Pharmacology Chapters 38-40, 41,42,43, 45-49
A patient is prescribed metronidazole (Flagyl) for a gynecologic infection, and she provides a list of medications she takes routinely to the nurse. Which medication would lead the nurse to question the order for Flagyl? A. multivitamin B. lithium C. thyroid replacement hormone D. ibuprofen
lithium Flagyl is known to cause and increase in neurologic-associated medications and specifically can lead to lithium toxicity. A patient who reports taking lithium should be a red flag for the nurse to alert the provider due to the potential significant interaction.
Which is a complication of vancomycin infusions? A. Cardiomyopathy B. Angioedema C. Red man syndrome Correct D. Neurotoxicity
Red man syndrome When infused too rapidly, patients receiving vancomycin may develop hypotension accompanied by flushing and warmth of the neck and face. This phenomenon is called red man syndrome.
The nurse should assess a patient for nephrotoxicity and ototoxicity when administering which antimicrobial? A. cefazolin B. clindamycin C. gentamicin D. erythromycin
gentamicin Aminoglycoside antibiotics, including gentamicin, have a high risk for nephrotoxicity and ototoxicity.
When administering a nonsteroidal antiinflammatory drug (NSAID) and penicillin concurrently, displacement of the penicillin antibiotic from the protein-binding sites results in
increased free drug in blood. Drugs that are not bound to protein are free and thus active to exert their therapeutic (or toxic, if too much free) effect.
when giving intravenous quinolones, the nurse needs to keep in mind that these drugs may have serious interactions with which drug? A. selective serotonin reuptake inhibitor antidepressants B. NSAIDS C. oral anticoagulants D. antihypertensives
C
Which statement, if made by a patient with HIV infection, demonstrates a need for continued patient teaching? A. "I will change my position slowly to prevent dizziness and potential injury." B. "I must take these medications exactly as prescribed for the rest of my life." C. "I don't need to use condoms as long as I take my medication as prescribed." D. "I should remain upright for 30 minutes after taking my zidovudine."
"I don't need to use condoms as long as I take my medication as prescribed." Antiretroviral drugs do not stop the transmission of HIV, and patients need to continue standard precautions.
A patient prescribed azithromycin (Zithromax) expresses concern regarding gastrointestinal upset that he experienced when previously taking erythromycin. What is the nurse's best response?
"This drug is like erythromycin with less severe gastrointestinal side effects." Azithromycin is a newer macrolide antibiotic. It has a longer duration of action, as well as fewer and less severe gastrointestinal side effects than erythromycin.
When planning care for a patient receiving once-daily intravenous gentamicin therapy, the nurse schedules a trough drug level to be drawn A. 30 minutes after beginning the antibiotic infusion. Incorrect B. 60 minutes after beginning the antibiotic infusion. C. 12 hours after completing the antibiotic infusion. D. 18 hours after completing the antibiotic infusion.
12 hours after completing the antibiotic infusion. Trough serum drug levels should be drawn at least 8 to 12 hours after the medication is infused.
A patient taking an anthelmintic drug should be instructed to notify the physician immediately if he or she experiences which side effect? A. Darkened urine B. Light-colored stools C. Anal irritation D. Gastrointestinal discomfort
A. Darkened urine may be a sign of hemolysis, a serious side effect of anthelmintic drugs.
during drug therapy with basiliximab, the nurse monitors for signs of cytokine release syndrome, which results in A. fever, dyspnea, and general malaise B. neurotoxicity, and peripheral neuropathy C. hepatotoxicity with jaundice D. thrombocytopenia with increased bleeding tendencies
A
a patient is experiencing stomatitis after a round of chemotherapy. which intervention by the nurse is correct? A. clean the mouth with a soft bristle tooth brush and warm saline solution B. rinse the mouth with commercial mouthwash twice a day C. use lemon glycerin swabs to keep mouth moist D. keep the dentures in the mouth between meals
A
before administering antiprotozoal drugs, the nurse will review which baseline assessment? A. complete blood count B. serum magnesium level C. creatinine clearance D. arterial blood gas concentrations
A
the nurse is counseling a woman who is beginning antitubercular therapy with rifampin. the patient also takes an oral contraceptive. which statement by the nurse is the most accurate regarding the potential drug interactions? A. you will need to switch to another form of birth control while you're taking rifampin B. your birth control pills will be effective while taking rifampin C. you will need to take a stronger dose of birth control pills while you're on rifampin D. you will need to abstain from sexual intercourse while on the rifampin to avoid pregnancy
A
the nurse knows that antimalarial drugs are used to treat patients with infections caused by which microorganism? A. plasmodium spp. B. candida albicans C. pneumocystis jirovecci D. mycobacterium
A
when administering vancomycin, the nurse knows that which of these is most important to access before giving the medication? A. renal function B. WBC count C. liver function D. platelet count
A
when chemo with alkylating drugs is planned, the nurse expects to implement which intervention to prevent nephrotoxicity? A. hydrating the patient with intravenous fluids before chemo B. limiting fluids before chemo C. monitoring drug levels during chemo D. assessing creatinine clearance during chemotherapy
A
when planning care for a patient who is receiving interferon therapy, the nurse must keep in mind that the major dose limiting factor is A.fatigue B. bone marrow suppression C. fever D. nausea and vomiting
A
when the nurse is teaching a patient who is taking acyclovir for genital herpes, which statement by the nurse is accurate? A. this drug will help the lesions to dry and crust over B. acyclovir will eradicate the herpes virus C. this drug will prevent the spread of the virus to others D. be sure to give this drug to your partner too
A
The nurse would question an order for chloroquine in a patient also prescribed which medication? A. valproic acid B. doxycycline (Doryx) C. clindamycin (Cleocin) D. diazepam (Valium)
A Concurrent use of chloroquine with valproic acid may reduce serum drug levels of valproic acid and thus increase the risk of seizure activity. Chloroquine may be given concurrently with clindamycin or doxycycline for synergistic actions.
when monitoring a patient who is receiving caspofungin, the nurse will look for which serious adverse effect? select all that apply: A. blood dyscrasias B. hypotension C. pulmonary infiltrates D. tinnitus E. hepatotoxicity
A B E
the nurse is reviewing the medical history of a patient who is about to receive therapy with etanercept (Enbrel). which conditions if present would be a contraindication or caution for therapy with this drug? select all that apply A. urinary tract infection B. psoriasis C. heart failure D. glaucoma E. latex allergy
A C E
when giving metronidazole, the nurse implements appropriate administration techniques, including which of these? select all that apply: A. giving oral forms with food B. giving oral forms on an empty stomach with a full glass of water C. infusing intravenous doses over 30 to 60 minutes D. administering intravenous doses by bolus over 5 minutes E. obtaining ordered specimens before starting the medication
A C E
while administering bevacizumab ( Avastin) what will the nurse assess to look for drug related toxicities. select all that apply: A. blood pressure B. color of the skin and sclera of the eye( for jaundice) C. blood glucose level D. urine protein level E. hearing
A D
the nurse is reviewing the orders for wound care, which includes use of an antiseptic. which statement best describes the use of antiseptics? A. antiseptics are appropriate for use on living tissue B. antiseptics work by sterilizing the surface of the wound C. antiseptics are applied to nonliving objects that kill microorganisms D. the patients alleriges must be assessed before using an antiseptic E. antiseptics are used to inhibit the growth of microorganisms of the wound surface.
