VN148 Pharm Wksht 1 - Immune
Which patient outcomes are major goals of antiretroviral therapy? (Select all that apply.) a. Prevention of opportunistic infections b. Conversion to an HIV-negative antibody status c. Reduction of the number of viral particles in the patient's blood d. Increase in CD4+ cells e. Decrease in CD8+ cells f. Prevention of disease spread
a. Prevention of opportunistic infections c. Reduction of the number of viral particles in the patient's blood d. Increase in CD4+ cells f. Prevention of disease spread
The nurse tells the family of a patient who has just undergone bone marrow transplant that to help stabilize the immune response and prevent rejection, ________________ will be given. a. dexamethasone (Decadron) b. filgrastim (Neupogen) c. zidovudine (Retrovir) d. nevirapine (Viramune)
a. dexamethasone (Decadron)
A patient who is taking zidovudine (Retrovir) reports diarrhea. Which dietary change does the nurse suggest for this patient? a. "Avoid fatty and fried foods." b. "Increase your intake of fiber." c. "Take an antacid 30 minutes before each meal." d. "Restrict your intake of fluids to 1 L per day."
a. "Avoid fatty and fried foods."
A pediatric patient is prescribed nelfinavir (Viracept) 450 mg orally. The available drug is 50 mg/scoop. How many level scoops does the nurse measure into the patient's pudding to administer the correct dose? a. 9 b. 6 c. 3 d. 2
a. 9
Which statement about human immune deficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is true? a. Everyone with AIDS has HIV infection but not everyone with HIV infection has AIDS. b. Everyone with HIV infection eventually dies of it because the disease cannot be cured. c. With successful antiretroviral therapy, HIV-infected patients become HIV-antibody negative. d. When HIV disease becomes AIDS, the infection is in the blood and treatment must be given intravenously.
a. Everyone with AIDS has HIV infection but not everyone with HIV infection has AIDS.
A patient who has been taking efavirenz (Sustiva) reports a sore throat, fever, and blisters. What is the nurse's best action? a. Hold the dose and notify the prescriber. b. Document the report as the only action. c. Remind the patient that these are symptoms of opportunistic infection. d. Reassure the patient that these are common and expected side effects of the drug.
a. Hold the dose and notify the prescriber.
A patient who has been taking indinavir (Crixivan) for a year has just been told that the organism is now resistant to this drug. The patient expresses worry to the nurse that this means the disease will now progress to acquired immunodeficiency syndrome (AIDS) and death will soon follow. What is the nurse's best response? a. "Your health care provider can change this drug to the intravenous form, which prevents viral replication even in HIV that has developed drug resistance." b. "Although the HIV is now resistant to this drug, other antiretroviral drugs are likelyto be effective in controlling your disease." c. "The HIV easily becomes drug resistant. That is why the drug combinations are switched so often." d. "TThat is a possibility because these drugs do not kill the virus. It is best to be prepared."
b. "Although the HIV is now resistant to this drug, other antiretroviral drugs are likelyto be effective in controlling your disease."
Which precaution is most important for the nurse to teach a patient who is prescribed enfuvirtide (Fuzeon)? a. "After the drug is mixed, store it away from light." b. "Use sterile technique to draw up and inject the drug." c. "Do not take this drug if there is any possibility that you are pregnant." d. "Mix the drug with tap water, then rinse the drug's original container and add that fluid to the drug mixture."
b. "Use sterile technique to draw up and inject the drug."
A patient is prescribed 20 mg of ketorolac (Toradol) intramuscularly. How many milliliters does the nurse draw up from a vial of ketorolac containing 30 mg/mL?a. 0.5 b. 0.7 c. 1 d. 2
b. 0.7
A client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine isethionate (Pentam 300). The nurse assisting in caring for the client monitors the client most closely for signs of: a. Nausea b. Anemia c. Restlessness d. Gastrointestinaal discomfort
b. Anemia
A patient taking highly active antiretroviral therapy (HAART) for a year has the following blood laboratory test values. Which value does the nurse report to the prescriber immediately? a. White blood cell count 3500 cells/mm3 b. Lactate dehydrogenase 990 IU/L c. Sodium 132 mEq/L d. Hematocrit 32%
b. Lactate dehydrogenase 990 IU/L
How are retroviruses different from common viruses?a. Retroviruses respond to antibacterial drugs but common viruses do not. b. Retroviruses have a greater efficiency of infection than common viruses. c. Common viral infections can be cured while retroviral infections can only be controlled. d. Common viruses can infect anyone whereas retroviruses can only cause infection inan immunosuppressed host.
b. Retroviruses have a greater efficiency of infection than common viruses.
A nurse is assigned to care for a client with a diagnosis of toxoplasmosis. The physician has prescribed sulfasalazine (Azulfidine). The nurse preparing to administer this medication understands that this medication is a(n): a. Antibiotic b. Sulfonamide c. Opioid analgesic d. Nonsteroidal anti-inflammatory
b. Sulfonamide
A patient has human immunodeficiency virus (HIV) disease and is taking a "cocktail" consisting of protease inhibitors, nucleoside analogue reverse transcriptase inhibitors, and nonnucleoside analoguereverse-transcriptase inhibitors. Which statement made by the patient indicates that more teaching about the drug therapy is needed? a. "Using three drugs at the same time enhances suppression of viral replication." b. "There is no problem using these drugs during the last trimester of my pregnancy." c. "Because this drug combination kills HIV, I do not need to worry about transmitting the virus." d. "If the virus becomes resistant to this cocktail, another combination of drugs may be required to reduce my viral load."
c. "Because this drug combination kills HIV, I do not need to worry about transmitting the virus."
A human immunodeficiency virus (HIV)-positive patient taking highly active antiretroviral therapy informs the nurse she is now pregnant. What advice regarding drug therapy does the nurse give this patient? a. "Stop taking these drugs for your entire pregnancy." b. "Stop taking these drugs for the first trimester and start again for the second and third trimesters." c. "Continue to take these drugs throughout your pregnancy exactly as they have been prescribed." d. "It will be necessary to double your dosages of these drugs to ensure your unborn baby is adequately protected."
c. "Continue to take these drugs throughout your pregnancy exactly as they have been prescribed."
A patient prescribed highly active antiretroviral therapy (HAART) is flying to a wedding and will be gone 1 day. The patient asks about skipping prescribed drug doses that day in order to avoid having to show them all at the airport. What is the nurse's best response? a. "Yes, just one day off your drugs will not make any difference." b. "Yes, as long as you avoid direct contact with anyone who is ill." c. "No, even one day off the drugs can help the virus become drug resistant." d. "No, even one day off the drugs increases the chance that you can spread the disease."
c. "No, even one day off the drugs can help the virus become drug resistant."
A child is prescribed emtricitabine (Emtriva) 120 mg orally. The drug on hand is emtricitabine suspension 10 mg/mL. How many mL does the nurse prepare? a. 2 b. 6 c. 12 d. 20
c. 12
An older adult patient is prescribed linezolid (Zyvox) 500 mg oral suspension. The drug on hand is 100 mg/5 mL. How many mL does the nurse prepare? a. 2 b. 10 c. 25 d. 50
c. 25
Cyclosporine (Sandimmune) is prescribed for a client following an allogenic kidney transplant. The nurse provides instructions to the client regarding the medication and tells the client that: a. The medication will need to be taken for a period of 6 months. b. The medication is administered by the intravenous route on a monthly basis. c. Blood levels of the medication will need to measured periodically. d. There are no known adverse effects of the medication.
c. Blood levels of the medication will need to measured periodically.
A nursing home resident has been prescribed to take 20 mg of prednisolone immediately. The facilitydoes not have prednisolone, only prednisone. What is the nurse's best action? a. Substitute prednisone for prednisolone because they are both corticosteroids. b. Hold the dose until the pharmacy opens the next day. c. Notify the prescriber immmediately of this situation. d. Administer the parenteral form of the drug
c. Notify the prescriber immmediately of this situation.
A patient who has been taking 30 mg of prednisone daily for the last 10 days reports crying more often and then suddenly getting angry at small issues. What is the nurse's best action? a. Document the patient's response as the only action. b. Hold the next dose and notify the prescriber immediately. c. Reassure the patient that this is an expected drug response. d. Suggest that the patient see a counselor or attend an anger management class.
c. Reassure the patient that this is an expected drug response.
Dapsone (DDS) is prescribed for a client with acquired immunodeficiency syndrome for the treatment of toxoplasmosis. The nurse provides medication instructions and determines that the client understands the instructions if the client states she will: a. Discontinue the medication if nausea develops. b. Plan to take the medication every 4 hours around the clock. c. Report a sore throat to the physician. d. Expect that abdominal pain and jaundice will occur as a normal side effect.
c. Report a sore throat to the physician.
Which food, drink, or herbal supplement does the nurse warn a patient who is prescribed nevirapine (Viramune) to avoid? a. Caffeinated beverages b. Grapefruit juice c. St. John's wort d. Dairy products
c. St. John's wort
How do protease inhibitor (PI) drugs prevent viral replication? a. They are counterfeit bases that prevent reverse transcriptase from synthesizing the DNA needed for viral replication. b. They inactivate the enzyme that allows the viral genetic material to be integrated into the human host's cellular DNA. c. They prevent the production of proteins needed for viral particles to leave the cell and infect other cells. d. They prevent initial infection by blocking the receptor the virus uses to enter target cell
c. They prevent the production of proteins needed for viral particles to leave the cell and infect other cells.
A patient is prescribed to begin highly active antiretroviral therapy (HAART). What is the most important question the nurse asks this patient before beginning therapy? a. "Do you have any symptoms now of active infection?" b. "Is there any possibility that you are pregnant?" c. "Are you currently sexually active?" d. "What other drugs do you take?"
d. "What other drugs do you take?"
Which test results indicate to the nurse that a patient's antiretroviral therapy is effective? a. White blood cell count 5000 cells/mm3 b. Blood urea nitrogen level 15 mg/dL c. Blood positive for human immunodeficiency virus (HIV) antibodies d. CD4+ to CD8+ ratio increased
d. CD4+ to CD8+ ratio increased
A client with acquired immunodeficiency syndrome has been started on therapy with zidovudine (AZT, Retrovir). The nurse reviews the physician's orders, expecting to note that which laboratory test has been prescribed? a. Blood glucose level b. Blood urea nitrogen c. Blood culture d. Complete blood count (CBC)
d. Complete blood count (CBC)
A client who is human immunodeficiency virus (HIV) seropositive has been taking zalcitabine (ddC,Hivid) as a component of treatment. The nurse tells the client that which laboratory test will need to be monitored while taking this medication? a. Glucose level b. Platelet count c. Red blood cell count d. Liver function studiies
d. Liver function studiies
A patient who has been taking lamivudine (Epivir) for 6 months reports reduced sensation in the fingers and toes. What is the nurse's best action? a. Document the report as the only action. b. Hold the dose and notify the prescriber. c. Remind the patient to continue the drug as usual and take a multiple vitamin daily. d. Reassure the patient that this is an expected drug side effect and to use injury precautions.
d. Reassure the patient that this is an expected drug side effect and to use injury precautions.
A hospitalized patient has been prescribed dexamethasone (Decadron) for an allergic reaction. The instructions that the patient should be given with the discharge teaching relative to this drug is: a. report blurry vision. b. take the medication on an empty stomach. c. do not operate heavy machinery. d. take this medication with meals
d. take this medication with meals