Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A 17-year-old male patient with athlete’s foot is extremely upset that he cannot get
rid of it. He calls the clinic and asks the nurse whether the doctor can give him an
antibiotic to cure the infection. What should the nurse include in the explanation of
treatment for fungal infections?
a. Fungi differ from bacteria in that the fungus has flexible cell walls that
allow for free transfer into and out of the cell.
b. Protective layers contain sterols, which change the membrane permeability.
c. The composition of the protective layers of the fungal cell makes the
organism resistant to antibiotics.
d. Fungi cell walls contain Candida, which makes the cells rigid.
Ans: C
Feedback:
The nurse should tell the patient that the composition of the protective layers of the
fungal cell makes the organism resistant to antibiotics so that antibiotics would not
have any positive effect. Fungi do differ from bacteria, but the fungus has rigid cell
walls that allow for free transfer in and out of the cell. The protective layers contain
ergosterol, not Candida, that helps keep the cell wall rigid, not permeable.
2. The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with
cryptococcal meningitis. What drug will the nurse anticipate receiving an order for
to treat this child?
a. Amphotericin B (Fungizone)
b. Fluconazole (Diflucan)
c. Griseofulvin (Fulvicin)
d. Ketoconazole (Nizoral)
Ans: B
Feedback:
Fluconazole is used in the treatment of cryptococcal meningitis and is safe to use in a
1-year-old child. Amphotericin B has many unpleasant adverse effects and is very
potent, so it would not be the first or best medication to administer initially but would
be reserved for use if fluconazole was not effective. Griseofulvin is given to treat
tinea pedis and tinea unguium in children. Ketoconazole is not given to children
younger than 2 years because safety has not been established.
3. The nurse is teaching the patient about a newly prescribed systemic antifungal
drug. What sign or symptom will the nurse instruct the patient to report to the
provider immediately?
, a. Unusual bruising and bleeding
b. Constipation or diarrhea
c. Red and dry eyes
d. Increased appetite with weight gain
Ans: A
Feedback:
Unusual bruising and bleeding can be an indication of hepatic toxicity, which should
be reported immediately. Yellowing of the eyes, not redness, and tearing are also
indicative of hepatic toxicity. Usually GI symptoms include nausea and vomiting with
antiviral drugs, which could cause decreased appetite and weight loss. These
symptoms should be reported if they persist but are not emergency symptoms to
report immediately.
4. A patient who has a tinea infection calls the clinic and complains of intense local
burning and irritation with use of a topical antifungal drug. Even before asking the
patient, the nurse suspects he or she is applying what medication?
a. Butoconazole (Gynazole I)
b. Ciclopirox (Loprox)
c. Econazole (Spectazole)
d. Haloprogin (Halotex)
Ans: C
Feedback:
Econazole can cause intense local burning and irritation in treatment of tinea
infections. Butoconazole is used to treat vaginal Candida infections. Ciclopirox is
used to treat toenail and fingernail tinea infections and does not produce intense
burning and irritation. Haloprogin is used to treat athlete’s foot, jock itch, and
ringworm infections and is not associated with burning or irritation.
5. A patient asks the nurse if he or she should use a topical antifungal. The nurse is
aware that the most important contraindication to topical antifungals is what?
a. Hepatic impairment
b. Renal impairment
c. Congestive heart failure
d. Known allergy to any of the antifungal drugs
Ans: D
Feedback:
Topical antifungals are not absorbed systemically so they are not metabolized and
excreted. As a result, the only contraindication would be an allergy to the drug.
Hepatic and renal impairment and congestive heart failure would not be a
contraindication because these drugs do not enter the bloodstream and impact these
organ systems.
1. A 17-year-old male patient with athlete’s foot is extremely upset that he cannot get
rid of it. He calls the clinic and asks the nurse whether the doctor can give him an
antibiotic to cure the infection. What should the nurse include in the explanation of
treatment for fungal infections?
a. Fungi differ from bacteria in that the fungus has flexible cell walls that
allow for free transfer into and out of the cell.
b. Protective layers contain sterols, which change the membrane permeability.
c. The composition of the protective layers of the fungal cell makes the
organism resistant to antibiotics.
d. Fungi cell walls contain Candida, which makes the cells rigid.
Ans: C
Feedback:
The nurse should tell the patient that the composition of the protective layers of the
fungal cell makes the organism resistant to antibiotics so that antibiotics would not
have any positive effect. Fungi do differ from bacteria, but the fungus has rigid cell
walls that allow for free transfer in and out of the cell. The protective layers contain
ergosterol, not Candida, that helps keep the cell wall rigid, not permeable.
2. The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with
cryptococcal meningitis. What drug will the nurse anticipate receiving an order for
to treat this child?
a. Amphotericin B (Fungizone)
b. Fluconazole (Diflucan)
c. Griseofulvin (Fulvicin)
d. Ketoconazole (Nizoral)
Ans: B
Feedback:
Fluconazole is used in the treatment of cryptococcal meningitis and is safe to use in a
1-year-old child. Amphotericin B has many unpleasant adverse effects and is very
potent, so it would not be the first or best medication to administer initially but would
be reserved for use if fluconazole was not effective. Griseofulvin is given to treat
tinea pedis and tinea unguium in children. Ketoconazole is not given to children
younger than 2 years because safety has not been established.
3. The nurse is teaching the patient about a newly prescribed systemic antifungal
drug. What sign or symptom will the nurse instruct the patient to report to the
provider immediately?
, a. Unusual bruising and bleeding
b. Constipation or diarrhea
c. Red and dry eyes
d. Increased appetite with weight gain
Ans: A
Feedback:
Unusual bruising and bleeding can be an indication of hepatic toxicity, which should
be reported immediately. Yellowing of the eyes, not redness, and tearing are also
indicative of hepatic toxicity. Usually GI symptoms include nausea and vomiting with
antiviral drugs, which could cause decreased appetite and weight loss. These
symptoms should be reported if they persist but are not emergency symptoms to
report immediately.
4. A patient who has a tinea infection calls the clinic and complains of intense local
burning and irritation with use of a topical antifungal drug. Even before asking the
patient, the nurse suspects he or she is applying what medication?
a. Butoconazole (Gynazole I)
b. Ciclopirox (Loprox)
c. Econazole (Spectazole)
d. Haloprogin (Halotex)
Ans: C
Feedback:
Econazole can cause intense local burning and irritation in treatment of tinea
infections. Butoconazole is used to treat vaginal Candida infections. Ciclopirox is
used to treat toenail and fingernail tinea infections and does not produce intense
burning and irritation. Haloprogin is used to treat athlete’s foot, jock itch, and
ringworm infections and is not associated with burning or irritation.
5. A patient asks the nurse if he or she should use a topical antifungal. The nurse is
aware that the most important contraindication to topical antifungals is what?
a. Hepatic impairment
b. Renal impairment
c. Congestive heart failure
d. Known allergy to any of the antifungal drugs
Ans: D
Feedback:
Topical antifungals are not absorbed systemically so they are not metabolized and
excreted. As a result, the only contraindication would be an allergy to the drug.
Hepatic and renal impairment and congestive heart failure would not be a
contraindication because these drugs do not enter the bloodstream and impact these
organ systems.
