A nurse is educating a group of travelers who are going to a region where malaria is endemic.
Which of the following antimalarial drugs should the nurse recommend for prophylaxis? (Select all that apply.).
Quinine
Primaquine
Mefloquine
Pyrimethamine-sulfadiazine
Atovaquone-proguanil.
Correct Answer : C,D,E
These are the antimalarial drugs that are recommended for prophylaxis by the CDC and other sources.
They are effective against the malaria parasites that are resistant to chloroquine and primaquine, which are the other two options.
Choice A is wrong because chloroquine is not effective in areas where chloroquine resistance is present, which is most of the malaria-endemic regions.
Choice B is wrong because primaquine is not used for prophylaxis, but for radical cure of vivax and ovale malaria. It also requires a test for glucose-6-phosphate dehydrogenase (G6PD) deficiency before use, as it can cause hemolysis in people with this condition.
Choice C is correct because mefloquine is a suppressive prophylactic that can be used in areas with chloroquine resistance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is E
Explanation
Gentamicin is an example of a concentration-dependent antimicrobial, which means that it achieves increasing bacterial kill with increasing levels of drug.The peak concentration and the area under the concentration curve (AUC) determine the efficacy of these antibiotics.Other examples of concentration-dependent antimicrobials include fluoroquinolones, daptomycin, aminoglycosides, and amphotericin
Choice A is wrong because ciprofloxacin is a fluoroquinolone, which is also a concentration-dependent antimicrobial.
Choice B is wrong because imipenem is a carbapenem, which is a type of beta-lactam antibiotic.Beta-lactams are time-dependent antimicrobials, which means that their bactericidal activity depends on the duration of the effective concentration.
Choice C is wrong because penicillin V is another type of beta-lactam antibiotic, which is also a time-dependent antimicrobial.
Choice D is wrong because metronidazole is a bactericidal agent that has both time- and concentration-dependent properties.However, it is not classified as a concentration-dependent antimicrobial according to the AMEG categorization of antibiotics in the European Union.
Correct Answer is A
Explanation
This is because itraconazole can cause renal impairment and decreased urine output as an adverse effect.A normal serum creatinine level is 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females.
Choice B is wrong because decreased serum potassium level is not an adverse effect of itraconazole.Itraconazole can cause hypokalemia, which is a low level of potassium in the blood, but this is usually due to fluid retention and heart failure caused by the drug.A normal serum potassium level is 3.5 to 5.0 mEq/L.
Choice C is wrong because increased serum glucose level is not an adverse effect of itraconazole.Itraconazole can cause hyperglycemia, which is a high level of glucose in the blood, but this is usually due to diabetes mellitus or steroid use in patients taking the drug.A normal serum glucose level is 70 to 100 mg/dL.
Choice D is wrong because decreased white blood cell count is not an adverse effect of itraconazole.Itraconazole can cause leukopenia, which is a low level of white blood cells in the blood, but this is usually due to bone marrow suppression or infection in patients taking the drug.A normal white blood cell count is 4,500 to 11,000 cells/mm3.
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