Chapter 91: Antifungal Agents

Chapter 91: Antifungal Agents

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1. A patient is taking oral ketoconazole (Nizoral) for a systemic fungal infection. The nurse reviews the medication administration record and notes that the patient is also taking omeprazole (Prilosec) for reflux disease. What action should the nurse take?

ANS:   B

The nurse should administer the omeprazole at least 2 hours after the ketoconazole to prevent a drug-drug interaction. Drugs that reduce gastric acidity should be administered no sooner than 2 hours after ingestion of ketoconazole because they reduce absorption of the drug.

Drugs that reduce gastric acidity should be administered no sooner than 2 hours after ingestion of ketoconazole because they reduce absorption of the drug.

There is no need to confer with prescriber or refuse to administer the drugs as this is an appropriate drug combination.

DIF:    Cognitive Level: Application             REF:    p. 1061

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The nurse is caring for a patient who has a fungal infection and has been prescribed fluconazole (Diflucan). The patient is also taking tolbutamide (Orinase). The nurse would especially monitor the patient for which effects?

ANS:   A

The nurse should monitor the patient for hypoglycemia. Fluconazole can increase levels of other drugs, including warfarin, phenytoin, sulfonylureas, and others. Because it would increase the effects of tolbutamide, the blood glucose level would be lowered.

The patient is not at risk for hyperglycemia, bleeding, or hyperkalemia.

DIF:    Cognitive Level: Analysis                  REF:    p. 1060

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

3. Voriconazole (Vfend), an antifungal used to treat life-threatening fungal infections, has which unique adverse effect?

ANS:   A

An adverse effect unique to voriconazole is visual disturbances.

Voriconazole does not cause kidney damage, osteopenia, or blood dyscrasias.

DIF:    Cognitive Level: Application             REF:    pp. 1060-1061

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse is preparing to administer micafungin (Mycamine) to a patient for the treatment of esophageal candidiasis. When the nurse reviews the medication administration record (MAR), which drug, when administered concurrently with micafungin, would cause the nurse the greatest concern?

ANS:   D

Micafungin has a drug-drug interaction with Procardia (a calcium channel clocker). Patients treated with micafungin should be monitored closely for signs of toxicity.

No drug-drug interactions are associated with micafungin and mycophenolate, cyclosporine, or tacrolimus.

DIF:    Cognitive Level: Analysis                  REF:    p. 1062

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies