Rheumatic Disorders/Immunity

The type of lymphocyte that matures in the bone marrow is:

b lymphocytes

What is the mechanism of action of hydroxyzine (Vistaril), an antihistamine, that enables it to have antiemetic effects? Choose the BEST answer.

blocks the action of acetylcholine

In which stage of rheumatic disease is passive range-of-motion (ROM) utilized?

acute

All of the following are centrally acting antiemetics EXCEPT

adsorbents

Prochlorperazine is contraindicated in what population if other antiemetics are effective?

all of the above

The nurse understands that the most frequent adverse reaction seen with the topical application of a sulfonamide is which of the following?

burning sensation

You are teaching your 57-year-old client about metoclopramide, which the physician has prescribed to control nausea. What statement, made by your client, suggests that he understands what you have taught?

"I shouldn't drink alcohol while I'm taking this medication."

Which statement by a client taking a sulfonamide requires further instruction?

"I will be sure to use extra sunscreen when going to a tanning booth"

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

"My finger joints are oddly shaped"

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client receiving chemotherapy has begun receiving aprepitant. The client also takes oral contraceptives. What should the nurse tell the client in regard to birth control?

"Use alternative means of birth control for 1 month after taking aprepitant."

The nurse is caring for a client with ulcerative colitis who is taking sulfasalazine. What instruction will the nurse give this client?

"expect your urine to turn yellow-orange"

A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide?

10 pound weight loss

The nurse is caring for a client with a hepatic impairment. The nurse knows that the dose of ondansetron should not exceed what amount?

8mg

The nurse is caring for four patients on a medical floor. For which of the following patients would she suspect the physician might order a sulfonamide?

A 35-year-old woman with a urinary tract infection and a history of ulcerative colitis

You are caring for an oncology patient who will be prescribed an antiemetic drug to control vomiting. Which of the following nursing diagnoses is appropriate for this patient?

Altered Tissue Perfusion: Hypotension related to fluid volume depletion or antiemetic drug effect

Which of the following refers to fixation of a joint?

Ankylosis

Which agent would the nurse identify as acting directly in the central nervous system to block receptors associated with nausea and vomiting with little to no effect on serotonin, dopamine, or corticosteroid receptors?

Aprepitant

When describing the action of prochlorperazine, which of the following would the nurse include as being affected?

Chemoreceptor trigger zone

A nurse should expect to administer which medication to a client with gout?

Colchicine

A nurse assesses a client in the physician's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?

Facial erythema, pericarditis, pleuritis, fever, and weight loss

A patient develops significant nausea and vomiting related to antineoplastic chemotherapy. Which of the following agents would be most appropriate to use in this situation? Select all that apply.

Dolasetron • Granisetron • Aprepitant • Nabilone

The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action?

Inflammation is decreased because of interaction with intestinal bacteria.

Which of the following points should be included in the medication-teaching plan for a patient taking adalimumab (Humira)?

It is important to monitor injection sites for signs of reaction

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process?

It will get better and worse again

The nurse is caring for a client who is experiencing chemotherapy-induced nausea and vomiting. The physician has prescribed aprepitant as part of a combination therapy. The nurse knows that what other drugs are part of this combination?

Ondansetron and dexamethasone

A group of students are reviewing information about the 5-HT3 receptor blockers. The students demonstrate understanding of this group of drugs when they identify which drug as being available only in parenteral form?

Palonosetron

The nurse is caring for a client with a nursing diagnosis of "Impaired urinary elimination related to discomfort of urinary tract infection." Which medication will provide comfort to this client?

Phenazopyridine

A 44-year-old woman has presented to her local clinic with complaints of burning and pain when voiding. In addition to prescribing an antibiotic, the clinician has recommended the use of phenazopyridine (Pyridium). What is the rationale for including phenazopyridine in this patient's plan of care?

Phenazopyridine provides topical relief to many of the painful symptoms of UTIs.

You are writing a plan of care for an 85-year-old male patient who has been prescribed sulfisoxazole for treatment of a severe urinary tract infection. Which of the following would be an appropriate nursing diagnosis for this patient?

