Pharm week 8

An otherwise healthy child receives a varicella virus vaccine. Three weeks later the parent calls to report that the child has a mild case of chickenpox and wonders how this could happen after the vaccination. What will the nurse tell the parent? a. "A varicella-like rash can occur after the vaccine is given." b. "The vaccine was probably ineffective." c. "This represents a serious vaccine side effect." d. "Give the child aspirin to treat any fever that may occur."

a. "A varicella-like rash can occur after the vaccine is given."

A patient who has chronic allergies takes loratadine [Claritin] and develops a severe reaction to bee stings. The patient asks the nurse why the antihistamine did not prevent the reaction. What will the nurse say? a. "Allergy symptoms that are severe are caused by mediators other than histamine." b. "H1 blockers do not prevent the release of histamine from mast cells and basophils." c. "Second-generation H1 blockers contain less active drug and do not work in severe reactions." d. "Severe allergic reactions occur through actions on muscarinic receptors."

a. "Allergy symptoms that are severe are caused by mediators other than histamine."

A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines? a. "Antihistamines block H1 receptors to prevent actions of histamine at these sites." b. "Antihistamines block release of histamine from mast cells and basophils." c. "H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors." d. "First-generation antihistamines are more selective than second-generation antihistamines."

a. "Antihistamines block H1 receptors to prevent actions of histamine at these sites."

A woman who is breastfeeding is prescribed a low pharmacologic dose of a glucocorticoid and asks the nurse about potential effects on her infant. What will the nurse tell her about this medication? a. "At this dose, the concentration in your breast milk is safe." b. "Contact your provider to discuss lowering the dose." c. "There will be reversible side effects for your baby." d. "This drug is likely to cause growth retardation in your baby."

a. "At this dose, the concentration in your breast milk is safe."

A nurse is discussing glucocorticoids with a group of nursing students. Which statement by a student indicates understanding of the teaching? a. "Glucocorticoids have both endocrine and nonendocrine uses." b. "Patients treated for adrenocortical insufficiency receive pharmacologic doses." c. "Pharmacologic effects are achieved with low doses of glucocorticoids." d. "Physiologic doses are used to treat inflammatory disorders."

a. "Glucocorticoids have both endocrine and nonendocrine uses."

A nurse is providing teaching for an adult patient with arthritis who has been instructed to take ibuprofen [Motrin] for discomfort. Which statement by the patient indicates a need for further teaching? a. "I may experience tinnitus with higher doses of this medication." b. "I may take up to 800 mg 4 times daily for pain." c. "I should limit alcohol intake to fewer than three drinks a day." d. "I will take this medication with meals to help prevent stomach upset."

a. "I may experience tinnitus with higher doses of this medication."

A nurse is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching? a. "I should reduce the dose by half each day until I stop taking the drug." b. "I will need to have cortisol levels monitored during the withdrawal process." c. "The withdrawal schedule may take several months." d. "If I have surgery, I may need to take the drug for a while, even after I have stopped."

a. "I should reduce the dose by half each day until I stop taking the drug."

A nurse is teaching a group of nursing students about immunoglobulins. Which statement by a student indicates a need for further teaching? a. "IgD provides a first line of defense against microbes entering the body through the lungs." b. "IgE plays a role in hypersensitivity reactions and responses to parasites." c. "IgG and IgM participate in the complement response to promote target-cell lysis." d. "Neonatal immunity is the result of IgG crossing the placenta."

a. "IgD provides a first line of defense against microbes entering the body through the lungs."

A 1-year-old child is scheduled to receive the MMR vaccine, pneumococcal vaccine (PCV), Varivax, and hepatitis A vaccine. The child's parents request that the MMR vaccine not be given, saying that, even though there is no demonstrated link with autism, they are still concerned about toxic levels of mercury in the vaccine. Which response bythe nurse is correct? a. "Most U.S.-made vaccines have zero to low amounts of mercury." b. "Other vaccine preparations contain mercury as well." c. "Thimerosal is a nontoxic form of mercury." d. "You can get more mercury from breast milk and many foods on the market."

a. "Most U.S.-made vaccines have zero to low amounts of mercury."

The parent of a 2-month-old infant who has just received the first dose of DTaP asks the nurse about expected reactions to the vaccine. The nurse will respond by saying that: a. "mild reactions, including a low-grade fever, are common." b. "most children do not experience any reaction." c. "seizures are common and may require anticonvulsant medication." d. "the most common reaction is a rash that develops into itchy vesicles."

a. "mild reactions, including a low-grade fever, are common."

