ATI Pharm. Made Easy 4.0 Immune System Test
A nurse is instructing a client on how to self-administer enfuvirtide. Which of the following instructions should the nurse include? -"Allow the vial to sit until the solution is completely clear and without particulates." -"After reconstituting with sterile water, vigorously shake the vial to mix the solution." -"Use the medication immediately upon removing from the refrigerator." -"Use the same location for five injections before rotating to a new site."
"Allow the vial to sit until the solution is completely clear and without particulates." When administering enfuvirtide, the client should inject sterile water to reconstitute it and gently roll the vial between the hands. Then, the client should let the vial sit until the solution is completely clear and without particulates, which might take up to 45 min. The client should allow the vial to warm to room temperature before the injection and refrigerate any unused portion. The nurse should instruct the client to rotate injection sites and avoid injecting into any area with reddened, abraded, or scarred skin. The nurse should instruct the client to report tenderness, redness, swelling, hardened areas, itching, or other skin reactions.
A nurse is teaching a client about miraviroc. Which of the following instructions should the nurse include? -"It is important to report any noticeable rash immediately as it might indicate an issue with your liver." -"Make sure you take this medication without any other medications first thing in the morning." -"You might experience flu-like symptoms for which you can take any over-the-counter medication." -"The side effects of this medication are minimal, so you can continue to work and drive as normal."
"It is important to report any noticeable rash immediately as it might indicate an issue with your liver." Hepatic injury can manifest as a rash in clients who take maraviroc and should be reported to the provider regardless of how mild it appears. Maraviroc must be administered with other HIV drugs, which are determined and selected based on pre-testing for the HIV strain CCR5-tropic. It is not advised for clients to take any over-the-counter drugs without first consulting their provider to ensure there are no interactions. Side effects include central nervous system dysfunction such as dizziness, paresthesia, and sleep disorders, so clients should use caution when operating a motor vehicle or other equipment.
A nurse is teaching a guardian of a child about the recommended age range to receive the human papillomavirus (HPV) vaccine. Which of the following age ranges should the nurse include? -11 to 12 years old -7 to 9 years old -13 to 15 years old -15 to 17 years old
11 to 12 years old Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old.
A nurse is caring for a client who is prescribed zidovudine. Which of the following laboratory values should the nurse report to the provider? -Hemoglobin 7.1 g/dL -RBC count 5.2/mm3 -Neutrophil 57% -Triglycerides 125 mg/dL
Hemoglobin 7.1 g/dL The provider might consider dose reduction, discontinuation of therapy, or blood transfusions if the client's hemoglobin is less than 7.5 g/dL or has a reduction of greater than 25% from baseline. An RBC count of 5.2/mm3 is within the expected reference range and does not need to be reported to the provider. A neutrophil count of 57% is within the expected reference range and does not need to be reported to the provider. A triglyceride level of 125 mg/dL is within the expected reference range and does not need to be reported to the provider.
A nurse is teaching a client about the recommended immunizations. Which of the following should the nurse recommend a client receive starting at 50 years of age? -Herpes zoster vaccine -Human papillomavirus vaccine (HPV) -Pneumococcal vaccine -Haemophilus influenzae type B vaccine (Hib)
Herpes zoster vaccine The herpes zoster, or shingles vaccine, is recommended for adults older than 50 years of age. Three doses of the human papillomavirus vaccine (HPV) are recommended for adolescents who are 11 to 12 years old. The pneumococcal vaccine, which prevents meningitis, pneumonia, and middle ear infections caused by Streptococcus pneumoniae, is recommended for children who are 0 to 6 years old (and younger adults who smoke and older adults [65+]) The Haemophilus influenzae type B vaccine (Hib), which prevents a serious type of meningitis, is recommended for children who are 0 to 6 years old.