A D E
when assessing a patient who is to begin therapy with an immunosuppressant drug, the nurse recognizes that such drugs should be used cautiously in patient with which conditions? select all that apply A. pregnancy B. Glaucoma C. anemia D. myalgia E. renal dysfunction F. hepatic dysfunction
A D F
The patient's culture has grown gram-positive cocci, and the patient is prescribed two different antibiotics, one of which is gentamicin. To treat this type of infection, which type of drug is typically prescribed with gentamicin? A. A penicillin B. A cephalosporin C. A fluoroquinolone D. An aminoglycoside
A penicillin A penicillin In gram-positive cocci, gentamicin is usually given in combination with a penicillin. The other antibiotics are not typically prescribed with gentamicin for this culture result.
Combinations of chemotherapeutic drugs are frequently used for which purpose? (Select all that apply.) A.Preventing drug resistance B.Providing a synergistic action C.Decreasing cost of treatment D.Decreasing the severity of adverse effects E.Decreasing drug tolerance
A, B, D div>Administering a combination of antineoplastic drugs allows for smaller doses of each, which can minimize the severity of side effects and help prevent drug resistance. Additionally, there is a synergistic action between some of the medications. Decreasing cost is not a benefit of combination therapy.</div>
a newly admitted patient reports a penicillin allergy. the prescriber has ordered a second generation cephalosporin as part of the therapy. which nursing action is appropriate? A. call the prescriber to clarify the order because of the patients allergy B. give the medication and monitor for adverse effects C. ask the pharmacy to change the order to a first generation cephalosporin D. administer the drug with an NSAID to reduce adverse effects
A.
Which cells are activated by aldesleukin (interleukin-2)? A. T-cells B. Red blood cells C. Undifferentiated cells D. Neutrophils
A. Aldesleukin enhances the immune system by stimulating the production and activity of T-cells
Before administering intravenous basiliximab (Simulect), the nurse would anticipate giving which medication? A. methylprednisolone sodium (Solu-Medrol) B. diphenhydramine (Benadryl) C. acetaminophen (Tylenol) D. meperidine (Demerol)
A. Methylprednisolone sodium is administered 30 minutes before basiliximab injection to prevent or minimize acute allergic-type reactions associated with this medication.
patient has been prescribed monoclonal antibody therapy for the treatment of rheumatoid arthritis. What known disorder or disease is a contraindication and would alert the nurse to question the order for this class of drugs? A. AIDS B. Hypertensive crisis C. Chronic obstructive pulmonary disease D. Nephrotic syndrome
A. Monoclonal antibodies are usually contraindicated in patients with known active infectious processes due to their immunosuppressive qualities. Use of alemtuzumab is also contraindicated in patients with active systemic infections and immunodeficiency conditions, including AIDS.
What is the most common drug used to treat oropharyngeal candidiasis? A. nystatin (Mycostatin) B. oseltamivir (Tamiflu) C. amantadine (Symmetrel) D. griseofulvin (Fulvicin P/G)
A. Nystatin is an antifungal ointment that is used for a variety of candidal infections. It is applied topically as a cream, ointment, or powder. It is also available as a troche and an oral liquid or tablet.
A patient with low platelets is prescribed a drug to stimulate platelet production. Which drug would the nurse anticipate being prescribed? A. oprelvekin (Neumega) B. epoetin (Epogen) C. aldesleukin (Proleukin) D. interferon beta-1a (Avonex)
A. Oprelvekin stimulates the production of platelets. Epoetin stimulates the production of red blood cells in the bone marrow. Interleukins (aldesleukin) and interferons activate the immune system but do not increase production of white blood cells.
Before administering an immunosuppressant drug, the nurse should perform which assessments? (Select all that apply.) A.Blood urea nitrogen and creatinine levels B.Level of consciousness C.Blood pressure and pulse D.Hepatic enzymes
All of them
when teaching a patient who is taking nystatin lozenges for oral candidiasis, which instruction by the nurse is correct? A. chew the lozenge carefully before swallowing B. dissolve the lozenge slowly and completely in your mouth C. dissolve the lozenge until it is half the original size and then swallow it D. these lozenges need to be swallowed with a glass of water
B
a patient receiving chemo is experiencing severe bone marrow suppression. which nursing diagnosis is most appropriate at this time? A. Activity intolerance B. risk for infection C. disturbed body image D. impaired physical mobility
B
during antitubercular therapy with isoniazid, the patient received another prescription for pyridoxine. which statement by the nurse best explains the rationale for this second medication? A. this vitamin will help to improve your energy levels B. this vitamin will help to prevent neurologic adverse effects C. this vitamin will help to protect your heart from toxic effects D. this vitamin helps to reduce gastrointestinal adverse effects
B
the nurse is assessing a patient who is about to receive antifungal drug therapy. which problem would be of most concern? A. endocrine disease B. hepatic disease C. cardiac disease D. pulmonary disease
B
the nurse is caring for a patient who becomes severely nauseated during chemotherapy. which intervention is most appropriate? A. encourage light activity during chemo as a distraction B. provide antiemetic meds 30 to 60 minutes before chemo begins C. provide antiemetic meds only upon the request of the patient D. hold fluids during chemo to prevent vomiting
B
the nurse is conducting a class on drugs for malignant tumors for a group of new oncology staff members. which best describes the action of interferons in the management of malignant tumors? A. interferons increase the production of specific anticancer enzymes B. interferons have antiviral and antitumor properties and strengthen the immune system C. interferons stimulate the production and activation of T lymphocytes and cytotoxic T cells D. interferons help improve the cell killing action of the T cells because they are retrieved from healthy donors
B
when teaching a patient about the potential drug interactions with antiprotozoal drugs, the nurse will include information about: A. acetaminophen B. warfarin C. decongestants D. antibiotics
B
which teaching point would be appropriate to include when the nurse is informing a patient about the adverse effects of antimalarials? A. the skin may turn blotchy while these medications are taken B. these medications may cause anorexia and abdominal distress C. these medications may cause an increase in urinary output D. the patient may experience periods of diaphoresis and chills
B
while assessing a patient who is to receive muromonab-CD3, the nurse knows that which condition would be a contraindication for this drug? A. acute myalgia B. fluid overload C. polycythemia D. diabetes mellitus
B
while teaching a patient who is about to receive cyclophosphamine (Cytoxan) chemo, the nurse will instruct the patient to watch for potential adverse effects such as: A. cholinergic diarrhea B. hemorrhagic cystitis C. peripheral neuropathy D. ototoxicity
B
the nurse is reviewing the use of multidrug therapy for HIV with a patient. which statements are correct regarding the reason for using multiple drugs to treat HIV? select all that apply A. the combination of drugs has fewer associated toxicities B. the use of multiple drugs is more effective against the resistant strains of HIV C. effective treatment results in reduced t cell count D. the goal of this treatment is to reduce the viral load E. this type of therapy reduces the incidence of opportunistic infections
B D E
the nurse is monitoring for liver toxicity in a patient who has been receiving long term isoniazid therapy. manifestations of liver toxicity include, select all that apply: A. orange discoloration of sweat and tears B. darkened urine C. dizziness D. fatigue E. visual disturbances F. jaundice
B D F
the nurse is assessing a patient who has experienced severe neutropenia after chemo and will monitor for which possible signs of infection? select all that apply A. elevated WBC count B. fever C. nausea D. sore throat E. chills
B DE
Which are general adverse effects of chemotherapy? (Select all that apply.) A.Leukocytosis B.Thrombocytopenia C.Alopecia D.Urinary retention E.Hypertension
B, C div>Bone marrow suppression (leukopenia, thrombocytopenia, and anemia) and alopecia are common adverse reactions to antineoplastic drugs. Urinary retention, hypertension, and leukocytosis are not expected side effects.</div>
What disorders are considered contradictions for use of antifungal medications? (Select all that apply.) A.Heart failure B.Liver failure C.Kidney failure D.Pancreatic failure E.Respiratory failure
B, C, D
A patient is scheduled for colorectal surgery tomorrow. he does not have sepsis, his white blood count is normal and he has no fever, and is otherwise in good health. however, there is an order to administer an antiobiotic on call before he foes to surgery. the nurse kows that the rationale for this antibiotic order is to: A. provide empiric therapy B. provide prophylactic therapy C. treat for a superinfection D. reduce the number of resistant organisms
B.
