Chapter 11 Antifungal Agents

Chapter 11  Antifungal Agents

Complete Chapter Questions And Answers
 

Sample Questions

1.
A 17-year-old male patient with athlete’s foot is extremely upset that he cannot get rid of it. He calls the clinic and asks the nurse whether the doctor can give him an antibiotic to “cure the infection.” What should the nurse include in the explanation of treatment for fungal infections?
A)
“Fungi differ from bacteria in that the fungus has flexible cell walls that allow for free transfer into and out of the cell.”
B)
“Protective layers contain sterols, which change the membrane permeability.”
C)
“The composition of the protective layers of the fungal cell makes the organism resistant to antibiotics.”
D)
“Fungi cell walls contain Candida, which makes the cells rigid.
Ans:
C

Feedback:

The nurse should tell the patient that the composition of the protective layers of the fungal cell makes the organism resistant to antibiotics so that antibiotics would not have any positive effect. Fungi do differ from bacteria, but the fungus has rigid cell walls that allow for free transfer in and out of the cell. The protective layers contain ergosterol, not Candida, that helps keep the cell wall rigid, not permeable.

2.
The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal meningitis. What drug will the nurse anticipate receiving an order for to treat this child?
A)
Amphotericin B (Fungizone)
B)
Fluconazole (Diflucan)
C)
Griseofulvin (Fulvicin)
D)
Ketoconazole (Nizoral)
Ans:
B

Feedback:

Fluconazole is used in the treatment of cryptococcal meningitis and is safe to use in a 1-year-old child. Amphotericin B has many unpleasant adverse effects and is very potent, so it would not be the first or best medication to administer initially but would be reserved for use if fluconazole was not effective. Griseofulvin is given to treat tinea pedis and tinea unguium in children. Ketoconazole is not given to children younger than 2 years because safety has not been established.

3.
The nurse is teaching the patient about a newly prescribed systemic antifungal drug. What sign or symptom will the nurse instruct the patient to report to the provider immediately?
A)
Unusual bruising and bleeding
B)
Constipation or diarrhea
C)
Red and dry eyes
D)
Increased appetite with weight gain
Ans:
A

Feedback:

Unusual bruising and bleeding can be an indication of hepatic toxicity, which should be reported immediately. Yellowing of the eyes, not redness, and tearing are also indicative of hepatic toxicity. Usually GI symptoms include nausea and vomiting with antiviral drugs, which could cause decreased appetite and weight loss. These symptoms should be reported if they persist but are not emergency symptoms to report immediately.

4.
A patient who has a tinea infection calls the clinic and complains of intense local burning and irritation with use of a topical antifungal drug. Even before asking the patient, the nurse suspects he or she is applying what medication?
A)
Butoconazole (Gynazole I)
B)
Ciclopirox (Loprox)
C)
Econazole (Spectazole)
D)
Haloprogin (Halotex)
Ans:
C

Feedback:

Econazole can cause intense local burning and irritation in treatment of tinea infections. Butoconazole is used to treat vaginal Candida infections. Ciclopirox is used to treat toenail and fingernail tinea infections and does not produce intense burning and irritation. Haloprogin is used to treat athlete’s foot, jock itch, and ringworm infections and is not associated with burning or irritation.

5.
A patient asks the nurse if he or she should use a topical antifungal. The nurse is aware that the most important contraindication to topical antifungals is what?
A)
Hepatic impairment
B)
Renal impairment
C)
Congestive heart failure
D)
Known allergy to any of the antifungal drugs
Ans:
D

Feedback:

Topical antifungals are not absorbed systemically so they are not metabolized and excreted. As a result, the only contraindication would be an allergy to the drug. Hepatic and renal impairment and congestive heart failure would not be a contraindication because these drugs do not enter the bloodstream and impact these organ systems.