Risk for Injury: Hypersensitivity reaction, kidney, liver, or blood disorders

Which nursing diagnosis is most appropriate for an elderly client with osteoarthritis?

Risk for injury related to altered mobility

Place the following steps of the pathophysiology of vomiting in order from what happens first to last.

Stimulation of the pharynx or the gastrointestinal tract Stimulation of the chemoreceptor trigger zone Stimulation of the vomiting center in the medulla Stimulation of salivary center, pharyngeal, and gastrointestinal system Vomiting

Aprepitant (Emend) is the prototype of which class of antiemetic medications?

Substance P/neurokinin 1 antagonist

The physician considers prescribing an oral tetracycline for a patient suspected of having a urinary tract infection. What action needs to be completed before the medication can be prescribed?

The physician should order culture and susceptibility studies.

A nurse is caring for a patient receiving nitrofurantoin for acute bacterial UTI. The drug is known to cause acute pulmonary reactions such as dyspnea, chest pain, cough, fever, and chills. What interventions should the nurse perform if these reactions are observed in the patient?

Withhold the drug and contact primary health care provider.

Promethazine (Phenergan) is a derivative of phenothiazine making it an antiemetic and also which type of medication?

antipsychotic

You are caring for a client who has been prescribed dronabinol. When teaching the client about the drug, which of the following adverse effects would you mention?

anxiety

The primary healthcare provider has prescribed mafenide for a patient with second-degree burns. Which of the following is the most frequent adverse reaction associated with the topical application of mafenide on the affected area?

burning sensation during application

A high school student starts vomiting and goes to the school nurse. The student asks the nurse what part of his brain makes him vomit. What will the nurse tell the student must be stimulated in order for vomiting to occur?

chemoreceptor trigger zone

The nurse is caring for a client with liver disease who is receiving promethazine for nausea. What adverse effect may occur in this client?

cholestatic jaundice

Which of the following would be consistent with the diagnosis of rheumatoid arthritis?

cloudy synovial fluid

The nurse is reviewing the medication administration record of the client. Which of the following medications would lead the nurse to suspect that the client is suffering from an acute attack of gout?

colchicine

Which of the following is a plasma protein associated with the immunologic reaction?

complement

The nurse is assessing a client who is receiving aprepitant for adverse effects. Which of the following would the nurse expect to find? (Select all that apply.)

constipation, anorexia, headache

If a client who is prescribed tacrolimus has impaired liver function, what would the nurse expect the physician to do?

decrease the dose

A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?

decreased absorption of tetracycline

What is the main action of antiemetics?

depressing hyperactive vomiting reflex

What is a medication, given with aprepitant (Emend) that is used to effectively manage chemotherapy-induced emesis?

dexamethasone

A client who was diagnosed with scleroderma 2 years ago is withdrawn, does not look at the nurse, and asks to be left alone. An appropriate nursing diagnosis for the client is:

disturbed body image

In the event of a bioterrorism attack with anthrax, you would anticipate the use of which drug?

doxycycline

Where is the chemoreceptor trigger zone (CTZ) located in the brain?

fourth ventricle

Methenamine (Hiprex) should be used cautiously in patients with which of the following medical conditions?

gout

A group of students are reviewing the actions of the various antiemetics. The students demonstrate understanding of the information when they identify which agent as blocking 5-HT3 receptors locally and in the chemoreceptor trigger zone (CTZ)?

granisetron

After reviewing the various agents used as antiemetics, a group of students demonstrate understanding of the information when they identify which agent as a 5-HT3 receptor blocker?

granisetron

Medications are given post-operatively to prevent or treat severe nausea and vomiting associated with the surgery. What serotonin receptor antagonist would you expect the surgeon to order?

odansetron

In the earlier stages of an inflammatory process leukocytosis occurs due to a(n):

increase in circulating neutrophils

A patient is being prescribed tetracycline for the treatment of rickettsiae. The nurse learns that the patient is also taking an anticoagulant for a circulatory disorder. What is the effect of oral anticoagulant drugs interacting with tetracycline?

increased risk of breathing

A client develops labyrinthitis. What would the nurse expect the physician to order?

