Try Naxlex NCLEX-RN (Free-Trial)

A woman is traveling to a country where she will be at high risk for malarial infection. What will the nurse teach her regarding prophylactic therapy with hydroxychloroquine?

The drug is usually started 1 to 2 weeks before traveling to endemic areas and is continued for 4 weeks after leaving the area.

The drug is started 3 weeks before exposure but can be discontinued once she leaves the area.

Hydroxychloroquine is better absorbed and has fewer adverse effects if taken on an empty stomach.

The medication is taken only when she observes mosquito bites because it can have toxic effects if taken unnecessarily.

Answer and Explanation

The Correct Answer is A

Choice A reason: Hydroxychloroquine prophylaxis for malaria starts 1-2 weeks before travel to build therapeutic blood levels, inhibiting Plasmodium heme polymerization. Continuing for 4 weeks post-travel ensures eradication of liver-stage parasites, preventing delayed malaria onset, aligning with standard guidelines for effective prophylaxis.

Choice B reason: Starting hydroxychloroquine 3 weeks before travel is excessive, as 1-2 weeks is sufficient for therapeutic levels. Discontinuing immediately after leaving risks malaria from liver-stage parasites, which can emerge weeks later. The standard 4-week post-travel continuation is critical for complete protection.

Choice C reason: Hydroxychloroquine absorption is not significantly improved on an empty stomach, and food reduces gastrointestinal irritation. Its adverse effects, like retinal toxicity, are unrelated to food intake. Taking it with food is recommended to minimize side effects, making this statement incorrect for patient education.

Choice D reason: Taking hydroxychloroquine only after mosquito bites is incorrect, as prophylaxis requires steady-state levels before exposure. Its antimalarial action prevents parasite development, not just symptomatic infection. Ad-hoc use risks inefficacy and toxicity, as consistent dosing is needed for malaria prevention.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Immunosuppression is not significantly increased with inhaled fluticasone and hydrochlorothiazide. Fluticasone has minimal systemic absorption, limiting systemic immunosuppression. Hydrochlorothiazide, a diuretic, does not enhance immune suppression but affects electrolytes, making hypokalemia a more relevant concern in this combination.

Choice B reason: Increased clearance of fluticasone is unlikely with hydrochlorothiazide. Fluticasone is metabolized by hepatic CYP3A4, and hydrochlorothiazide does not significantly induce this enzyme. Drug interactions affecting clearance are minimal, and the primary concern is the additive effect on potassium levels, not fluticasone metabolism.

Choice C reason: Reduced clearance of fluticasone is not a known interaction with hydrochlorothiazide. Fluticasone’s low systemic absorption and hepatic metabolism are unaffected by hydrochlorothiazide, which primarily affects renal electrolyte excretion. The combination does not increase fluticasone’s systemic side effects but may exacerbate electrolyte imbalances.

Choice D reason: Hydrochlorothiazide, a thiazide diuretic, promotes potassium excretion, causing hypokalemia. Inhaled fluticasone has minimal systemic effects but may contribute to hypokalemia when combined with systemic corticosteroids. The nurse should monitor potassium levels, as the diuretic’s effect is the primary driver of this electrolyte imbalance in this scenario.

A. Quinolones B. Sulfonamides C. Cephalosporins D. Tetracyclines

Correct Answer is C

Explanation

Choice A reason: Quinolones, like ciprofloxacin, inhibit bacterial DNA gyrase and have no structural similarity to penicillin. They are safe in penicillin-allergic patients, as there is no cross-reactivity. Their side effects, like tendonitis, are unrelated to penicillin’s beta-lactam ring, making this class safe.

Choice B reason: Sulfonamides, like trimethoprim-sulfamethoxazole, inhibit bacterial folate synthesis and are not structurally related to penicillin. They do not cause cross-reactivity in penicillin-allergic patients. Their hypersensitivity reactions are distinct, making them a safe alternative for patients with penicillin allergies.

Choice C reason: Cephalosporins share a beta-lactam ring with penicillins, leading to a 5-10% cross-reactivity risk in penicillin-allergic patients. Allergic reactions, like anaphylaxis, may occur, so the nurse should question cephalosporin orders, especially for first-generation agents, to ensure patient safety.

Choice D reason: Tetracyclines, like doxycycline, inhibit protein synthesis and have no structural similarity to penicillin’s beta-lactam ring. They are safe in penicillin-allergic patients, with no cross-reactivity risk. Their side effects, like photosensitivity, are unrelated to penicillin allergies, making this class safe.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A woman is traveling to a country where she will be at high risk for malarial infection. What will the nurse teach her regarding prophylactic therapy with hydroxychloroquine?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which effect would a nurse anticipate might occur in a patient receiving inhaled fluticasone who is also prescribed hydrochlorothiazide for hypertension?

Correct Answer is D

Explanation

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?

Correct Answer is C

Explanation

When a patient is on gentamicin therapy, the nurse will monitor for which indicator of potential toxicity?

Which antifungal drug is used to treat systemic fungal infections and can cause nephrotoxicity?

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?

The nurse is caring for a client receiving an intravenous heparin infusion. The client has a new prescription for warfarin and asks the nurse why he has to be on two medications. What response by the nurse is appropriate?

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?

The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? (Select all that apply)

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?

Which statements made about theophylline by a patient with asthma would alert the nurse that further intervention is warranted? (Select all that apply)