The nurse is providing education to a patient who is prescribed metronidazole (Flagyl) for trichomoniasis. What statement by the patient indicates the patient has understood the teaching? A. "I will stop taking the medication when the discharge stops." B. "I will have my partner evaluated and treated." C. "I can continue to have intercourse as long as we use condoms." D. "I won't get this again since I have had it once."
B. Inform the patient taking metronidazole for a sexually transmitted disease to avoid sexual intercourse until the prescriber states otherwise. The partner, any sexual partners possibly exposed, need to be evaluated and treated if positive. All other statements would require further teaching by the nurse.
The nurse anticipates an order for vitamin supplementation for a patient who is receiving INH therapy. What vitamin supplement is usually used with INH? A. Folate B. Vitamin B6 C. Vitamin E D. Calcium
B. Pyridoxine (vitamin B6) is typically ordered to assist in prevention of the neurologic side effects of the INH.
The nurse would monitor which laboratory values in a patient receiving intravenous gentamicin (Garamycin)? A. Hematocrit and hemoglobin B. Serum glutamic-oxaloacetic transaminase (SGOT) and alanine transaminase (ALT) C. Prothrombin time (PT) and partial thromboplastin time (PTT) D. Blood urea nitrogen (BUN) and creatinine
Blood urea nitrogen (BUN) and creatinine Gentamycin has a high potential for nephrotoxicity and is thus contraindicated in patients with elevated renal function tests such as BUN and creatinine.
a nurse is teaching a patient who is starting antitubucular therapy with rifampin. which adverse effects would the nurse expect to see? A. headache and neck pain B. Gynecomastia C. reddish brown urine D. tingling or numbness in the extremities
C
a patient has been admitted for treatment of an infected leg ulcer and will be started on intravenous linezolid. the nurse is reviewing the list of the patients current medications. which type of medication, if listed, would be of most concern if taken with linezolid? A. beta blocker B. oral anticoagulant C. selective serotonin reuptake inhibitor antidepressant D. thyroid replacement hormone
C
a woman who has been taking an antibiotic for a UTI calls the nurse practitioner to complain of severe vaginal itching. she also noticed a thick, whitish vaginal discharge. the nurse practitioner suspects that A. this is an expected response to the antibiotic B. the UTI has become worse instead of better C. a superinfection has developed D. the UTI is resistant to the antibiotic
C
after giving an injection to a patient with HIV infection, the nurse accidently sticks herself. recommendations for occupational HIV exposure may include which of these drugs? A. Didanosine B. lamivudine and efuviritide C. zidovudine, lamivudine, and indinavir D. acyclovir
C
after surgery for organ transplantation a patient is receiving glanciclovir even though he does not have a viral infection. which statement best explains the rationale for this medication therapy? A. glanciclovir is used to prevent potential exposure to the HIV virus B. this medication is given prophylactically to prevent influenza A virus C. Ganciclovir is given to prevent CMV infection D. the drug works synergistically with antibiotics to prevent superinfections
C
during a teaching session for a patient receiving an immunosuppressant drug, the nurse will include which statement? A. It is better to use oral forms of these drugs to prevent the occurrence of thrush B. you will remain on antibiotics to prevent infection C. it is important to use some form of contraceptive during treatment and for up to 12 weeks after the end of therapy D. be sure to take your medication with grapefruit juice to increase absorption
C
during an infusion of amphotecerin B, the nurse knows that which administration technique may be used to minimize infusion related adverse effects? A. forcing of fluids during the infusion B. infusing the medications quickly C. infusing the medication over a longer period of time D. stopping the infusion for 2 hours after half of the bag has infused, then resume 1 hour later
C
during therapy with the cytotoxic antibiotic bleomycin, the nurse will assess for a potentially serious adverse effect by monitoring A. blood urea nitrogen and creatinine levels B. cardiac ejection fraction C. respiratory function D. cranial nerve function
C
during treatment with Doxorubicin (Adriamycin) the nurse must monitor closely for which potentially life threatening adverse effect? A. nephrotoxicity B. peripheral neuritis C. cardiomyopathy D. ototoxicity
C
if extravasation of an antineoplastic medication occurs, which intervention does the nurse do first? A. apply a cold compress to the site while elevating the arm B. inject sub Q doses of epinipherine around the IV site every 2 hours C. stop the infusion immediately while keeping the catheter in place D. inject the appropriate antidote through the IV catheter
C
in caring for a patient receiving therapy with a myelosupressive antineoplastic drug, the nurse notes an order to begin filgrastim after the chemo is completed. which statement correctly describes when the nurse will begin the fibrastim therapy? A. it can be started during the chemo B. it will begin immediately after the chemo is completed C. It will be initiated 24 hours after the chemo is completed D. it will not be started until at least 72 hours after chemo is completed
C
the nurse is administering methotrexate as part of the treatment for RA and will monitor for which sign of bone marrow suppression? A. edema B. tinnitus C. increased bleeding tendencies D. tingling in the extremities
C
while assessing a woman who is receiving an antibiotic for community acquired pneumonia, the nurse notes that the patient has thick, white vaginal discharge. the patient is also complaining about perineal itching. the nurse suspects that the patient has A. resistance to the antibiotic B. an adverse effect to the antibiotic C. a superinfection D. an allergic reaction
C
while monitoring a patient who is receiving intravenous amphotericin B, the nurse expects to see which adverse effects? A. hypertension B. bradycardia C. fever and chills D. diarrhea and stomach cramps
C
the nurse is administering an intravenous aminoglycoside to a patient who has had gastrointestinal surgery which nursing measures are appropriate? select all that apply A. report a trough level of 0.8 mcg/ mL and hold the drug B. enforce a strict fluid restriction C. monitor serum creatinine levels D. instruct the patient to report dizziness, or feeling of fullness in ears.
C D
a teenge patient is taking a tetracycline drug as part of treatment for severe acne. when the nurse teaches this patient about drug related precautions, which is the most important information to convey? A. when the acne clears up, the medication may be discontinued B. this medication needs to be taken with antacids to reduce GI upset C. the patient needs to use sunscreen and avoid exposure to sunlight, because it can cause photosensitivity D. the teeth should be observed closely for signs of mottling or other color changes
C.