meclizine

Which part of the brain is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting?

medulla oblongata

Different medications are used to treat the differing causes of nausea and vomiting. Antihistamines may be effective in the treatment of nausea and vomiting created by:

motion sickness

Different medications are used to treat the differing causes of nausea and vomiting. Phenothiazines, although effective against many causes, are usually ineffective in the treatment of nausea and vomiting created by:

motion sickness

Nausea and vomiting have many, many causes. Which of the following are causes for nausea and/or vomiting? Select all that apply.

neurologic and metabolic disorders

A 32-year-old female patient has a urinary tract infection. Her record reveals that she has recently been treated for anemia. The physician has indicated that drug therapy for the urinary tract infection will last more than 2 weeks. The most important nursing action will be to

obtain a CBC to obtain baseline

What is the preferred route for administering promethazine (Phenergan)?

oral

A patient has been prescribed an oral sirolimus solution following renal transplant. Which of the following can be used to dilute sirolimus just prior to administration?

orange juice

You are caring for a client following his organ transplant procedure. He complains that oral cyclosporine tastes awful and that he is unable to swallow it. You tell the client that he can make his medication more palatable by mixing it with

orange juice

A group of students are reviewing information about the 5-HT3 receptor blockers. The students demonstrate understanding of this group of drugs when they identify which drug as being available only in parenteral form?

palonosetron

Prochlorperazine (Compazine) is contraindicated in which population?

pregnant women

Your client tells you that she is taking an antibiotic and a pain medication for a urinary tract infection. She cannot recall the name of the pain medication. You suspect the name of her pain medication is:

pyridium

A nurse is caring for a patient with irritation of the lower genitourinary tract. The patient is administered phenazopyridine. Which of the following conditions in patients contraindicates the use of the drug?

renal impairment

Urinary antiseptics may be bactericidal for sensitive organisms in the urinary tract because these drugs are concentrated in what structure?

renal tubules

The anatomical structures involved in the physiologic process of vomiting are activated by various stimuli. Which is the consummating step in the physiologic process of vomiting?

reverse peristalsis

You are caring for a patient who has begun vomiting related to barriatric surgery. When including this complication in the plan of care what would be an appropriate nursing diagnosis related to the adverse effects of drowsiness and weakness associated with an antiemetic?

risk for injury related to CNS

Ondansetron (Zofran) belongs to which pharmacological category of medications?

selective 5-ht3 antagonist

A male client presents to the emergency department in pain. He is diagnosed with mild to moderate burns on his forearms secondary to exposure to hot pipes in his home. The nurse expects the physician to order what topical medication?

sulfadiazine

Cellular immunity is mediated by which of the following cells?

t lymphocytes

A young pregnant patient with intestinal amebiasis is prescribed a tetracycline. Which of the following can be an adverse effect of the drug?

toxic effects to the fetus

In which of the following scenarios would the nurse question the order for ondansetron (Zofran)?

treatment of GERD

The nurse is caring for a client who has been prescribed a sulfonamide but does not have an infection. The nurse is aware that the medication has been prescribed to treat what condition?

ulcerative colitis

A male client has been receiving promethazine for nausea that occurred following chemotherapy. Recently it has been discovered that this client has developed liver dysfunction. The nurse anticipates that the physician will do what to treat this client's nausea?

use an alternative medication

A client who is receiving chemotherapy is experiencing nausea. The client has been receiving antiemetics with moderate success but would like to try a nonpharmacologic solution. The nurse knows that which nonpharmacologic technique is most accepted and widely studied in the treatment of nausea?

use of acupuncture

woman who is 7 weeks pregnant is experiencing morning sickness but does not want to use any medications to treat the nausea. What nonpharmacologic therapy would be helpful to this client?

wear accupressure wrist bands

Tetracyclines are generally contraindicated in pregnant women because of what effects? (Select all that apply.)

• Cause fatal hepatic necrosis in the mother • Interfere with bone and tooth development in the fetus

When educating a patient about antiemetic medications, which of the following information should the nurse include?

