pharm exam 4
3. During therapy with azathioprine, the nurse must monitor for which adverse effects? (Select all that apply.) a. Liver toxicity b. Diarrhea c. Vomiting d. Bradycardia e. Thrombocytopenia
A, E
8. The nurse is assessing a patient who has developed anemia after two rounds of chemotherapy. Which of these may be indications of anemia? (Select all that apply.) a. Hypoxia b. Fever c. Infection d. Bleeding e. Fatigue
A, E
2. The nurse is preparing to administer sirolimus and is aware that this drug has a black box warning for which possible condition? a. Heart failure b. Lymphoma c. Severe hypertension d. Cytokine release syndrome
B
A nurse is disposing of urine from a patient who is receiving chemotherapeutic drugs. Which action would the nurse take to decrease the risk for occupational exposure? A. Dispose the urine in an enclosed container. B. Apply a face shield. C. Have the patient dispose of the urine. D. Dispose of the urine in a biohazard container.
B
For which type of cancer is sorafenib indicated? A. Breast cancer B. Hepatocellular cancer C. Lung cancer D. Testicular cancer
B
Which potential side effects and adverse effects would a nurse share with Ms. Wilson regarding treatment with intramuscular medroxyprogesterone acetate (Depo Provera®)? Select all that apply. A. Weight loss B. Osteoporosis C. Injection-site reactions D. Delay of conception upon discontinuation of therapy E. Menstrual irregularities, particularly heavier menstrual bleeding
B, C, D
6. While administering bevacizumab (Avastin), what will the nurse assess to look for drug-related adverse effects? (Select all that apply.) a. Blood pressure b. Color of the skin and sclera of the eye (for jaundice) c. Blood glucose level d. Urine protein level e. Hearing f. Weight loss
B, D, E
Which indications can testosterone undecanoate be used to treat? Select all that apply. A. Catabolism B. Hypogonadism C. Ovulatory dysfunction D. Delayed male puberty E. Testicular failure for hormone replacement
B, E
8. The nurse is reviewing cyclosporine and recognizes that this drug works by which mechanism of action? a. Suppressing viral replication b. Enhancing the action of macrophages c. Inhibiting activation of T-lymphocyte cells d. Increasing the number of T-lymphocyte cells
C
A patient is prescribed erlotinib and gemcitabine for pancreatic cancer. Which information would the nurse provide regarding the risk for infection? A. Risk for infection is the same as when taking one drug. B. The risk for infection occurs only when the neutrophil count is low. C. Risk for infection will increase. D. Risk for infection is higher with intravenous dose of erlotinib.
C
Which type of chemotherapy refers to chemotherapeutic drugs packaged in a fat globule? A. Conventional B. Topical C. Liposomal D. Prodrug
C
3. The nurse is administering methotrexate as part of treatment for a patient with rheumatoid arthritis and will monitor for which signs of bone marrow suppression? Select all that apply. a. Edema b. Tinnitus c. Increased bruising d. Tingling in the extremities e. Fever f. Chills
C, E, F
Which statement accurately describes the glucocorticoid that is secreted from the adrenal cortex along with its effect in the body? A. Cortisol, which impacts carbohydrate metabolism B. Aldosterone, which impacts carbohydrate metabolism C. Cortisol, which maintains sodium levels and blood pressure D. Aldosterone, which maintains sodium levels and blood pressure
A
Which statement accurately describes the pharmacokinetic parameters of clomiphene citrate? A. The drug is readily absorbed following oral administration. B. Clomiphene citrate's volume of distribution is very small. C. The drug does not undergo metabolism. D. Clomiphene citrate is predominantly excreted in the urine.
A
1. The nurse is conducting a class for a group of new oncology staff members on drugs for malignant tumors. Which best describes the action of interferons in the management of malignant tumors? a. Interferons increase the production of specific anticancer enzymes. b. Interferons have antiviral and antitumor properties and strengthen the immune system. c. Interferons stimulate the production and activation of T lymphocytes and cytotoxic T cells. d. Interferons help improve the cell-killing action of T cells because they are retrieved from healthy donors.
B
A patient is prescribed vincristine for Hodgkin's lymphoma. On further questioning, the nurse discovers the patient has plant allergies, specifically to periwinkle. Which action would the nurse take? A. Administer the drug. B. Administer an antihistamine. C. Notify the health care provider. D. Conduct an allergy test before administering vincristine.
C
Which hormonal contraceptive has the longest elimination half-life? A. Norethindrone tablet (Micronor®) B. Etonogestrel implant (Nexplanon®) C. Medroxyprogesterone acetate injection (Depo Provera®) D. Ethinyl estradiol + etonogestrel vaginal ring (NuvaRing®)
C
Which statement accurately describes corticosteroids? A. The adrenal medulla secretes corticosteroids. B. There are two types of corticosteroids - epinephrine and norepinephrine. C. Glucocorticoids affect carbohydrate metabolism, and mineralocorticoids regulate electrolytes. D. Corticosteroid levels are regulated by the hypothalamic-pituitary-adrenal axis with use of a positive feedback mechanism.
