Pharm 2 test 1 Lippincott quiz questions

The nurse is teaching a client who will require long-term corticosteroid therapy how to reduce the risk of infection. What suggestions will the nurse include?

"Avoid large crowds of people in confined spaces."

A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction the nurse provide the client's family about this drug?

"Don't stop this medication suddenly; you will have to taper dosage gradually."

Which statement indicates that the client understands immunosuppressant therapy following a solid organ transplant?

"I know that I will need to stay on this medication for the rest of my life."

A nurse is caring for a client who is receiving a corticosteroid for arthritic pain. Which statement made by the client would raise concern about medication dosage revision?

"I recently lost my health care coverage and need to look for another job."

A home care nurse is caring for a client who has received a liver transplant. The nurse is reinforcing earlier teaching about the client's immunosuppressant therapy and the need for appropriate self-care. Which client statement suggests that the client understands?

"I will always be at risk for serious infection."

The nurse just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. Which statement indicates the client requires further instruction?

"I will start this medication as soon as I am feeling ill or tired."

The nurse instructs a client who is prescribed low-dose prednisone daily for a chronic condition. Which client statement indicates to the nurse that teaching has been effective?

"I will take the medication with a meal."

A 23-year-old man has received a recent diagnosis of appendicitis following 24 hours of acute abdominal pain. The nurse providing care for the man is explaining that while unpleasant, the inflammation of his appendix is playing a role in his body's fight against the underlying infectious process. Which teaching point should the nurse not teach to the patient?

"Inflammation helps your body to produce the right antibodies to fight the infection."

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."

A client prescribed alternate-day administration of corticosteroids asks the nurse why the drug isn't administered every day. How would the nurse describe the benefit of alternate-day therapy (ADT)?

"It minimizes suppression of adrenal function."

A 45-year-old woman has been taking a corticosteroid and calls the clinic reporting the development of acne-like lesion on her face as well as facial hair. What is the nurse's bestresponse?

"Sadly, this is an adverse effect seen in women. It should improve when you finish the medication."

When explaining the risks of pretransplant immunosuppression, the nurse demonstrates understanding of the process when making which statement?

"Serious complications can occur if you are not monitored carefully while you are immunosuppressed."

The nurse is reviewing the medication instruction for the client taking acyclovir. Which statement by the client would indicate the need for additional teaching?

"This medication will maintain the symptoms and cure my disease."

The nurse is teaching a 21-year-old client with AIDS about zidovudine, a nucleoside reverse transcriptase inhibitor (NRTI) that the health care provider has prescribed for treatment of the disease. Which client statement suggests that the nurse's teaching has been successful?

"This medication will slow the progression of the disease but will not cure it."

A child is to receive a topical corticosteroid agent. Which statement by the parents indicates a need for additional teaching?

"We need to cover the area snugly with plastic wrap to prevent scratching."

A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?

"You will have multidrug therapy for 6 to 24 months."

A client, planning to travel to an area where malaria is endemic, has been given a prescription for prophylactic chloroquine. Which instruction would the nurse include in the teaching? Select all that apply. -Begin therapy 1 month before exposure. -Begin therapy 2 weeks before exposure. -Continue therapy 6 to 8 weeks after leaving endemic area. -Continue therapy 1 to 2 weeks after leaving endemic area. -Stop therapy 2 days prior to leaving endemic area.

-Begin therapy 2 weeks before exposure. -Continue therapy 6 to 8 weeks after leaving endemic area.

A nurse is preparing to administer IV acyclovir to a client diagnosed with a herpes simplex viral infection. The health care provider has ordered 5 mg/kg every 8h. The client weighs 60 kg. How much medication will the nurse administer per dose?

300 mg

The nurse should question a prescription for corticosteroid therapy for which client(s)? Select all that apply. A 42-year-old diagnosed with a systemic fungal infection An 8-year-old who recently received a live influenza vaccine A 25-year-old who has been diagnosed with leukemia A 59-year-old diagnosed with bronchial pneumonia A 71-year-old with a staph aureaus infected hip

A 42-year-old diagnosed with a systemic fungal infection An 8-year-old who recently received a live influenza vaccine A 25-year-old who has been diagnosed with leukemia

For which clients would treatment with acyclovir be most clearly indicated?

