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Daily Free Practice Question
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Updated on: 6/18/2026
A 23-year-old sexually active female presents with frothy, yellow-green discharge, vaginal pruritus, and dysuria, and microscopy reveals motile protozoa. The nurse practitioner diagnoses her condition and prescribes the appropriate treatment of choice. The next morning, the patient calls the clinic reporting severe nausea and vomiting after taking her first evening medication dose. What is the nurse practitioner’s best response?
Rationale
AANP Domain Level: Evaluate
ANCC Domain Level: Evaluation
Focus Area: Reproductive Health
The symptoms described by the patient – frothy, yellow-green discharge, vaginal pruritis, and dysuria – are indicative of the sexually transmitted infection trichomoniasis. The first-line treatment for trichomoniasis involves the use of metronidazole or tinidazole, which can induce a disulfiram-like reaction when alcohol is consumed. Nausea and vomiting are common symptoms of a disulfiram-like reaction. Therefore, it’s crucial to inquire about alcohol consumption, as it may be the cause of the adverse effects reported by the patient. Asking about penicillin allergy does not address the nausea and vomiting and is unrelated to treating trichomoniasis. Stating that the symptoms are an expected treatment side effect is inaccurate. While nausea and vomiting can be side effects of metronidazole, they are not typical and should be investigated. Inquiring about other medications taken today is a valid consideration but may not provide immediate insight into the cause of the reported symptoms. The focus should initially be on the known interaction between metronidazole and alcohol.
Study Tip:
Metronidazole and Alcohol: Metronidazole is an antibiotic used to treat bacterial vaginosis and trichomoniasis. Avoid alcohol during treatment and for at least 48 hours after the last dose. It may cause a disulfiram-like reaction: nausea, vomiting, flushing, headache, and abdominal cramps.