The patient is being treated with the drug fingolimod (Gilenya). What disease or disorder would the nurse expect the patient to have? A. Guillain-Barré syndrome B. Amyotrophic lateral sclerosis C. Multiple sclerosis D. Parkinson's disease and dementia
C. A new drug, fingolimod (Gilenya), which actually failed as an antirejection drug, was approved in 2010 for multiple sclerosis. It is the only oral drug for relapsing forms of multiple sclerosis. It has significant adverse effects, including headache, hepatotoxicity, flulike symptoms, back pain, atrioventricular block, bradycardia, hypertension, and macular edema.
What is the priority nursing assessment to monitor when administering vaccinations? A. Pain at the injection site B. Signs and symptoms of infection C. Anaphylaxis D. Myalgias
C. Anaphylaxis is a potential life-threatening adverse reaction to vaccines. Pain and myalgias can occur but are not life threatening.
When providing instructions to patients on use of antibiotics, which instructions would the nurse include in the teaching? (Select all that apply.) A.Complete the entire course of therapy. B.Notify the provider of any possible reactions that occur. C.Save any leftover medication in a cool dry place for later use. D.Wash hands before and after preparing food. E.Increase fluid intake.
Complete the entire course of therapy.,Notify the provider of any possible reactions that occur.,Wash hands before and after preparing food.,Increase fluid intake. <div>There should not be any leftover medication, and if there is, it needs to be discarded in the appropriate method. The provider typically only writes a prescription for the exact amount of medication needed by the patient.</div>
In an effort to prevent superinfections of the gastrointestinal tract (e.g., from Clostridium difficile), the nurse will instruct patients to eat which foods?
Cultured dairy products such as yogurt The natural flora in the gastrointestinal tract may be killed off by antibiotics, leaving other bacteria such as C. difficile to overgrow. This process may be prevented through consumption of probiotics (e.g., yogurt, buttermilk, kefir).
a patient has a new order for glatiramer acetate. the patient has not had an organ transplant. the nurse knows that the patient is receiving this drug for which condition? A. psoriasis B. RA C. irritable bowel syndrome D. relapse remitting multiple sclerosis
D
a patient who is receiving chemo with cisplatin (Platinol) has developed pneumonia. the nurse would be concerned about nephrotoxicity if which type of antibiotic was ordered as a treatment for the pneumonia at this time? A. penicillin B. sulfa drug C. Fluroquinolone D. aminoglycoside
D
during patient education regarding an oral macrolide such as erythromycin, the nurse will include which information? A. If GI upset occurs, the drug will have to be stopped B. the drug needs to be taken with antacids to avoid GI problems C. the patient needs to take each dose with a sip of water D. the patient may need to take the drug with a small snack to reduce GI irritation
D
during therapy with Azathioprine (Imuran) the nurse must monitor for which common adverse effect? A. bradycardia B. diarrhea C. vomiting D. thrombocytopenia
D
during therapy with an intravenous aminoglycoside, the patient calls the nurse and says, "I'm hearing some off sounds, like ringing in my ears" what is the nurses priority action? A. reassure the patient that these are expected adverse effects B. reduce the rate of intravenous infusion C. increase the rate of the intravenous infusion D. stop the infusion immediately
D
during treatment of zidovudine, the nurse needs to monitor for which potential adverse effect? A. retinitis B. deep vein thrombosis C. Kaposi's sarcoma D. bone marrow suppression
D
the nurse is monitoring a patient who has been receiving aldesleukin II (IL-2) (Proleukin) for treatment of malignant melanoma. which adverse effect if noted on assessment is of primary concern? A. chills B. Fatigue C. headache D. Fluid retention
D
the nurse is reviewing the medication history of patient who is taking hydroxychloroquine. however, the patients chart does not reveal a history of malaria or travel out of the country. the patient is most likely taking this medication for A. plasmodium B. thyroid disorders C. roundworms D. rheumatoid arthritis
D
the nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for A. severe weakness and fatigue B. elevated body temperature C. decrease skin turgor D. excessive bleeding and bruising
D
when administering antifungal drug therapy, the nurse knows that an issue that contributes to many of the drug interactions with antifungals is the patients A. history of cardiac disease B. history of gallbladder surgeries C. ethnic background D. cytochrome P 450 enzyme system
D
when counseling a patient who has been newly diagnosed with TB the nurse will make sure that the patient realizes that he or she is contagious A. during all phases of the illness B. any time up to 18 months after therapy begins C. during the postictal phase of TB D. during the initial period of the illness and its diagnosis
D
while monitoring a patient, the nurse knows that a therapeutic response to antitubercular drugs would be: A. the patient states that he is feeling much better B. the patients lab test results show a lower white blood cell count C. the patient reports a decrease in cough and night sweats D. there is a decrease in symptoms, a long with improved chest radiograph and sputum culture results
D
a patient who has been newly diagnosed with HIV has many questions about the effectiveness of drug therapy. after a teaching session, which statement by the patient reflects a need for more education? A. I will be monitored for side effects and improvements while I'm taking this medicine B. these drugs do not eliminate the HIV but hopefully the amount of the virus in my body will be reduced. C. there is no cure for HIV D. these drugs will eventually eliminate the virus from my body
D.
An allergy to which substance is listed as a contraindication to the administration of an immunizing drug? A. Soy B. Corn C. Wheat D. Egg
D. Contraindications to the administration of immunizing drugs include allergy to the immunization itself or allergy to any of its components, such as eggs or yeast.
When preparing to administer metronidazole via an intravenous route, the nurse will anticipate administering the medication for how long? A. 1 to 5 minutes B. 5 to 10 minutes C. 15 to 30 minutes D. 30 to 60 minutes
D.Infuse intravenous doses of metronidazole as ordered and generally over more than 30 to 60 minutes and never as an intravenous bolus.
When planning care for a patient receiving a sulfonamide antibiotic, it is important for the nurse to perform which action?
Encourage fluid intake of 2000 to 3000 mL/day. Patients should be encouraged to drink plenty of fluids (2000 to 3000 mL/24 hours) to prevent drug-related crystalluria associated with sulfonamide antibiotics.
is the most significant protozoal disease in terms of morbidity and mortality
Malaria
Which statement best describes health care-associated infections?
They are defined as health care-acquired infections that the patient did not have or incubate before admission. Health care-associated infections occur in 5% to 10% of hospitalized patients and are very difficult to treat. They are incubated once the patient is admitted to a health care facility and are caused by germs that live within that environment.
Which information will the nurse include in discharge teaching for a patient receiving doxycycline?
Use sunscreen and protective clothing when outdoors." Photosensitivity is a common side effect of doxycycline, a tetracycline antibiotic. The patient should avoid direct sun exposure while taking this medication. Exposure to the sun can cause severe burns.
How is the effectiveness of antiviral drugs administered to treat HIV infection assessed and evaluated? A. Megakaryocytes B. Red blood cell counts C. Lymphocyte counts D. Viral load
Viral Load All antiretroviral drugs work to reduce the viral load, which is the number of viral RNA copies per milliliter of blood.
When providing health promotion teaching at a senior citizen center, the nurse would include information about which medication used to decrease the duration of influenza A and B? oseltamivir (Tamiflu) B. ganciclovir (Cytovene) C. enfuvirtide (Fuzeon) D. indinavir (Crixivan)
oseltamivir (Tamiflu) Oseltamivir (Tamiflu) and zanamivir (Relenza) are active against influenza virus types A and B and have been shown to reduce the duration of influenza infection by several days.