• Most antiemetic medications are better at preventing nausea than treating it. • Before taking any other medications be sure to consult your health care provider.

The nurse is caring for a client who is on sulfonamide therapy and monitors the client for which common side effects? Select all that apply.

• Nausea • Diarrhea • Photosensitivity

A nurse is caring for a patient receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the patient and the family? Select all that apply.

• Notify the PHCP in case of fever, chills, or cough • Continue therapy for at least 1 week • Take the drug with food or milk to improve absorption

Which of the following is an example of a sulfonamide antibiotic? Select all that apply

• Silver sulfadiazine (Silvadene) • Sulfamethoxazole/Trimethoprim (Bactrim)

Which of the following are true of sulfonamides? Select all that apply.

• Sulfonamides are well-absorbed when given orally. • Sulfonamides are excreted by the kidneys.

The immune abnormalities that characterize systemic lupus erythematosus (SLE) include which of the following? Select all that apply.

• Susceptibility • Abnormal innate and adaptive immune responses • Autoantibodies immune complexes • Inflammation • Damage

A nurse is caring for a patient receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the patient and the family? Select all that apply.

• Take the drug with food or milk to improve absorption • Continue therapy for at least 1 week • Notify the PHCP in case of fever, chills, or cough

The nurse has learned that some patients should not take sulfonamides. These include which of the following patients? (Select all that apply.)

• Women who are lactating • Patients with a hypersensitivity to sulfonamides • Children younger than 2 months

An interleukin-receptor antagonist works to block the activity of the interleukins that are released in an inflammatory or immune response. Which of the following are examples of these? Choose all that apply.

• anakinra (Kineret) Explanation: Anakinra (Kineret) is an interleukin-receptor antagonist. It is the only available interleukin receptor. The others are all examples of monoclonal antibodies.

The nurse is preparing an immunostimulant drug called oprelvekin to administer to a client 32 years of age who is diagnosed with a chemotherapy-induced bleeding disorder. The nurse plans to teach the client about why the provider ordered the drug. The nurse will explain which of the following reasons?

"The drug is used to increase platelet count associated with immunosuppression during chemotherapy."

The nurse knows that the recommended time to administer a sulfonamide to a patient is which of the following?

1 hour before or 2 hours after meals

A care aide who works in a long term care facility has observed the high incidence of infectious illnesses among the older adults who reside there. Which of the following consequences of aging is most likely the reason for diminished immune capacity older adults?

Decreased numbers and responsiveness of T lymphocytes

A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?

Exercising at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.

The nursing student is studying about sulfonamides and learns that their mode of action is which of the following?

Inhibit the activity of folic acid in bacterial cell metabolism

The nurse is assessing a client during a home health visit. The client asks how interferon works. The nurse would include which of the following information?

Interferon works by controlling cellular proteins.

A client who was diagnosed with iron deficiency anemia is worried because she does not know why she was prescribed iron supplements. The nurse teaches the client about which of the following actions of oral iron administration?

Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia.

Which of the following statements is accurate regarding osteoarthritis?

It is a noninflammatory disorder and the most common and frequently disabling of joint disorders.

Which of the following are usually the first choice in the treatment of rheumatoid arthritis (RA)

NSAIDs

A nurse has been instructed to administer mafenide to a patient. Which of the following adverse reactions should the nurse assess for in this patient?

Rash, itching, or other allergic reactions

Which of the following clinical manifestations would the nurse expect to find in a client who has had rheumatoid arthritis for several years?

Small joint involvement

Mrs. Jones, age 35, has sought care because of complaints of urinary frequency, dysuria, and inability to empty her bladder completely, which she has experienced for the last 6 months. The physician diagnoses her with chronic urethritis and prescribes sulfonamide, which has led to crystalluria. Which medication can be added to her current medical therapy?

Sulfisoxazole

The nurse is caring for a client who is vomiting and has a severe urinary tract infection. The nurse knows that which anti-infective can be given IV?

Trimethoprim and sulfamethoxazole (TMP-SMZ)

You are caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?