A 77-year-old whose recent debilitating pain has been attributed to a herpes zoster infection

While learning about corticosteroids in pharmacology class, a student asks the instructor what a clinical indication for the use of corticosteroids would be. What would be the instructor's bestresponse?

A disease with an inflammatory component

A nurse is assessing a 66-year-old man who is HIV-positive. The patient has been prescribed didanosine (Videx). It would be most important to question the patient about which of the following?

Alcohol use

Viral infections commonly occur in what age group?

All age groups

A nurse is caring for a patient who is taking cyclosporine following a heart transplant. The patient is subsequently found to have a systemic Aspergillus infection. Which of the following antifungals, if administered to treat the infection, can increase serum levels of cyclosporine?

All the above

A nurse is preparing to administer ferrous to a client. Which adverse reaction should the nurse point out to the client to report if noted?

Allergic reaction

The nurse is caring for a client diagnosed with a life-threatening systemic fungal infection that is not responding to treatment with an azole. What medication should the nurse anticipate the provider may order next?

Amphotericin B

A client with intestinal amebiasis is preparing for discharge. The nurse will include which instruction when teaching the client about the prescribed metronidazole?

Avoid intake of alcohol.

The nurse is explaining to a client how an antigen previously encountered elicits a much faster immune response because the body's immune cells "remember" previous encounters with the antigen. The nurse is describing the function of what cells?

B cells

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?

Baclofen

The nurse is caring for a client who is HIV positive. What laboratory test is used to determine this client's ability to fight against viral infections?

CD4

The nurse is caring for an obese female client who is also HIV positive. The nurse takes special care to dry all skin folds in the client after her bath to prevent which fungal infection?

Candidiasis

A male client taking oral prednisone informs the home care nurse that the medication is upsetting his stomach. What guidance can the nurse provide to help the client?

Confirm that the client takes the medication with a meal.

A male client received a kidney transplant 2 years ago. He asks the provider if he may begin to wean himself off of the immunosuppressive drug therapy. He is healthy and works as an engineer full time, and he finds the cost of the medication prohibitive. What would the nurse expect the health care provider to do?

Continue the medication because it is lifelong therapy.

A female client is diagnosed with adrenal insufficiency. She presents to the emergency department with hypotension. What would the nurse expect her to be prescribed?

Corticosteroids

The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine?

Cyclobenzaprine produces an anticholinergic response

The nurse is educating an 82-year-old client regarding amphotericin B (Fungizone). The nurse knows the client understand when the client states that he could develop which adverse effect?

Damage to his kidneys

The nurse is caring for a client who has been diagnosed with cerebral edema caused by trauma. Which medication should the nurse be prepared to administer?

Dexamethasone

Concerned that a client is not taking the prescribed medication correctly, the nurse arranges for the client to visit the health care provider's office and take the medications in front of the nurse. Which form of treatment is the client participating in?

Directly observed therapy

When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction?

Drowsiness

When combination therapy is ineffective, what needs to be reassessed?

Drug-drug interactions

A 44-year-old man has come to the clinic with an asthma exacerbation. He tells the nurse that his father and brother also suffer from asthma, as does his 15-year-old son. The nurse explains that this is an allergic response based on a genetic predisposition. The specific allergen initiated by immunological mechanisms is usually mediated by immunoglobulin:

E.

When reviewing a journal article about seizure disorders, the nurse would expect to find tonic-clonic seizures and myoclonic seizures being classified as which type of seizures?

Generalized seizures

The nurse is monitoring a child who has been receiving long-term therapy with systemic corticosteroids. Which would be most important for the nurse to assess?

Growth pattern

The nurse has just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. What statement indicates the client requires further instruction?

I will start this medication when I am feeling ill or tired.

A pharmacology student is learning about amphotericin B. This drug can be administered via which route?

IV

A client has sought care because of seasonal allergies that are having a negative effect on the client's quality of life. The nurse should recognize the role of what immunoglobulin in this client's health problem?