During antibiotic therapy, the nurse will assess the patient for a condition that may occur due to the disruption of normal flora. The nurse recognizes this as:
superinfection. Antibiotic therapy can destroy the normal flora of the body, which normally would inhibit the overgrowth of fungi and yeast. When the normal flora are decreased, these organisms can overgrow and cause infections.
Which are mechanisms of action of biologic response-modifying drugs? (Select all that apply.) A.Interruption of the cell lifecycle at the genetic level to interfere with growth of the cancer cell B.Direct toxic effect on tumor cells, causing them to rupture C.Adverse modification of a tumor's biology, making it harder for the tumor cells to survive and reproduce D.Enhancement or restoration of the host's immune system defenses against a tumor
B, C, D In terms of their activity against cancer cells, biologic response–modifying drugs work by one of three mechanisms: (1) enhancement or restoration of the host’s immune system defenses against the tumor; (2) direct toxic effect on the tumor cells, which causes them to lyse, or rupture; or (3) adverse modification of the tumor’s biology, which makes it harder for the tumor cells to survive and reproduce. This class does not interrupt any genetic level of cell replication.</div>
What is the most important action for the nurse to complete before administration of intravenous amphotericin B? A. Administer the drug along with potassium aliquots to prevent hypokalemia. B. Premedicate the patient with an antipyretic, antihistamine, and antiemetic as prescribed. C. Administer insulin as prescribed to prevent severe hyperglycemia. D. Administer intravenous dextrose as prescribed to prevent severe hypoglycemia.
B. Almost all patients given intravenous amphotericin B develop fever, chills, nausea and vomiting, and hypotension. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions.
The current immunization for tetanus and diphtheria toxoids and pertussis, Tdap, is administered to people in which age range? A. Under 6 years of age B. 11 years of age and older C. Any age range D. In the first two years of life
B. Currently DTaP is the preferred preparation for primary and booster immunization against these diseases in children from 6 weeks to 6 years of age, unless use of the pertussis component is contraindicated. Tdap is the recommended vaccine for adolescents and adults, those over the age of 11.
Upon which patient finding would the nurse hold the ordered dose of filgrastim (Neupogen) and notify the provider? A. Fever of 99.5° F B. Absolute neutrophil count (ANC) count of 12,000 cells/mm3 C. White blood cell (WBC) count of 4.5/mm3 D. Blood pressure of 142/88 mm Hg
B. Filgrastim (Neupogen) is usually discontinued when a patient's ANC rises above 10,000 cells/mm3. However, some prescribers will stop it when the ANC is between 1000 and 2000 cells/mm3.
Which adverse effect can result if tetracycline is administered to children under 8 years of age?
Permanent discoloration of the teeth Tetracycline is contraindicated in children under 8 years of age because it can cause permanent discoloration of the adult teeth, which are still forming in the child.
When assessing for adverse reactions to Rifamate (combination isoniazid and rifampin), the nurse would monitor which laboratory values? (Select all that apply.) A.Liver function tests B.CBC C.Sputum cultures D.Uric acid levels E.Cholesterol
A, B. <div>Rifamate can lead to impairment of liver function as well as hematologic disorders. Assessment of sputum cultures confirms the diagnosis but is not related to adverse effects. The drug does not affect uric acid levels or cholesterol.</div>
When educating patients on immunosuprressants, what information would the nurse include in the teaching? (Select all that apply.) A."Never stop taking these medications without being instructed by the prescribing provider." B."Over-the-counter medication are OK to take as needed." C."You must take all medications exactly as prescribed." D."Medications must be taken at the correct time every time to avoid interactions.
A, C, D <div>Immunosuppressants must be taken exactly as directed and at the exact times and with the exact foods. Adherence to dosing schedules can be very difficult for patients because they are taking multiple medications that must be taken at different times throughout the day. Patients should never stop taking their immunosuppressants without being told to do so by their transplant doctor.</div>
Which is most important for the nurse to monitor in a patient receiving an antifungal medication? (Select all that apply.) A.Daily weights B.Mental status C.Intake and output D.Blood urea nitrogen (BUN) E.Creatinine
A, C, D, E <div>Nursing assessments appropriate to patients receiving antifungal drugs vary depending on the particular drug. However, it is important for the nurse to monitor all patients for indications of possible medication-induced renal damage so that prompt interventions can occur to prevent further dysfunction. Monitoring intake and output amounts, daily weights, and renal function tests will help prevent such damage.</div>
When providing education to a patient undergoing antineoplastic drug therapy, the nurse would teach the patient that which signs and symptoms indicate an oncologic emergency that requires immediate notification of the health care provider? (Select all that apply.) A.Swollen tongue B.Bleeding gums C.Difficulty sleeping D.New and persistent cough E.Nausea on the day of treatment F.Blood in urine
A,B,D, F <div>The patient must contact the prescriber immediately if any of the listed signs or symptoms occurs:<br>· Fever and/or chills with a temperature higher than 100.5° F (38.1° C)<br>· New sores or white patches in the mouth or throat<br>· Swollen tongue with or without cracks and bleeding<br>· Bleeding gums<br>· Dry, burning, “scratchy,” or “swollen” throat<br>· A cough that is new and persistent<br>· Changes in bladder function or patterns<br>· Blood in the urine<br>· Changes in gastrointestinal or bowel patterns, including heartburn& or nausea, vomiting, constipation, or diarrhea lasting longer than 2 or 3 days Blood in the stools
A patient is seen in the clinic for signs and symptoms of malaria after a trip to South America. What drug would the nurse expect to be prescribed? A. chloroquine (Aralen) B. penicillin C. metronidazole (Flagyl) D. pentamidine (Pentam)
A. Chloroquine is a standard drug used for the treatment of malaria in an acute stage.
What information must be provided to a patient receiving rifampin? A. A nonharmful side effect of the drug is red-orange discoloration of urine, sweat, and tears. B. Oral contraception is the preferred method of birth control when using rifampin. C. Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities. D. The patient will only need to take this medication for the prescribed 14-day period.
A. Red-orange discoloration of body fluids is a common side effect of rifampin, but it is not harmful. Rifampin does not cause peripheral neuropathies (INH does), but it does interfere with the effectiveness of oral contraceptives. All antitubercular drugs need to be taken long term in order to eradicate the slow-growing mycobacterium lying deep within the tissues.
A patient visits the health care provider for treatment of tinea pedis (athlete's foot). Which medication would the nurse most likely instruct the patient on to treat this condition? A. terbinafine (Lamisil) B. voriconazole (Vfend) C. caspofungin (Cancidas) D. amphotericin B Incorrect
A. Terbinafine (Lamisil) is classified as an allylamine antifungal drug and is currently the only drug in its class. It is available in a topical cream, gel, and spray for treating superficial dermatologic infections, including tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm).
What cells are the functional cells of the humoral immune system that mature into immunoglobulins? A. B cells B. Granulocytes C. T cells D. Red blood cells
A. The functional cells of the humoral immune system are the B lymphocytes. When an antigen binds to receptors located on the B cells, a biochemical signal is sent to the B lymphocytes. These B cells then mature into plasma cells, which in turn produce antibodies.
The nurse would question an order for voriconazole (Vfend) if the patient was taking which medication? A. quinidine B. prednisone C. captopril (Capoten) D. clindamycin (Cleocin)
A. The nurse would question an order for quinidine, since both voriconazole and quinidine are metabolized by the cytochrome P-450 enzyme system. The drugs will compete for the limited number of enzymes, and one of the drugs will end up accumulating.
