A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?

Intestinal tapeworms

Lyme disease

Systemic lupus erythematosus

Toxoplasmosis

Answer and Explanation

The Correct Answer is C

Choice A reason: Hydroxychloroquine is not used for intestinal tapeworms, which are treated with antiparasitic drugs like praziquantel. Hydroxychloroquine inhibits lysosomal function and is used for malaria or autoimmune diseases like lupus, not helminth infections, which require drugs targeting parasitic metabolism.

Choice B reason: Lyme disease, caused by Borrelia burgdorferi, is treated with antibiotics like doxycycline, not hydroxychloroquine. Hydroxychloroquine’s antimalarial and immunomodulatory effects are irrelevant to bacterial infections like Lyme disease, which requires antimicrobial therapy to eliminate the spirochete.

Choice C reason: Hydroxychloroquine is commonly used for systemic lupus erythematosus (SLE). It modulates the immune system by inhibiting toll-like receptor signaling, reducing inflammation and autoantibody production. This makes it effective for managing SLE symptoms like joint pain or rashes, even in non-travelers, as it is not exclusively an antimalarial.

Choice D reason: Toxoplasmosis, caused by Toxoplasma gondii, is treated with pyrimethamine and sulfadiazine, not hydroxychloroquine. Hydroxychloroquine’s mechanism does not target protozoal infections like toxoplasmosis, which require drugs that inhibit folate synthesis in the parasite, making this an incorrect indication.

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Correct Answer is A

Explanation

Choice A reason: Garlic can enhance warfarin’s anticoagulant effect by inhibiting platelet aggregation and potentially increasing INR, raising bleeding risk. Its sulfur compounds may also induce hepatic enzymes, affecting warfarin metabolism. Patients on warfarin should avoid high garlic intake to maintain stable anticoagulation and prevent hemorrhage.

Choice B reason: Acetaminophen has no significant interaction with garlic. Acetaminophen is metabolized by the liver, primarily via glucuronidation, and garlic’s effects on platelet function or enzymes do not notably affect its pharmacokinetics or analgesic efficacy, making this an unlikely interaction concern.

Choice C reason: Phenytoin, an anticonvulsant, is metabolized by hepatic CYP450 enzymes, but garlic’s weak enzyme induction does not significantly alter phenytoin levels. Garlic’s primary interaction is with anticoagulants like warfarin, not anticonvulsants, making this drug less relevant for garlic-related concerns.

Choice D reason: Digoxin has no major interaction with garlic. Digoxin’s pharmacokinetics are primarily renal, and garlic’s effects on platelets or minor enzyme induction do not significantly alter digoxin levels or cardiac effects. Warfarin’s bleeding risk is more impacted by garlic’s antiplatelet properties.

A. Amphotericin B B. Isoniazid C. Vancomycin D. Fluconazole

Correct Answer is B

Explanation

Choice A reason: Amphotericin B is an antifungal drug used for systemic fungal infections like cryptococcosis. It binds to ergosterol in fungal cell membranes, causing cell death. It has no activity against Mycobacterium tuberculosis, the causative agent of tuberculosis, and is not used in tuberculosis treatment regimens.

Choice B reason: Isoniazid is a first-line drug for active tuberculosis. It inhibits mycolic acid synthesis, disrupting the cell wall of Mycobacterium tuberculosis, leading to bactericidal effects. It is highly effective in combination with other drugs like rifampin, ethambutol, and pyrazinamide, forming the cornerstone of tuberculosis therapy.

Choice C reason: Vancomycin is an antibiotic used for gram-positive bacterial infections, such as methicillin-resistant Staphylococcus aureus (MRSA). It inhibits cell wall synthesis but is ineffective against Mycobacterium tuberculosis, which has a unique mycolic acid-containing cell wall, requiring specific antitubercular drugs like isoniazid for treatment.

Choice D reason: Fluconazole is an antifungal drug that inhibits fungal cytochrome P450, disrupting ergosterol synthesis. It is used for infections like candidiasis but has no activity against Mycobacterium tuberculosis. Tuberculosis treatment requires bactericidal drugs targeting the mycobacterial cell wall, not antifungal agents like fluconazole.

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A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient tells the nurse that he likes to eat large amounts of garlic to help lower his cholesterol levels naturally. The nurse reviews his medication history and notes which drug has a potential interaction with the garlic?

Correct Answer is A

Explanation

Which of the following is a first-line drug for the treatment of active tuberculosis?

Correct Answer is B

Explanation

When monitoring a patient who is taking intravenous dexamethasone, the nurse will monitor for signs of which condition?

A patient with coronary artery disease asks the nurse about the "good cholesterol" laboratory values. The nurse knows that "good cholesterol" refers to which lipids?

The prescriber has changed the patient’s medication regimen to include montelukast to treat asthma. The nurse will emphasize which point about this medication?

The nurse is providing teaching to a patient taking tetracycline. Which statement by the nurse is correct?

A nurse is preparing to administer enoxaparin to a patient for deep vein thrombosis (DVT) prophylaxis. The nurse is using a prefilled syringe with enoxaparin. Which action by the nurse indicates a need for further teaching?

The nurse is providing instructions about the fluticasone propionate and salmeterol combination inhaler. Which statement about this inhaler is accurate?

A patient has been taking antitubercular therapy for 3 months. The nurse will assess for what findings that indicate a therapeutic response to the drug therapy?

A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week and calls the clinic, saying, "My urine is dark orange! What’s wrong with me?" Which response by the nurse is correct?