C
Which part of the cell does fluorouracil affect during the S phase of the cell cycle? A. Estrogen receptors B. RNA C. Mitochondria D. DNA
D
A patient receiving targeted antineoplastic drug reports not wanting to eat at mealtimes. Which action would the nurse take first? A. Determine the reason for not wanting to eat. B. Encourage small frequent meals. C. Tell the patient to take the drug with food. D. Notify the health care provider.
A
By which route would the nurse administer imatinib? A. Orally B. Subcutaneously C. Intradermally D. Topically
A
Through which primary route is cyclophosphamide excreted? A. Kidneys B. Liver C. Intestines D. Sudoriferous glands
A
Which route would the nurse administer erlotinib? A. Orally B. Subcutaneously C. Intravenously D. Topically
A
Which statement made by the patient indicates a need for further teaching regarding doxorubicin, an antitumor antibiotic? A. "I do not have to worry about infection because the drug is an antibiotic." B. "I will notify my doctor if the injection site becomes red." C. "I will need to avoid large crowds." D. "If I start having trouble breathing, I will notify my doctor."
A
A nurse instructs a patient with rheumatoid arthritis who was prescribed prednisone 20 mg PO daily. Which statements by the patient indicate that patient teaching was effective? Select all that apply. A. "I will make sure to have a diet rich in vitamin D and calcium to reduce my risk for osteoporosis." B. "I will make sure to take the prednisone with food to avoid an upset stomach." C. "I may experience side effects and adverse effects such as insomnia, weight gain, and mood swings." D. "If my rheumatoid arthritis symptoms do not improve or get worse, I can take an extra dose of prednisone." E. "If side effects are bothering me, I will stop taking the prednisone and follow up with my physician later."
A, B, C
Which parameters would be assessed in a patient who has been prescribed prednisone? Select all that apply. A. Vital signs B. Glucose levels C. Potassium levels D. Testosterone levels E. Presence of preexisting edema F. Skin color, turgor, and temperature
A, B, C, E, F
Which statements describe the benefits of treating cancer cells with a combination of different classes of chemotherapeutic drugs? Select all that apply. A. Therapeutic effect in all phases of cancer cells is increased. B. Adverse effects are decreased. C. Development of drug resistance is decreased. D. Destruction of cancer cells is increased. E. Length of treatment is decreased.
A, C, D
4. A patient receiving chemotherapy is experiencing severe bone marrow suppression. Which potential problem is the highest priority at this time? a. Extreme fatigue b. Risk for infection c. Changing body image d. Reduced physical mobility
B
A patient diagnosed with leukemia is to receive imatinib. Before initiating imatinib, the nurse would ensure the patient is positive for which chromosomal abnormality? A. CD20+ B. Ph+ C. CYP3A4+ D. 26S
B
A patient is prescribed temsirolimus for advanced renal cell cancer. Before the administration of temsirolimus, which substance would the nurse most likely administer? A. Antiemetic B. Antihistamine C. Packed red blood cells D. Intravenous immunoglobulin (IV Ig)
B
A patient receiving chemotherapeutic drugs complains of mouth lesions and inability to eat or swallow. The nurse notes the patient has opioid analgesic, topical anesthetic, antiemetic, and sedative prescribed. Which drug would the nurse most likely provide? A. Opioid analgesic B. Topical anesthetic C. Antiemetic D. Sedative
B
1. A patient who is receiving chemotherapy with cisplatin (Platinol) has developed pneumonia. The nurse would be concerned about nephrotoxicity if which type of antibiotic was ordered as treatment for the pneumonia at this time? a. Penicillin b. Sulfa drug c. Fluoroquinolone d. Aminoglycoside
D
8. The nurse notes in the patient's medication history that the patient is taking natalizumab. Based on this finding, the nurse interprets that the patient has which disorder? a. Multiple sclerosis b. Rheumatoid arthritis c. Non-Hodgkin lymphoma d. Crohn's disease
A
A nurse is caring for a patient prescribed tofacitinib extended-release 11 mg PO daily who is also receiving methotrexate, HCTZ, and ethinyl estradiol/levonorgestrel. Which teaching point would the nurse provide to the patient about administration? A. It cannot be crushed or chewed. B. It should be given 2 hours before all other drugs. C. It should be taken with food to increase absorption. D. It should be taken on an empty stomach to enhance absorption.
