been taking aspirin for chronic pain. The patient states that the pain is not relieved with 650 mg of aspirin every 4 hours. What is the best instruction for the nurse to give the patient? 1 "Increase your dose to 1000 mg every 4 hours." 2 "Take aspirin and a COX-1 inhibitor at the same time." 3 "Alternate aspirin and a narcotic analgesic every 4 hours." 4 "Notify your health care provider that the medication is not effective."

4 "Notify your health care provider that the medication is not effective." Unlike opioids, NSAIDs show a ceiling effect that limits their effectiveness; that is, any further increase in the dosage beyond a certain level increases the risk for adverse effects without a corresponding increase in the therapeutic effect. If pain persists, the best advice is for the patient to switch to another pain reliever. Increasing the dose of aspirin may lead to gastric distress. Changing the medication regimen is outside of the nurse's scope of practice.

The nurse is caring for a patient who has symptoms of acute toxicity due to an overdose of immediate-release ibuprofen, which was administered 1 hour earlier. What is the appropriate action in this situation? 1 Administer aspirin to the patient 2 Conduct hemodialysis on the patient 3 Administer mercaptopurine to the patient 4 Administer activated charcoal to the patient

4 Administer activated charcoal to the patient Ibuprofen is a nonsalicylate nonsteroidal antiinflammatory drug. If the patient shows signs of overdose, activated charcoal should be administered to avoid further absorption of the medication and to reduce further toxic effects. Aspirin should not be administered to the patient in this situation, because it causes gastrointestinal irritation and can cause ulcers. Hemodialysis is an effective treatment option during salicylate intoxication. Administering mercaptopurine to the patient is not an effective treatment option, because it does not reduce the symptoms of toxicity.

The nurse is caring for a patient with tuberculosis. The patient's drug susceptibility test reports are not known. What will the nurse expect the provider to order for this patient? 1 Cycloserine 2 Capreomycin 3 No drug therapy 4 Four-drug regimen therapy

4 Four-drug regimen therapy Four-drug regimen therapy is given to a patient when the drug susceptibility reports are unknown. The four-drug regimen consists of isoniazid, rifampin, ethambutol, and pyrazinamide. These drugs are 95% effective in combating the infection. Use of multiple medications reduces the possibility of the organisms' becoming drug resistant.

A patient is prescribed primaquine phosphate for malaria. After a few days of therapy, the patient is found to have hemolytic anemia. What could be the reason? 1 Long-term consequence of malaria 2 Side effect of primaquine phosphate 3 Nutritional deficiency of iron in the diet 4 Glucose-6-phosphate dehydrogenase deficiency

4 Glucose-6-phosphate dehydrogenase deficiency Primaquine phosphate tends to cause hemolytic anemia in patients who have a glucose-6-phosphate dehydrogenase deficiency. Glucose-6-phosphate dehydrogenase is an important enzyme in red blood cell metabolism. A patient with deficiency of this enzyme may develop hemolytic anemia, with primaquine phosphate acting as a trigger. Nutritional deficiency of iron may cause iron-deficiency anemia, but not hemolytic anemia.

Which opportunistic infection complicates human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)? 1 Giardiasis 2 Toxoplasmosis 3 Trichomoniasis 4 Pneumocystosis

4 Pneumocystosis Pneumocystosis is a pulmonary infection caused by Pneumocystis jirovecii. This infection complicates some disease conditions such as HIV and AIDS. Giardiasis is an intestinal protozoal infection caused by Giardia lamblia. Toxoplasmosis is an infection caused by Toxoplasma gondii. Trichomoniasis is a sexually transmitted infection caused by Trichomonas vaginalis. These infections do not complicate conditions such as HIV and AIDS.

Which antimalarial drug can cause folate deficiency in patients? 1 Penicillin G 2 Doxycycline 3 Clindamycin 4 Pyrimethamine

4 Pyrimethamine Pyrimethamine is the antimalarial drug that can cause folate deficiency in patients. It acts by inhibiting the dihydrofolate reductase enzyme, thereby blocking synthesis of tetrahydrofolate. Penicillin G is not an antimalarial drug. It does not inhibit the dihydrofolate reductase enzyme. It acts by causing bacterial cell wall lysis. Tetracycline acts by inhibiting the protein synthesis. Clindamycin does not inhibit dihydrofolate reductase enzyme.

In what anatomic region(s) in human beings can fungi be found as part of the normal flora? Select all that apply. 1 Liver 2Lungs 3 Spleen 4 Vagina 5 Intestine

4 Vagina 5 Intestine Certain fungi are part of the normal flora in the vagina and intestines of human beings. Fungi can also be part of normal flora in the mouth and on the skin. The presence of fungi in the liver, lungs, or spleen is not normal and should be investigated for possible infection.

A nurse is caring for a patient with giardiasis. The patient has been prescribed metronidazole. Which action does the nurse take to ensure effective treatment? 1 The nurse advises the patient's family members to use metronidazole for prophylaxis. 2 The nurse administers the medication to the patient on an empty stomach with a glass of water. 3 The nurse administers the medication as an intravenous (IV) bolus for rapid absorption and action. 4The nurse immediately obtains the prescribed specimens before starting the medication.

4The nurse immediately obtains the prescribed specimens before starting the medication. Metronidazole is prescribed for the treatment of giardiasis. The nurse obtains the prescribed specimens before starting the medication. It helps the nurse identify the infection-causing species and plan the dosage regimen. To prevent gastric irritation and ulcers, metronidazole must not be administered on an empty stomach. It should be administered after meals. This also helps in faster absorption of the drug. Metronidazole should never be administered as an IV bolus, because it can lead to drug accumulation and toxic side effects. The nurse cannot suggest metronidazole for prophylaxis without consulting the primary health care provider.