The prescriber orders 20 mg of hydrocortisone orally once each day. The nurse will make sure the drug is scheduled to be administered at what time? a. 8:00 AM b. 12:00 PM c. 4:00 PM d. 9:00 PM

a. 8:00 AM

An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago. The nurse will anticipate administering which of the following? a. Acetylcysteine [Mucomyst] b. Activated charcoal c. Hemodialysis d. Respiratory support

a. Acetylcysteine [Mucomyst]

A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the patient? a. Antihistamines should be avoided unless absolutely necessary. b. Second-generation antihistamines are safer than first-generation antihistamines. c. Antihistamines should not be taken during pregnancy but may be taken when breastfeeding. d. The margin of safety for antihistamines is clearly understood for pregnant patients.

a. Antihistamines should be avoided unless absolutely necessary.

A patient taking a glucocorticoid for arthritis reports feeling bloated. The nurse notes edema of the patient's hands and feet. Which action by the nurse is correct? a. Ask the patient about sodium intake. b. Obtain a blood glucose level. c. Suggest the patient limit potassium intake. d. Tell the patient to stop taking the drug.

a. Ask the patient about sodium intake.

A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine [Zyrtec] syrup once daily. The parents tell the nurse that the child does not like the syrup, and they do not think that the drug is effective. The nurse will suggest they discuss which drug with their child's health care provider? a. Cetirizine [Zyrtec] 5-mg chewable tablet once daily b. Loratadine [Claritin] 10-mg chewable tablet once daily c. Fexofenadine [Allegra] syrup 5 mL twice daily d. Desloratadine [Clarinex] 5-mg rapid-disintegrating tablet oncedaily

a. Cetirizine [Zyrtec] 5-mg chewable tablet once daily

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What will the nurse do? a. Contact the provider to ask about reducing the dose. b. Encourage the patient to restrict sodium intake. c. Reassure the patient that this is an expected side effect. d. Tell the patient to stop taking the drug.

a. Contact the provider to ask about reducing the dose.

A patient who has arthritis has been taking ibuprofen [Motrin] and a glucocorticoid medication. The patient reports having tarry stools but denies gastric pain. Which action by the nurse is correct? a. Contact the provider to discuss ordering an antiulcer medication. b. Counsel the patient to use over-the-counter antacids. c. Reassure the patient not to worry unless there is gastric pain. d. Tell the patient to stop taking the glucocorticoid immediately.

a. Contact the provider to discuss ordering an antiulcer medication.

A woman who has arthritis is breastfeeding her infant and asks the nurse if it is safe to take NSAIDs while nursing. What will the nurse tell this patient? a. NSAIDs are safe to take while breastfeeding. b. NSAIDs are not safe, even in small amounts. c. She should take only COX-2 inhibitors while breastfeeding. d. She should request a prescription for narcotic analgesics.

a. NSAIDs are safe to take while breastfeeding.

A clinic nurse receives a phone call from a parent who states that a 2-month-old infant has a severe cough, a low-grade fever, and a runny nose that have lasted over a week. What will the nurse ask the parent? a. Whether the infant has had the first set of vaccines b. Whether the infant received a hepatitis B vaccine as a newborn c. Whether the infant attends day care d. Whether there is a family history of respiratory disorders

a. Whether the infant has had the first set of vaccines

A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarial rash. The nurse will contact the provider to discuss: a. administering epinephrine. b. changing to a first-generation NSAID. c. reducing the dose of aspirin. d. giving an antihistamine.

a. administering epinephrine.

A patient has been receiving intravenous ketorolac 30 mg every 6 hours for postoperative pain for 4 days. The patient will begin taking oral ketorolac 10 mg every 4 to 6 hoursto prepare for discharge in 1 or 2 days. The patient asks the nurse whether this drug will be prescribed for management of pain after discharge. The nurse will respond by telling the patient that the provider will prescribe a(n): a. different nonsteroidal anti-inflammatory drug for home management of pain. b. fixed-dose opioid analgesic/nonsteroidal anti-inflammatorymedication. c. lower dose of the oral ketorolac for long-term pain management. d. intranasal preparation of ketorolac for pain management at home.

a. different nonsteroidal anti-inflammatory drug for home management of pain.

