Chapter 36

Which data should the nurse review prior to administering nystatin to a female client? 1) Positive pregnancy 2) Last menstrual period 3) Type of contraception used 4) Height and weight

1) Positive pregnancy p540 prototype box--> oral Class C (question doesnt say whether it is oral or topical...)

A client with a fungal infection of the toenails prescribed oral terbinafine (Lamisil) asks the nurse how a pill will heal the nail infection. What should be the nurse's response? 1) "The prescription accumulates in the nail beds and remains there for many months." 2) "The prescription will be combined with a topical agent to increase effectiveness." 3) "The prescription works by destroying toxins excreted by the fungi in your nails." 4) "The prescription works by destroying circulating fungi in your blood."

1) "The prescription accumulates in the nail beds and remains there for many months." (pg. 541 --> R side 2nd paragraph)

Which information should the nurse include in the client teaching for amebiasis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "The primary symptom is diarrhea." 2) "Severe muscle cramping is a common symptom." 3) "Amebiasis may damage the liver." 4) "Brain abscesses are the typical fatal event." 5) "Amebiasis is contracted through contact with contaminated water."

1) "The primary symptom is diarrhea." 3) "Amebiasis may damage the liver." 5) "Amebiasis is contracted through contact with contaminated water." (pg 544, table 36.6 first bullet)

A parent of a child diagnosed with pinworms tells the nurse they are concerned about administering the prescription because it may be toxic. Which information should the nurse include in the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Very little of the drug is absorbed into the system." 2) "Severe infestations can result in malabsorption." 3) "It is critical that you give this medication." 4) "Many types of pinworms are resistant to treatment." 5) "The child may be at an increased risk for immunosuppression."

1) "Very little of the drug is absorbed into the system." 2) "Severe infestations can result in malabsorption." (pg 546, R side second paragraph, pg 547, prototype--->A&U)

Which information should the nurse include in the education for a client prescribed rifampin (Rifadin)? 1) "Your urine may turn reddish orange." 2) "Your skin may turn yellowish orange." 3) "Your stools may turn black." 4) "Your sweat may turn yellow."

1) "Your urine may turn reddish orange." (pg. 531, 4th one down in AE)

The nurse is preparing education for a client prescribed metronidazole (Flagyl). Which laboratory tests should the nurse anticipate to be affected by the prescription? 1) ALT/AST 2) BUN/Creatinine 3) CBC 4) Electrolytes

1) ALT/AST (pg. 546, Prototype box-->LT)

Which nursing interventions are required for the client prescribed amphotericin B (Fungizone)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Administer the medication by IV push. 2) Administer acetaminophen before giving the amphotericin B (Fungizone). 3) Review the BUN level. 4) Administer corticosteroids 1 hour after infusion is completed. 5) Monitor for GI bleeding.

1) Administer the medication by IV push. 2) Administer acetaminophen before giving the amphotericin B (Fungizone). 3) Review the BUN level. pg 537, drug box, actions/uses & admin alerts

Which information should the nurse include in the education for a client prescribed an oral suspension of nystatin (Nystop) for oral fungal infection? 1) Apply with a swab to the affected area. 2) Mix the solution in 1 cup of water. 3) Swallow the solution as soon as possible. 4) Swish in the mouth for 2 minutes.

1) Apply with a swab to the affected area. pg 540, drug box, admin alerts first bullet point (this is for ped patients, adults should be swishing for 2 minutes)

The nurse is caring for a client suspected of an overdose of amphotericin B (Fungizone). Which condition should the nurse observe the client for? 1) Cardiorespiratory arrest 2) Acute renal failure 3) Hepatotoxicity 4) Stevens-Johnson Syndrome

1) Cardiorespiratory arrest (pg. 537, Prototype box--> AE)

Which findings indicate the prescription used to treat a client's tuberculosis is therapeutic? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Diminished cough 2) Diminished nausea 3) Diminished fever 4) Diminished pain 5) Diminished sputum

1) Diminished cough 3) Diminished fever 4) Diminished pain 5) Diminished sputum (pg 534, NP-->R side first bullet)

Which information should the nurse include in the education for a client prescribed metronidazole (Flagyl)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Do not drink alcohol with this medication. 2) Do not take this medication with milk or milk products. 3) Drink at least 3000 mL of fluid per day with this medication. 4) Do not become pregnant while taking this medication. 5) You may experience a metallic taste while on this medication.