A
A nurse is caring for a patient who has been prescribed clomiphene citrate for infertility. The patient also takes methyldopa for hypertension. Which outcome would a nurse anticipate may come from the drug interaction between methyldopa and clomiphene citrate? A. Impaired fertility due to an increase in prolactin B. Increased drug level of methyldopa causing hypotension C. Decreased drug level of methyldopa causing blood pressure to increase D. Increase in clotting factors leading to increased risk for deep vein thrombosis
A
A nurse is caring for a patient with RA who has been prescribed leflunomide. In addition to leflunomide, the patient is also receiving tamsulosin (for benign prostatic hyperplasia), duloxetine (for diabetic peripheral neuropathy), metformin (for diabetes), and glipizide (for diabetes). Which of the patient's drugs would a nurse anticipate interacting with leflunomide? A. Duloxetine B. Glipizide C. Metformin D. Tamsulosin
A
A patient has been prescribed prednisone 10 mg PO daily for worsening systemic lupus erythematous (SLE). The patient is also on hydroxychloroquine (for SLE) and warfarin (for venous thromboembolism). Which effect does the nurse anticipate will occur if prednisone is administered to this patient? A. The prednisone will interact with warfarin, increasing the effects of warfarin. B. The prednisone will interact with warfarin, decreasing the effects of warfarin. C. The prednisone will interact with hydroxychloroquine, increasing the effects of hydroxychloroquine. D. The prednisone will interact with hydroxychloroquine, decreasing the effects of hydroxychloroquine.
A
A patient is prescribed rituximab for chronic lymphocytic leukemia. Which condition would the nurse teach the patient to seek immediate medical care? A. Chest pain B. Night sweats C. Myalgia D. Cephalgia
A
A patient presents with Philadelphia chromosome-negative acute lymphoblastic leukemia that has failed multiple chemotherapeutic drug therapy. Which chemotherapeutic agent would the nurse expect to administer? A. Vincristine liposomal B. Doxorubicin liposomal C. Doxorubicin conventional D. Vincristine conventional
A
A patient who has been on sorafenib for advanced renal cancer started taking St. John's wort for depression. Which effects would the nurse assess as a result of the drug-herbal interaction? A. Increased proliferation of cancer cells B. Increased side effects of sorafenib C. Prolonged QT interval D. Decreased metabolism of sorafenib
A
A patient whose diet consists of fried foods is prescribed sorafenib. Which information on the drug-food interactions would the nurse provide to the patient? A. High-fat foods decrease the bioavailability of sorafenib. B. The bioavailability of sorafenib is not affected by food. C. Any food will increase the level of free sorafenib. D. Milk will help decrease nausea and vomiting.
A
A patient with rheumatoid arthritis (RA) asks the nurse why he or she was told to take folic acid with methotrexate. Which rationale would the nurse provide? A. To reduce gastrointestinal and hepatic toxicity B. To prevent nephrotoxicity C. To prevent bone loss and fractures D. To reduce the risk for myocardial infarction and stroke
A
Angiogenesis inhibitors prevent the formation of which structures? A. Blood vessels B. Platelets C. Red blood cells D. Lymph vessels
A
Mrs. Samson, who has a history of diabetes and hypertension, is prescribed sorafenib for advanced renal cancer. Which assessment finding is a contraindication for sorafenib? A. Prolonged QT interval B. Hemoglobin (Hgb) 8.5 g/dL C. Blood pressure (BP) 193/92 mm Hg D. Creatinine clearance 19 mL/min
A
Understanding J.W.'s anxiety about his cyclophosphamide treatment and wishing to facilitate as smooth a procedure as possible, the nurse plans to administer anti-emetic drug therapy. During which time frame will the anti-emetic therapy be most beneficial to J.W.? A. Just before administration of the cyclophosphamide to J.W. B. Every three hours as requested by J.W. C. Two hours before administration of the cyclophosphamide to J.W. D. Upon initial complaints of nausea by J.W.