A child is to begin long-term glucocorticoid therapy. The parents ask the nurse about the effects of this drug on the child's growth. Which response by the nurse is correct? a. "A smaller dose may be indicated for your child." b. "Ask your provider about every-other-day dosing." c. "Long-acting glucocorticoid preparations should prevent growth suppression." d. "Oral glucocorticoids rarely cause growth suppression."

b. "Ask your provider about every-other-day dosing."

A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct? a. "Aspirin is safe during the second and third trimesters of pregnancy." b. "Aspirin may cause premature closure of the ductus arteriosus in your baby." c. "Aspirin may induce premature labor and should be avoided in the third trimester." d. "You should use a first-generation nonsteroidal anti-inflammatory medication."

b. "Aspirin may cause premature closure of the ductus arteriosus in your baby."

A nurse is teaching a group of nursing students about cyclooxygenase (COX) inhibitors. A student asks the nurse about characteristics of COX-1 inhibitors. Which statement by the nurse is true? a. "COX-1 inhibitors protect against colorectal cancer." b. "COX-1 inhibitors protect against myocardial infarction and stroke." c. "COX-1 inhibitors reduce fever." d. "COX-1 inhibitors suppress inflammation."

b. "COX-1 inhibitors protect against myocardial infarction and stroke."

A patient who is a long-distance runner has been diagnosed with rheumatoid arthritis in both knees and will begin glucocorticoid therapy. When teaching the patient about the medication, the nurse will include what information? a. "By reducing inflammation, this drug will slow the progression of your disease." b. "Glucocorticoids are used as adjunctive therapy during acute flare-ups." c. "Oral glucocorticoids cause less toxicity than intra-articular injections." d. "You may resume running when the pain and swelling improve."

b. "Glucocorticoids are used as adjunctive therapy during acute flare-ups."

A nurse is teaching a group of nursing students why glucocorticoids are preferred over nonsteroidal anti-inflammatory drugs in the treatment of inflammation. Which statement by a student indicates a need for further teaching? a. "Glucocorticoids act by multiple mechanisms and have more anti-inflammatory effects than NSAIDs." b. "Glucocorticoids have fewer side effects than nonsteroidal anti-inflammatorydrugs." c. "Glucocorticoids help avert damage to tissues from lysosomal enzymes." d. "Glucocorticoids reduce the immune component of inflammation."

b. "Glucocorticoids have fewer side effects than nonsteroidal anti-inflammatorydrugs."

A nurse is providing medication teaching for a patient who will begin taking diclofenac [Voltaren] gel for osteoarthritis in both knees and elbows. Which statement by the patient indicates understanding of the teaching? a. "Because this is a topical drug, liver toxicity will not occur." b. "I should cover areas where the gel is applied to protect them from sunlight." c. "I will apply equal amounts of gel to all affectedareas." d. "The topical formulation has the same toxicity as the oral formulation."

b. "I should cover areas where the gel is applied to protect them from sunlight."

A 60-year-old female patient is about to begin long-term therapy with a glucocorticoid. Which of the following will be important for minimizing the risk of osteoporosis? a. Baseline vitamin D level b. Calcium and vitamin D supplements c. Estrogen therapy d. Skeletal x-rays before treatment

b. Calcium and vitamin D supplements

A 41⁄2-year-old child who has been receiving high-dose systemic glucocorticoids for several months comes to a clinic for school immunizations, which usually include the DTaP vaccine; varicella virus vaccine [Varivax]; the measles, mumps, and rubella virus (MMR) vaccine; and the inactivated poliovirus vaccine (IPV). The clinic nurse will expect to administer which vaccines to this child? a. All four school immunizations b. DTaP and IPV only c. DTaP, OPV, and Varivax only d. DTaP and IPV, along with immunoglobulins

b. DTaP and IPV only

A family is preparing for travel and the parents report that their 5-year-old child has frequent motion sickness. The nurse will tell the parents to ask the provider about which antihistamine to help prevent symptoms? a. Desloratadine [Clarinex] b. Dimenhydrinate [Dramamine] c. Hydroxyzine [Vistaril] d. Promethazine [Phenergan]

b. Dimenhydrinate [Dramamine]

A patient has seasonal allergies and needs an antihistamine to control symptoms. The patient likes to have wine with dinner occasionally and wants to know which antihistamine will be the safest to take. The nurse will tell the patient to discuss which medication with the provider? a. Cetirizine [Zyrtec] b. Fexofenadine [Allegra] c. Levocetirizine [Xyzal] d. Loratadine [Claritin]

b. Fexofenadine [Allegra]

A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen? a. It does not inhibit cyclooxygenase. b. It has minimal effects at peripheral sites. c. It is more similar to opioids than to nonsteroidal anti-inflammatory drugs(NSAIDs). d. It is selective for cyclooxygenase-2.

b. It has minimal effects at peripheral sites.

