Chapter 35 Antiprotozoal Drugs
1. The patient is having an acute malarial attack with chills and fever. The nurse knows
chills and fever are caused by what?
A) Formation of sporozoites into the system
B) Rupture of red blood cells due to invasion of merozoites
C) Invasion of the tsetse fly into the central nervous system
D) Release of amastigotes into the blood vessels
Ans B
Feedback
The chills and fever associated with an acute malarial attack are caused by the rupture of
red blood cells containing merozoites. These symptoms are related to the pyrogenic
effects of the protozoa and the toxic effects of the red blood cell components on the
system. The formation of sporozoites occurs in the stomach of the mosquito when the
male and female gametocytes mate and produce a zygote. Invasion of the tsetse fly causes
trypanosomiasis, which affects the central nervous system. The release of amastigotes
occurs in leishmaniasis, which is caused by the sand fly and is part of a cyclic pattern that
causes serious skin lesions.
2. The nurse is caring for a patient of Greek descent who plans to travel to an area of the
world in which malaria is endemic. What should this patient be tested for before
administering antimalarial medications?
A) Tay-Sachs disease
B) Glucose-6-phosphate dehydrogenase (G6PD) deficiency
C) Plasmodium
D) Penicillin allergy
Ans B
Feedback
Patients of Mediterranean descent, including Greeks, are more likely to have a G6PD
deficiency. When patients with this deficiency take primaquine, chloroquine, or quinine,
an acute hemolytic crisis may occur. Patients of Mediterranean descent should be tested
for G6PD deficiency before any antimalarial drugs are prescribed. Tay-Sachs disease is a
disorder seen in those of middle-eastern descent that causes death of the child by age 5.
Plasmodium is the genus strain that causes malaria. Penicillin allergy has no connection
to this situation.
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3. The nurse is caring for a patient who is being treated with quinine (Qualaquin) for drug-
resistant malaria. The nurse will monitor the patient for cinchonism that will present
with what manifestations?
A) Diarrhea, nausea, and fever
B) Yellowing of the sclera and skin
C) Tremors and ataxia
D) Vomiting, tinnitus, and vertigo
Ans D
Feedback
Patients with cinchonism or quinine toxicity may complain of tinnitus, headache,
dizziness, nausea, fever, tremors, and visual disturbances. Diarrhea, yellowing of
the sclera or skin, and ataxia are not associated with cinchonism.
4. Patients receiving chloroquine (Aralen Phosphate) for malaria prophylaxis should receive
patient teaching from the nurse, which includes instructions to receive what regularly?
A) Cardiovascular studies
B) Eye exams
C) Immunizations
D) Pulmonary studies
Ans B
Feedback
Chloroquine is associated with visual disturbances and a patient receiving this drug
should receive regular ophthalmic exams. Heart and lung toxicity is not associated with
chloroquine use. Immunizations are not associated with chloroquine use.
5. A 28-year-old woman is planning to be part of a mission team going to Central Africa.
She will take mefloquine (Lariam) once a week, beginning 1 week before traveling to
Africa until 4 weeks after leaving Africa. What precaution will the nurse teach this
patient is needed?
A) Avoid excessive weight gain.
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B) Have regular cancer screening.
C) Use contraceptives to avoid pregnancy.
D) Stop the medication if diabetes is diagnosed.
Ans C
Feedback
Mefloquine is teratogenic and should be avoided during pregnancy. The nurse will
want to determine whether a possibility exists that the patient is pregnant and warn
about the need to avoid pregnancy for 2 months after completing therapy. Avoiding
weight gain and having regular cancer screenings are good preventive care but not
associated with mefloquine. This medication is not contraindicated in patients with
diabetes.
6. The nurse is writing a plan of care for a patient receiving antimalarial drug therapy. What
nursing diagnosis would be appropriate for this patient if common adverse effects were
indicated?
A) Disturbed sensory perception (visual) related to central nervous system effects
B) Imbalanced nutrition more than body requirements
C) Constipation
D) Ineffective breathing pattern
Ans A
Feedback
Visual disturbances, including blindness related to retinal damage from the drug,
may occur. Patients usually have gastrointestinal (GI) upset including diarrhea, not
constipation, which could produce loss of weight and not an increase. Respiratory
disturbances are not associated with antimalarial agents.
7. During a lecture on intestinal parasites, the students learn that what is the most commonly
diagnosed intestinal parasite infection in the United States?
A) Amebiasis
B) Giardiasis
C) Leishmaniasis
D) Trichomoniasis
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1. The patient is having an acute malarial attack with chills and fever. The nurse knows
chills and fever are caused by what?