A nurse is caring for a client who has a new prescription for cisplatin to treat testicular cancer. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply.) -Paresthesia -Sore throat -Flank pain -Tinnitus -Conjunctivitis
Paresthesia is correct. Cisplatin, a platinum compound, can cause peripheral neuropathy. The nurse should tell the client to report numbness, tingling, or decreased sensation in the hands or feet. Sore throat is correct. Cisplatin can cause bone marrow depression. The nurse should tell the client to report fever, sore throat, bruising, or fatigue. Flank pain is correct. Cisplatin can cause kidney toxicity. Prior to therapy, the nurse should hydrate the client with 1 to 2 L of IV fluid and continue for 24 hr following therapy to flush the kidneys and help prevent kidney toxicity. Tinnitus is correct. Cisplatin can cause ototoxicity. The nurse should monitor the client's hearing and instruct the client to report hearing loss, vertigo, or tinnitus. Conjunctivitis is incorrect. Cisplatin is unlikely to cause conjunctivitis, although it can cause blurred vision, papilledema, and optic neuritis.
A nurse should recognize that raltegravir is used to treat clients who have which of the following conditions? -Hairy cell leukemia -Thyroid cancer -Kaposi's sarcoma -Resistant HIV
Resistant HIV Raltegravir, an integrase inhibitor, along with other antiretroviral drugs, treats HIV that is resistant to other drugs. The nurse should administer raltegravir with other antiretroviral drugs. Raltegravir, an integrase inhibitor, does not treat hairy cell leukemia. Interferon alfa-2a treats hairy cell leukemia and chronic myelogenous leukemia. Raltegravir, an integrase inhibitor, does not treat thyroid cancer. Doxorubicin, an anthracycline, treats thyroid cancer. Raltegravir, an integrase inhibitor, does not treat Kaposi's sarcoma. Paclitaxel, a taxane, treats Kaposi's sarcoma.
A nurse is caring for a client who is receiving vincristine to treat lung cancer. The nurse should monitor the client and recognize which of the following manifestations and as an indication that the client is experiencing an adverse effect of the drug. -Weak hand grasps -Constricted pupils -Bradycardia -Crackles
Weak hand grasps Vincristine, a vinca alkaloid, can cause peripheral neuropathy. The nurse should monitor deep-tendon reflexes and the strength and movement of the hands and feet. The nurse should instruct the client to report paresthesia or reduced sensation in the hands or feet. Vincristine is unlikely to cause constricted pupils, but it can cause ptosis and diplopia. Vincristine is unlikely to cause bradycardia, but it can cause hyperkalemia, as well as hypertension or hypotension. Vincristine is unlikely to cause crackles. Imatinib is an immune system drug that can cause pulmonary edema, manifesting as crackles.
A nurse is assessing a client following a traztuzumab infusion to treat metastatic breast cancer. Which of the following findings should the nurse recognize as an indication that the client is experiencing an adverse reaction to the drug? (Select all that apply) -Wheezing -Dysrhythmias -Hypotension -Fever -Ascites
Wheezing is correct. Trastuzumab, a monoclonal antibody, can cause a severe allergic reaction, manifesting as hives, bronchospasm, dyspnea, and wheezing. The nurse should have epinephrine ready to treat anaphylaxis. Dysrhythmias is correct. Trastuzumab can cause cardiotoxicity, manifesting as ventricular dysfunction, heart failure, and dysrhythmias. The nurse should monitor the client's ECG. Hypotension is correct. Trastuzumab can cause a severe allergic reaction, manifesting as hives, dyspnea, hypotension, and hypoxia. The nurse should have epinephrine ready to treat anaphylaxis. Fever is correct. Trastuzumab can cause flu-like reactions, manifesting as fever, chills, nausea, and headache. The nurse should monitor the client's temperature. Ascites is incorrect. Trastuzumab is unlikely to cause ascites, although it can cause abdominal pain, nausea, and vomiting. The nurse should monitor the client's fluid and electrolyte balance.
A nurse is teaching a client who has a new prescription for mercaptopurine to treat leukemia. Which of the following instructions should the nurse include. (Select all that apply.) -Use contraception if pregnancy is a risk. -Perform oral hygiene frequently. -Avoid activities that require mental alertness. -Perform hand hygiene frequently. -Avoid activities that can cause injury.
