PrepU (7,10,14-16)
Which statement indicates that a client understands immunosuppressant therapy following a solid organ transplant?
"I will need to stay on this med for life"
What client is most likely to be experiencing increased phagocytosis?
A client being treated for Sepsis
The nurse is explaining the reason why the intracellular space has a potassium concentration of approximately 150 mEq/L (150 mmol/L) while serum potassium levels are between 3.5 and 5.0 mEq/L (3.5 and 5.0 mmol/L). Maintenance of this large difference is dependent on:
Active transport
An adult client has been admitted to the emergency department after deliberately overdosing on approximately 50 grams of Tylenol. The nurse should prepare for what intervention?
Administration of acetylcysteine as prescribed
A home care nurse is seeing a 66-year-old female who has just been released from the hospital after being treated for pneumonia. The nurse knows that it is important to assess the client's knowledge of which area?
Adverse effects of nonsteroidal anti-inflammatory drugs
An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of which of the following?
BUN and creatinine
The client is instructed to return to the clinic after calling and reporting various concerns. The nurse alerts the primary health care provider after noting which signs on the assessment? Select all that apply
Bleeding gums Hematuria Petechia
A client is experiencing an inflammatory response following an injury. What assessment finding would confirm the role of thromboxanes in the inflammatory process?
Bleeding has stopped at the injury site
Which antineoplastic drugs are classified as antineoplastic antibiotics? (Select all that apply.)
Bleomycin (Blenoxane) Dactinomycin (Cosmegen) Daunorubicin (DaunoXome)
The nurse is providing care for a client with a diagnosis of cirrhosis, and notes that the client's sclerae are jaundiced. The nurse recalls that jaundice is a pigment that can accumulate in which part of the cell?
Cytoplasm
After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example?
Doxorubicin
When planning the care for a client receiving imatinib, the nurse would identify which nursing diagnosis as most likely?
Excess fluid volume related to fluid retention
During which phase is the cell involved in gathering the substances needed to produce the building blocks for DNA?
G1
A client is receiving ganciclovir for the long-term treatment and prevention of cytomegalovirus infection. What should the nurse do when administering this drug?
Give IV over 60 mins
Fewer adverse effects are associated with monoclonal antibody therapy than those of cytotoxic drugs. However, some of the potential adverse effects of monoclonal antibodies can be life threatening, including which effect?
Heart failure and bleeding problems
A group of students are reviewing class material about lymphoid tissue. The students demonstrate a need for additional teaching when they identify this as lymphoid tissue?
Histamine
A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?
Hodgkin lymphoma
The nurse has administered an intravenous solution that is expected to draw interstitial fluid into the vascular space. The nurse likely administered what type of solution?
Hypertonic
A client comes to the clinic to learn about interferons. What would the nurse include in the lesson plan?
Interferons modulate the response of the immune system to viruses, bacteria, cancer, and other foreign substances.
What best describes the role of the major histocompatibility complex as a barrier defense?
It allows the body to distinguish cells as foreign or belonging to the person.
A client is exposed to a viral infection. What role will interferon most likely play during this exposure?
It will interfere with virus replication
Which agent would the nurse expect to be administered orally?
Methotrexate
Which would the nurse identify as an antineoplastic antibiotic?
Mitomycin
A male client is informed that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the health care provider to do?
Monitor the client closely and repeat LFTs routinely.
How is the risk of renal impairment best minimized when foscarnet is administered?
Monitoring renal function two or three times weekly during induction
The genetic makeup of a particular cell determines the rate at which that cell can complete which action?
Multiply
Which event in the inflammatory response would the nurse correlate with the action of bradykinin?
Pain
A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do?
Reassure client that this is a normal expected side effect of the drug
A 70-year-old man is being treated for herpes zoster virus. He has been prescribed acyclovir (Zovirax). The clinic nurse should prioritize assessment of what?
Renal function
The student nurse has learned that HIV is a retrovirus. Reverse transcriptase is the enzyme it contains. The student understands this enzyme when making which statement?
Reverse transcriptase is used to turn the RNA of the virus into DNA.
Tamoxifen achieves a therapeutic effect by which means?
Slowing the growth of cancer cells
A client is experiencing an immune response and the only immunoglobulin that is currently in circulation is IgM. How should the nurse best interpret this fact?
The client has very recently been exposed to the antigen
The nurse assesses the client and recognizes leukotrienes have been released in the client's body as the result of what sign or symptom?
The client reports calf, thigh and knee pain
The nurse is providing health education to a client who has recently been diagnosed with HIV and will soon begin antiretroviral therapy. What teaching point should the nurse prioritize?
The need to adhere to the prescribed drug regimen.
The nurse is teaching a client about cell structure in response to the client's question. What aspect of the cell structure and function should the nurse describe?
The nucleolus is located within the nucleus.
The nurse is teaching a group of colleagues about the cell division cycle as background to a oncology nursing. Which statement is true of the cell cycle?
The two broad phases of the cell cycle are mitosis and synthesis
A client has chosen to receive palliative care after lung cancer metastasized to the bones and liver. Which is the most appropriate during palliative cancer care?
The use of chemotherapy to reduce pain
Which drug would be classified as a mitotic inhibitor?
Vincristine
The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?
Weight
A nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib?