What are important for the nurse to monitor in a client receiving an antifungal medication? (Select all that apply.) CC. Creatinine DD. Daily weights EE. Mental status FF. Intake and output GG. Blood urea nitrogen

CC. Creatinine DD. Daily weights FF. Intake and output GG. Blood urea nitrogen Nursing interventions appropriate to clients receiving antifungal drugs vary depending on the particular drug. However, it is important for the nurse to monitor all clients for indications of possible medication-induced renal damage so that prompt interventions can occur to prevent further dysfunction. Monitoring intake and output amounts, daily weights, and renal function tests will help prevent such damage.

When teaching a client about potential adverse effects of NSAID therapy, the nurse will teach the client to immediately notify the health care provider of which effect? E. Diarrhea F. Mild indigestion G. Black tarry stools H. Nonproductive cough

G. Black tarry stools A major adverse effect of NSAID therapy is gastrointestinal (GI) distress with potential GI bleeding. Black or tarry stools are indicative of a GI bleed.

The nurse would question a prescription to administer misoprostol (Cytotec) to a client with which condition? GG. Pregnancy HH. Peptic ulcer II. Gastroesophageal reflux disease JJ. Chronic obstructive pulmonary disease

GG. Pregnancy Misoprostol is an abortifacient and thus is contraindicated in pregnancy.

A patient is admitted with salicylate toxicity. When assessing the patient, the nurse anticipates which manifestation associated with salicylate toxicity? Bradycardia Hypoventilation Constipation Hyperglycemia

Hyperglycemia

What conditions are considered contradictions for use of antifungal medications? (Select all that apply.) HH. Heart failure II. Liver failure JJ. Kidney failure KK. Pancreatic failure LL. Respiratory failure

II. Liver failure KK. Pancreatic failure Drug allergy, liver failure, kidney failure, and porphyria (for griseofulvin) are the most common contraindications for antifungal drugs.

Which NSAID would the nurse anticipate administering parenterally for the treatment of acute postoperative pain? OO. Ketorolac (Toradol) PP. Diclofenac (Cataflam) QQ. Allopurinol (Zyloprim) RR. Indomethacin (Indocin)

OO. Ketorolac (Toradol) Ketorolac can be administered by injection (intramuscularly or intravenously) and is indicated for the short-term treatment of moderate to severe acute pain.

Which nursing diagnosis is appropriate for a client prescribed colchicine (Colcrys)? Y. Constipation related to adverse effect of the medication Z. Risk for infection related to medication-induced leukocytosis AA. Risk for injury related to adverse effect of life threatening seizures BB. Risk for fluid volume deficient related to nausea, vomiting, and diarrhea

Risk for fluid volume deficient related to nausea, vomiting, and diarrhea Colchicine is administered on an hourly basis until pain is relieved, the client develops severe nausea and diarrhea, or the maximum dose (6 mg) has been administered. Bleeding into the GI or urinary tracts is a potential serious adverse effect of colchicine.

A patient is receiving INH for the treatment of TB. Which vitamin does the nurse anticipate administering with the INH to prevent INH-precipitated peripheral neuropathies? Vitamin C Vitamin B12 Vitamin D Vitamin B6

Vitamin B6

The nurse has provided education to a client about fungal skin infections. Further client teaching is necessary when the client includes which condition in the discussion of fungal skin infections? Y. Thrush Z. Impetigo AA. Athlete's foot BB. Vaginal yeast infection

Z. Impetigo Impetigo is a bacterial skin infection and would not be classified as a fungal skin infection. If the client included this in the discussion, further teaching is needed. All other skin infections listed are fungal and would be treated with antifungal medications.

Which antifungal drug is contraindicated during pregnancy? 1 Nystatin 2 Imidazole 3 Voriconazole 4 Amphotericin B

3 Voriconazole Voriconazole is used for the treatment severe fungal infections and is the only antifungal drug that is contraindicated in pregnant patients, because it may cause fetal toxicity. Nystatin, imidazole, and amphotericin B are safe to use during pregnancy and therefore are not contraindicated.

The nurse is assessing a patient with pulmonary tuberculosis who has been prescribed ethambutol, isoniazid, pyrazinamide, and rifampin. The patient says, "Can you tell me why four medications are prescribed and how I should administer all of them?" What response does the nurse give to the patient? 1 "You should take all these medications at a time before meals." 2 "You can stop administering pyrazinamide if you have nausea." 3 "You have to complete the course of any two prescribed medications." 4"You may have a more complete, more rapid response when four medications are given."

"You may have a more complete, more rapid response when four medications are given." The nurse should provide the patient instructions about drug administration and the need for medication. It helps the patient to adhere to the medication and effectively complete the treatment regimen. The nurse should inform the patient that multiple medications are prescribed for treating tuberculosis to increase the rate of cure and have effective treatment.

A patient who will be traveling to a malaria-infested country is receiving instructions on the prophylactic use of chloroquine. Which instruction should the nurse give the patient? 1 "Take the medication for 4 weeks." 2 "Start the medication 2 weeks before the trip." 3 "After leaving the affected area, take the medication for a year." 4 "Do not take the medication until you are certain you do not have the disease."

2 "Start the medication 2 weeks before the trip." Treatment for malaria prophylaxis is usually started 2 weeks before travel and continues for 8 weeks after travel is completed.