Use contraception if pregnancy is a risk is correct. Mercaptopurine, a purine analog, is a pregnancy risk category D drug. Clients of childbearing age who take the drug should use contraception, and the nurse should confirm nonpregnancy before starting therapy. Perform oral hygiene frequently is correct. Mercaptopurine can cause stomatitis. The nurse should instruct the client to perform frequent oral hygiene to help prevent or minimize this adverse effect. Avoid activities that require mental alertness is incorrect. Mercaptopurine is unlikely to cause sedation or dizziness. Trastuzumab, a monoclonal antibody, is an immune system drug that can cause dizziness, which would require the client to avoid activities that require mental acuity. Perform hand hygiene frequently is correct. Mercaptopurine can cause neutropenia. The nurse should instruct the client to wash hands thoroughly or use an alcohol-based hand rub frequently and to avoid crowds and contact with people who have communicable infections. Avoid activities that can cause injury is correct. Mercaptopurine can cause thrombocytopenia. The nurse should monitor the client's CBC throughout treatment and instruct the client to avoid activities that can cause injury and report any unexplained bruising or bleeding.
A nurse is considering drug therapy options for a client who has metastatic breast cancer that is positive for human epidermal growth factor receptor 2 (HER2). Which of the following drugs should the nurse expect the provider to prescribe? -Trastuzumab -Imatinib -Leuprolide -Flutamide
Trastuzumab Trastuzumab, a monoclonal antibody and a pregnancy risk category D drug, treats and helps control the cell growth of metastatic breast cancer with tumors that overexpress HER2. This form of breast cancer accounts for up to 30% of metastatic breast tumors. Imatinib, a targeted antineoplastic drug, provides initial treatment of chronic myeloid leukemia, certain metastatic gastrointestinal tumors, and acute lymphoblastic leukemia, not metastatic breast cancer that is positive for HER2. Leuprolide, a gonadotropin-releasing hormone agonist, provides palliative treatment of prostate cancer, uterine fibroids, and endometriosis, not metastatic breast cancer that is positive for HER2. Flutamide, an androgen receptor blocker, treats early and metastatic prostate cancer, not metastatic breast cancer that is positive for HER2.
A nurse is teaching a client about immunizations. Which of the following information should the nurse include in the teaching. -The nurse should inform the client that the tetanus-diphtheria (Td) vaccine is recommended every 10 years. -"You should not receive the influenza immunization if you have a common cold." -"You do not have to receive the shingles vaccine if you have received two doses of the varicella virus vaccine." -"As long as you don't have risk factors, you will start receiving the pneumococcal vaccine when you are 50 years old."
"You should receive a tetanus booster every 10 years." The nurse should inform the client that the tetanus-diphtheria (Td) vaccine is recommended every 10 years. The nurse should instruct the client to differ the influenza immunization if they have moderate to severe febrile illness. It is recommended to receive the influenza immunization with mild infections such as the common cold. The nurse should inform the client that it is recommended to receive the shingles vaccine regardless of previous varicella virus vaccine doses. The nurse should inform the client that the pneumococcal vaccine is recommended beginning at age 65.
A nurse is preparing to administer enfuvirtide to a client. Which of the following actions should the nurse plan to perform? (Select all that apply.) -Administer the drug subcutaneously. -Discard the unused portion. -Roll the vial gently to reconstitute the solution. -Inject the solution at room temperature. -Expect a cloudy solution.
Administer the drug subcutaneously is correct. The nurse should administer enfuvirtide, a fusion inhibitor, subcutaneously, twice per day. This is the only appropriate route of administration for the drug. Discard the unused portion is incorrect. The nurse should refrigerate the unused portion. The nurse should also warm the solution to room temperature prior to giving the next dose out of the vial. Roll the vial gently to reconstitute the solution is correct. The nurse should roll the vial of enfuvirtide gently between the palms of the hands after adding sterile water for injection. This reconstitutes the drug. Inject the solution at room temperature is correct. The nurse can store unused solutions of enfuvirtide in a refrigerator up to 24 hr but should restore it to room temperature before injection. Expect a cloudy solution is incorrect. Enfuvirtide should be clear and without particulates after reconstitution. The nurse should not administer a cloudy solution.