With food and a large glass of water
Which agent would be least appropriate to administer to a client with joint inflammation and pain?
acetaminophen
To prevent viral infections, what precaution should the general public take?
become vaccinated against prevalent viral infections
The nurse assesses a client and finds an injured area that is slightly swollen. The nurse interprets this finding as being the result of:
changes in capillary permeability
The nurse is providing care for a group of adult clients. Which client's health is most likely affected by disruptions to histocompatibility antigens?
client who is being treated for systemic lupus erythematosus (SLE)
A patient who is receiving methotrexate is also receiving leucovorin. The nurse understands that this drug is being given for which reason?
counteract the effects of methotrexate
A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care?
daily weights
A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance?
erythropoietin
A client had a myocardial infarction a few hours ago and is consequently experiencing tissue hypoxia. When assessing the client, the nurse should expect to identify the effects of what change in cell physiology?
failure of the sodium-potassium pump
After reviewing information about the various myelocytes, the students demonstrate understanding when they identify mast cells as:
fixed basophils
A deficiency in what area would result in an inhibition of the inflammatory response?
histamine
A red blood cell placed in which solution would shrink as water moves out of the cell?
hypertonic
The nurse starts an intravenous (IV) line on a client with edema. The order reads 500 mL bolus of D5LR over 30 min. The nurse knows that this IV fluid will cause water to move out of the cell because it is which type of fluid?
hypertonic
A nurse is caring for a client who is taking acyclovir. What is likely to be a priority nursing diagnoses for this client?
imbalanced nutrition: less than body requirements due to adverse effects of the drug
A 58-year-old with HIV is starting treatment with Combivir. He currently has a CD4+ cell count of less than 200 cells/mL and a viral load greater than 45,000 copies/mL. The nurse treating the client knows that what is a sign of effective drug therapy?
increased CD4+ counts
A client's immune response include phagocytosis of the bacteria that have infected the client. What cells are capable of performing this role in the immune response?
monocytes
The development of what symptomology would warrant discontinuation of HAART therapy that contains the administration of zidovudine?
musculoskeletal pain (black box warning for lactic acidosis)
A client has developed a wound infection and leukocytes are leaving the bloodstream to perform phagocytosis on pathogens. What white cells are most likely performing this function?
neutrophils
A nurse is preparing to administer imatinib to a client. The nurse expects to administer this drug by which route?
oral
Among the multiple genetic abnormalities that are characteristic of cancer cells, which gene mutation results in more than 90% of small cell lung cancers and more than 50% of breast and colon cancers?
p53
A client with heart failure has been prescribed a calcium channel blocker. The nurse is aware that this medication primarily affects what what aspect of cardiac cell function?
permeability of the cell membrane
A client, undergoing treatment for cytomegalovirus, received an initial dose of IV ganciclovir 3 days ago. When reviewing this client's most recent blood work, what abnormality should the nurse recognize as a possible adverse effect of this drug?
platelet count 118,000/mm3 (low)
When explaining the structure and function of the cell membrane to a client, the nurse should describe it as being:
primarily responsible for maintaining cellular integrity
A client develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be most appropriate?
risk for infection
A patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen?
risk for infection related to bone marrow suppression
When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify which cells as an example?
skin cells
A 56-year-old client, discharged from the hospital following a successful kidney transplant, is prescribed antirejection drug therapy. When performing health education with the client and the client's family, which topic should the nurse emphasize?
strategies for reducing the client's risk for infection
What does the clinical presentation of an inflammatory reaction include? (Select all that apply.)
swelling heat pain redness
An HIV-positive patient is being treated for hypothyroidism with levothyroxine. The patient is also taking saquinavir therapy for HIV. Which clinical manifestations by the patient should the nurse be concerned about?
tachycardia, intolerance to heat, weight loss
A client who is a young adult was immunized against pertussis as a child and has now been exposed to the causative bacteria, Bordetella pertussis. The client's exposure to this bacteria will cause:
the release of IgG by memory B cells.
The nurse is caring for a 3-year-old with HIV. The nurse knows that, when administering antiviral drug therapy in young children with HIV, dosage calculations are typically based on:
their weight
Histology testing has revealed that many of a client's cancer cells are in the M phase of cell division. The nurse explains to the client that this phase will result in:
two identical daughter cells!
A nurse assesses a client and notes an area that is reddened and warm. The nurse understands that these findings are related to:
vasodilation
A client is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. Administration of filgrastim may aid in achieving what desired outcome?
increased leukocytes
What is the mechanism of action of most of the drug classes included in the Highly Active Antiretroviral Drug Therapy (HAART) treatment plan?
inhibits function of enzymes required for replication in host cells
The nurse is assessing a new client admitted to a nursing home. The client asks the nurse to explain interleukins. The nurse would include which information?
interleukins help the immune system with inflammation
What would the nurse recognize as the primary goal(s)of highly active antiretroviral therapy (HAART)? Select all that apply.
Suppress virema. Delay drug-resistant mutations. Preserve CD4 counts.
When explaining the types of leukocytes produced by the bone marrow, the nurse describes lymphocytes. Which would the nurse include? (Select all that apply.)
T cells B cells Natural killer cells
A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient's drug regimen. What patient education should the nurse provide to this patient?
it is important that you tell us if you experience any significant swelling or puffiness
After reviewing cell physiology in preparation for a test, a group of students demonstrate understanding of the topic when they identify what as the main goal of a cell?
maintain homeostasis
A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug?
menopausal effects
