Nokea
A patient is receiving chloroquine. The nurse would instruct the client to do which of the following?
- A. Avoid foods that acidify the urine.
- B. Take the drug on an empty stomach.
- C. Increase dosage if dosage missed once.
- D. Discontinue drug if color of urine changes.
Correct Answer: A
Rationale: The nurse should educate the patient to avoid foods that acidify the urine (cranberries, plums, prunes, meats, cheeses, eggs, fish, and grains), as they may interact with the antimalarial drug and increase excretion and thereby decrease the effectiveness of chloroquine while taking the drug. Taking the drug on an empty stomach is not advisable for antimalarial drugs. The nurse should instruct the patient to adhere to the dosage regimen unless instructed otherwise. Yellow or brownish discoloration of the urine during chloroquine treatment is normal; there is no need to discontinue the therapy.
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A nurse understands that anthelmintic drugs are contraindicated in which patients?
- A. Patients who are pregnant
- B. Patients with myasthenia gravis
- C. Patients with clinical depression
- D. Children younger than 15 years
Correct Answer: A
Rationale: Anthelmintic drugs are contraindicated in patients who are pregnant. Quinine, not anthelmintic drugs, should not be prescribed for patients with myasthenia gravis. Anthelmintic drugs are not known to be contraindicated in patients with clinical depression or in children younger than 15.
A patient is receiving doxycycline as short-term therapy for malaria. Which of the following instructions would the nurse include in the teaching plan about the possible side effects of the drug?
- A. Avoid taking warfarin because it increases the risk of bleeding.
- B. Avoid exposure to the sun by wearing protective clothing.
- C. Take the drug with food, or immediately afterward.
- D. Do not drive or perform other activities requiring alertness.
Correct Answer: B
Rationale: The nurse should instruct the patient to avoid exposure to the sun by wearing protective clothing (e.g., long-sleeved shirts, wide-brimmed hats) and by using sunscreen. Combining warfarin with quinine, not doxycycline, increases the risk of bleeding. Doxycycline should be taken on an empty stomach. Doxycycline does not impair alertness, so the patient can drive or perform other activities requiring alertness.
After teaching a group of nursing students about the actions of the various antifungal drugs, the instructor determines that the teaching was successful when the students identify which drug as having only fungistatic activity?
- A. Fluconazole
- B. Amphotericin B
- C. Miconazole
- D. Nystatin
Correct Answer: A
Rationale: Fluconazole has fungistatic activity, whereas amphotericin B, miconazole, and nystatin exert both fungicidal and fungistatic activity.
After teaching a group of nursing students about amphotericin B, the instructor determines that the teaching was successful when the students identify which of the following as true?
- A. The drug is light sensitive.
- B. It can be administered via IM injection.
- C. The drug can cause renal damage.
- D. Amphotericin B is administered in the outpatient setting.
- E. The drug should be used within 8 hours.
Correct Answer: A,C,E
Rationale: Amphotericin B is given only under close supervision in the hospital setting, can cause renal damage, is given IV usually over a period of 6 hours, and should be protected from light and used within 8 hours of reconstitution.
Which of the following should be included in the teaching plan when instructing a female client on the use of miconazole (Monistat) vaginal cream?
- A. Discontinue drug during the menstrual period.
- B. Avoid nylon and tight-fitting garments to avoid reinfection.
- C. Wear a sanitary napkin after insertion to prevent staining of clothes and bed linens.
- D. Do not have intercourse while taking the drug to avoid reinfection.
- E. If there is no improvement in 2 days, stop using the drug and consult a physician.
Correct Answer: B,C,D
Rationale: When instructing a female client on the use of miconazole (Monistat) vaginal cream, the nurse should include the following: inserting the drug high in the vagina using the applicator provided: wearing a sanitary napkin after insertion of the drug to prevent staining of clothes and bed linens; continuing the drug during the menstrual period; not having intercourse while taking the drug or advising her partner to use a condom to avoid reinfection; avoiding nylon and tight-fitting garments to avoid reinfection; stopping the drug and notifying the primary health care provider if there is no improvement in 5 to 7 days; and if abdominal pain, pelvic pain, rash, fever, or offensive-smelling vaginal discharge is present, not using the drug but notifying the physician.