A nurse should recognize that enfuvirtide can be prescribed to clients who have which of the following conditions? -Advanced prostate cancer -Primary brain tumors -Advanced HIV -Metastatic ovarian cancer
Advanced HIV Enfuvirtide, a fusion inhibitor, treats HIV that is advanced or resistant to other types of treatment. The nurse should always administer the drug with other antiretroviral drugs. Enfuvirtide, a fusion inhibitor, does not treat advanced prostate cancer. Flutamide, an androgen receptor blocker, treats early or metastatic prostate cancer. Enfuvirtide, a fusion inhibitor, does not treat primary brain tumors. Carmustine, a nitrosourea drug, treats primary and metastatic brain tumors. Enfuvirtide, a fusion inhibitor, does not treat early estrogen-receptor-positive ovarian cancer. Topotecan, a topoisomerase inhibitor, treats metastatic ovarian cancer.
A nurse is preparing to administer the measles, mumps, and rubella (MMR) vaccine to a child. The nurse should recognize that the MMR vaccine provides which of the following types of immunity? -Artificial active immunity -Active -Passive -Artificial passive immunity
Artificial active immunity The nurse should recognize that the MMR vaccine provides artificial active immunity to the child. A vaccine contains a form of the disease that is live, attenuated, or killed, which will allow the body to build up an active immunity against the disease. The nurse should recognize that active immunity occurs when the body produces its own antibodies in response to an antigen, such as the common cold. The nurse should recognize that passive immunity occurs when the body gets antibodies from an external source, such as through breastfeeding an infant. The nurse should recognize that artificial passive immunity occurs when the body receives artificial antibodies, such as immune globulins.
A nurse should recognize that maraviroc is used in the treatment of which of the following conditions? -Diabetes mellitus -Meningeal infection -Pancreatitis -Chemokine receptor 5 (CCR5)-tropic HIV-1
Chemokine receptor 5 (CCR5)-tropic HIV-1 Maraviroc, a CCR5 antagonist, acts by binding to CCR5 and preventing HIV-1 from entering the cell. It is used in the treatment of clients who have CCR5-tropic HIV-1. Maraviroc, a chemokine receptor 5 (CCR5) antagonist is used in the treatment of drug resistant HIV to block the entry of HIV into host cells. It is not used to treat diabetes. The treatment of diabetes involves antidiabetic drugs. Maraviroc, a chemokine receptor 5 (CCR5) antagonist is used in the treatment of drug resistant HIV to block the entry of HIV into host cells. It is not used to treat meningeal infections. The treatment of meningeal infections involves anti-viral drugs or antibiotics. Maraviroc, a chemokine receptor 5 (CCR5) antagonist is used in the treatment of drug resistant HIV to block the entry of HIV into host cells. It is not used to treat pancreatitis. The treatment of pancreatitis involves analgesics and acid-suppressive drugs in addition to parenteral nutrition.
A nurse is teaching a client who has a new prescription for imatinib to treat chronic myeloid leukemia. Which of the following instructions should the nurse include? (Select all that apply.) -Clean fruits and vegetables thoroughly. -Increase calcium intake. -Weigh yourself daily. -Perform hand hygiene frequently. -Avoid grapefruit and grapefruit juice.
Clean fruits and vegetables thoroughly is correct. Imatinib, a targeted antineoplastic drug, can cause bone marrow suppression. The nurse should instruct the client to clean fruits and vegetables carefully and completely to prevent transmission of bacteria. Increase calcium intake is incorrect. Imatinib is more likely to cause hypokalemia than hypocalcemia or bone loss. Weigh yourself daily is correct. Imatinib can cause fluid retention and weight gain. The nurse should instruct the client to record daily weights and monitor for edema. Perform hand hygiene frequently is correct. Imatinib can cause bone marrow suppression. The nurse should instruct the client to wash hands or use an alcohol-based hand rub frequently and to avoid exposure to illness. Avoid grapefruit and grapefruit juice is correct. Grapefruit and grapefruit juice can cause the blood levels of imatinib to be higher than normal. The nurse should instruct the client to avoid grapefruit and grapefruit juice during therapy.