A client, who weighs 45.4 kg, is prescribed pyrantel (Pin-X) for a roundworm infection. The dosage is 11 mg/kg in one single dose to a maximum of 1 g. What is the appropriate dosage for this client?

499 mg 45.4 kg × 11 mg/kg = 499.4 mg, which rounds to 499 mg.

The nurse should question a prescription to administer acetylsalicylic acid (aspirin) to which client? KK. A 62-year-old patient with a history of stroke LL. A 45-year-old patient with a history of heart attack MM. A 28-year-old patient with a history of sports injury NN. A 14-year-old patient with a history of flulike symptoms

A 14-year-old patient with a history of flulike symptoms Aspirin should never be administered to children with flulike symptoms. The use of aspirin in children with flulike symptoms has been associated with Reye's syndrome.

A patient is taking nystatin (Mycostatin) in an oral troche form for oral candidiasis. Which instruction is correct? Allow the troche to dissolve slowly in the mouth. Swish the medication in the mouth and then swallow it. Chew the troche thoroughly to activate the medication. Swallow the troche whole without chewing.

Allow the troche to dissolve slowly in the mouth.

Fifteen minutes after an infusion of amphotericin B was started, the patient begins to complain of fever, chills, muscle pain, and nausea. His heart rate has increased slightly, but his blood pressure is down to 100/68 mm Hg. What is the nurse's priority? Notify the prescriber immediately. Recognize an impending anaphylactic reaction and stop the infusion. Assess for other symptoms of this expected infusion-related reaction. Slow the infusion to reduce these adverse effects.

Assess for other symptoms of this expected infusion-related reaction.

What is the mechanism of action of nonsteroidal antiinflammatory drugs (NSAIDs)? A. Enhancing pain perception B. Inhibiting prostaglandin production C. Increasing blood flow to painful areas D. Increasing the supply of natural endorphins

B. Inhibiting prostaglandin production Prostaglandins are produced in response to activation of the arachidonic pathway. NSAIDs work by blocking cyclooxygenase (COX-1 and COX-2), the enzyme responsible for conversion of arachidonic acid into prostaglandins. Decreasing the synthesis of prostaglandins results in decreased pain and inflammation.

A nurse teaching a client receiving allopurinol (Zyloprim) should include which information? CC. "Increase your fluid intake to 3 L per day." DD. "This medication may cause your urine to turn orange." EE. "Include salmon and organ meats in your diet on a weekly basis." FF. "Take the medication with an antacid to minimize GI distress."

CC. "Increase your fluid intake to 3 L per day." Clients taking allopurinol should be informed to increase fluid intake to 3 L per day, avoid hazardous activities if dizziness or drowsiness occurs with the medication, and avoid the use of alcohol and caffeine because these drugs will increase uric acid levels and decrease the levels of allopurinol.

What would be the result of a drug-drug interaction between mefloquine and beta blockers in a patient with malaria? 1 Potential toxicity 2 Treatment failure 3 Muscle weakness 4 Cardiac dysrhythmia

Cardiac dysrhythmia Simultaneous administration of mefloquine with beta blockers causes cardiac dysrhythmia. Simultaneous administration of chloroquine with digoxin results in potential toxicity from the increased serum levels of digoxin. Simultaneous administration of primaquine with other hemolytic drugs results in muscle weakness. Simultaneous administration of chloroquine with beta blockers results in treatment failure of the target drugs, which occurs because of the decreased serum levels of the targeted drug.

When admitting a client to a medical-surgical unit with a diagnosis of Pneumocystis jirovecii pneumonia, the nurse will anticipate administering which medication? E. Iodoquinol (Yodoxin) F. Albendazole (Albenza) G. Pentamidine (Pentam) H. Paromomycin (Humatin)

G. Pentamidine (Pentam) Iodoquinol and paromomycin are used to treat intestinal amebiasis, and albendazole is used to treat helminthic infections.

A male patient with an HIV infection has a severe case of P. jirovecii pneumonia (PJP) and needs to be treated with pentamidine. However, he is allergic to the inhaled form of this medication. Considering the seriousness of his condition, what does the nurse expect will be done in this situation? He will be given the inhaled form of pentamidine and be monitored closely. He will be given the pentamidine in an intravenous or intramuscular injection and be monitored closely. Another drug, such as metronidazole (Flagyl), will be ordered. He will receive supportive care because he is unable to take pentamidine.

He will be given the pentamidine in an intravenous or intramuscular injection and be monitored closely.

Four weeks after beginning antitubercular drug therapy on an outpatient basis, the patient reports that he still experiences night sweats. What does the nurse identify as the main concern at this time? He is not taking his medication properly. More time is needed to see a therapeutic response. His infection may be resistant to the drug therapy ordered. He may have contracted a different strain of TB.

His infection may be resistant to the drug therapy ordered.

Which client statement indicates to the nurse that the client understands the discharge teaching for ethambutol (Myambutol)? I. "Constipation will be a problem, so I will increase the fiber in my diet." J. "Dizziness and drowsiness are common adverse effects with this drug." K. "I will need to have my vision checked periodically while I am taking this drug." L. "This medication may cause my bodily secretions to turn red-orange-brown."

K. "I will need to have my vision checked periodically while I am taking this drug." Ethambutol can cause optic neuritis. Ophthalmologic examinations should be performed periodically to assess visual acuity.