A
Which description of clomiphene citrate's mechanism of action is accurate? A. Inhibits estrogen receptors in the hypothalamus and pituitary gland to secrete less follicle stimulating hormone (FSH) and luteinizing hormone (LH) to stimulate ovulation B. Stimulates estrogen receptors in the hypothalamus and pituitary gland to secrete less FSH and LH to stimulate ovulation C. Inhibits estrogen receptors in the hypothalamus and pituitary gland to secrete more FSH and LH to stimulate ovulation D. Stimulates estrogen receptors in the hypothalamus and pituitary gland to secrete more FSH and LH to stimulate ovulation
A
Which patient cannot safely receive therapy with fludrocortisone? A. A 40-year-old patient with pulmonary aspergillosis B. A 52-year-old patient with type 2 diabetes C. A 60-year-old patient with gastroesophageal reflux disease D. A 70-year-old patient with glaucoma
A
Which parameters will a nurse ensure have been assessed before administering prednisone to a patient newly diagnosed with systemic lupus erythematous? Select all that apply. A. Weight B. Sodium level C. Glucose level D. Blood pressure E. Liver function tests F. Presence of preexisting edema
A, B, C, D, F
Which mechanisms of action describe how levonorgestrel works as emergency contraception? Select all that apply. A. Prevention of ovulation B. Prevention of fertilization C. Reduction in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) peaks D. Inhibition of implantation through alteration of the endometrium E. Delay of the egg's travel through the fallopian tubes
A, B, D
Which statements regarding the pharmacokinetics of glucocorticoids are accurate? Select all that apply. A. Rate of absorption varies depending on the glucocorticoid and route of administration. B. Rapid absorption occurs when sodium phosphate and sodium succinate esters are given intramuscularly. C. Glucocorticoids are minimally protein bound. D. Glucocorticoids undergo hepatic metabolism to produce inactive metabolites. E. Glucocorticoids undergo biliary excretion.
A, B, D
Which actions are specific to targeted therapy for cancer treatment? Select all that apply. A. Blocks certain cell receptors B. Blocks signals from one cell to another C. Disrupts cells' DNA and RNA D. Induces cell apoptosis E. Stimulates immune system
A, B, D, E
Which drug classes are used in the management of rheumatoid arthritis (RA)? Select all that apply. A. Biologic disease-modifying antirheumatic drugs (DMARDs) B. Glucocorticoids C. Mineralocorticoids D. Nonbiologic DMARDs E. Nonsteroidal antiinflammatory drugs (NSAIDs)
A, B, D, E
A nurse provides teaching to a male patient receiving chemotherapeutic drugs. Which statements made by the patient indicate an understanding of potential side effects of chemotherapeutic drugs? Select all that apply. A. "I will use a soft toothbrush to brush my teeth." B. "I may need to take stool softeners to avoid constipation." C. "When I have an appetite, I will make sure to eat large amounts of high-protein food." D. "I should use an alcohol-based mouthwash to kill germs." E. "I will bank some of my sperm so I still have the option of having children in the future."
A, B, E
4. The nurse is monitoring a patient who has received a second course of chemotherapy. Which of these are indications of an oncologic emergency? (Select all that apply.) a. A new and persistent cough b. Constipation c. Bleeding gums d. A swollen tongue e. Nausea and vomiting
A, C, D
8. The day before a third round of chemotherapy, the nurse reads that a patient's neutrophil count is 1650 cells/mm3. The nurse expects that the oncologist will follow which course of treatment? a. The chemotherapy will be started as scheduled. b. The chemotherapy will be given at a lower dosage. c. The oncologist will order a neutrophil transfusion to be given first. d. The chemotherapy will not be given today.
A, E
Which advantages are associated with the use of progestin-only products (POPs) compared with combined hormonal contraceptives (CHCs)? Select all that apply. A. Relative safety of contraception B. Less irregular menstrual bleeding C. Increased efficacy of the contraceptive D. Protection against sexually transmitted infections E. Reversibility of contraception, except the depot POP
A, E
6. When assessing a patient who is to begin therapy with an immunosuppressant drug, the nurse recognizes that such drugs should be used cautiously in patients with which condition(s)? (Select all that apply.) a. Pregnancy b. Glaucoma c. Anemia d. Myalgia e. Renal failure f. Liver failure
A, E, F
Which patients does a nurse determine cannot safely receive prednisone? Select all that apply. A. A 33-year-old patient with active tuberculosis B. A 48-year-old patient with hypothyroidism C. A 55-year-old patient with type 2 diabetes D. A 59-year-old patient with dyslipidemia E. A 61-year-old patient with benign prostatic hyperplasia F. A 78-year-old patient with cataracts
A, F
2. The nurse is caring for a patient who becomes severely nauseated during chemotherapy. Which intervention is most appropriate? a. Encourage light activity during chemotherapy as a distraction. b. Provide antiemetic medications 30 to 60 minutes before chemotherapy begins. c. Provide antiemetic medications only upon the request of the patient. d. Hold fluids during chemotherapy to avoid vomiting.
B
3. While teaching a patient who is about to receive cyclophosphamide (Cytoxan) chemotherapy, the nurse will instruct the patient to watch for potential adverse effects, such as: a. cholinergic diarrhea. b. hemorrhagic cystitis. c. peripheral neuropathy. d. ototoxicity.
B
A nurse is caring for a patient who has been prescribed oral methyltestosterone therapy for infertility. This patient also takes warfarin and lisinopril. Which outcome and intervention are recommended to manage a potential drug interaction with methyltestosterone? A. Methyltestosterone may increase the effects of warfarin; decrease the dosage of warfarin. B. Methyltestosterone may decrease the effects of warfarin; increase the dosage of warfarin. C. Methyltestosterone may increase the effects of lisinopril; decrease the dosage of lisinopril. D. Methyltestosterone may decrease the effects of lisinopril; increase the dosage of lisinopril.
