What will the nurse tell her a this indicates that

What will the nurse tell her?
a. This indicates that she should begin taking oral contraceptives.
b. This is caused by a reversible effect on estradiol synthesis.
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c. This is a serious side effect that warrants discontinuation of the drug.
d. This is a sign of hepatic toxicity, and the drug dose should be lowered.
ANS: B
Ketoconazole inhibits steroid synthesis in humans, and in females it reduces estradiol synthesis,
causing menstrual irregularities. It is not an indication that oral contraceptive pills (OCPs) are
needed. Because it is reversible, there is no indication for withdrawing the drug until treatment is
complete. Menstrual irregularities are not a sign associated with hepatotoxicity.DIF: Cognitive
Level: ApplicationREF: p. 860TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
873. A patient is receiving intravenous voriconazole [Vfend]. Shortly after the infusion starts, the
patient tells the nurse, “Colors look different, and the light hurts my eyes.” What will the nurse
do?
a. Observe the patient closely for the development of hallucinations.
b. Reassure the patient that these effects will subside in about 30 minutes.
c. Stop the infusion and notify the provider of CNS toxicity.
d. Tell the patient that this is an irreversible effect of the drug.
ANS: B
Reduced visual acuity, increased brightness, altered color perception, and photophobia are
reversible visual disturbances that can occur in 30% of patients receiving voriconazole. These
usually begin within 30 minutes of dosing and then diminish over the next 30 minutes. They are
not precursors to other effects, such as hallucinations. They do not indicate CNS toxicity. They are
reversible.DIF: Cognitive Level: ApplicationREF: p. 859TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
874. A patient with a history of congestive heart failure and renal impairment has esophageal
candidiasis. Which antifungal agent would the nurse anticipate giving to this patient?
a. Amphotericin B [Abelcet]
b. Fluconazole [Diflucan]
c. Itraconazole [Sporanox]
d. Voriconazole [Vfend]
ANS: B
Fluconazole is a drug of choice for treating systemic candidal infections. Amphotericin is
nephrotoxic and should not be used in patients with existing renal disease. Itraconazole is a possible
alternative agent for treating candidiasis but has serious cardiac side effects. Voriconazole is a drug
of first choice for treating aspergillosis but not for candidiasis.DIF: Cognitive Level:
ApplicationREF: p. 858TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
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