Which antifungal drug can be given intravenously to treat severe yeast infections as well as a one-time oral dose to treat vaginal yeast infections? I. Voriconazole (Vfend) J. Nystatin (Mycostatin) K. Fluconazole (Diflucan) L. Caspofungin (Cancidas)

K. Fluconazole (Diflucan) . Fluconazole is an antifungal drug that does not cause the major adverse effects of amphotericin when given intravenously. It is also very effective against vaginal yeast infections, and a single dose is often sufficient to treat vaginal infections.

The nurse would question a prescription for chloroquine (Aralen) in a client also prescribed which medication? I. Diazepam (Valium) J. Doxycycline (Doryx) K. Clindamycin (Cleocin) L. Valproic acid (Depakote)

L. Valproic acid (Depakote) Concurrent use of chloroquine with valproic acid may reduce serum drug levels of valproic acid and thus increase the risk of seizure activity. Chloroquine may be given concurrently with clindamycin or doxycycline for synergistic actions.

A patient has developed an aspergillosis infection. Which tissue does the aspergillosis affect? Skin Nails Blood Lungs

Lungs aspergillosis=Cancides

A client visits the health care provider for treatment of tinea pedis (athlete's foot). Which medication would the nurse MOST likely instruct the client to take to treat this condition? M. Terbinafine (Lamisil) N. Voriconazole (Vfend) O. Caspofungin (Cancidas) P. Amphotericin B (Amphocin)

M. Terbinafine (Lamisil) Terbinafine (Lamisil) is classified as an allylamine antifungal drug and is currently the only drug in its class. It is available in a topical cream, gel, and spray for treating superficial dermatologic infections, including tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm).

Which group of helminths is comprised of flatworms that are parasitic in humans? 1 Cestodes 2 Nematodes 3 Trematodes 4Platyhelminthes

Platyhelminthes Helminthic infections are more common in human beings, and the parasitic organisms are classified into four groups based on their characteristics. Flatworms are categorized as platyhelminthes. Tapeworms are categorized as cestodes. Roundworms are categorized as nematodes. Flukes are categorized as trematodes.

The nurse is caring for a patient with malaria who has been prescribed chloroquine. On reviewing the medical history of the patient, the nurse finds that the patient is also receiving digoxin. Which possible drug interaction can occur in this patient? 1 Potential toxicity of digoxin 2 Treatment failure of digoxin 3 Potential toxicity of chloroquine 4 Treatment failure of chloroquine

Potential toxicity of digoxin Chloroquine increases the toxicity of digoxin by increasing serum levels of digoxin. There is no evidence for treatment failure if digoxin is administered along with chloroquine. There is no toxicity of chloroquine when used with digoxin. There is no reported treatment failure of chloroquine when used with digoxin.

The nurse is administering probenecid (Benemid) to a client with recurrent strep throat. The nurse teaches the client that the MOST likely reason for taking this medication is for what drug effect? I. Increase uric acid excretion J. Prevent the occurrence of gout K. Inhibit bacterial growth and replication L. Prolong the effectiveness of penicillin therapy

Prolong the effectiveness of penicillin therapy Besides its use for the treatment of the hyperuricemia associated with gout and gouty arthritis, probenecid also has the ability to delay the renal excretion of penicillin, thus increasing serum levels of penicillin and prolonging its effect.

An 82-year-old woman is taking ibuprofen (Motrin) 3200 mg divided three times daily as treatment for arthritis. She has had no other health problems. What is the most important assessment for the nurse to monitor while the patient is on this therapy? Blood sugar Liver function studies Assessment of hearing Renal function studies

Renal function studies

The nurse anticipates a prescription for vitamin supplementation for a client who is receiving isoniazid (Nydrazid) therapy. What vitamin supplement is usually prescribed with isoniazid? Q. Folate R. Calcium S. Vitamin E T. Vitamin B6

T. Vitamin B6 Pyridoxine (vitamin B6) is often given concurrently with isoniazid to prevent the adverse effect of isoniazid induced peripheral neuropathy associated with neurotoxicity.

The acetic acid derivative indomethacin (Indocin) has which properties? (Select all that apply.) SS. Antinausea TT. Antipyretic UU. Anticonvulsant VV. Antirheumatic WW. Antiinflammatory

TT. Antipyretic VV. Antirheumatic WW. Antiinflammatory NSAIDs are known for their antiinflammatory effects. Indomethacin, in addition, is also used for its antirheumatic and antipyretic properties. NSAIDs are often known to have nausea as a common adverse effect. Indomethacin is not used as an anticonvulsant.

When a client is receiving an IV infusion of metronidazole (Flagyl), what adverse effect would the nurse immediately report to the health care provider? U. Dark colored urine V. Dizziness or confusion W. Elevated blood pressure X. Diminished breath sounds

V. Dizziness or confusion During use of this drug, metronidazole administered intravenously, report to the health care provider any changes in neurologic status (e.g., dizziness, confusion).

When pyrimethamine is used to treat malaria, a sulfonamide antibiotic is often also used. The purpose of the antibiotic is to: treat the bacterial infections that often accompany malaria. allow the antimalarial drug to be effective in the exoerythrocytic phase. cause synergism, allowing for a stronger antimalarial effect. allow for reduced adverse effects because smaller doses of each drug are used.

cause synergism, allowing for a stronger antimalarial effect.

A home care nurse is visiting a patient with a diagnosis of TB. The patient traveled abroad 2 months ago. He lives with his wife and 5-year-old son. The patient tells the nurse that he is concerned his son will also get TB, so he wants to share his pills with his son. What is the best response by the nurse? "That is a good idea. Children should not be exposed to TB." "You should give your son half of the dose you take." "Do not share any of your medications with anyone. Contact your son's health care provider to discuss your concerns." "Children have an immune system that makes them immune to TB."

