Chapter 98: Antiprotozoal Drugs I: Antimalarial Agents

Chapter 98: Antiprotozoal Drugs I: Antimalarial Agents

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is teaching a group of nursing students about the two most common forms of malaria, Plasmodium vivax malaria and Plasmodium falciparum malaria. Which statement by a student indicates a need for further teaching?

a.	“Once erythrocyte forms of P. falciparum are eliminated, relapse will not occur.”
b.	“Patients with P. vivax malaria experience relapse with increased frequency over time.”
c.	“Patients with P. falciparum malaria experience symptoms at irregular intervals.”
d.	“Patients with P. vivax malaria rarely encounter drug resistance.”

 

 

ANS:  B

Relapse is likely with P. vivax malaria, because dormant parasites remain in the liver. Over time, episodes of relapse become less frequent and eventually stop entirely. Relapse does not occur with P. falciparum malaria, because this type does not form hypnozoites that can become dormant. Symptoms of P. falciparum malaria occur at irregular intervals, unlike those of P. vivax malaria, which peak every 48 hours. Drug resistance by P. vivax is relatively uncommon.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 1187-1189

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

 

2. A patient who is a missionary has returned from Africa to the United States and has completed treatment for an acute attack of P. vivax malaria. The provider has determined that clinical cure has been achieved. The nurse will expect to teach this patient about:

a.	beginning medications for a radical cure.
b.	beginning suppressive therapy.
c.	reporting visual disturbances and headaches.
d.	using insect repellents and mosquito netting.

 

 

ANS:  A

Once a clinical cure has been achieved with treatment of an acute attack, radical cure is begun if the patient is out of a malaria-endemic region and not likely to become reinfected. Because this patient has returned to the United States, radical cure therapy may begin. Suppressive therapy is used to prevent infection in individuals traveling to areas where malaria is endemic. Insect repellants and mosquito netting are nondrug measures to prevent infection and are not necessary for this patient.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1189

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A patient who frequently travels to Africa has been treated for an acute attack of P. vivax malaria. The patient asks the nurse about medications to prevent relapse. Which response by the nurse is correct?

a.	“The form of malaria that you have does not relapse after a clinical cure has been achieved.”
b.	“Until you are no longer traveling to Africa, relapse drugs will be postponed.”
c.	“Using mosquito netting and DEET when you travel will prevent relapse.”
d.	“You will be given prophylactic medications when you travel to prevent relapse.”

 

 

ANS:  B

Relapse prevention, or a clinical cure, is postponed in patients with P. vivax malaria as long as the risk of reinfection continues. P. vivax malaria does relapse, so this response is incorrect. Using nondrug measures can help prevent reinfection but are not guaranteed to do so. Prophylactic medications prevent acute symptoms but not invasion of the liver.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1189

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient has been treated for an acute attack of P. vivax malaria. For relapse prevention, the nurse expects the provider to order which medication?

a.	Chloroquine [Aralen Phosphate]
b.	Doxycycline [Vibramax]
c.	Primaquine phosphate
d.	Quinine [Qualaquin]

 

 

ANS:  C

The agent of choice for preventing relapse of P. vivax malaria is primaquine, which is highly active against the hepatic forms of P. vivax. Chloroquine is the drug of choice for treating mild to moderate acute attacks of either type of malaria. Doxycycline is used for chloroquine-resistant malaria. Quinine has little effect on hepatic forms of malaria, so it is not useful for relapse prevention.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1190-1193

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies