A patient is taking nystatin oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?

Let the lozenge dissolve slowly and completely in your mouth without chewing it.

Rinse your mouth with water before taking the inhaler.

Rinse your mouth with mouthwash after taking the inhaler.

Chew the lozenges until they are completely dissolved.

Answer and Explanation

The Correct Answer is A

Choice A reason: Nystatin lozenges must dissolve slowly in the mouth to ensure prolonged contact with oral mucosa, effectively treating candidiasis by disrupting fungal cell membranes. Slow dissolution maximizes local antifungal activity, targeting Candida albicans in the oral cavity, a common complication of inhaled corticosteroid use.

Choice B reason: Rinsing the mouth with water before using an inhaler is appropriate for corticosteroids to prevent thrush but is irrelevant for nystatin lozenges. Nystatin treats existing oral candidiasis, and rinsing beforehand may reduce its contact time with affected mucosa, decreasing efficacy.

Choice C reason: Rinsing with mouthwash after an inhaler is not standard for nystatin or corticosteroid use. Mouthwash may contain alcohol, irritating oral mucosa or reducing nystatin’s antifungal effect. Rinsing with water after corticosteroids prevents thrush, but this instruction is misapplied to nystatin lozenges.

Choice D reason: Chewing nystatin lozenges is incorrect, as it reduces contact time with oral mucosa, decreasing antifungal efficacy. Swallowing the drug shifts its action to the gastrointestinal tract, ineffective for oral candidiasis. Slow dissolution ensures targeted treatment of Candida in the mouth, preventing recurrence.

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Correct Answer is D

Explanation

Choice A reason: Definitive therapy targets a confirmed infection with antibiotics chosen based on culture results. Prescribing antibiotics before a dental procedure for a heart condition aims to prevent infection, not treat an existing one, making this incorrect for endocarditis prophylaxis.

Choice B reason: Empiric therapy involves antibiotics for suspected infections without confirmed pathogens. Antibiotics before dental procedures in heart patients prevent endocarditis, not treat suspected infections. This is a preventive measure based on risk, not empiric treatment, making this incorrect.

Choice C reason: Supportive therapy addresses symptoms or supports other treatments, not infection prevention. Antibiotics before dental procedures in patients with heart conditions (e.g., valvular disease) prevent bacterial endocarditis, a specific prophylactic measure, not supportive care, making this an incorrect classification.

Choice D reason: Prophylactic antibiotic therapy prevents infections in high-risk patients, such as those with heart conditions (e.g., mitral valve prolapse) before dental procedures. It reduces the risk of bacterial endocarditis from transient bacteremia, aligning with guidelines for prophylaxis in susceptible individuals, making this correct.

A. Vitamin K B. Vitamin E C. Protamine sulfate D. Potassium chloride

Correct Answer is A

Explanation

Choice A reason: Warfarin overdose causes excessive anticoagulation, increasing bleeding risk by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Vitamin K reverses this by restoring clotting factor synthesis, correcting INR and stopping gastrointestinal bleeding, making it the standard treatment for warfarin toxicity.

Choice B reason: Vitamin E has no role in reversing warfarin toxicity. It is an antioxidant with no effect on clotting factor synthesis or warfarin’s mechanism. Its use may be associated with bleeding risk in high doses, making it inappropriate for managing warfarin-induced gastrointestinal bleeding.

Choice C reason: Protamine sulfate reverses heparin, not warfarin. Heparin enhances antithrombin activity, and protamine neutralizes it. Warfarin’s effect on vitamin K-dependent factors is unrelated, and protamine has no impact on warfarin toxicity or gastrointestinal bleeding, making it an incorrect choice.

Choice D reason: Potassium chloride treats hypokalemia, not warfarin toxicity. Warfarin’s bleeding complications result from inhibited clotting factor synthesis, not electrolyte imbalances. Potassium chloride is irrelevant to reversing anticoagulation or managing gastrointestinal bleeding caused by excessive warfarin, making this an inappropriate treatment.

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A patient is taking nystatin oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with a known heart condition is prescribed an antibiotic before a dental procedure. What type of antibiotic therapy is this considered?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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