Which statement most accurately describes the pharmacodynamics of vaccines? A. Vaccines work by stimulating the humoral immune system. B. Vaccines provide passive immunity. C. Vaccines work by suppressing immunoglobulins. D. Vaccines prevent the formation of antibodies against a specific antigen.
A. Vaccines work by stimulating the humoral immune system, which synthesizes immunoglobulins. They also stimulate the formation of antibodies against their specific antigen, providing active immunity.
Quinolones are a class of antibiotics known for several significant complications. Which are possible adverse effects with these drugs? (Select all that apply.) A.Abnormal cartilage development in children B.Prolongation of the QT interval C.Nephrotoxicity D.Tendon rupture E.Ototoxicity
Abnormal cartilage development in children,Prolongation of the QT interval,Tendon rupture div>Quinolones are not used in prepubescent children due to the risk of cartilage development issues. Quinolones may also cause a cardiac effect that involves prolongation of the QT interval on the electrocardiogram. The use of these medications can result in tendonitis or rupture tendons in adults. Nephrotoxicity and ototoxicity are not associated with quinolones.</div
When assessing a patient for adverse effects related to cisplatin (Platinol), the nurse will monitor for which adverse effects? (Select all that apply.) A.Nephrotoxicity B.Peripheral neuropathy C.Pulmonary toxicity D.Severe nausea/vomitin E.Ototoxicity
All except C. div>Cisplatin is known to be ototoxic, nephrotoxic, neurotoxic, and emetogenic.</div>
The anthrax vaccine is recommended for which groups of people? (Select all that apply.) A.Military personnel B.Veterinarians C.Workers who process imported animal hair D.Emergency department health care providers
All except D People at risk for exposure to the anthrax bacterium include military personnel, veterinarians, and workers who process imported animal hair.</div>
What are the major adverse effects specific to the cytotoxic antibiotics? A.Liver toxicity B.Cardiovascular toxicity C.Pneumonitis D.Neurotoxicity E.Nephrotoxicity
All except D. >As with all of the antineoplastic drugs, cytotoxic antibiotics have the undesirable effects of hair loss, nausea and vomiting, and myelosuppression. Major adverse effects specific to the cytotoxic antibiotics include pulmonary fibrosis, pneumonitis, liver toxicity, heart failure, cardiovascular toxicity, tissue damage in the event of extravasation, kidney toxicity, and lung toxicity. This class of drugs is not known for neurotoxicity.</div>
Before administration of any antiviral medication, what nursing care would be performed? (Select all that apply.) A.Head-to-toe physical assessment B.Documentation of known allergies C.History of medication use D.Monitoring for adverse effects E.Baseline vital signs
All except D. div>Before administering an antiviral drug, perform a thorough head-to-toe physical assessment and take a medical and medication history. Document any known allergies before use of these and any other medications. Also assess the patient’s baseline vital signs because of the profound effects of viral illnesses on physiologic status, especially if the patient is immunocompromised. Assess and document any contraindications, cautions, and drug interactions associated with all of the antiviral drugs. Monitoring for adverse effects would occur after the medication has been administered.</div>
Which are known adverse effects of alkylating agents? (Select all that apply.) A.Nephrotoxicity B.Neurotoxicity C.Ototoxicity D.Bone marrow suppression E.Cardiotoxicity
All except E. <div>Alkylating drugs are capable of causing pulmonary fibrosis, nephrotoxicity, neurotoxicity, bone marrow suppression, peripheral neuropathy, ototoxicity, and hemorrhagic cystitis. The adverse effects of these drugs are important because of their severity, but they can often be prevented or minimized by prophylactic measures. Cardiotoxicity is not listed as an adverse effect for this class of drugs.</div>
Which types of antiviral drugs are used to treat HIV infection? (Select all that apply.) A.Nonnucleoside reverse transcriptase inhibitors B.Protease inhibitors C.Reverse transcriptase inhibitors D.Fusion inhibitors E.Neuraminidase inhibitors
All except E. div>Neuraminidase inhibitors are used in the treatment of the influenza virus.</div>
The nurse is aware that viruses can enter the body through various routes. By which methods can viruses enter the body? (Select all that apply.) A.Inhalation through the respiratory tract B.Ingestion via the gastrointestinal (GI) tract C.Transplacentally from mother to infant D.Through an animal bite
All of the options are correct <div>Viruses can enter the body through at least four routes: inhalation through the respiratory tract, ingestion via the GI tract, transplacentally via mother to infant, and inoculation via skin or mucous membranes. The inoculation route can take several forms, including sexual contact, blood transfusions, sharing of syringes or needles, organ transplantation, and animal bites (including human, animal, insect, spider, and others).</div>
Which vaccination was developed to prevent bacterial meningitis caused by Haemophilus influenzae? A. Hepatitis B vaccine B. Hib conjugate vaccine C. Prevnar D. Gardasil
B. H. influenzae type b (Hib) (HibTITER, ActHIB, Liquid PedvaxHIB) vaccine is a noninfectious, bacteria-derived vaccine. Before this vaccine was developed, infections caused by Hib were the leading cause of bacterial meningitis in children 3 months to 5 years of age.
Which vaccination is marketed and recommended in the prevention of a virus that is known to cause cervical cancer? A. Herpes zoster vaccine (Zostavax) B. Papillomavirus vaccine (Gardasil) C. Pneumococcal vaccine (Prevnar 13) D. Hepatitis B virus vaccine (Recombivax HB)
B. Human papillomavirus virus (HPV) is a common cause of genital warts and cervical cancer. The papillomavirus vaccine (Gardasil, Cervarix) is the first and only vaccine known to prevent cancer.
When admitting a patient diagnosed with Pneumocystis jirovecii pneumonia, the nurse will anticipate administering which medication? A. iodoquinol (Yodoxin) B. pentamidine (Pentam) C. paromomycin (Humatin) D. albendazole (Albenza)
B. Iodoquinol and paromomycin are used to treat intestinal amebiasis, and albendazole is used to treat helminthic infections.
What teaching would the nurse provide to a patient receiving tetanus toxoid? A. "Increase fluid and fiber in your diet to prevent constipation." B. "Soreness at the injection site is a common reaction." C. "You will have lifetime immunity from this injection." D. "This medication must be repeated weekly for four weeks."
B. Myalgia at the injection site is a common side effect of tetanus toxoid.
How would the nurse define the term nadir to a patient? A. The average number of days it takes the bone marrow to recover from a dose of chemotherapy B. The average number of days it takes for chemotherapy to have its peak effect on the bone marrow C. The patient's tolerance to the chemotherapy's bone marrow suppressant effect D. The maximum dose for a chemotherapy drug in reference to bone marrow suppression
B. Nadir refers to the average number of days it takes for a chemotherapeutic drug to have its peak effect on the bone marrow, which would coincide with the patient's lowest blood count and highest risk for infection and/or bleeding.
What is considered a major dose-limiting side effect of doxorubicin (Adriamycin)? A. Hemorrhagic cystitis B. Cardiomyopathy C. Hepatoxicity D. Nephrotoxicity
B. Patients receiving doxorubicin need to be monitored for cardiac toxicity. There is a lifetime limited dose that patients are allowed to receive to minimize the occurrence of cardiomyopathy.
