C HAPTER 11 - A NTIFUNGAL A GENTS
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A 17-year-old male patient with athlete’s foot is extremel y 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
permeabilit y.
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 initiall y 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 tha n 2 years because
safet y has not been established.
3. The nurse is teaching the patient about a newl y prescribed systemic
antifungal drug. What sign or symptom will the nurse instruct the patient
to report to the provider immediatel y?
a. Unusual bruising and bl eeding
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 toxicit y, which
should be reported immediatel y. Yellowing of the eyes, not redness, and
tearing are also indicative of hepatic toxicit y. Usuall y 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 re port immediatel y.
,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 appl ying
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 antifunga l drugs
Ans: D
Feedback:
Topical antifungals are not absorbed systemicall y so they are not metabolized
and excreted. As a result, the onl y contraindication would be an allergy to the
, drug. Hepatic and renal impairment and congestive heart failure would no t be
a contraindication because these drugs do not enter the bloodstream and
impact these organ systems.
6. A patient with high cholesterol is taking lovastatin (Mevacor). What drug
would the nurse question if it was ordered for this patient?
a. Nifedipine (Pro cardia)
b. Ciprofloxacin (Cipro)
c. Itraconazole (Sporanox)
d. Oxazepam (Serax)
Ans: C
Feedback:
Itraconazole is an azole antifungal drug that has been associated with severe
cardiovascular events when taken with lovastatin. Nifedipine, ciprofloxacin,
and oxazepam have no drug interactions with lovastatin. Nifedipine is an
antihypertensive drug whose effects can be increased when taken with
cimetidine. The effects of ciprofloxacin are altered when taken with antacids
and theophyllines. Oxazepam is an antianxiet y dr ug that should not be taken
with alcohol or theophyllines.
7. An 85-year-old man who is a resident in an extended -care facilit y has
athlete’s foot. After appl ying an antifungal cream, what is the nurse’s next
action?
a. Wipe away excess medication from the affe cted area.
b. Wrap a sterile kling dressing around both feet.
c. Elevate the feet for 30 minutes.
d. Appl y clean dry socks.
Ans: D
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A 17-year-old male patient with athlete’s foot is extremel y 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
permeabilit y.
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 initiall y 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 tha n 2 years because
safet y has not been established.
3. The nurse is teaching the patient about a newl y prescribed systemic
antifungal drug. What sign or symptom will the nurse instruct the patient
to report to the provider immediatel y?
a. Unusual bruising and bl eeding
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 toxicit y, which
should be reported immediatel y. Yellowing of the eyes, not redness, and
tearing are also indicative of hepatic toxicit y. Usuall y 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 re port immediatel y.
,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 appl ying
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 antifunga l drugs
Ans: D
Feedback:
Topical antifungals are not absorbed systemicall y so they are not metabolized
and excreted. As a result, the onl y contraindication would be an allergy to the
, drug. Hepatic and renal impairment and congestive heart failure would no t be
a contraindication because these drugs do not enter the bloodstream and
impact these organ systems.
6. A patient with high cholesterol is taking lovastatin (Mevacor). What drug
would the nurse question if it was ordered for this patient?
a. Nifedipine (Pro cardia)
b. Ciprofloxacin (Cipro)
c. Itraconazole (Sporanox)
d. Oxazepam (Serax)
Ans: C
Feedback:
Itraconazole is an azole antifungal drug that has been associated with severe
cardiovascular events when taken with lovastatin. Nifedipine, ciprofloxacin,
and oxazepam have no drug interactions with lovastatin. Nifedipine is an
antihypertensive drug whose effects can be increased when taken with
cimetidine. The effects of ciprofloxacin are altered when taken with antacids
and theophyllines. Oxazepam is an antianxiet y dr ug that should not be taken
with alcohol or theophyllines.
7. An 85-year-old man who is a resident in an extended -care facilit y has
athlete’s foot. After appl ying an antifungal cream, what is the nurse’s next
action?
a. Wipe away excess medication from the affe cted area.
b. Wrap a sterile kling dressing around both feet.
c. Elevate the feet for 30 minutes.
d. Appl y clean dry socks.
Ans: D