"Do not share any of your medications with anyone. Contact your son's health care provider to discuss your concerns."

How can the nurse determine whether a patient will tolerate an amphotericin B infusion? 1 Administer a test dose 2 Desensitize the patient 3 Administer it with corticosteroids 4 Administer it with an antihistamine

1 Administer a test dose To assess a patient's ability to tolerate amphotericin B, a test dose of 1 mg should be administered over 20 to 30 minutes. Desensitization is a therapeutic procedure used to manage patients who have hypersensitivity reactions (in this case to amphotericin B) but require the drug. Administration of corticosteroids and antihistamines are measures used to prevent amphotericin B infusion reactions.

A patient is prescribed rifampin for the treatment of tuberculosis. While checking the patient's history, the nurse finds that the patient is on oral contraceptive therapy. What advice on the safe use of rifampin does the nurse give to the patient? 1 Take a lower dose of rifampin. 2Use other forms of birth control. 3 Take an initial half-dose of rifampin. 4 Use a double dose of the oral contraceptive.

2 Use other forms of birth control. Rifampin comes under the class of rifamycin antibiotics. It blocks the activity of oral contraceptives. As a result, contraception failure occurs. Therefore, the nurse should advise the patient to use other forms of birth control. A lower dose and initial half-dose of rifampin do not give the desired therapeutic effect; thus, avoid taking a lower dose or initial half-dose of rifampin. There is no need to take a double dose of the oral contraceptive, because that would be ineffective in this situation and might cause adverse effects for the patient.

A female patient has been diagnosed with giardiasis. The nurse anticipates treatment of the patient with which of the following types of medications? Antibiotics Antimalarial Antiprotozoal Anthelmintic

Antiprotozoal=Protozoa Antibiotics=Bacteria Antimalarial=Malaria Anthelmintic=Worms

What will the nurse teach a patient who is taking isoniazid? 1 "You will need to take vitamin C to potentiate the action of isoniazid." 2 "You should not be on that drug. I will check with the health care provider." 3 "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria." 4"Pyridoxine (vitamin B6) will prevent numbness and tingling associated with taking isoniazid."

Correct4 "Pyridoxine (vitamin B6) will prevent numbness and tingling associated with taking isoniazid." Isoniazid can cause peripheral neuropathy. Pyridoxine (vitamin B6) is the drug of choice to prevent this adverse reaction. It is not an antiinfective agent and thus will work to destroy the mycobacterium or prevent drug resistance. Vitamin C is not taken with this drug; the drug is appropriate for most patients, and isoniazid with pyridoxine is not multidrug therapy.

What is the MOST important action for the nurse to complete before administration of intravenous (IV) amphotericin B? E. Assess for nausea and vomiting. F. Monitor for cardiac dysrhythmias. G. Check for premedication prescriptions. H. Monitor IV site for signs of phlebitis.

G. Check for premedication prescriptions. Almost all clients given IV amphotericin B experience fever, chills, hypotension, tachycardia, malaise, muscle and joint pain, anorexia, nausea and vomiting, and headache. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions. The other choices are appropriate nursing actions after the IV infusion has begun.

A hospitalized patient has an order for ketorolac (Toradol). The nurse notes that the order is only for 5 days. What is the reason for this? The patient's pain should subside by that time. There are concerns about addiction to the drug. The drug can cause severe renal and GI effects. The drug loses its effectiveness over time.

The drug can cause severe renal and GI effects.

The nurse knows colchicine (Colcrys) exerts its therapeutic effect by what action? U. Increases uric acid metabolism V. Decreases mobility of leukocytes W. Increases process of phagocytosis X. Increases production of lactic acid

V. Decreases mobility of leukocytes Colchicine works by inhibiting the metabolism and migration of leukocytes into joints affected by gout, thus resulting in decreased inflammation.

The nurse is providing education to a client who is prescribed metronidazole (Flagyl) for trichomoniasis. What client statement indicates that the client understood the teaching? Y. "I will have my partner evaluated and treated." Z. "I won't get this again because I have had it once." AA. "I will stop taking the medication when the discharge stops." BB. "I can continue to have intercourse as long as we use condoms."

Y. "I will have my partner evaluated and treated." Inform the client taking metronidazole for a sexually transmitted infection to avoid sexual intercourse until the prescriber states otherwise. The partner, and any sexual partners possibly exposed, need to be evaluated and treated if positive. All other statements would require further teaching by the nurse.

Which drug does the nurse associate with the development of potentially life-threatening skin adverse effects of exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis? probenecid colchicine febuxostat (Uloric) allopurinol (Zyloprim)

allopurinol (Zyloprim)

A patient is receiving amphotericin B lipid complex. The nurse knows that an advantage of the lipid formulations of this drug is that they: have a lower cost. can be administered quickly. take longer to be absorbed. cause fewer adverse effects.

cause fewer adverse effects.

A patient is diagnosed with onychomycosis. The nurse anticipates use of which medication for the treatment of this condition? terbinafine (Lamisil) voriconazole (Vfend) fluconazole (Diflucan) amphotericin B (Amphocin, Fungizone)

terbinafine (Lamisil) onychomycosis=Nail Fungus

The nurse is administering medications. One patient has an order for aspirin 325 mg by mouth daily and another patient has an order for aspirin 650 mg 4 to 6 times daily (maximum 4 g/day). The nurse understands that the indication for the 325 mg of aspirin once daily is: pain management. fever reduction. treatment of OA. thromboprevention.

thromboprevention.