The nurse is discussing the use of alkylating drugs with the patient. What is the best way to describe the mechanism of action of alkylating drugs on cancer cells? A. They interact with the cell through intercalation. B. They alter the chemical structure of the DNA. C. They change the structure of the RNA. D. They stop the meiosis of the cell.
B. The alkylating drugs work by preventing cancer cells from reproducing. Specifically, they alter the chemical structure of the cells' DNA, which is essential to the reproduction of any cell. This stops the cancer from reproducing or spreading. Cytotoxic antibiotics interact with DNA through a process called intercalation, in which the drug molecule is inserted between the two strands of a DNA molecule, ultimately blocking DNA synthesis.
A nurse needs to be aware that the antifungal drug with the most common adverse events is which drug? A. griseofulvin B. fluconazole C. ketoconazole D. amphotericin B
B. The major adverse effects caused by antifungal drugs are encountered most commonly in conjunction with amphotericin B treatment. Drug interactions and hepatotoxicity are the primary concerns in patients receiving other antifungal drugs, but the intravenous administration of amphotericin B is associated with a multitude of adverse effects.
When a patient is receiving cyclophosphamide (Cytoxan), he or she should be advised to drink plenty of water/fluids to prevent which condition? A. Renal failure B. Hemorrhagic cystitis C. Liver dysfunction D. Red blood cell count
B. Patients receiving cyclophosphamide should drink at least 2 to 3 L of fluid before, during, and after administration to prevent hemorrhagic cystitis.
Which condition is not an anticipated side effect of azathioprine (Imuran)? A. Leukopenia B. Thrombocytopenia C. Alopecia D. Hepatotoxicity
C. Common side effects of azathioprine include leukopenia, thrombocytopenia, and hepatotoxicity. Alopecia (hair loss) is not an expected side effect
Which statement by the patient leads the nurse to believe that the patient has understood the teaching regarding ethambutol (Myambutol)? A. "Dizziness, drowsiness, and decreased urinary output are common with this drug, but they will subside over time." B. "Constipation will be a problem, so I will increase the fiber in my diet." C. "I will need to have my eyes checked periodically while I am taking this drug." D. "This medication may cause my bodily secretions to turn red-orange."
C. Ethambutol can cause optic neuritis. Ophthalmologic examinations should be performed periodically to assess visual acuity.
Current research has lead to discovery of cancer-causing viruses. Which virus that is linked to cancer can be prevented by vaccination in humans? A. Rous sarcoma virus B. Shope papillomavirus C. Human papillomavirus D. Leukemia viruses
C. Extensive research has indicated that there are cancer-causing viruses that can affect most mammalian species. Examples include human papillomavirus (HPV in humans), the various cat leukemia viruses, the Rous sarcoma virus in chickens, and the Shope papillomavirus in rabbits. The HPV now has a vaccination on market which is likely to decrease the chance of getting the virus which can lead to several different types of cancers.
Patients receiving filgrastim (Neupogen) should be taught to expect which side effect? A. Hypotension B. Constipation C. Bone pain D. Insomnia
C. Filgrastim increases the production of white blood cells in the bone marrow, triggering the common side effect of bone pain.
When reviewing a patient's medication regimen before discharge, the patient asks why he is taking pyridoxine when he is already taking isoniazid (INH) to treat tuberculosis. What is the nurse's best response? A. "Pyridoxine is another antitubercular drug that will work synergistically with the isoniazid." B. "You really should not be on that drug. I will check with the doctor." C. "Pyridoxine will help prevent numbness and tingling that can occur secondary to the isoniazid." D. "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria."
C. INH can cause neurotoxicity. Pyridoxine, vitamin B6, is the drug of choice to prevent this adverse reaction. It is not an antiinfective drug and thus will not work to destroy the mycobacterium or prevent drug resistance.
What is the general action of immunosuppressants? A. They increase antibody response. B. They increase natural killer (NK) cellular activity. C. They suppress T-lymphocytes. D. They suppress hepatic metabolism of steroids.
C. Immunosuppressants inhibit T-lymphocyte synthesis, thus preventing an immune response to organ transplants.
The nurse has provided education to a patient about fungal skin infections. The nurse needs to reinforce teaching when the patient includes what disorder in the discussion of fungal skin infections? A. Vaginal yeast infection B. Athlete's foot C. Impetigo D. Thrush
C. Impetigo is a bacterial skin infection and would not be classified as a fungal skin infection. If the patient included this in the discussion, further teaching is needed. All other skin infections listed are fungal and would be treated with antifungal medications.
Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy. Patients who are experiencing this unpleasant effect will be advised A. to avoid eating any food during chemotherapy. B. that nothing can be done for this effect and that it will pass with time. C. to try to maintain hydration and nutrition, which are very important during treatment. D. to use antacids to relieve the irritation to the stomach, which should stop the nausea.
C. It is very important for patients undergoing chemotherapy to maintain adequate nutrition and hydration. Several antiemetic drugs are available that are very successful in controlling this side effect.
The nurse would anticipate administering which medication to patients receiving high-dose methotrexate (Trexall)? A. bleomycin (Blenoxane) B. cisplatin (Platinol) C. leucovorin D. dactinomycin (Cosmegen)
C. Leucovorin is given to block the systemic toxic effect of high-dose methotrexate. It is a form of folic acid that does not require dihydrofolate reductase to produce folic acid. Therefore it is used to prevent or treat toxicity induced by methotrexate, a folic acid antagonist. All the other options are chemotherapeutic drugs, which are not specifically associated with methotrexate.
When teaching a patient receiving paclitaxel (Taxol), the nurse needs to prepare the patient for which adverse effect? A. Weight gain B. Vertigo C. Arthralgias D. Hypertension
C. Myalgias and arthralgias are a common side effect of paclitaxel that the patient should be prepared to expect.
The drug mycophenolate (CellCept) has a black box warning because of which potential adverse effect? A. Hypertension B. Suicidal ideations C. Congenital malformations D. Abnormal high number of adverse effects
C. Mycophenolate (CellCept) is an antimetabolite and suppresses T cell proliferation. It is indicated for the prevention of organ rejection as well as the treatment of organ rejection. Mycophenolate has a black box warning from the Food and Drug Administration stating that it is associated with an increased risk of congenital malformations and spontaneous abortions when used during pregnancy.
The nurse would anticipate administering which medication to a patient demonstrating acute organ rejection? A. azathioprine (Imuran) B. basiliximab (Simulect) C. muromonab-CD3 (Orthoclone OKT3) D. sirolimus (Rapamune)
C. Only muromonab-CD3 (Orthoclone OKT3) is used to treat acute organ rejection. The other immunosuppressants are used to prevent organ rejection.
The nurse would teach a patient prescribed cyclosporine to avoid which substance? A. Sunscreen B. Chocolate milk C. Grapefruit juice D. Acetaminophen
C. Patients should avoid consuming grapefruit or grapefruit juice because they will increase the blood concentrations of cyclosporine. Sunscreen should be used to avoid photosensitivity, and the medication should be taken with food or chocolate milk to prevent gastrointestinal upset.
The nurse will suspect which type of cancer in a patient receiving tamoxifen (Soltamox)? A. Lung cancer B. Renal cancer C. Breast cancer D. Colon cancer
C. Tamoxifen is an antiestrogen drug useful in treating malignancies that require estrogen for growth, such as breast cancer
The nurse is teaching a patient who is preparing to travel to a malarious country about the prophylactic medication chloroquine. The nurse would instruct the patient to take chloroquine for how long after leaving the affected area? A. 2 weeks B. 4 weeks C. 8 weeks D. 12 weeks
C. Treatment for malaria prophylaxis is usually started 2 weeks before travel and continues for 8 weeks after travel is completed.
