Mod 12- Antiprotozoals

Question 1

______________ is the most commonly diagnosed intestinal parasite in the United States.

Answer 1

Giardiasis

Question 2

T/F: Malaria is the most common protozoal parasite that causes acute disease in travelers

Answer 2

TRUE

Question 3

Quinine (generic) was the first drug found to be effective in treating malaria but is now reserved for the treatment of ___________________ infections in combination with other agents.

Answer 3

chloroquine-resistant

Question 4

T/F: Antimalarial drugs are frequently given in combination form in order to attach to the plasmodium at various stages of its life cycle.

Answer 4

TRUE

Question 5

_____________ is a disease caused by a protozoan that is passed from sandflies to humans.

Answer 5

leishmaniasis

Question 6

__________________ is well absorbed orally and is used to treat amebiasis, trichomoniasis, and giardiasis.

Answer 6

Metronidazole (Flagyl)

Question 7

T/F: Lactating women planning to travel to a high-risk malaria area may safely take antimalarials because they do not enter breast milk.

Answer 7

FALSE

because the drugs can enter breast milk and could be toxic to the infant.

Question 8

_______________ is a drug used to treat PCP and can be given as an inhaled or systemic medication

Answer 8

Pentamidine (NebuPent)

Question 9

T/F: Pneumocystis carinii pneumonia is the most common opportunistic infection seen in patients with HIV/AIDS

Answer 9

TRUE

Question 10

T/F: The parasites that cause human malaria enter the body through the oral/fecal route

Answer 10

FALSE

mosquito bites

Question 11

The nurse is caring for a client who has just returned from an overseas trip and been diagnosed with malaria. When updating the client’s provider on the client’s current health status, what assessment finding should the nurse prioritize?
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Answer 11

The client’s sclerae are yellowed and the client reports pruritis

Question 12

A client with amebiasis is to receive metronidazole. The client also takes warfarin for atrial fibrillation. The nurse would instruct the client to immediately report which symptom?

Answer 12

Increased bleeding

Question 13

A child has been taking mebendazole for the past 3 weeks after being diagnosed with roundworm. The nurse will determine the efficacy of the child’s treatment by referencing what diagnostic test?

Answer 13

Stool for ova and parasites

Question 14

A nurse is reviewing the health record of a client for whom antimalarial therapy is being proposed. The nurse should identify what aspect of the client’s history as contraindicating the use of antimalarials?

Answer 14

Alcoholic liver disease

Question 15

A client who is planning to travel to Africa is prescribed chloroquine to prevent malaria. The nurse would instruct the client to begin the therapy at approximately which time?

Answer 15

Ten days before leaving on the trip

Question 16

Which drug is currently the mainstay of antimalarial therapy and is directly toxic to parasites that absorb it?

Answer 16

Chloroquine

Question 17

A client has presented to the campus medical clinic reporting vaginal itching and burning accompanied by yellowish discharge. The client is diagnosed with trichomoniasis and prescribed metronidazole 250 mg PO t.i.d. What health education should the nurse provide?

Answer 17

Avoid drinking alcohol until treatment is complete.

Question 18

A 22-year-old female college student presented to the clinic and was given a prescription for metronidazole 250 mg PO tid for 7 days. The nurse at the clinic understands that metronidazole is used in the treatment of which?

Answer 18

trichomoniasis.

Question 19

A patient of Greek descent is traveling to an area of the world in which malaria is endemic. What could indicate a possible serious complication if the patient takes certain anti-malarial drugs?

Answer 19

Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Explanation:
Patients of Mediterranean descent, including Greeks, are more likely to have a G6PD deficiency. When patients with this deficiency take primaquine, chloroquine, or quinine, an acute hemolytic crisis may occur. This condition usually requires hospitalization and emergency care

Question 20

A client is prescribed metronidazole for the treatment of trichomoniasis. What is the most important information for the nurse to teach the client about proper administration of this medication?

Answer 20

“Do not drink alcohol while taking this medication.”

Question 21

A client has been prescribed primaquine to prevent a relapse of malaria and is nearing the end of the prescribed course of treatment. During the nurse’s most recent assessment, the client reports “I’m feeling dizzy and nauseous a lot, with ringing in my ears.” What is the nurse’s best action?

Answer 21

Communicate these assessment findings to the provider promptly.
Explanation:
The combination of dizziness, tinnitus and nausea during primaquine treatment suggests cinchonism, which should be reported to the provider. The presence of tinnitus suggests adverse effects rather than a relapse. Adverse effects are not necessary worst near the end of treatment.

Question 22

A nurse is preparing a presentation for a group of individuals who are receiving prophylactic treatment for malaria in preparation for a trip to an endemic area. What would the nurse include as the underlying cause of this disorder?

Answer 22

Bite of an infected mosquito

Question 23

Antimalarials are contraindicated in the presence of: (Select all that apply.)
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🍻
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Answer 23

liver disease or alcoholism.
lactation.
retinal disease or damage.

Question 24

A client is receiving chloroquine for a diagnosis of extraintestinal amebiasis. The nurse should provide information on which medication that is likely to be administered with chloroquine?

Answer 24

Metronidazole

Question 25

A client is admitted to the hospital for the treatment of malaria. The health care provider has ordered chloroquine. Which symptoms would indicate a serious adverse reaction?

