Question 1

A patient is diagnosed with histoplasmosis and will begin taking ketoconazole.What information will the nurse include when teaching this patient about this medication?

Accepted Answer

Ketoconazole should be taken with food.It is administered once daily.Patients taking antifungals should not consume alcohol.Antifungals can cause liver and renal toxicity,so patients will need lab monitoring.

Question 2

A patient who is taking metronidazole (Flagyl)reports reddish-brown urine.Which action will the nurse take?

Accepted Answer

Reddish-brown urine is a harmless side effect of metronidazole and is not cause for concern.

Question 3

The nurse is preparing to administer an intravenous polymyxin antibiotic.The patient reports dizziness along with numbness and tingling of the hands and feet.The nurse will perform which action?

Accepted Answer

Polymyxins can cause nephrotoxicity and neurotoxicity.This patient has signs of neurotoxicity,so the nurse should notify the provider.These effects are generally reversible when the drug is discontinued.It is not correct to administer the drug when these symptoms are present.Polymyxins are not absorbed orally.Serum electrolytes are not indicated.

Question 4

A patient is diagnosed with tinea capitis.The provider will order which systemic antifungal medication for this patient?

Accepted Answer

Griseofulvin is used to treat tinea capitis.Anidulafungin is used to treat esophageal candidiasis,candidemia,and other Candida infections.Fluconazole is used to treat Candida infections and cryptococcal meningitis.Ketoconazole is used to treat Candida infections,histoplasmosis,blastomycosis,and other infections.

Question 5

Which topical antifungal medication is used to treat vaginal candidiasis?

Accepted Answer

Topical miconazole is used to treat vaginal candidiasis.

Question 6

A patient who has tuberculosis asks the nurse why three drugs are used to treat this disease.The nurse will explain that multi-drug therapy is used to reduce the likelihood of

Accepted Answer

Without multi-drug therapy,patients easily develop resistance to antitubercular drugs.Using more than one antitubercular drug does not prevent relapse,hypersensitivity reactions,or adverse effects.

Question 7

The nurse is teaching a patient about rifampin.Which statement by the patient indicates understanding of the teaching?

Accepted Answer

Patients taking rifampin should be warned that urine,feces,saliva,sputum,sweat,and tears may turn a harmless red-orange color.Patients should not wear soft contact lenses to avoid permanent staining.Regular eye exams are necessary for patients who receive isoniazid and ethambutol.Orange urine is a harmless side effect and does not need to be reported.Renal toxicity is not common with rifampin.

Question 8

A young adult female who is taking metronidazole (Flagyl)to treat trichomoniasis calls the nurse to report severe headache,flushing,palpitations,cramping,and nausea.What will the nurse do next?

Accepted Answer

Patients who are taking metronidazole can experience a disulfiram-like reaction when they drink alcohol.These are not harmless adverse effects or a sign of worsening of her infection.

Question 9

A patient who is taking isoniazid (INH)as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes.The nurse will recommend discussing which treatment with the provider?

Accepted Answer

Peripheral neuropathy is an adverse reaction to INH,so pyridoxine is usually given to prevent this.It is not necessary to change medications.Increasing fluids will not help with this.

Question 10

A patient who has AIDS is at risk to contract aspergillosis.The nurse will anticipate that which antifungal medication will be ordered prophylactically for this patient?

Accepted Answer

Posaconazole is given for prophylactic treatment of Aspergillus and Candida infections.

Question 11

The nurse is teaching a nursing student about the antifungal drug amphotericin B.Which statement by the student indicates a need for further teaching?

Accepted Answer

Amphotericin B is not absorbed from the gastrointestinal tract,so is not given by mouth.It can cause nephrotoxicity and electrolyte imbalance.It is highly toxic and is reserved for severe,systemic infections.

Question 12

A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis.Before administering this medication,the nurse will review which laboratory values in the patient's medical record?

Accepted Answer

Streptomycin can cause significant renal toxicity.

Question 13

The nurse is caring for a patient who is diagnosed with tuberculosis.The patient tells the nurse that the provider plans to order a prophylactic antitubercular drug for family members and asks which drug will be ordered.The nurse will expect the provider to order which drug?

Accepted Answer

INH is the drug of choice for prophylactic treatment of patients who have had close contact with a patient who has tuberculosis.

Question 14

A patient who has chronic liver disease reports contact with a person who has tuberculosis (TB).The nurse will counsel this patient to contact the provider to discuss

Accepted Answer

Patients who have exposure to TB should have a TB skin test.A chest x-ray is performed if the skin test is positive.LFTs do not need to be done simply because of TB exposure.This patient is not a candidate for antitubercular drug prophylaxis.

Question 15

The nurse caring for a patient who has tuberculosis and who is taking isoniazid,rifampin,and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin.The nurse will anticipate that the provider will take which action?

Accepted Answer

The patient's current regimen is first-phase treatment.If resistance to streptomycin develops,the provider can change to kanamycin or to ciprofloxacin.Ethambutol is added if there is resistance to isoniazid.Clarithromycin is used during phase II.Renal function tests are not indicated.

Question 16

Which person should be treated with prophylactic antitubercular medication?

Accepted Answer

Personal contact with a person having a diagnosis of tuberculosis is required to indicate prophylactic treatment with antitubercular therapy.Attending the same school does not necessarily mean close contact occurs.Health care professionals do not need prophylactic treatment.HIV-positive individuals with negative TB skin tests do not need prophylaxis.

Question 17

A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan).The nurse will expect to monitor which lab values in this patient?

Accepted Answer

Patients taking sulfonylurea drugs may have altered serum glucose when taking antifungal medications.

Question 18

A patient who has oral candidiasis will begin using nystatin suspension to treat the infection.What information will the nurse include when teaching this patient?

Accepted Answer

Patients should be taught to swish the suspension in the mouth to coat the tongue and buccal mucosa and then swallow the medication.It should not be spit out,diluted with water,or swallowed with water.

Question 19

A patient is being treated with isoniazid (INH),rifampin,and pyrazinamide in phase I of treatment for tuberculosis.The organism develops resistance to isoniazid.Which drug will the nurse anticipate the provider will order to replace the isoniazid?

Accepted Answer

If there is bacterial resistance to isoniazid,the first phase may be changed to ethambutol,rifampin,and pyrazinamide.Ciprofloxacin,kanamycin,and streptomycin are not generally first-line antitubercular drugs.

Question 20

A patient who has completed the first phase of a three-drug regimen for tuberculosis has a positive sputum acid-bacilli test.The nurse will tell the patient that

Accepted Answer

The goal is for the patient's sputum test to be negative 2 to 3 months after the therapy.The positive test does not indicate drug resistance.The provider will not change the drugs or keep the patient in the first phase longer than planned.

Quiz 32: Antituberculars, Antifungals, peptides, and Metronidazole