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 A

Explanation

Choice A reason: Fluticasone/salmeterol is a combination of an inhaled corticosteroid and a long-acting beta-2 agonist used for maintenance therapy to prevent bronchospasms in asthma or COPD. Fluticasone reduces inflammation, while salmeterol provides sustained bronchodilation, making it effective for long-term control, not acute relief.

Choice B reason: Using a spacer with fluticasone/salmeterol is not mandatory, though it may improve drug delivery in some patients. Spacers enhance lung deposition for metered-dose inhalers, but this combination is often delivered via dry powder inhalers, which do not require spacers, making this statement inaccurate.

Choice C reason: Avoiding water for 1 hour after using fluticasone/salmeterol is unnecessary. Patients should rinse their mouth after inhalation to prevent oral thrush, but water restriction is not required. The drug’s local action in the lungs is unaffected by oral hydration, making this instruction incorrect.

Choice D reason: Fluticasone/salmeterol is not indicated for acute therapy. Its slow onset (salmeterol takes 20-30 minutes) makes it unsuitable for acute bronchospasm. It is used for maintenance to prevent symptoms, while short-acting beta-agonists like albuterol are used for acute asthma or COPD exacerbations.

A. Hair loss B. Peripheral neuropathy C. Heart failure D. Renal failure

Correct Answer is B

Explanation

Choice A reason: Hair loss is not a common side effect of isoniazid, nor is it prevented by pyridoxine. Isoniazid primarily causes hepatotoxicity or neurotoxicity due to its metabolism and pyridoxine depletion. Hair loss may occur with other drugs, but pyridoxine supplementation is unrelated to this effect.

Choice B reason: Pyridoxine (vitamin B6) is given with isoniazid to prevent peripheral neuropathy. Isoniazid depletes pyridoxine by forming inactive complexes, impairing nerve function and causing numbness or tingling. Supplementation restores pyridoxine levels, protecting peripheral nerves while allowing isoniazid to effectively treat tuberculosis by inhibiting mycolic acid synthesis.

Choice C reason: Heart failure is not associated with isoniazid or prevented by pyridoxine. Isoniazid’s primary toxicities are hepatic and neurological. Pyridoxine supports nerve health, not cardiac function, and heart failure is more linked to drugs like anthracyclines, not antitubercular therapy.

Choice D reason: Renal failure is not a common side effect of isoniazid, nor is it prevented by pyridoxine. Isoniazid is metabolized by the liver, and its toxicities include hepatotoxicity and neuropathy. Pyridoxine addresses neurological side effects, not renal function, making this an incorrect choice.

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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

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Correct Answer is A

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Correct Answer is B

Explanation

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