When preparing to administer an intravenous (IV) infusion of metronidazole (Flagyl), the nurse will anticipate infusing the medication over how many minutes? Q. 1 to 5 R. 5 to 10 S. 15 to 30 T. 30 to 60

30 to 60 Infuse IV doses of metronidazole as prescribed and generally are to infuse over 30 to 60 minutes and never as an IV bolus.

The nurse needs to know that major adverse effects are MOST common by which drug? Q. Fluconazole (Diflucan) R. Ketoconazole (Nizoral) S. Griseofulvin (Fulvicin P/G) T. Amphotericin B (Amphocin)

Amphotericin B (Amphocin) The major adverse effects caused by antifungal drugs are encountered most commonly in conjunction with amphotericin B treatment. Drug interactions and hepatotoxicity are the primary concerns in clients receiving other antifungal drugs, but the IV administration of amphotericin B is associated with a multitude of adverse effects.

What are the most common indications for celecoxib? Select all that apply. 1 Arthritis 2 Tendonitis 3Acute pain 4 Dysmenorrhea 5 Thromboprevention

1 Arthritis 3 Acute pain 4 Dysmenorrhea Celecoxib was the first cyclooxygenase-2 (COX-2) inhibitor and is currently still in use. It is available in oral form. This drug is commonly used for acute painful and inflammatory conditions. These conditions include arthritis, ankylosing spondylitis, and primary dysmenorrhea. Indomethacin is the most commonly used drug for the treatment of tendonitis. Aspirin is the primary nonsteroidal antiinflammatory drug. It is most commonly used for thromboprevention.

The nurse is assessing a 3-year-old child who has a fever. After checking the laboratory reports, the nurse finds that the child has influenza B. Which medications should the nurse expect to be included in the care plan? 1 Aspirin 2 Acetaminophen 3 Aspirin and ibuprofen 4 Aspirin combination drug

2 Acetaminophen Acetaminophen should be prescribed to reduce fever, because it is safe for the patient. Administration of aspirin to the child may cause Reye's syndrome. It may also result in encephalopathy and damage the child's liver. Therefore, the primary health care provider should avoid prescribing aspirin, aspirin and ibuprofen in combination, and aspirin combination medications. Ibuprofen alone can be prescribed to the patient, but not with aspirin.

What should the nurse do before administering intravenous (IV) amphotericin B? 1 Set up an IV solution with potassium. 2 Administer insulin as prescribed to prevent severe hyperglycemia. 3 Administer an antipyretic, antihistamine, and antiemetic as prescribed. 4 Administer intravenous dextrose as prescribed to prevent severe hypoglycemia.

3 Administer an antipyretic, antihistamine, and antiemetic as prescribed. Almost all patients given IV amphotericin B develop fever, chills, nausea and vomiting, and hypotension. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions. There is no need to treat with IV potassium or administer insulin or IV dextrose

A patient is hospitalized for the treatment of tuberculosis. How can the development of multidrug-resistant tuberculosis be prevented in the patient? 1 By performing regular blood tests 2 By performing regular chest x-rays 3 By performing regular sputum cultures 4 By performing drug susceptibility tests

4 By performing drug susceptibility tests Performing drug susceptibility tests will help prevent the development of multidrug-resistant tuberculosis in the patient. A drug susceptibility test is performed on the first Mycobacteriumspecies that is isolated from a patient specimen. Blood tests, chest x-rays, and sputum culture are done to diagnose tuberculosis and determine the prognosis; they are not preventive.

What information should the nurse provide to a client prescribed rifampin (Rifadin)? E. Oral contraception is the preferred method of birth control when using rifampin. F. The patient will only need to take this medication for the prescribed 14-day period. G. A nonharmful adverse effect of this medication is red-orange discoloration of urine, sweat, tears, skin, salvia, and feces. H. Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities.

G. A nonharmful adverse effect of this medication is red-orange discoloration of urine, sweat, tears, skin, salvia, and feces. Red-orange-brown discoloration of the skin, sweat, tears, urine, feces, sputum, saliva, and tongue as an adverse effect of the drug, but it is not harmful. Rifampin does not cause peripheral neuropathies (isoniazid does), but it does interfere with the effectiveness of oral contraceptives. All antitubercular drugs need to be taken long term to eradicate the slow-growing mycobacterium lying deep within the tissues.

Before starting treatment with antiprotozoal therapy, it is most important for the nurse to asses the patient's baseline? Blood sugar Blood pressure QT interval Liver function

Liver function

A nursing student asks the nurse which patients are more susceptible to tuberculosis infection. Which response by the nurse is correct? Select all that apply. 1Patients with cancer 2 Patients with diarrhea 3 Patients with malnutrition 4 Patients with gastric ulcer 5Patients with human immunodeficiency virus (HIV) infection

1 Patients with cancer 3 Patients with malnutrition 5 Patients with human immunodeficiency virus (HIV) infection Patients with cancer, malnutrition, and HIV infection are more susceptible to tuberculosis infections than other patients. Patients with these conditions have reduced immunity, which makes them more vulnerable to tuberculosis bacteria. Diarrhea and gastric ulcers do not decrease immunity and therefore do not increase the risk for infection.