B
A nurse is providing care to a patient with chronic kidney disease (CKD) who has been prescribed methylprednisolone. Which statement describes the appropriate nursing action for this patient and the rationale for this action? A. The nurse should administer methylprednisolone because there are no concerns about this drug. B. The nurse should monitor for side effects because methylprednisolone is renally excreted. C. The nurse should monitor for side effects because methylprednisolone undergoes biliary excretion. D. The nurse should call the health care provider because the presence of CKD is a contraindication to treatment with methylprednisolone.
B
A patient diagnosed with metastatic pancreatic cancer is prescribed fluorouracil as part of a combination regimen with oxaliplatin, leucovorin, and irinotecan. Which treatment cycle would the nurse expect fluorouracil to be repeated? A. Once a week B. Every 2 weeks C. Once a month D. Every 2 months
B
A patient has been newly prescribed theophylline for asthma management. In addition to theophylline, the patient is also receiving prednisone. Which drug interaction between theophylline and prednisone does a nurse anticipate for this patient? A. Prednisone will interact with theophylline, causing increased effects of prednisone. B. Prednisone will interact with theophylline, causing decreased effects of prednisone. C. Prednisone will interact with theophylline, causing increased effects of theophylline. D. Prednisone will interact with theophylline, causing decreased effects of theophylline.
B
A patient is receiving antineoplastic drugs. Which instruction would the nurse provide to decrease the risk for infection? A. Rest frequently. B. Wash hands. C. Wear a mask. D. Prevent mouth lesions.
B
A patient with multiple myeloma received cyclophosphamide at 0900. Which time would the nurse expect the drug to peak? A. 0930 B. 1100 C. 1300 D. 1500
B
A patient with rheumatoid arthritis (RA) receiving methotrexate has been prescribed trimethoprim/sulfamethoxazole to manage a urinary tract infection. Which outcome will a nurse anticipate occurring as a result of an interaction between these two drugs? A. Increased risk for hepatotoxicity B. Increased risk for bone marrow toxicity C. Reduced efficacy of methotrexate because of interference with its absorption D. Reduced efficacy of trimethoprim/sulfamethoxazole because of increased clearance
B
Which categories can be used for classifying glucocorticoids? Select all that apply. A. Onset of action B. Duration of action C. Route of administration D. Natural versus synthetic analog E. Potential for sodium and water retention
B, C, D, E
Which patient parameters will a nurse ensure are assessed before the initiation of ethinyl estradiol plus norgestimate tablets (Ortho Tri-Cyclen®)? Select all that apply. A. Alcohol intake B. Smoking status C. Reproductive history D. Current pregnancy status E. Bone mineral density value F. Complete medical, gynecologic, and obstetric history
B, C, D, F
Which actions can occur after a monoclonal antibody attaches to an antigen on a cancer cell? Select all that apply. A. Inhibits immune system activity against cancer cell B. Inactivates cancer cell C. Induces cancer cell to undergo apoptosis D. Destroys phagocytes, T cells, and natural killer cells (NKCs) E. Neutralizes cancer cell growth by direct interference
B, C, E
Which effects are advantages to the use of nonoral combined hormonal contraceptives (CHCs) over oral CHC? Select all that apply. A. Reduced risk for breast cancer B. Reduced drug interaction potential C. Rapidly achieved serum hormone levels D. Reduced risk for venous thromboembolism E. Decreased fluctuations of hormone levels in blood
B, C, E
Which side/adverse effects and/or laboratory results would a nurse monitor for while a patient is receiving fludrocortisone? Select all that apply. A. Symptoms of Cushing syndrome B. Swelling in the extremities C. Increased blood sugars D. Increased potassium levels E. Hypertension F. Decreased bone mineral density
B, C, E, F
Which drugs does a nurse anticipate will interact with tofacitinib? Select all that apply. A. Ciprofloxacin B. Ketoconazole C. Probenecid D. Rifampin E. Theophylline F. Trimethoprim/sulfamethoxazole
B, D
6. The nurse is assessing a patient who has experienced severe neutropenia after chemotherapy and will monitor for which possible signs of infection? (Select all that apply.) a. Elevated WBC count b. Fever c. Nausea d. Sore throat e. Chills
B, D, E
1. A patient is experiencing stomatitis after a round of chemotherapy. Which intervention by the nurse is correct? Select all that apply. a. Rinse the mouth with commercial mouthwash twice a day. b. Clean the mouth with a soft-bristle toothbrush and warm saline solution. c. Use lemon-glycerin swabs to keep the mouth moist. d. Keep dentures in the mouth between meals. e. Rinse the mouth with water every 2 hours while awake.