1) Do not drink alcohol with this medication. 4) Do not become pregnant while taking this medication. 5) You may experience a metallic taste while on this medication. (pg. 546, prototype box-->AE, CI, DD)

Which information should the nurse include in the education for a client prescribed mebendazole (Vermox)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Effectively treats adult parasites 2) High concentrations of the drug remain in the intestine 3) Generally requires a few days of therapy 4) Treatment of the larva will require a different prescription 5) The prescription should be taken with a high-fat meal

1) Effectively treats adult parasites 2) High concentrations of the drug remain in the intestine 3) Generally requires a few days of therapy 5) The prescription should be taken with a high-fat meal (pg 547, prototype box-->A&U, H/F)

Which symptoms should the nurse instruct a client receiving amphotericin B (Fungizone) to report? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Fever 2) Hearing loss 3) Dizziness 4) Constipation 5) Heart palpitations

1) Fever 2) Hearing loss 3) Dizziness 5) Heart palpitations (pg 537, prototype box-->AE)

Which mechanism of action do azole antifungals have? 1) Interfere with the synthesis of ergosterol 2) Cytotoxic effect on the fungus 3) Interferes with DNA replication 4) Impair fungal cellular growth

1) Interfere with the synthesis of ergosterol (pg 537, R side bottom paragraph)

Which information should the nurse include in the education for a client prescribed isoniazid (INH) for tuberculosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Return to the clinic in 1 month for laboratory work. 2) Report any numbness in your hands or feet. 3) Take your prescription with food. 4) Avoid the use of alcohol 5) Avoid aged cheeses and smoked meats.

1) Return to the clinic in 1 month for laboratory work. 2) Report any numbness in your hands or feet. 4) Avoid the use of alcohol 5) Avoid aged cheeses and smoked meats. (pg 533, prototype box--> AE,DD, LT)

Which physical areas does a superficial fungal infection affect? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Skin 2) Lungs 3) Nails 4) GI tract 5) Vagina

1) Skin 3) Nails 5) Vagina (pg. 535, L Side 2nd paragraph)

Which information should the nurse include in the education for a parent of a child diagnosed with ascariasis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Your child has pinworms." 2) "Children get worms from playing in infected soil." 3) "Treatment will consist of medication for 3 days." 4) "No treatment will be necessary after I give this one pill." 5) "No treatment is necessary; the worms will die on their own."

2) "Children get worms from playing in infected soil." 3) "Treatment will consist of medication for 3 days." (pg. 546, R side under 36.10)

The nurse has provided education for a client prescribed an antifungal. Which statement made by the client indicates further teaching is required? 1) "I will increase my fluid intake to 2 L per day." 2) "I will get up slowly to avoid feeling dizzy." 3) "I will avoid drinking carbonated beverages." 4) "I will take my prescription with milk."

2) "I will get up slowly to avoid feeling dizzy." pg 542, second box in the left column & 9th box in right column. It does elude to orthostatic hypotension but that is not the "best" answer

The nurse has provided education for a client being treated for pinworms with mebendazole (Vermox). Which statement made by the client indicates an understanding of the information? 1) "I will consume high-fiber foods to help with passage of the worms." 2) "I will make sure to chew the tablet." 3) "I will avoid aspirin while I am on this medication." 4) "I must have three negative stool cultures before I am cured."

2) "I will make sure to chew the tablet." pg 547, drug box, admin alerts

The nursing educator reviews the subject of fungal infections with a nurse. Which statements made by the nurse indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Superficial infections are more difficult to treat than systemic infections." 2) "Newer medications can be used for superficial as well as systemic infections." 3) "Systemic infections are much more common than superficial infections." 4) "Superficial infections are considered more benign than systemic infections." 5) "Systemic infections require oral medications that have serious adverse effects."