A3-year-old child who has asthma isinthe clinic for a well-child checkup. The nurse notes that the child is up to date for the DTaP, hepatitis A, hepatitis B, and the MMR vaccines but has only had one each of the Hib, the rotavirus, and the PCV13 vaccines. Which vaccine(s) will the nurse anticipate administering to this child? a. Hib and rotavirus vaccines b. PCV13 c. PCV13 and Hib d. Rotavirus

b. PCV13

A patient who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes that the patient's cheeks appear full and that a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which test(s)? a. Liver function tests b. Serum electrolytes c. Tuberculin skin test d. Vitamin D levels

b. Serum electrolytes

The nurse at a public health infant immunization clinic is acting as a preceptor for a nursing student. To assess the student's understanding of vaccinations, the nurse asks the student where the hepatitis B vaccine (HepB) should be administered. The student would be correct to respond that the hepatitis B vaccine should be administered in the: a. dorsogluteal muscle in an adult. b. anterolateral thigh in infants. c. ventrogluteal muscle in adolescents. d. deltoid of toddlers.

b. anterolateral thigh in infants

A patient tells a nurse that antihistamines help relieve cold symptoms and wants to know why they are not recommended or prescribed for this purpose. The nurse tells the patient that antihistamines provide only mild relief from some cold symptoms by: a. anticholinergic properties that decrease rhinorrhea. b. blocking H1 receptors in nasal passages. c. reducing secretions at H2 receptor sites. d. having sedative effects, which help patients rest and sleep.

b. blocking H1 receptors in nasal passages

A patient will begin taking fexofenadine [Allegra] for hay fever. The nurse teaching this patient will tell the patient that: a. fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms. b. the medication may be taken once or twice daily. c. tolerance to sedation will occur in a few weeks. d. with renal impairment, this drug should be taken every other day.

b. the medication may be taken once or twice daily.

A nurse is discussing the role of antibodies in the complement system with a group ofnursing students. Which statement by a student is correct? a. "Antibodies activate the complement cascade by turning on the alternative pathway." b. "Antibodies that are free in solution can activate the complement system." c. "Antibodies flag target cells to be lysed by membrane attack complexes." d. "Antibody receptors are nonspecific to antigenic determinants."

c. "Antibodies flag target cells to be lysed by membrane attack complexes."

A nurse tells a nursing student that the glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct? a. "As long as the drug is taken as prescribed, side effects usually do not occur." b. "By interrupting the inflammatory process, these drugs inhibit side effects." c. "Side effects can occur and are dependent on the dose and duration of treatment." d. "The negative feedback loop prevents side effects."

c. "Side effects can occur and are dependent on the dose and duration of treatment."

A patient who breastfeeds her infant asks the nurse about the immunity the infant receives from breast milk. What does the nurse tell the patient about immunity throughbreastfeeding? a. "The immunity protects the infant from hypersensitivity reactions." b. "The immunity provides phagocytes to help the infant fight infections." c. "The immunity results from the transfer of IgA through the breast milk." d. "The immunity protects the infant from respiratory and gastrointestinal (GI) microbes."

c. "The immunity results from the transfer of IgA through the breast milk."

The parents of an infant who will be attending day care tell the nurse that they do not want their child vaccinated against rotavirus because an older cousin developed intussusception after receiving this vaccine. Which response by the nurse is correct? a. "Intussusception is much less serious than getting the disease." b. "It was probably just a coincidental reaction to the vaccine." c. "The newer vaccines for rotavirus are not associated with intussusception." d. "Your child will have herd immunity and will not need the vaccine."

c. "The newer vaccines for rotavirus are not associated with intussusception."

A nurse is teaching a nursing student who wants to know how aspirin and nonaspirin first- generation NSAIDs differ. Which statement by the student indicates a need for further teaching? a. "Unlike aspirin, first-generation NSAIDs cause reversible inhibition ofcyclooxygenase." b. "NSAIDs do not increase the risk of myocardial infarction and stroke; however, unlike ASA, they do not provide protective benefits against those conditions." c. "Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions." d. "Unlike aspirin, first-generation NSAIDs cause little or no suppression of platelet aggregation."

c. "Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions."

