Chapter 42: Antifungal Drugs

Chapter 42: Antifungal Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first?

a.	Discontinue the infusion immediately.
b.	Reduce the infusion rate gradually until the adverse effects subside.
c.	Administer the medication by rapid IV infusion to reduce these effects.
d.	Nothing; these are expected side effects of this medication.

 

 

ANS:  A

Once the intravenous infusion of amphotericin B has begun, vital signs must be monitored frequently to assess for adverse reactions such as cardiac dysrhythmias, visual disturbances, paresthesias (numbness or tingling of the hands or feet), respiratory difficulty, pain, fever, chills, and nausea. If these adverse effects or a severe reaction occur, the infusion must be discontinued (while the patient is closely monitored) and the prescriber contacted. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 676

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction?

a.	Reduced action of oral anticoagulants
b.	Increased effects of oral anticoagulants
c.	Hypokalemia
d.	Decreased effectiveness of the antifungal drug

 

 

ANS:  B

Azole antifungal drugs increase the effects of oral anticoagulants. As a result, increased bleeding may occur. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 675

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B?

a.	Discontinuing the infusion immediately if fever, chills, or nausea occur
b.	Gradually increasing the infusion rate until the expected adverse effects occur
c.	If fever, chills, or nausea occur during the infusion, administering medications to treat the symptoms
d.	Before beginning the infusion, administering an antipyretic and an antiemetic drug

 

 

ANS:  D

Almost all patients given the drug intravenously experience fever, chills, hypotension, tachycardia, malaise, muscle and joint pain, anorexia, nausea and vomiting, and headache. For this reason, pretreatment with an antipyretic (acetaminophen), antihistamines, and antiemetics may be conducted to decrease the severity of the infusion-related reaction. The other options are incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 672

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember?

a.	The lipid formulations may be given in oral form.
b.	The doses are much lower than the doses of the older drugs.
c.	The lipid formulations are associated with fewer adverse effects than the older drugs.
d.	There is no difference in cost between the newer and older forms.

 

 

ANS:  C

Newer lipid formulations of amphotericin B have been developed in an attempt to decrease the incidence of its adverse effects and increase its efficacy. However, the lipid formulations are more costly.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   p. 673

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies