Week 2- The Immune System Pharmacology ATI Questions (Exam 1)
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 Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old.
A client is about to start therapy with topotecan to treat metastatic ovarian cancer. To minimize neutropenia, an adverse effect of topotecan, you should administer filgrastim at which of the following times?
24 hr after the topotecan infusion
You should instruct a client who is taking tamoxifen to treat breast cancer for watch for and report which of the following serious adverse effects of this drug?
Abnormal menstrual bleeding
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 Roll the vial gently to reconstitute the solution Inject the solution at room temperature 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 enfluvirtide can be prescribed to clients who have which of the following conditions?
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.
A nurse is instructing a client 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 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.
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 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.
A client is about to start taking mercaptopurine to treat acute lymphocytic leukemia. You should instruct the client to watch for and report which of the following indications of an adverse effect of this drug?
Bruising
A nurse should recognize that maraviroc is used in the treatment of which of the following conditions?
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.is used in the treatment of drug resistant HIV to block the entry of HIV into host cells
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?
Clean fruits and vegetables thoroughly 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.
You are assessing a client who is receiving imatnib to treat chronic myeloid leukemia. Which of the following findings might indicate an adverse reaction to this drug?
Crackles at lung bases Because this drug can cause fluid retention and pulmonary edema
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 Tamoxifen, an estrogen receptor blocker, can cause thromboembolism. Its use requires cautious use with clients who have deep-vein thrombosis.
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 also receive which of the following drugs to reduce the risk of neurotoxicity?
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.
When talking with the client about chemotherapy with doxorubicin, you explain the need for periodic diagnostic tests. The result of which of the following diagnostic tests or procedures requires monitoring?
ECG Because doxorubicin can cause cardiotoxicity
While administering trastuzumab IV to a client who has breast cancer, you should ensure that you have which of the following drug available to treat an adverse reaction to this drug?
Epinephrine
A client is about to start taking ritonavir to treat HIV-1 infection. Which of the following instructions should you include when talking with the client about taking this drug?
Expect periodic blood glucose testing Watch for and report jaundice Increase weight- bearing activity Expect periodic cholesterol testing
You should monitor this client for which of the following indications of an adverse reaction to cyclophosphamide?
Fever
A nurse preparing to administer paclitaxel IV to a client who has ovarian cancer. Which of the following actions should the nurse take?
Give the client an antihistamine Administer the drug through non- PVC tubing Use an in- line filter 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.
Delaviridine therapeutic use:
HIV-1 infection
A nurse is teaching the guardian of a 4- month- old infant about recommended immunizations for the infant. Which of the following immunizations should the nurse include?
Haemophilus influenza 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.
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 (shouldn't be less than 7.5) 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.
Your administering cyclophosphamide and mesna to a client. Mesna, a chemoprotective agent, helps prevent which adverse reactions to cyclophosphamide?
Hemorrhagic cystitis
A nurse is teaching a client about recommended immunizations. Which of the following immunizations should the nurse recommend the client receive starting at 50 years of age?
Herpes zoster vaccine The herpes zoster, or shingles vaccine, is recommended for adults older than 50 years of age.
A nurse is caring for a client who has a new prescription for topotecan therapy to treat resistant, small- cell lung cancer. The nurse should advise the client against taking which of the following types of over-the-counter drugs while receiving the therapy?
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.
You are about to adminster cisplatin to a client who has ovarian cancer. Before the infusion, you should take which of the following actions?
Infuse 1 to 2 L of IV fluid Administer an antiemetic Evaluate the client's hearing Determine the client's weight
A nurse is teaching a client about maraviroc. 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 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. 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 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?
Paresthesia Cough 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.
During IV administration of doxorubicin, the infusion site becomes swollen, red, and painful. Which of the following actions should you take?
Stop the IV infusion
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?
Paresthesia Sore Throat Flank Pain Tinnitus 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 is caring for a client who has a new prescription for delavirdine to treat HIV-1. The nurse should instruct the client to report which of the following adverse reactions to the drug?
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. likely to cause fatigue and dizziness than insomnia. is more likely to cause bronchitis than rhinitis.
You should give the client which of the following instructions about chemotherapy with doxorubicin?
Report vaginal itching Expect red- tinged tears Use effective contraception Expect regrowth after hair loss
A nurse should recognize that raltegravir is used to treat clients who have which of the following conditions?
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.
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 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.
A nurse is considering drug therapy options for a client who has metastatic breast cancer that is postive for human epidermal growth factor receptor 2 (HER2). Which of the following drugs should the nurse expect the provider to prescribe?
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.
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?
Use contraception if pregnancy is a risk Perform oral hygiene frequently 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 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 as an indication that the client is experiencing an adverse effect of the drug.
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. can cause ptosis and diplopia can cause hyperkalemia, as well as hypertension or hypotension.
A nurse is assessing a client following a trastuzumab 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?
Wheezing Dysrhythmias Hypotension Fever 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.
Flutamide therapeutic use:
prostate cancer
A nurse is teaching a client about immunizations. Which of the following information should the nurse include in the teaching?
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.
You are caring for a client who is pregnant and is HIV- positive. Which of the following drugs helps prevent the transfer of HIV to the fetus?
Zidovudine (Retrovir)
Cystarabine therapeutic use:
acute myelocytic leukemia
Enfuvirtide therapeutic use:
advanced or resistant HIV disease
Tamoxifen therapeutic use:
estrogen- receptor- positive breast cancer
Carmustine therapeutic use:
gastrointestinal adenocarcinoma
Paclitaxel therapeutic use:
kaposi's sarcoma
Cyclophosphamide therapeutic use:
multiple myeloma