Answer 25

blurred vision

Question 26

What are some ADE of chloroquine?

Answer 26

Chloroquine also is contraindicated for clients with preexisting eye disease, because the drug may cause corneal opacities, keratopathy, or retinopathy. Retinopathy can lead to blindness and can progress even after the drug is discontinued. The most common adverse effects are hypotension; cardiac changes reflected on an electrocardiogram (ECG); nausea; vomiting; diarrhea; and abdominal pain. Infrequent but important potential adverse effects include blurred vision; difficulty focusing; changes in accommodation; irreversible retinal damage; tinnitus and reduced hearing in clients with preexisting auditory damage; headaches or psychic stimulation; convulsive seizures; and neuromyopathy. Vomiting, diarrhea, and abdominal pain are common side effects from the medication.

Question 27

Chloroquine acts against erythrocytic forms of plasmodial parasites to prevent or treat what condition?

Answer 27

Malaria

Question 28

Which medication will be administered to treat the diarrhea and abdominal distention associated with giardiasis?

Answer 28

Metronidazole

Question 29

A male client is traveling to a country where malaria is endemic. The nurse suggests that he visit his health care provider and receive a prescription for what medication?

Answer 29

Chloroquine

Question 30

A client has been prescribed metronidazole 250 mg PO. Which measures would the nurse suggest for safe and effective drug administration of metronidazole 250 mg PO? Select all that apply.

Answer 30

Assess if the client may be pregnant before proceeding with prescription.
Provide instruction that the drug can cause metallic taste, and take with food.
Instruct the client to avoid sexual intercourse or use condoms until treatment is complete.

Question 31

When explaining the action of chloroquine to a client, the nurse would incorporate knowledge of which of the following about the drug?

Answer 31

Interferes with the parasites ability to reproduce

Question 32

A nurse is preparing to administer primaquine therapy to a client. The nurse should anticipate administering the drug by which route?

Answer 32

Oral
Explanation:
Primaquine, like all the antimalarial agents, is administered orally.

Question 33

A client has been prescribed pyrimethamine 25 mg PO weekly for antimalarial prophylaxis. When reviewing the client’s health history, the nurse reads that the client has type 2 diabetes that is controlled with gliclazide, a sulfonamide. What is the nurse’s best action?

Answer 33

Monitor the client’s complete blood count results closely.
Explanation:
The combination of sulfonamides and pyrimethamine creates a heightened risk for bone marrow suppression. The nurse should consequently monitor the client’s complete blood count for signs of this adverse effect.

Question 34

A client has been admitted to the emergency department with signs, symptoms, and travel history that are consistent with malaria. When assessing the client for possible contraindications to treatment with antimalarials, what assessment should the nurse prioritize?

Answer 34

Assessing the client for any history of liver disease
Explanation:
Liver disease contraindicates the use of antimalarials.

Question 35

A 28-year-old female is planning to be part of a mission team going to Central Africa. She will take mefloquine once a week, beginning 1 week before traveling to Africa until 4 weeks after leaving Africa. What will the nurse be sure to question her about?

Answer 35

Her last menstrual period
Explanation:
Mefloquine is teratogenic and should be avoided during pregnancy. The nurse will want to determine if there is a possibility that the patient is pregnant.

Question 36

Which statement best reflects the use of multiple antimalarial agents for treatment of the protozoan?

Answer 36

Combination therapy is used to attack the parasite at various life cycle stages

Question 37

The nurse is providing health education for a client who has been prescribed atovaquone (Malarone) prior to leaving on a tropical vacation. The nurse should state:

Answer 37

“You’ll have to take this drug each day, starting before you leave on your trip.”
Explanation:
Malarone is taken PO daily starting one to two days before exposure. Malarone prevents malaria.

Question 38

A client is taking antiprotozoal medications to prevent a relapse of Plasmodium vivax malaria. The nurse is assessing the client during a scheduled follow-up appointment. What assessment finding suggests an increased risk for hepatotoxicity during antimalarial therapy?

Answer 38

The client is taking acetaminophen 1000 mg PO every four hours

Question 39

Which recommendations should be made to a client being treated for trichomoniasis to prevent re-infection?

Answer 39

Sexual partners should be treated.

Question 40

A client has been prescribed tinidazole for the treatment of a protozoal infection. What statement by the client indicates to the nurse that further teaching is warranted?

Answer 40

“I like to have a small glass of white wine each evening to unwind.”
Explanation:
Alcohol is contraindicated with the use of tinidazole.

Question 41

A female client is receiving mefloquine as part of malarial prevention. After teaching about the drug, which statement by the client indicates successful teaching?

Answer 41

“I should avoid getting pregnant for at least 2 months after I finish the drug.”
Explanation:
Mefloquine is teratogenic in preclinical studies; pregnancy should be avoided during and for 2 months after completion of therapy.

Question 42

A client is prescribed metronidazole for the treatment of trichomoniasis. What is the most important information for the nurse to teach the client about proper administration of this medication?

Answer 42

“Do not drink alcohol while taking this medication.”

Question 43

Infections caused by protozoa are relatively rare in the United States, but with people moving throughout the world in increasing numbers, it is not unusual to find a person who returns home from travel with a fully developed protozoal infection. Which of the following areas are where protozoa infections are most prevalent? Select all that apply.

Answer 43

Colombia
Thailand
Egypt