IgE

In an allergic reaction, the immunoglobulin that binds to mast cells that release histamine is the:

IgE

The nurse reviews laboratory results from a client experiencing an allergic reaction to a medication. Which immunoglobulin level will the nurse expect to be elevated in this client?

IgE

A school-aged client was vaccinated against varicella several years ago according to the recommended immunization schedule. The client has now been exposed to the virus by a classmate with chickenpox. What immune response will prevent the client's infection?

IgG will be released by B memory cells

A client diagnosed with tuberculosis was prescribed antitubercular therapy but stopped after 1 month because of difficulty with the medication scheduling. As a result, secondary drugs are being prescribed. Which nursing diagnosis would the nurse identify?

Ineffective Self-Health Management

A 78-year-old male client begins an immunosuppressant therapy for his rheumatoid arthritis. The nurse is concerned because this client is at greater risk for what complication, compared with younger adults using the same treatment modality?

Infections

Your client has a history of supraventricular tachycardia, for which she is taking a calcium channel blocker. Recently, she was diagnosed with blastomycosis. She has mild to moderate disease, so she is being treated with itraconazole for 6 to 12 months. As part of your client's education, you would include which of the following instructions?

Itraconazole can increase the effects and risks of toxicity of your calcium channel blocker. You should see your health care provider on a regular basis to have this evaluated while taking itraconazole.

What should the nurse include as a possible adverse effect when teaching a client about phenytoin?

Liver toxicity

A major concern among public health authorities is an increase in drug-resistant tuberculosis (TB) infections. What new evidence suggests a possible cause for this resistant tendency?

Many drug-resistant infections are new infections, especially in those who are immunosuppressed.

The nurse is caring for an 84-year-old client with diabetes who is receiving hydrocortisone 40 mg daily PO for treatment of an arthritic flare-up. When writing a plan of care for this client, which nursing intervention would be most appropriate?

Monitoring blood glucose levels frequently

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 client presents to the emergency department with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The health care provider has ordered a complete blood count and white cell differential. Which blood components would the provider most likely anticipate to be elevated?

Neutrophils

A client is to receive ethotoin. The nurse would expect to administer this drug by which route?

Oral

The nurse is preparing to administer prednisone. The nurse would expect to administer this agent by which route?

Oral

Based on the metabolic action of glucocorticoids, a client who is on long-term glucocorticoid therapy is at risk of developing what disease?

Osteoporosis

After teaching a group of nursing students about seizures, the instructor determines that the teaching was successful when the group identifies seizures that do not impair consciousness but can involve the senses or motor ability as which type?

Partial seizures

What stage in the replication cycle of a virus represents viral DNA being injected into a host cell?

Penetration

A nurse is administering lorazepam to a client with status epilepticus. The nurse will be prepared to administer which additional drug to treat the status epilepticus for the next several hours?

Phenytoin

An HIV-positive patient is in a continuing phase of TB. The patient has completed the initial phase of the treatment program. In the continuing phase, the patient has shown no positive sputum results for six months. The nurse knows that under what circumstances does the treatment in the second phase last for four months or more?

Positive sputum culture after the completion of initial treatment

A male client is diagnosed with Addison disease. What daily medication would the nurse expect to be administered?

Prednisone

A patient diagnosed with TB is undergoing treatment. The nurse knows that which of the following preventive therapies will avoid the spreading of TB?

Prophylactic therapy

The client newly diagnosed with epilepsy begins to show signs of seizure activity. What is the nurse's priority action?

Protect the client's safety.

A client with roundworms is prescribed pyrantel. The nurse determines the client teaching is successful after the client correctly chooses which adverse reactions to immediately report to the health care provider?

Rashes

The nurse has completed a teaching with a client prescribed phenytoin daily for seizure activity. The nurse determines the session is successful after the client correctly chooses which potential adverse reaction that can occur if the client misses a dose of medication?

Recurrence of seizures

The nurse caring for a patient who is on prednisone understands that the drug's anti-inflammatory effects are due to what mechanism of action?