B, E
2. During treatment with doxorubicin (Adriamycin), the nurse must monitor closely for which potentially life-threatening adverse effect? a. Nephrotoxicity b. Peripheral neuritis c. Cardiomyopathy d. Ototoxicity
C
4. During a teaching session for a patient receiving an immunosuppressant drug, the nurse will include which statement? a. "It is better to use oral forms of these drugs to prevent the occurrence of thrush." b. "You will remain on antibiotics to prevent infections." c. "It is important to use some form of contraception during treatment and for up to 12 weeks after the end of therapy." d. "Be sure to take your medications with grapefruit juice to increase absorption."
C
4. In caring for a patient receiving therapy with a myelosuppressive antineoplastic drug, the nurse notes an order to begin filgrastim after the chemotherapy is completed. Which statement correctly describes when the nurse will begin the filgrastim therapy? a. It can be started during the chemotherapy. b. It will begin immediately after the chemotherapy is completed. c. It will be started 24 hours after the chemotherapy is completed. d. It will not be started until at least 72 hours after the chemotherapy is completed
C
5. During therapy with the cytotoxic antibiotic bleomycin, the nurse will assess for a potentially serious adverse effect by monitoring which of these? a. Blood urea nitrogen and creatinine levels b. Cardiac ejection fraction c. Respiratory function d. Cranial nerve function
C
5. If extravasation of an antineoplastic medication occurs, which intervention will the nurse perform first? a. Apply cold compresses to the site while elevating the arm. b. Inject subcutaneous doses of epinephrine around the intravenous site every 2 hours. c. Stop the infusion immediately while leaving the intravenous catheter in place. d. Inject the appropriate antidote through the intravenous catheter.
C
A 29-year-old woman with hypertension had unprotected sexual intercourse about 36 hours ago. Which statement accurately explains whether this patient is a candidate for emergency contraception? A. She is a candidate because she is less than 30 years old. B. She is not a candidate for emergency contraception because she has hypertension. C. She is a candidate for emergency contraception because it may be taken within 72 hours of unprotected sexual intercourse. D. She is not a candidate for emergency contraception because it is not effective when taken more than 24 hours after unprotected sexual intercourse.
C
A nurse is caring for a patient with rheumatoid arthritis (RA) who is prescribed leflunomide. The patient is currently taking metformin and pioglitazone for type 2 diabetes, lisinopril for hypertension, and simvastatin for dyslipidemia. Which drug is expected to interact with leflunomide? A. Lisinopril B. Metformin C. Pioglitazone D. Simvastatin
C
A nurse is caring for a patient with rheumatoid arthritis who has been prescribed abatacept. Which drug-drug product can be safely administered to a patient who is receiving abatacept? A. Anakinra B. Etanercept C. Methotrexate D. Measles, mumps, and rubella (MMR) vaccine
C
A patient who has been taking ethinyl estradiol and norgestimate (Ortho Tri-Cyclen®) tablets calls a nurse to determine what she needs to do because she has missed two doses of her daily regimen. She is in week 2 of the contraceptive cycle and is a "Sunday starter." Which instructions would the nurse give the patient? A. Take 1 tablet as soon as she remembers. Continue taking 1 tablet daily and no backup contraception needed. B. Take the 2 missed tablets as soon as she remembers and then 1 tablet daily. No backup contraception is needed. C. Take the 2 missed tablets as soon as she remembers and the next 2 active tablets the next day. Continue taking daily until package is finished. Backup contraception should be used for 7 days. D. Continue taking 1 tablet daily until Sunday. Throw out pack and start a new pack. Backup contraception should be used for 7 days.
C
A patient who takes carbamazepine for epilepsy has purchased levonorgestrel to use as emergency contraception. Which outcome does a nurse anticipate may occur in a patient taking levonorgestrel with carbamazepine? A. Increased carbamazepine levels B. Decreased carbamazepine levels C. Decreased efficacy of levonorgestrel D. Increased risk for venous thromboembolism
C
A patient with Hodgkin's lymphoma is taking phenobarbital, a CYP2D6 inducer, along with cyclophosphamide. The nurse is concerned knowing that CYP2D6 inducers have which effect on chemotherapeutic drugs? A. Increase drug concentration B. Increase drug absorption C. Decrease drug concentration D. Increase drug elimination
C
Which statement about the pharmacokinetic parameters of testosterone is accurate? A. Testosterone is highly protein bound. B. The drug is predominantly excreted in the feces. C. Testosterone undergoes hepatic metabolism and beta-oxidation. D. Oral administration of testosterone requires smaller doses because the drug does not undergo first-pass metabolism.