A nurse is teaching a client who has a new diagnosis of breast cancer about the drug tamoxifen. The nurse should tell the client that which of the following conditions is a contraindication for taking tamoxifen? -Deep-vein thrombosis -COPD -Diabetes mellitus -Alcohol use disorder
Deep-vein thrombosis Tamoxifen, an estrogen receptor blocker, can cause thromboembolism. Its use requires cautious use with clients who have deep-vein thrombosis. Clients who have COPD can take tamoxifen, an estrogen receptor blocker. Trastuzumab is an immune system drug that requires cautious use with clients who have pulmonary disease. Clients who have diabetes can take tamoxifen, an estrogen-receptor blocker. Interferon Alfa-2a is an immune system drug that requires cautious use with clients who have diabetes. Clients who have alcohol use disorder can take tamoxifen, an estrogen-receptor blocker. Zidovudine is an immune system drug that requires cautious use with clients who have alcohol use disorder.
A nurse is caring for a client who has a new prescription for intrathecal cytarabine therapy to treat meningeal leukemia. The nurse should inform the client that they will receive which of the following drugs to reduce the risk of neurotoxicity? -Diphenhydramine -Leucovorin -Folic acid -Dexamethasone
Dexamethasone Clients who have a prescription for the intrathecal form of cytarabine should also receive dexamethasone, a glucocorticoid, to help decrease the inflammation of the arachnoid that the drug can cause. IV dexamethasone reduces the client's risk for neurotoxicity. Diphenhydramine, an antihistamine, prevents or minimizes allergic reactions. It does not reduce the risk of neurotoxicity for clients who are receiving intrathecal cytarabine, an antimetabolite. Leucovorin, a chemotherapeutic protectant, protects cells from the actions of folic acid antagonists, such as methotrexate. It does not reduce the risk of neurotoxicity for clients who are receiving intrathecal cytarabine, an antimetabolite. Folic acid supplements help reduce the risk of toxicity from folic acid antagonists, such as methotrexate. It does not reduce the risk of neurotoxicity for clients who are receiving intrathecal cytarabine, an antimetabolite.
A nurse is preparing to administer paclitaxel IV to a client who has ovarian cancer. Which of the following actions should the nurse take? (Select all that apply.) -Give the client an antihistamine. -Infuse the drug over 1 hr. -Administer the drug through non-PVC tubing. -Use an in-line filter. -Add heparin to the paclitaxel solution.
Give the client an antihistamine is correct. Prior to administering paclitaxel, an antimitotic drug, the nurse should give the client an antihistamine, such as diphenhydramine, a proton-pump inhibitor, such as cimetidine, and a glucocorticoid, such as dexamethasone, to prevent a hypersensitivity reaction. Infuse the drug over 1 hr is incorrect. The nurse should infuse paclitaxel over 3 hr, not 1 hr. Administer the drug through non-PVC tubing is correct. Paclitaxel is incompatible with PVC tubing. Use an in-line filter is correct. Paclitaxel requires administration through an in-line filter. Add heparin to the paclitaxel solution is incorrect. The nurse should not mix paclitaxel with any other drugs. Heparin and other anticoagulants increase the risk for bleeding.
A nurse is teaching the guardian of a 4-month-old infant about the recommended immunizations for the infant. Which of the following immunizations should the nurse include? -Haemophilus influenzae type B vaccine (Hib) -Varicella vaccine -Meningococcal conjugate vaccine (MCV4) -Tetanus-diphtheria-acelluar pertussis vaccine (Tdap)
Haemophilus influenzae type B vaccine (Hib) The nurse should inform the guardian that the Haemophilus influenzae type B vaccine (Hib) is recommended for infants and children to prevent a serious type of meningitis commonly seen in young children. The nurse should inform the guardian that the varicella vaccine is not given to infants under 12 months of age. The first dose is given at 12 months with a booster given between 4 and 6 years of age. The nurse should inform the guardian that the meningococcal conjugate vaccine is recommended for adolescents 11 to 18 years old. Adolescents should receive two doses of MCV4. The first dose should be given at 11 or 12 years old, with a booster dose at age 16. The nurse should inform the guardian that the Tdap vaccine is given to adolescents between the ages of 11 and 12 years old as a booster to the DTaP vaccine.