The nurse will teach patients taking rifampin and INH prophylactically secondary to tuberculosis exposure that A. these drugs will only need to be taken for 7 to 10 days. B. INH may decrease serum glucose in susceptible people. C. oral contraceptives become ineffective when given with rifampin. D. tanning beds may be used to counteract the pale skin tone caused by these medications.
C. Women taking oral contraceptives who are prescribed rifampin must be switched to another form of birth control because oral contraceptives become ineffective when given with rifampin. These medications must be taken long term because mycobacterium is slow growing. They can cause photosensitivity, necessitating the use of sunscreen, not tanning beds. Finally, INH may increase, not decrease, serum glucose levels.
When a patient is receiving metronidazole (Flagyl) via an intravenous route, what side effect would the nurse immediately report to the health care provider? A. Elevated blood pressure B. Diminished breath sounds C. Dark colored urine D. Dizziness or confusion, change in neurologic status
D. During use of this drug, metronidazole administered intravenously, report to the prescriber any changes in neurologic status (e.g., dizziness, confusion).
Which antifungal drug can be given intravenously to treat severe yeast infections as well as a one-time oral dose to treat vaginal yeast infections? A. nystatin (Mycostatin) B. caspofungin (Cancidas) C. voriconazole (Vfend) D. fluconazole (Diflucan)
D. Fluconazole is an antifungal drug that does not cause the severe side effects of amphotericin when given intravenously. It also has almost 100% bioavailability and therefore a single dose is often sufficient to treat vaginal yeast infections.
Which laboratory test result would cause the nurse to question administration of hydroxyurea (Hydrea)? A. White blood cell count of 8000/mm3 B. Platelet count of 450,000/mm3 C. Hemoglobin of 15 g/dL D. Thrombocyte count of 8000/mm3
D. Hydroxyurea causes bone marrow suppression, which is evidenced by a decrease in red blood cells, white blood cells, and platelets. A thrombocyte count of 8000/mm3 is significantly lower than normal. All the other options are within normal limits.
Administration of which of the following provides passive immunity? A. Vaccines B. Toxoids C. Antitoxins D. Immunoglobulins
D. Vaccines, antitoxins, and toxoids provide active immunity by stimulating the humoral immune system. Immunoglobulins provide passive immunity by giving the patient substances to fight specific antigens.
A new vaccination, Zostavax, has been approved to prevent the development of what condition in adults over the age of 50? A. Herpes simplex B. Herpes zoster C. Influenza A D. Avian influenza
Herpes zoster Zostavax is a new vaccination developed and approved for use in adults over the age of 50 to prevent the onset or outbreak of herpes zoster (shingles).
The most significant drug interactions with use of antivirals occur when antivirals are administered via which route? A. Topically B. Rectally C. Intravenously D. Optically
Intravenously Significant drug interactions that occur with antiviral drugs arise most often when they are administered via systemic routes such as intravenously and orally. Many of these drugs are also applied topically to the eye or body, however, and the incidence of drug interactions associated with these routes of administration is much lower.
Bacterial resistance to antibiotics can occur with which situations? (Select all that apply.)
Patients stop taking an antibiotic once they feel better. Antibiotics are prescribed to treat a viral infection. div>Not completing a full course of antibiotic therapy can allow bacteria that are not killed but have been exposed to the antibiotic to adapt their physiology to become resistant to that antibiotic. Administering antibiotics to treat viral infections is not effective and also may expose small amounts of bacteria that may be present to the antibiotic and therefore risk the development of resistance.</div>
A patient with a known heart condition is scheduled to have dental surgery and is prescribed antibiotics before the dental surgery. What type of therapy is this considered?
Prophylactic therapy Prophylactic antibiotic therapy is used to prevent infections in individuals who are at high risk of development of an infection during or after a procedure. The antibiotics are given before the procedure for prophylactic treatment.
The nurse would teach a patient receiving metronidazole (Flagyl) to avoid ingestion of which drink? A. Milk B. Wine C. Coffee D. Orange juice
Wine A disulfuram-like (Antabuse) reaction may occur with concurrent ingestion of metronidazole and alcohol, leading to flushing of the face, tachycardia, palpitations, nausea, and vomiting.
The nurse is obtaining a medication history from an 18-year-old female patient who has been diagnosed with genital herpes. Which drug would the nurse expect this patient to be prescribed? A. amantadine (Symmetrel) B. acyclovir (Zovirax) C. zidovudine (Retrovir) D. ribavirin (Virazole)
acyclovir (Zovirax) Acyclovir is the drug of choice to treat herpes simplex infections. Ribavirin is effective against respiratory syncytial virus (RSV), zidovudine against human immunodeficiency virus (HIV), and amantadine against Haemophilus influenzae type A.
A priority assessment of a patient on antibiotic therapy includes questioning the patient about
allergies. Antibiotic allergy is one of the most common drug allergies. An allergic reaction that occurs after administration of an antibiotic has the potential to cause severe anaphylaxis and possible death.
The nurse will question the use of a floroquinolone antibiotic in a patient already prescribed which medication? A. amiodarone B. metoprolol C. furosemide D. omeprazole
amiodarone Dangerous cardiac dysrhythmias are more likely to occur when quinolones are taken by patients receiving class IA and class III antiarrhythmic drugs such as disopyramide and amiodarone. For this reason, such drug combinations should be avoided.
Medications used to treat HIV infections are more specifically classified as A. antifungal drugs. B. antiviral drugs. C. antiretroviral drugs. D. antiparasitic drugs.
antiretroviral drugs. HIV is a member of the retrovirus family; therefore drugs used to treat this virus are classified as antiretroviral drugs. Although antiretroviral drugs also fall under the broader category of antiviral drugs in general, their mechanisms of action are unique to the AIDS virus. So, they are more commonly referred to by their subclassification as antiretroviral drugs.
When teaching a patient being discharged on linezolid (Zyvox) to treat methicillin-resistant Staphylococcus aureus (MRSA), the nurse must emphasize the importance of A. reporting any occurrence of constipation. B. avoiding ingestion of foods containing tyramine. C. stopping the drug as soon as the patient feels better. D. taking the medication with an antacid to avoid gastrointestinal upset.
avoiding ingestion of foods containing tyramine. Acute hypertension may occur in patients consuming large amounts of tyramine while taking linezolid. Linezolid causes diarrhea, not constipation, and should be taken with food to decrease gastrointestinal distress. An antacid would interfere with absorption.
A patient who is allergic to penicillin is at increased risk for an allergy to which drug?
cefazolin sodium (Ancef) Patients who are allergic to penicillins have a fourfold to sixfold increased risk of allergy to other beta-lactam antibiotics. The incidence of cross-reactivity between cephalosporins and penicillins is reported to be between 1% and 4%.
The dose-limiting toxicity of ganciclovir treatment is assessed by monitoring A. liver function tests (LFTs). B. complete blood count (CBC). C. blood urea nitrogen (BUN). D. creatine phosphokinase (CPK).
complete blood count (CBC). Bone marrow suppression is a dose-limiting toxicity of ganciclovir; therefore, CBC should be monitored.