C
Which statements accurately describe the actions glucocorticoids exert in the inflammatory process? Select all that apply. A. Stimulation of erythroid cells B. Maintenance of sodium levels in the blood C. Reduction of interleukin-1 release from white blood cells D. Promotion of protein metabolism, glycogen production, and fat redistribution E. Stabilization of lysosomal cell membranes to reduce capillary permeability and leukocyte migration
C, D, E
1. A patient has a new order for glatiramer acetate. The patient has not had an organ transplant. The nurse knows that the patient is receiving this drug for which condition? a. Psoriasis b. Rheumatoid arthritis c. Irritable bowel syndrome d. Relapse-remitting multiple sclerosis
D
3. The nurse monitors a patient who is experiencing thrombocytopenia from severe bone marrow suppression by looking for which of these? a. Severe weakness and fatigue b. Elevated body temperature c. Decreased skin turgor d. Excessive bleeding and bruising
D
5. The nurse is monitoring a patient who has been receiving aldesleukin (IL-2) for treatment of malignant melanoma. Which adverse effect, if noted on assessment, is of primary concern? a. Diarrhea b. Fatigue c. Nausea d. Fluid retention
D
A patient receiving erlotinib asks why it is important to prevent the formation of blood vessels. Which response would the nurse provide? A. "Blood vessels allow nutrients to reach the cancer cells." B. "Blood vessels allow cancer cells to receive oxygen." C. "Blood vessels prevent the apoptosis of cancer cells." D. "Blood vessels allow cancer cells travel to distant sites."
D
A patient receiving vincristine asks why it must be given intravenously. Which response would the nurse provide to the patient? A. "Intravenous drug administration has fewer side effects." B. "Intravenous administration allows the drug effects to peak in 1 day." C. "Oral administration has a faster onset." D. "Oral administration has a low absorption rate."
D
The nurse preparing to administer chemotherapeutic drugs notes the patient has had a significant drop in neutrophils. The nurse would anticipate administering which product into the patient's plan of care? A. Red blood cells (RBCs) B. Platelets C. Natural killer cells (NKCs) D. Colony-stimulating factors (CSFs)
D
Which disease-modifying antirheumatic drug (DMARD) is beneficial in rheumatoid arthritis (RA) by inhibiting the enzyme Janus kinase? A. Abatacept B. Etanercept C. Methotrexate D. Tofacitinib
D
Which disease-modifying antirheumatic drug's (DMARD's) metabolism occurs through CYP3A4 and is subject to drug interactions involving this isoenzyme? A. Abatacept B. Methotrexate C. Leflunomide D. Tofacitinib
D
Which statement about the pharmacodynamic parameters of medroxyprogesterone acetate is accurate? A. The drug begins working in about 2 hours. B. Medroxyprogesterone acetate's elimination half-life is 25 hours. C. The effects of one dose of medroxyprogesterone acetate last for up to 3 years. D. Intramuscular injection provides higher peak levels due to reabsorption of crystalline deposits.
D
Which statement accurately describes the pharmacokinetic parameters for levonorgestrel used as emergency contraception? A. The drug is slowly absorbed with oral administration. B. Levonorgestrel is minimally protein bound (<25%). C. The drug is subject to first-pass metabolism. D. Levonorgestrel is excreted in both urine and feces.
D
Which statement accurately describes the pharmacokinetic parameters of the ethinyl estradiol plus norelgestromin patch (Ortho Evra®)? A. Application is fastest through the skin of the abdomen. B. Both hormones are minimally protein bound. C. The hormones undergo hepatic first-pass metabolism through transdermal administration. D. Both hormones are excreted in the urine and feces.
D
Which statement is accurate regarding tamoxifen? A. It blocks or alters DNA replication, decreasing the estrogen response. B. It is primarily indicated for cervical cancer. C. It mostly affects the S phase of the cell cycle. D. It acts as both an agonist and antagonist at estrogen receptor sites.
D
Which teaching point would a nurse share with Ms. Harrison as she begins therapy with etanercept? A. She should inject the etanercept into the same site daily. B. She should inject the etanercept into the upper arm or buttocks. C. She should notice improvements in her symptoms within 1 to 2 days of starting etanercept. D. She should contact her health care provider if she has a fever of 100.5°F (38.1°C) or higher, nausea, vomiting, or sore throat because infection may occur with etanercept.
