A patient has been prescribed a 2-week course of antifungal suppositories for a vaginal yeast infection.
She asks the nurse if there is an alternative to this medication, stating, “I don’t want to do this for 2 weeks!” What could be a possible alternative in this situation?

A one-time infusion of amphotericin B

A single dose of a vaginal antifungal cream

A single dose of a fluconazole oral tablet

There is no better alternative to the suppositories

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Amphotericin B is a potent antifungal medication used to treat severe fungal infections. However, it is typically reserved for life-threatening systemic fungal infections due to its potential for serious side effects, including kidney damage and infusion reactions. It is not commonly used as a first-line treatment for vaginal yeast infections.

Choice B rationale:

While antifungal creams can be effective for treating vaginal yeast infections, they typically require a treatment course of several days. This option may not be the best choice for a patient seeking a quicker, one-time treatment.

Choice C rationale:

A single dose of a fluconazole oral tablet is often an effective treatment for vaginal yeast infections. Fluconazole works by inhibiting the growth of the yeast causing the infection. It is convenient for patients because it only requires one dose, unlike creams or suppositories that need to be applied for several days.

Choice D rationale:

There are indeed alternatives to antifungal suppositories for treating vaginal yeast infections. As mentioned above, a single dose of fluconazole is one such alternative. Therefore, stating that there is no better alternative to the suppositories is not accurate.

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Correct Answer is D

Explanation

Choice A rationale:

Administering the antibiotic dose before obtaining the cultures could potentially affect the results of the cultures. Antibiotics are designed to kill or inhibit the growth of bacteria, so administering them before obtaining the cultures could lead to false negatives. This could lead to incorrect or delayed diagnosis and treatment.

Choice B rationale:

While obtaining the urine culture before administering the antibiotic dose is a good step, it should not be done before obtaining the blood culture. Blood cultures are usually obtained before urine cultures because they can help identify bacteria or fungi in the blood. This can be crucial in diagnosing conditions like sepsis. Furthermore, administering the antibiotic dose before obtaining the blood culture could affect the results of the culture.

Choice C rationale:

Obtaining the blood culture before administering the antibiotic dose is a good step, but the urine culture should also be obtained before the antibiotic dose is administered. Administering the antibiotic dose before obtaining all necessary cultures could affect the results of the cultures and lead to incorrect or delayed diagnosis and treatment.

Choice D rationale:

This is the correct sequence of actions. The nurse should first obtain both blood and urine cultures before administering the antibiotic dose. This is because the antibiotic could potentially kill or inhibit the growth of bacteria, which could affect the results of the cultures. By obtaining the cultures first, the healthcare team can ensure they are getting accurate results that have not been influenced by the antibiotics. This can lead to a more accurate diagnosis and more effective treatment plan.

A. Proton pump inhibitors B. Calcium channel blockers C. Loop diuretics D. Phenytoin

Correct Answer is C

Explanation

Choice A rationale:

Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.

However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.

Choice B rationale:

Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.

Choice C rationale:

The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.

Choice D rationale:

Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.

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A patient has been prescribed a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, stating, “I don’t want to do this for 2 weeks!” What could be a possible alternative in this situation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy. Which other medication or medication class, if ordered, would be a potential interaction concern?

Correct Answer is C

Explanation

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A patient has been prescribed a 2-week course of antifungal suppositories for a vaginal yeast infection.
She asks the nurse if there is an alternative to this medication, stating, “I don’t want to do this for 2 weeks!” What could be a possible alternative in this situation?