The nurse is assessing a geriatric patient who has high blood pressure and prediabetes and was prescribed propranolol 10 mg. Which treatment can be given to the patient to reduce the risk of coronary artery disease? 1 81 mg of aspirin 2 10 units of insulin 3 50 mg of ketorolac 4 20 mg of propranolol

1 81 mg of aspirin Aspirin may be prescribed as a prophylactic treatment to prevent coronary artery disease in patients having high risk factors like high blood pressure and prediabetes. Aspirin has an antiplatelet action, which reduces the risk of coronary artery disease. A dose of 81 to 325 mg is safe to administer to patients at high risk of coronary artery disease. Insulin is not prescribed to a patient during prediabetic conditions, because the patient has insulin resistance. Metformin is prescribed to patients with prediabetes. Ketorolac should not be administered to the patient, because it does not have an antiplatelet action. Administering propranolol will not reduce the risk of coronary action, because it does not have any antiplatelet action.

Which is the first-line antitubercular drug? 1 Isoniazid 2 Amikacin 3 Cycloserine 4 Capreomycin

1 Isoniazid Isoniazid is a first-line and primary antitubercular drug. It is most widely used. It can be administered either as the sole drug in the prophylaxis of tuberculosis or in combination with other antitubercular drugs in the treatment of tuberculosis. Amikacin, cycloserine, and capreomycin are second-line antitubercular drugs.

What are the common primary tissues that are affected by infection with the Trichophyton spp.? Select all that apply. 1 Skin 2 Scalp 3 Brain 4 Lungs 5 Blood

1 Skin 2 Scalp Trichophyton spp infections are superficial or topical infections that affect the skin and scalp. Cryptococcus neoformans infections affect the meninges of the brain. Infections by Aspergillus spp. affect the lungs. Severe infections caused by Candida albicans may affect the blood.

Why is the lipid dosage form of amphotericin B used only when patients are intolerant to nonlipid amphotericin B? 1 The lipid dosage form of amphotericin B is costly. 2 The lipid dosage form of amphotericin B is less effective. 3 The lipid dosage form of amphotericin B has a high incidence of adverse effects. 4 The lipid dosage form of amphotericin B requires the preadministration of antihistamines and corticosteroids

1 The lipid dosage form of amphotericin B is costly. The lipid dosage form of amphotericin B is costlier than conventional amphotericin B, so it is used only when patients are intolerant to nonlipid amphotericin B. The lipid dosage form of amphotericin B is more effective and safe and shows fewer adverse drug interactions than conventional amphotericin B. Nonlipid amphotericin B requires preadministration of antihistamines and corticosteroids to decrease the severity of infusion-related reactions, but lipid formulations do not.

A patient with athlete's foot asks the nurse about the pathogenesis of fungal infections. What should the nurse include in the response? Select all that apply. 1 "Fungal infections are not fatal." 2 "Fungi can grow on skin and nails." 3 "Fungal infection may manifest as a mild illness." 4 "Fungal infections always spread through the oral route." 5 "Severe systemic fungal infections occur in immunocompromised people."

2 "Fungi can grow on skin and nails." 3 "Fungal infection may manifest as a mild illness." 5 "Severe systemic fungal infections occur in immunocompromised people." Dermatomycoses are fungal infections that develop on the skin, nails, or hair; they can range from mild, localized infections to serious, sometimes fatal systemic illness. Systemic fungal infections usually occur in patients with compromised immunity, such as those with acquired immune deficiency syndrome or patients who are receiving immunosuppressive drugs after an organ or bone marrow transplant. Infection may occur after oral ingestion, inhalation, or uncontrolled growth of normal skin flora.

Which instruction is appropriate for a patient who is on nonsteroidal antiinflammatory drug (NSAID) therapy? 1 Increase fluid intake to 1 to 2 L per day. 2 Take the NSAID with food, milk, or an antacid. 3 Stop the medication if you have any gastrointestinal disturbance. 4 Slowly increase the dosage of medication based on pain intensity.

2 Take the NSAID with food, milk, or an antacid. Gastrointestinal distress is the most common complication with NSAID therapy. Taking the medication along with food, milk, or an antacid minimizes gastrointestinal distress. Therefore, the nurse advises the patient to take the NSAID with food, milk, or an antacid. The nurse should tell the patient who is on antigout therapy to increase fluid intake to at least 3 L per day. The patient should immediately report to the health care team if he or she feels any gastrointestinal disturbance during NSAID therapy, but the patient should not stop the medication abruptly, because this may lead to complications. The nurse should not encourage the patient to increase the dosage of the medication based on pain intensity; this may lead to serious complications such as gastrointestinal bleeding due to toxicity.

A patient is prescribed enteric-coated aspirin for joint pain management. What does the nurse tell the patient while administering enteric-coated aspirin? 1 "You should chew the tablet properly." 2"You should swallow the tablet with water." 3 "You should crush the tablet and mix with food." 4 "You should dissolve the tablet in water and then ingest."

2"You should swallow the tablet with water." The enteric coating of the aspirin tablet prevents the release of the drug in the stomach; instead it dissolves in the duodenum. Because aspirin does not come in contact with the stomach; this dosage form prevents gastric ulceration. While administering enteric-coated aspirin, the patient should take certain precautionary measures. The patient should swallow the tablet with water.

Which statement by the patient leads the nurse to believe that the patient has understood the teaching regarding ethambutol? 1 "This medication may cause my bodily secretions to turn red-orange." 2 "Constipation will be a problem, so I will increase the fiber in my diet." 3 "I will need to have my eyes checked periodically while I am taking this drug." 4 "Dizziness, drowsiness, and decreased urinary output are common with this drug, but they will subside over time."

3 "I will need to have my eyes checked periodically while I am taking this drug." Ethambutol can cause optic neuritis. Ophthalmologic examinations should be performed periodically to assess visual acuity. Rifabutin, rifampin, and rifapentine (not ethambutol) turn bodily secretions orange. Constipation is not an adverse effect of ethambutol. Dizziness, drowsiness, and decreased urinary output are not common with ethambutol.