D
2. The nurse is planning care for a patient who is receiving interferon therapy. Which of these is the major dose-limiting factor associated with interferon therapy? a. Fatigue b. Bone marrow suppression c. Fever d. Nausea and vomiting
A
5. During drug therapy with basiliximab, the nurse monitors for signs of cytokine release syndrome, which results in which of these? a. Fever, dyspnea, and general malaise b. Neurotoxicity and peripheral neuropathy c. Hepatotoxicity with jaundice d. Thrombocytopenia with increased bleeding tendencies
A
Which targeted antineoplastic drugs would most likely interact with St. John's wort? Select all that apply. A. Erlotinib B. Sorafenib C. Bortezomib D. Temsirolimus E. Rituximab
A, B, C, D
A nurse is caring for a patient diagnosed with rheumatoid arthritis (RA) who has been prescribed leflunomide 100 mg PO daily for 3 days then 10 mg PO daily. Before the patient begins leflunomide, which baseline parameters would the nurse assess? Select all that apply. A. Blood cell counts B. Blood pressure C. Lipid panel D. Liver function tests E. Purified protein derivative (PPD) test
A, B, D, E
6. The nurse is reviewing the medical history of a patient who is about to receive therapy with etanercept. Which conditions, if present, would be a contraindication or caution for therapy with this drug? (Select all that apply.) a. Urinary tract infection b. Psoriasis c. Heart failure d. Glaucoma e. Latex allergy
A, C, E
A nurse is caring for a patient diagnosed with rheumatoid arthritis (RA) who has been prescribed etanercept 50 mg subcutaneously each week. Before the patient begins etanercept, which baseline parameters would be assessed? Select all that apply. A. Hepatitis B panel B. Lipid panel C. Liver function tests D. White blood cell count E. Purified protein derivative (PPD) test
A, D, E
Oral cyclophosphamide 700 mg is prescribed to a patient weighing 125 pounds. Which action would the nurse take first? A. Decrease the dose. B. Hold the drug. C. Notify the health care provider. D. Notify the pharmacist.
B
Which corticosteroid is the treatment of choice for a patient with Addison disease? A. Betamethasone B. Fludrocortisone C. Prednisone D. Triamcinolone
B
Which disease-modifying antirheumatic drug (DMARD) is highly protein bound (99%)? A. Abatacept B. Leflunomide C. Methotrexate D. Tofacitinib
B
Which molecules that serve as templates for protein production undergo enhanced synthesis by testosterone? A. DNA B. mRNA C. tRNA D. rRNA
B
Which patient would a nurse determine cannot safely receive therapy with leflunomide? A. A 38-year-old patient with hypothyroidism B. A 49-year-old patient with end-stage liver disease C. A 58-year-old patient with type 2 diabetes D. A 66-year-old patient with NYHA Class I heart failure
B
Which statement about fludrocortisone is accurate? A. Fludrocortisone is a glucocorticoid that is used in the management of inflammatory conditions such as rheumatoid arthritis. B. Fludrocortisone possesses both mineralocorticoid and glucocorticoid activity. C. The anticipated onset of action of fludrocortisone is 1 to 2 hours. D. When given orally, it is minimally protein bound.
B
Bortezomib is prescribed to a patient who is on prednisone, a hepatic inhibitor. Which change to the dose of bortezomib would the nurse expect? A. Increased dose of bortezomib B. Increased dose of prednisone C. Decreased dose of bortezomib D. Decreased dose of prednisone
C
In which phase of the cell cycle do most antimetabolites affect cells? A. Mitosis B. G2 phase C. S phase D. G1 phase
C
Which disease-modifying antirheumatic drug (DMARD) may be given orally, subcutaneously, or intramuscularly? A. Abatacept B. Etanercept C. Methotrexate D. Tofacitinib
C
Which disease-modifying antirheumatic drug (DMARD) requires a "washout" if it needs to be quickly removed from the body? A. Etanercept B. Methotrexate C. Leflunomide D. Tofacitinib
C
Which location would the nurse prepare chemotherapeutic drugs before administration? A. Patient's room B. Medication room C. Nurse's station D. Separate work area
D
Which time frame accurately describes methotrexate's onset of action? A. 0.5 to 1 hour B. 1 to 2 hours C. 3 to 10 hours D. 3 to 6 weeks
D
Which drugs currently taken by Mrs. Gabriel are anticipated to interact with prednisone? Select all that apply. A. Atenolol B. Atorvastatin C. Enalapril D. HCTZ E. Metformin
D, E
Which patients diagnosed with rheumatoid arthritis (RA) would a nurse determine can safely receive therapy with methotrexate? Select all that apply. A. A 33-year-old pregnant patient B. A 34-year-old breastfeeding patient C. A 44-year-old patient with chronic hepatitis B D. A 49-year-old patient with hypertension E. A 55-year-old patient with active pneumonia F. A 56-year-old patient with dyslipidemia
D, F
Which disease-modifying antirheumatic drugs (DMARDs) are considered nonbiologic? Select all that apply. A. Anakinra B. Abatacept C. Etanercept D. Tocilizumab E. Methotrexate F. Hydroxychloroquine
E, F