A nurse is caring for a client who has a new prescription for tepotecan therapy to treat resistant, small-call lung cancer. The nurse should advise the client against taking which of the following types of over-the-counter drugs while receiving the therapy? -Folic acid -St. John's wort -Ibuprofen -Aluminum hydroxide
Ibuprofen NSAIDs, anticoagulants, and antiplatelet drugs increase the client's risk for bleeding while receiving topotecan, a topoisomerase inhibitor. The nurse should advise the client against taking aspirin, ibuprofen, and other NSAIDs during therapy. Folic acid does not specifically interact with topotecan, a topoisomerase inhibitor. It can, however, change the response to methotrexate, another immune system drug. St. John's wort does not specifically interact with topotecan, a topoisomerase inhibitor. It can, however, decrease the levels of maraviroc, another immune system drug. Antacids, such as aluminum hydroxide, do not specifically interact with topotecan, a topoisomerase inhibitor. Antacids decrease the absorption of delavirdine, another immune system drug.
A nurse is caring for a client who has a new prescription for maraviroc therapy. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply.) -Paresthesia -Cough -Tinnitus -Jaundice -Fever
Paresthesia is correct. Maraviroc, a chemokine receptor 5 antagonist, can cause paresthesia, dizziness, and musculoskeletal pain. Cough is correct. Maraviroc can cause a cough and upper respiratory infection. Tinnitus is incorrect. Maraviroc is unlikely to cause tinnitus. Cisplatin, a platinum compound, is an immune system drug that can cause ototoxicity and hearing loss. Jaundice is correct. Maraviroc can cause liver damage. The nurse should instruct the client to report an allergic reaction, such as a rash, because it can precede liver damage, manifested as jaundice or abdominal pain. Fever is correct. Maraviroc can cause a fever and sinus infection.
A nurse is caring for a client who has a new prescription for delavirdine therapy to treat HIV-1. The nurse should instruct the client to report which of the following adverse reactions to the drug? -Rash -Insomnia -Rhinitis -Alopecia
Rash Delavirdine, a non-nucleoside reverse transcriptase inhibitor, can cause a rash. The nurse should instruct the client to report a rash, which can occur 1 to 3 weeks after therapy, because it can develop into Stevens-Johnson syndrome, a potentially life-threatening complication. Delavirdine, a non-nucleoside reverse transcriptase inhibitor, is more likely to cause fatigue and dizziness than insomnia. Delavirdine, a non-nucleoside reverse transcriptase inhibitor, is more likely to cause bronchitis than rhinitis. Delavirdine, a non-nucleoside reverse transcriptase inhibitor, is unlikely to cause alopecia. Vincristine, an antimitotic, is an immune system drug that can cause alopecia.
A nurse is caring for a client who has a new prescription for ritonavir and zidovudine therapy to treat HIV-1. The nurse should inform the client that zidovudine is prescribed with ritonavir for which of the following reasons? -To prevent an infusion reaction -To increase platelet production -To protect healthy cells from the toxic effects of ritonavir -To prevent drug resistance
To prevent drug resistance The nurse should explain that zidovudine, a nucleoside reverse transcriptase inhibitor, is administered along with ritonavir, a protease inhibitor, to reduce the risk for drug resistance and to increase drug effectiveness. Monotherapy with zidovudine quickly results in drug resistance, as is also the case with monotherapy with ritonavir. Zidovudine, a nucleoside reverse transcriptase inhibitor, is unlikely to prevent an adverse reaction to an infusion of ritonavir, a protease inhibitor. Prior to the administration of paclitaxel, an antimitotic drug, administering an antihistamine, a proton-pump inhibitor, and a glucocorticoid can prevent a hypersensitivity reaction. Zidovudine, a nucleoside reverse transcriptase inhibitor, is unlikely to increase the production of platelets. Filgrastim, a colony-stimulating drug, can increase neutrophil production. Zidovudine, a nucleoside reverse transcriptase inhibitor, is unlikely to protect healthy cells from the toxic effects of ritonavir. The nurse should administer leucovorin rescue within 12 hr of high doses of methotrexate to protect healthy cells from the toxic effects of that drug.