2) "Newer medications can be used for superficial as well as systemic infections." 4) "Superficial infections are considered more benign than systemic infections." 5) "Systemic infections require oral medications that have serious adverse effects." pg 541

Which class of antifungals is the largest and most versatile group? 1) Polyene 2) Azole 3) Anthelminthic 4) Mycolic acid inhibitor

2) Azole (pg. 537. R side last paragraph)

Which is the most common type of opportunistic fungal infection? 1) Cryptococcus neoformans 2) Candida albicans 3) Pneumocystis jiroveci 4) Microsporum species

2) Candida albicans (pg. 532-535, last line of 532 continued)

The nurse reviewing a client's records notes the client has been receiving nitazoxanide (Alinia). Which question should the nurse ask the client? 1) "Has your partner been treated?" 2) "Do you still have mosquito bites?" 3) "Do you have access to clean water?" 4) "Are you still cleaning the cat litter box?"

3) "Do you have access to clean water?" (table 36.6 on Pg. 544)

The nurse has provided education for a client prescribed a topical antifungal. Which statement made by the client indicates further teaching is needed? 1) "I will allow the area to dry after applying the prescription." 2) "I will make sure my clothing is loose over the area." 3) "I will protect the area with an occlusive dressing." 4) "I will not scrub the area where the prescription will be applied."

3) "I will protect the area with an occlusive dressing." (pg. 543, NP--> R side in PCC 2nd to last bullet)

Which laboratory values should the nurse plan on monitoring for the client receiving amphotericin B (Fungizone)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Serum amylase 2) Serum sodium 3) BUN 4) Serum glucose 5) Serum creatinine

3) BUN 5) Serum creatinine pg 537, drug box, lab tests

A client receiving an oral nystatin suspension for a candida infection tells the nurse that he cannot continue to "swish and swallow" because his nausea is too great. What should be the nurse's response? 1) "I will ask your healthcare provider if a pill form can be substituted." 2) "Try having a carbonated drink after you swallow the prescription." 3) "You can swish the prescription around and then spit it out." 4) "I will request an antiemetic to be prescribed for you."

4) "I will request an antiemetic to be prescribed for you." (pg 542, NP--> Left hand 2nd from bottom)

A client who has had malaria for many years asks the nurse why the prescriptions might not cure his or her illness when there are several drugs available. Which is the best response by the nurse? 1) "When erythrocytes rupture, the parasites are too numerous for prescriptions to be effective." 2) "Late in the illness, the immune system is too overwhelmed for prescriptions to be effective." 3) "Once the parasite starts multiplying in your liver, prescriptions are usually ineffective." 4) "When cysts occur late in the disease, the parasite is too resistant for the prescriptions to be effective."

4) "When cysts occur late in the disease, the parasite is too resistant for the prescriptions to be effective." pg 543, 2nd paragraph left column

Which prophylactic treatment should the nurse anticipate to be prescribed for a client prior traveling to Africa? 1) Antibiotics 2) Protease inhibitors 3) Immunizations for malaria 4) Antimalarial drugs

4) Antimalarial drugs pg 543-544, 36.8

Which prescription should the nurse anticipate prescribed for a client with trichomoniasis? 1) Praziquantel (Biltricide) 2) Chloroquine (Aralen) 3) Nitazoxanide (Alinia) 4) Metronidazole (Flagyl)

4) Metronidazole (Flagyl) (pg. 546, prototype box-->A&U, 3rd line in)

Which client is at the greatest risk for acquiring a fungal infection? 1) The client with severe burns over 20% of the body 2) The adolescent client with a fractured femur 3) The client with anemia who is pregnant with triplets 4) The client with malignant melanoma who is receiving chemotherapy

4) The client with malignant melanoma who is receiving chemotherapy pg 535, 36.2, 3rd full paragraph talks about compromised immune system