Reduction in erythrocyte sedimentation rate

A client who has been diagnosed with a compromised immune system is eager to know about the condition. Which explanation should the nurse provide regarding the potential consequences of a compromised immune system?

Results in immunodeficiency diseases

A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?

Rifampin and isoniazid

A client with asthma has been prescribed an inhaled corticosteroid. When providing client education related to correct use of the inhaler, what statement would the nurse include?

Rinse your mouth completely after using the inhaler.

A client has been prescribed a subcutaneous medication to treat rheumatoid arthritis (RA). The nurse should teach the client to do which?

Rotate sites when administering the injections.

When does a client with spinal cord injury-associated spasticity require treatment for this condition?

Safety, mobility, and activities of daily living are impaired.

An elderly female client is admitted to the medical floor with pustules on her body that travel along the nerve route in her legs and arms. The health care provider prescribes the drug acyclovir (Zovirax). What disease is this client demonstrating?

Shingles

The nurse is conducting an ongoing assessment on a client who was administered ethotoin. Which finding should the nurse prioritize?

Slurred speech

The home health nurse is making a plan of care for a new client who is taking oral prednisolone. What suggestion may decrease the nausea related to oral administration of prednisolone?

Take with a meal

The nurse understands that which is the highest priority when teaching about antitubercular medications?

Taking medications as prescribed

The nursing instructor is discussing short-term versus long-term corticoid steroid therapy with the nursing students. What would be the most appropriate teaching for a client on long-term corticosteroid therapy?

Taper doses when discontinuing drug

A 24-year-old client is treated with acyclovir for herpes. The client has a history of epilepsy. What indication would the nurse see that would indicate a serious reaction?

The client is having tremors more pronounced at rest.

A client is being treated for histoplasmosis with amphotericin B. The nurse has completed a comprehensive assessment of the client and should report what assessment finding?

The client's urine output is 75 mL over six hours

A client with skin lesions due to a viral infection has been prescribed a topical antiviral agent. When teaching the client about this therapy, which factor would the nurse emphasize?

The drug will not prevent the spread of the disease to others.

A patient with skin lesions due to a viral infection has been prescribed topical application of an antiviral. Which of the following points should the nurse inform the patient regarding the therapy and the infection?

The drug will not prevent the spread of the disease to others.

A client diagnosed with asthma has responded well to treatment with oral corticosteroids, and a switch to inhaled corticosteroids is planned. What strategy for managing this change in treatment should be implemented?

The inhaled drug should be started during tapering of the oral drug.

A client is prescribed a corticosteroid to reduce inflammation caused by an autoimmune disorder. Which information would the nurse include when teaching the client about this medication?

The medication is prescribed in gradually decreasing doses.

A 65-year-old client who has been on long-term corticosteroid therapy is admitted to the hospital and will need an IV inserted. What adverse effect of corticosteroid may negatively affect this procedure?

Thinning of the skin

A group of nursing students are preparing for an examination about fungal infections. They demonstrate they are prepared by correctly choosing what as a superficial fungal infection?

Thrush

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?

To prevent resistance

The client is receiving ketoconazole. The nurse should be concerned about a drug-drug interaction on the basis of what other co-morbidity?

Type 2 diabetes

A client with HIV is frustrated by the size and complexity of the current medication regimen. What should the nurse teach the client about combination therapy for the treatment of HIV?

Use of combination therapy attacks the virus at different stages of the life cycle.

A client is receiving hydroxychloroquine for a musculoskeletal disorder. Which adverse reactions are irreversible and needs to be reported immediately?

Visual changes

A nurse is providing client education to a female client who is taking fludrocortisone. The nurse will instruct the client to monitor what at home?

Weight gain

A client, newly diagnosed with a seizure disorder, asks the nurse why the client is receiving a specific drug. What would be the best answer by the nurse?

When prescribing an AED, the health care provider takes into account the type of seizure the client is having.