Unrelenting, progressive tissue damage without any verifiable etiology

A patient who is on sulfonamide therapy is about to be discharged. Which of the following precautions should the nurse instruct the patient to follow to reduce the effects of photosensitivity?

Wear protective clothing and sunscreen when outside.

A nurse is assessing a client with possible osteoarthritis. The most significant risk factor for primary osteoarthritis is:

age

A client is receiving meclizine. The nurse would caution the client to avoid which of the following?

alcohol

The nurse is caring for a 19-month-old child who has been hospitalized with dehydration secondary to nausea and vomiting. The nurse is aware that promethazine will not be used for this client because it can cause what in children under the age of 2?

fatal respiratory depression

A parent of a child who gets carsick is planning on using dimenhydrinate to help the child on a future care trip. When should the nurse tell the parent to administer the medication?

four hours before the trip

A pregnant woman in her first trimester is experiencing mild to moderate nausea and vomiting. She does not want to take any pharmacologic medication because she is concerned about the effects on the baby. What could the nurse recommend as an alternative therapy?

ginger

The tetracyclines are effective against a wide range of which type of organisms?

gram positive and gram negative organisms

The nurse is caring for a neonate of a mother who took a sulfonamide during the last weeks of pregnancy. For which condition will the nurse monitor the neonate? Select all that apply.

hemolytic anemia, jaundice

Which nursing diagnosis is most inappropriate for the client with osteoarthritis?

imbalanced nutrition: less than body requirements

Tetracyclines treat infection by which of the following effects? (Choose one)

inhibit bacterial protein synthesis

A group of students are reviewing information about immune modulators in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as an immune stimulant?

interferon

Which agent would be classified as an immune stimulant?

interferon alpha 2b

To induce vomiting for therapeutic reasons, various substances can be used. Which of the following is used to induce vomiting?

ipecac

Tetracyclines must be used cautiously in the presence of what condition?

kidney and liver impairment

The nurse educator is teaching a class of RN to BSN online learners about different types of immunostimulant drugs. A student asks about the goal of hematopoietic drugs. The nurse knows it is important to explain about stimulation of the body in order to make more of the specific cell. Which of the following cell counts would the nurse want to emphasize when the topic is chemotherapy?

low platelet and low WBC

The nurse is assisting in the admission of a client with a suspected urinary tract infection. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?

obtain urine for culture and sensitivity

The pharmacology students are learning about medications used to treat urinary tract problems. What symptoms does phenazopyridine treat?

pain and urgency

A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for?

photosensitivity

The client with rheumatoid arthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

reports increased fatigue

Which of the following would the nurse anticipate to be used for the prevention of nausea from motion sickness? Select the best answer.

scopolamine

The nurse assists and educates clients on the difference between nonspecific and specific immunity. The body possesses several defense systems. Which nonspecific defense mechanism provides a physical barrier and secretes enzymes that kill or reduce the virulence of bacteria?

skin

A 48-year-old female patient has acute pyelonephritis. Her urine pH is below 5.5, which indicates that it is acidic. Which of the following medications would serve to decrease the acidity of her urine?

sodium bicarbonate

(see full question) You are the clinic nurse providing health teaching to a patient who has been prescribed doxycycline (Doxycin). You know that health teaching for this patient should include what instructions?

stay out of the sun

A client who has received a heart transplant has been prescribed an oral cyclosporine solution. Which of the following should the client be advised to do as part of his self-care?

take the medication at the same time of day

Tetracyclines should not be used in children younger than 8 years of age because of their effects on what?

teeth and bones

Your client has been diagnosed with syphilis. He states that he is allergic to penicillin. You would anticipate which of the following drugs being prescribed for his treatment?

tetracycline

You are providing discharge teaching to a patient who is being sent home on tetracycline (Sumycin) PO. What should the instructions include?

the need to take the drug on an empty stomach

The nurse is caring for a male client who has benign prostatic hypertrophy. The nurse would be alert for what complication if this client is given promethazine for treatment of nausea?

urinary retention

The nurse is caring for a client who is taking a sulfonamide and notices that the client has developed itchy hives. After contacting the health care provider, what term will the nurse use to describe the client's symptoms?

urticaria