How is congenital malaria transmitted to an infant? 1 Through a mosquito bite 2 Through a blood transfusion 3Through an infected placenta 4 Through a contaminated needle

3 Through an infected placenta Malaria is an infectious disease caused by Plasmodium. The congenital route of infection or transmission takes place from mother to infant through an infected placenta. The most common route of transmission of malaria (not congenital malaria) is by the bite of a female anopheline mosquito. Malaria can also be transmitted through a blood transfusion, but not in a case of congenital malaria. An infant may also acquire malaria through contaminated needles, but not in a case of congenital malaria.

Which change observed in a patient on antitubercular therapy should the nurse immediately report to the primary health care provider? 1 Absence of fever 2 Increased urine output 3Tingling of extremities 4 Decreased sputum production

3 Tingling of extremities The nurse should immediately report to the primary health care provider any adverse changes in the patient's health status during drug therapy. These changes include numbness or a tingling sensation in the extremities, which indicates a potential central nervous system complication such as peripheral neuropathy. Absence of fever indicates the patient's adherence to drug therapy. It is not mandatory to report to the primary health care provider.

Which antifungal drug is available in injectable, oral, and topical preparations? 1 Nystatin 2 Terbinafine 3 Caspofungin 4Amphotericin B

4 Amphotericin B Amphotericin B is available in injectable, oral, and topical preparations. Nystatin is not available in a parenteral form. Terbinafine is available as a topical cream, gel, and spray. Caspofungin is available only in an injectable form.

A nurse is assessing a patient with malaria who has been prescribed an antiprotozoal drug. On reviewing the medical history of the patient, the nurse finds that the patient was previously prescribed analgesics, anticoagulants, antiemetics, and antibiotics. Which category of medication prescribed for the patient produces severe adverse effects from drug interaction? 1 Analgesics 2 Antibiotics 3 Antiemetics 4 Anticoagulants

4 Anticoagulants While assessing a patient with malaria who has been prescribed antiprotozoal drugs, the nurse should check the patient's medical history. It helps to identify and prevent the adverse effects caused by drug interaction. Antiprotozoal drugs interact with anticoagulants such as warfarin and increase the risk of bleeding by enhancing the action of anticoagulants. Analgesics can be administered with caution in patients for relief of joint pain. Antibiotics can be administered along with antiprotozoal drugs for synergistic effects. Antiemetics do not interact with antiprotozoal drugs, so they are safe to be administered.

Which form of the antifungal drug terbinafine is used primarily to treat onychomycoses of the fingernails or toenails? 1 Gel 2 Spray 3 Cream 4 Tablet

4 Tablet Terbinafine is an allylamine antifungal drug and is the only drug in its class. Onychomycoses of the fingernails or toenails are primarily treated using the oral form of terbinafine. Gel, spray, and cream forms are used for the treatment of superficial dermatologic infections.

The client asks the nurse about the use of herbal and dietary supplements to treat arthritis pain. What is the nurse's best response? Q. "High doses of vitamins and minerals have been used for many years to help maintain joint health." R. "There really are no safe herbal treatments for pain. Your best action would be to take your prescription medications." S. "Ginkgo biloba has shown tremendous benefit as an antiinflammatory drug and is used to treat the symptoms of pain." T. "There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider.

"There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider." There is evidence that clients would benefit from glucosamine and chondroitin supplements to decrease the pain of osteoarthritis. However, they should always be used in consultation with a health care provider.

Before discharge, the nurse is reviewing a client's prescribed medication regimen for tuberculosis (TB). The client asks the nurse why pyridoxine (vitamin B6) has been prescribed while continuing to take isoniazid (Nydrazid) to treat TB. What is the nurse's best response? A. "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria." B. "You really should not be on that drug. I will check with the health care provider." C. "Pyridoxine is another antitubercular drug that will work synergistically with the isoniazid." D. "Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid."

D. "Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid." Isoniazid can cause neurotoxicity. Pyridoxine, vitamin B6, is the drug of choice to prevent this adverse reaction. It is not an antiinfective drug and thus will not work to destroy the mycobacterium or prevent drug resistance.

What instruction should the nurse include for a client prescribed rifampin (Rifadin) and isoniazid (Nydrazid) prophylactically secondary to TB exposure? M. Advise that these drugs will only need to be taken for 7 to 10 days. N. Remind that sunscreen is not needed during outdoor activities. O. Explain that isoniazid may decrease blood serum glucose in susceptible people. P. Emphasize that oral contraceptives become ineffective when given with rifampin.

P. Emphasize that oral contraceptives become ineffective when given with rifampin. Women taking oral contraceptives who are prescribed rifampin must be switched to another form of birth control because oral contraceptives become ineffective when given with rifampin. These medications must be taken long term because mycobacterium is slow growing. They can cause photosensitivity, necessitating the use of sunscreen. Finally, isoniazid may increase, not decrease, serum glucose levels.

The patient tells the nurse, "I had a shot after I returned from my trip overseas. I thought that was supposed to stop me from getting a TB infection." What information regarding TB-related injections does the nurse identify as being true? BCG is used to prevent infection with TB for women of childbearing age. A positive result for a PPD test is indicated by redness at the site of injection. PPD is a diagnostic injection given intradermally to detect exposure to the TB organism. BCG is a vaccine injection derived from an activated strain of Mycobacterium bovis.

PPD is a diagnostic injection given intradermally to detect exposure to the TB organism.