What client is most vulnerable to infection with cytomegalovirus (CMV)?

a client being treated for acquired immunodeficiency syndrome

The nurse is caring for a client who is prescribed long-term corticosteroid therapy. Which information will the nurse include when teaching the client about this medication? Select all that apply. a."Do not miss any doses." b."Slowly increase activity and exposure to other people." c."Wear a medical alert bracelet that identifies the medication." d."Inform all health care providers that you are taking the medication." e. "Avoid all other medications until discussing them with the health care provider."

a. "Do not miss any doses." c. "Wear a medical alert bracelet that identifies the medication." d. "Inform all health care providers that you are taking the medication." e. "Avoid all other medications until discussing them with the health care provider."

A school-aged child is brought to the clinic by their parents. The parents state that the child will be engaged in some activity at home and then will just stop suddenly for a few seconds and then pick up the activity again as if there had been no break in what the child was doing. This child should be assessed for what neurological disorder?

absence seizures

A female client has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid:

adrenal insufficiency.

It will be most important for the nurse to monitor nevirapine therapy for a male patient during the first few months of therapy in order to:

assess for potentially life-threatening hepatotoxicity or skin reactions.

A client is taking rifampin (Rifadin) for active TB. The nurse should stress that what may be caused by the use of this drug?

body fluids such as urine, saliva, tears, and sputum may become discolored.

A client's seizure activity, which is isolated to facial and neck muscles, has been identified as being caused by one area of the client's brain. The nurse should anticipate the administration of what drug?

carbamazepine

A nurse teaching the client with tuberculosis (TB) should state that ethambutol can:

cause optic neuritis.

A nurse is caring for a 52-year-old client who has been diagnosed with a latent tuberculosis infection. The health care provider is considering ordering isoniazid (INH). The preexistence of what condition would require cautious use of INH in this client?

cirrhosis of the liver

What is a common risk for epileptic seizures during late infancy to early childhood?

fever

When considering the immunosuppressed client, which assessment finding has the greatestsignificance?

fever

The nurse is caring for a client diagnosed with an acute infection that resulted in a prompt immune reaction. What signs or symptoms experienced by the client would the nurse recognize as being mediated by interleukins? Select all that apply. fever joint pain muscle pain hyperactivity insomnia

fever joint pain muscle pain

Nursing care for the postoperative client requiring long-term glucocorticoid therapy will be directed at overcoming what adverse effect of the drug?

impaired wound healing

A client has been prescribed a corticosteroid for the treatment of chronic adrenocortical insufficiency. The nurse's instructions for administration should include taking the medication under what condition?

in the morning.

When caring for a client who is receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?

infection

The nurse reviews the Nurse's Notes which contains data collected during the assessment of a client with a swollen knee. Based on this information, which condition should the nurse suspect the client is experiencing?

inflammatory response

The nurse is assessing a client who has been prescribed treatment with isoniazid. What assessment finding would most likely necessitate contacting the health care provider to recommend discontinuing treatment?

jaundice

Which laboratory value would the nurse find consistent with acute viral infection?

normal white blood cell (WBC) count

A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away?

numbness and tingling in his feet

A nurse is caring for an older adult client with tuberculosis. The client has been prescribed ethambutol. Which adverse reactions of ethambutol should the nurse assess for?

optic neuritis

The nurse is caring for a client who has been prescribed corticosteroid therapy. The nurse should notify the prescribing health care provider when observing what in the client's history?

peptic ulcer.

A client being treated with oral prednisone is also prescribed furosemide. The nurse should prioritize assessment of what laboratory value?

potassium

A client is receiving amphotericin B. The nurse would assess the client closely for which adverse reaction?

renal impairment

What type of seizure activity is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness?

status epilepticus

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 of infection

Minimizing the effects of what process is typically the primary goal of alternate-day administration of corticosteroids?

suppression of normal adrenal function

The nurse admitted a client diagnosed with a systemic fungal infection. Before administering ketoconazole as prescribed, what should the nurse confirm?

the client's hepatic function

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:

the client's weight.

A client 45-years-old just received a heart transplant. One of the clients medications is ganciclovir. The nurse knows this medication was prescribed why?

to prevent CMV infection.

The client reports cough, low-grade fever, anorexia, and night sweats. The client has also been coughing up blood at times. What disease does this client most likely have?

tuberculosis