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.
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
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A reason: Using a corticosteroid inhaler like fluticasone for asthma attacks is incorrect. Corticosteroids reduce inflammation over days, not immediately, and are for maintenance. Acute attacks require short-acting beta-agonists like albuterol for rapid bronchodilation, indicating a need for further patient education on inhaler roles.
Choice B reason: Cleaning the inhaler casing weekly with warm soapy water is correct. This prevents drug residue buildup, ensuring proper dose delivery and reducing infection risk. Removing the canister and drying the casing properly maintains inhaler function, reflecting appropriate understanding of maintenance.
Choice C reason: Rinsing the mouth with water and spitting it out after using a corticosteroid inhaler is correct. This removes residual drug, preventing oral candidiasis by reducing fungal growth in the oral cavity. It reflects proper understanding of post-inhalation hygiene, requiring no further instruction.
Choice D reason: Gargling and swallowing after using a corticosteroid inhaler is incorrect. Swallowing residual corticosteroid can increase systemic absorption, raising the risk of side effects like adrenal suppression. Rinsing and spitting out is necessary to minimize oral thrush and systemic effects, indicating a need for correction.
Correct Answer is B
Explanation
Choice A reason: Headache and nervousness are not significant adverse effects of antitubercular drugs like isoniazid or rifampin. These symptoms are nonspecific and less concerning than neurotoxicity. Antitubercular drugs primarily affect the liver, nerves, or blood, making neurological symptoms like numbness more critical to report.
Choice B reason: Numbness and tingling of extremities indicate peripheral neuropathy, a serious adverse effect of isoniazid, which depletes pyridoxine (vitamin B6), impairing nerve function. This requires immediate reporting to adjust therapy or add pyridoxine supplementation, preventing irreversible nerve damage while continuing effective tuberculosis treatment.
Choice C reason: Reddish-orange urine and stool are expected effects of rifampin, which is metabolized to a red-orange compound excreted in bodily fluids. This is harmless and does not require reporting unless accompanied by other symptoms like jaundice, which could indicate hepatotoxicity, a more serious concern.
Choice D reason: Gastrointestinal upset is common with antitubercular drugs like rifampin or pyrazinamide but is not typically severe enough to warrant immediate reporting unless persistent or accompanied by signs of hepatotoxicity. Numbness is a more concerning neurological effect, requiring prompt prescriber notification to prevent complications.
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