Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. The patient is having an acute malarial attack with chills and fever. The nurse
knows chills and fever are caused by what?
a. Formation of sporozoites into the system
b. Rupture of red blood cells due to invasion of merozoites
c. Invasion of the tsetse fly into the central nervous system
d. Release of amastigotes into the blood vessels
Ans: B
Feedback:
The chills and fever associated with an acute malarial attack are caused by the rupture
of red blood cells containing merozoites. These symptoms are related to the pyrogenic
effects of the protozoa and the toxic effects of the red blood cell components on the
system. The formation of sporozoites occurs in the stomach of the mosquito when the
male and female gametocytes mate and produce a zygote. Invasion of the tsetse fly
causes trypanosomiasis, which affects the central nervous system. The release of
amastigotes occurs in leishmaniasis, which is caused by the sand fly and is part of a
cyclic pattern that causes serious skin lesions.
2. The nurse is caring for a patient of Greek descent who plans to travel to an area of
the world in which malaria is endemic. What should this patient be tested for
before administering antimalarial medications?
a. Tay-Sachs disease
b. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
c. Plasmodium
d. Penicillin allergy
Ans: B
Feedback:
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. Patients of Mediterranean descent
should be tested for G6PD deficiency before any antimalarial drugs are prescribed.
Tay-Sachs disease is a disorder seen in those of middle-eastern descent that causes
death of the child by age 5. Plasmodium is the genus strain that causes malaria.
Penicillin allergy has no connection to this situation.
3. The nurse is caring for a patient who is being treated with quinine (Qualaquin) for
drug-resistant malaria. The nurse will monitor the patient for cinchonism that will
present with what manifestations?
, a. Diarrhea, nausea, and fever
b. Yellowing of the sclera and skin
c. Tremors and ataxia
d. Vomiting, tinnitus, and vertigo
Ans: D
Feedback:
Patients with cinchonism or quinine toxicity may complain of tinnitus, headache,
dizziness, nausea, fever, tremors, and visual disturbances. Diarrhea, yellowing of the
sclera or skin, and ataxia are not associated with cinchonism.
4. Patients receiving chloroquine (Aralen Phosphate) for malaria prophylaxis should
receive patient teaching from the nurse, which includes instructions to receive what
regularly?
a. Cardiovascular studies
b. Eye exams
c. Immunizations
d. Pulmonary studies
Ans: B
Feedback:
Chloroquine is associated with visual disturbances and a patient receiving this drug
should receive regular ophthalmic exams. Heart and lung toxicity is not associated
with chloroquine use. Immunizations are not associated with chloroquine use.
5. A 28-year-old woman is planning to be part of a mission team going to Central
Africa. She will take mefloquine (Lariam) once a week, beginning 1 week before
traveling to Africa until 4 weeks after leaving Africa. What precaution will the
nurse teach this patient is needed?
a. Avoid excessive weight gain.
b. Have regular cancer screening.
c. Use contraceptives to avoid pregnancy.
d. Stop the medication if diabetes is diagnosed.
Ans: C
Feedback:
Mefloquine is teratogenic and should be avoided during pregnancy. The nurse will
want to determine whether a possibility exists that the patient is pregnant and warn
about the need to avoid pregnancy for 2 months after completing therapy. Avoiding
weight gain and having regular cancer screenings are good preventive care but not
associated with mefloquine. This medication is not contraindicated in patients with
diabetes.
1. The patient is having an acute malarial attack with chills and fever. The nurse
knows chills and fever are caused by what?
a. Formation of sporozoites into the system
b. Rupture of red blood cells due to invasion of merozoites
c. Invasion of the tsetse fly into the central nervous system
d. Release of amastigotes into the blood vessels
Ans: B
Feedback:
The chills and fever associated with an acute malarial attack are caused by the rupture
of red blood cells containing merozoites. These symptoms are related to the pyrogenic
effects of the protozoa and the toxic effects of the red blood cell components on the
system. The formation of sporozoites occurs in the stomach of the mosquito when the
male and female gametocytes mate and produce a zygote. Invasion of the tsetse fly
causes trypanosomiasis, which affects the central nervous system. The release of
amastigotes occurs in leishmaniasis, which is caused by the sand fly and is part of a
cyclic pattern that causes serious skin lesions.
2. The nurse is caring for a patient of Greek descent who plans to travel to an area of
the world in which malaria is endemic. What should this patient be tested for
before administering antimalarial medications?
a. Tay-Sachs disease
b. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
c. Plasmodium
d. Penicillin allergy
Ans: B
Feedback:
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. Patients of Mediterranean descent
should be tested for G6PD deficiency before any antimalarial drugs are prescribed.
Tay-Sachs disease is a disorder seen in those of middle-eastern descent that causes
death of the child by age 5. Plasmodium is the genus strain that causes malaria.
Penicillin allergy has no connection to this situation.
3. The nurse is caring for a patient who is being treated with quinine (Qualaquin) for
drug-resistant malaria. The nurse will monitor the patient for cinchonism that will
present with what manifestations?
, a. Diarrhea, nausea, and fever
b. Yellowing of the sclera and skin
c. Tremors and ataxia
d. Vomiting, tinnitus, and vertigo
Ans: D
Feedback:
Patients with cinchonism or quinine toxicity may complain of tinnitus, headache,
dizziness, nausea, fever, tremors, and visual disturbances. Diarrhea, yellowing of the
sclera or skin, and ataxia are not associated with cinchonism.
4. Patients receiving chloroquine (Aralen Phosphate) for malaria prophylaxis should
receive patient teaching from the nurse, which includes instructions to receive what
regularly?
a. Cardiovascular studies
b. Eye exams
c. Immunizations
d. Pulmonary studies
Ans: B
Feedback:
Chloroquine is associated with visual disturbances and a patient receiving this drug
should receive regular ophthalmic exams. Heart and lung toxicity is not associated
with chloroquine use. Immunizations are not associated with chloroquine use.
5. A 28-year-old woman is planning to be part of a mission team going to Central
Africa. She will take mefloquine (Lariam) once a week, beginning 1 week before
traveling to Africa until 4 weeks after leaving Africa. What precaution will the
nurse teach this patient is needed?
a. Avoid excessive weight gain.
b. Have regular cancer screening.
c. Use contraceptives to avoid pregnancy.
d. Stop the medication if diabetes is diagnosed.
Ans: C
Feedback:
Mefloquine is teratogenic and should be avoided during pregnancy. The nurse will
want to determine whether a possibility exists that the patient is pregnant and warn
about the need to avoid pregnancy for 2 months after completing therapy. Avoiding
weight gain and having regular cancer screenings are good preventive care but not
associated with mefloquine. This medication is not contraindicated in patients with
diabetes.