A) Formation of sporozoites into the system
B) Rupture of red blood cells due to invasion of merozoites
C) Invasion of the tsetse fly into the central nervous system
D) Release of amastigotes into the blood vessels
Ans B
Feedback
The chills and fever associated with an acute malarial attack are caused by the rupture of
red blood cells containing merozoites. These symptoms are related to the pyrogenic
effects of the protozoa and the toxic effects of the red blood cell components on the
system. The formation of sporozoites occurs in the stomach of the mosquito when the
male and female gametocytes mate and produce a zygote. Invasion of the tsetse fly causes
trypanosomiasis, which affects the central nervous system. The release of amastigotes
occurs in leishmaniasis, which is caused by the sand fly and is part of a cyclic pattern that
causes serious skin lesions.
2. The nurse is caring for a patient of Greek descent who plans to travel to an area of the
world in which malaria is endemic. What should this patient be tested for before
administering antimalarial medications?
A) Tay-Sachs disease
B) Glucose-6-phosphate dehydrogenase (G6PD) deficiency
C) Plasmodium
D) Penicillin allergy
Ans B
Feedback
Patients of Mediterranean descent, including Greeks, are more likely to have a G6PD
deficiency. When patients with this deficiency take primaquine, chloroquine, or quinine,
an acute hemolytic crisis may occur. Patients of Mediterranean descent should be tested
for G6PD deficiency before any antimalarial drugs are prescribed. Tay-Sachs disease is a
disorder seen in those of middle-eastern descent that causes death of the child by age 5.
Plasmodium is the genus strain that causes malaria. Penicillin allergy has no connection
to this situation.
Page 1 of 17
, lOMoARcPSD|35516335
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3. The nurse is caring for a patient who is being treated with quinine (Qualaquin) for drug-
resistant malaria. The nurse will monitor the patient for cinchonism that will present
with what manifestations?
A) Diarrhea, nausea, and fever
B) Yellowing of the sclera and skin
C) Tremors and ataxia
D) Vomiting, tinnitus, and vertigo
Ans D
Feedback
Patients with cinchonism or quinine toxicity may complain of tinnitus, headache,
dizziness, nausea, fever, tremors, and visual disturbances. Diarrhea, yellowing of
the sclera or skin, and ataxia are not associated with cinchonism.
4. Patients receiving chloroquine (Aralen Phosphate) for malaria prophylaxis should receive
patient teaching from the nurse, which includes instructions to receive what regularly?
A) Cardiovascular studies
B) Eye exams
C) Immunizations
D) Pulmonary studies
Ans B
Feedback
Chloroquine is associated with visual disturbances and a patient receiving this drug
should receive regular ophthalmic exams. Heart and lung toxicity is not associated with
chloroquine use. Immunizations are not associated with chloroquine use.
5. A 28-year-old woman is planning to be part of a mission team going to Central Africa.
She will take mefloquine (Lariam) once a week, beginning 1 week before traveling to
Africa until 4 weeks after leaving Africa. What precaution will the nurse teach this
patient is needed?
A) Avoid excessive weight gain.
Page 2 of 17
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B) Have regular cancer screening.
C) Use contraceptives to avoid pregnancy.
D) Stop the medication if diabetes is diagnosed.
Ans C
Feedback
Mefloquine is teratogenic and should be avoided during pregnancy. The nurse will
want to determine whether a possibility exists that the patient is pregnant and warn
about the need to avoid pregnancy for 2 months after completing therapy. Avoiding
weight gain and having regular cancer screenings are good preventive care but not
associated with mefloquine. This medication is not contraindicated in patients with
diabetes.
6. The nurse is writing a plan of care for a patient receiving antimalarial drug therapy. What
nursing diagnosis would be appropriate for this patient if common adverse effects were
indicated?
A) Disturbed sensory perception (visual) related to central nervous system effects
B) Imbalanced nutrition more than body requirements
C) Constipation
D) Ineffective breathing pattern
Ans A
Feedback
Visual disturbances, including blindness related to retinal damage from the drug,
may occur. Patients usually have gastrointestinal (GI) upset including diarrhea, not
constipation, which could produce loss of weight and not an increase. Respiratory
disturbances are not associated with antimalarial agents.
7. During a lecture on intestinal parasites, the students learn that what is the most commonly
diagnosed intestinal parasite infection in the United States?
A) Amebiasis
B) Giardiasis
C) Leishmaniasis
D) Trichomoniasis
Page 3 of 17