A provider has ordered intravenous promethazine [Phenergan] for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do? a. Administer the drug at a rate of 25 mg/minute or more to achieve maximum effects. b. Contact the provider to suggest using dimenhydrinate [Dramamine] instead. c. Ensure that the IV is infusing freely through a large-bore needle. d. Monitor the patient closely for cardiac dysrhythmias.

c. Ensure that the IV is infusing freely through a large-bore needle.

A nurse is teaching a group of nursing students about antibodies. The nurse correctly explains which type ofresponse istriggered when antigens bind to antibodies on mast cells or basophils? a. Acquired immune response b. Autoimmune response c. Hypersensitivity reaction d. Transplant rejection

c. Hypersensitivity reaction

An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine [Phenergan]. What will the nurse do? a. Give the medication as ordered. b. Monitor the child for bronchoconstriction. c. Question the order. d. Request an order to give the drug orally.

c. Question the order.

A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls the nurse to report that the child has a temperature of 103°F. What will the nurse do? a. File an adverse event report with the Vaccine Adverse Event Reporting System(VAERS). b. Notify the child's provider that thrombocytopenia is likely to occur. c. Reassure the parent that fever can occur with the MMR vaccine. d. Tell the parent to take the child to the emergency department.

c. Reassure the parent that fever can occur with the MMR vaccine.

A 11-year-old boy received all childhood immunizations before attending school asa kindergartner. Which vaccines are recommended for this child at his current age? a. DTaP, MCV4, Varivax b. PCV-23, Td, MMR c. Tdap, MCV4, HPV d. Tdap, Varivax, hepatitis B

c. Tdap, MCV4, HPV

A prescriber orders hydroxyzine [Vistaril] for a patient with acute urticaria. The nurse will include which information when teaching the patient about this drug? a. The drug will reduce redness and itching but not edema. b. This antihistamine is not likely to cause sedation. c. The patient should avoid drinking alcohol while taking the drug. d. The patient should report shortness of breath while taking the drug.

c. The patient should avoid drinking alcohol while taking the drug.

A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest? a. The patient should avoid anytype of COX inhibitor because of the risk ofReye syndrome. b. The patient should increase the dose to a level that suppresses inflammation. c. The patient should use a first-generation nonsteroidal anti-inflammatory medication instead. d. The patient should use acetaminophen because of its selective effects on uterine smooth muscle.

c. The patient should use a first-generation nonsteroidal anti-inflammatory medication instead.

Which statement is true about helper T cells? a. They are useful but are not essential to immune responses. b. They do not play a role in antibody production. c. They have highly specific receptors to antigens on their surface. d. They prevent CD4 molecules from attaching to antigens.

c. They have highly specific receptors to antigens on their surface.

A 5-year-old child is brought to the emergency department after ingesting diphenhydramine [Benadryl]. The child is uncoordinated and agitated. The nurse observes that the child's face is flushed, the temperature is 37.1°C, and the heart rate is 110 beats/minute. The nurse will expect to: a. administer atropine to reverse the adverse effects. b. apply ice packs to stop the flushing. c. give activated charcoal to absorb the drug. d. prepare to provide mechanical ventilation.

c. give activated charcoal to absorb the drug.

A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It is a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her." The patient's blood pressure is 100/60 mm Hg. The nurse will report this to the provider and ask about: a. reducing the patient's dose. b. using every-other-day dosing. c. increasing the patient's dose. d. tapering the dose.

c. increasing the patient's dose.

A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to: a. continue to use aspirin as scheduled. b. reduce the aspirin dosage by half until after surgery. c. stop using aspirin immediately. d. stop using aspirin 3 days before surgery.

c. stop using aspirin immediately.

A nurse is reviewing the immune system with a group of nursing students. One student asks about the difference between cell-mediated immunity and humoral immunity. What should the nurse reply? a. "Humoral immunity does not involve helper T cells in the immune response." b. "Humoral immunity does not have a role in hypersensitivity reactions." c. "Humoral immunity requires cytolytic T cells that attack antigens directly." d. "Humoral immunity uses cells produced by B lymphocytes in the immune response."

d. "Humoral immunity uses cells produced by B lymphocytes in the immune response."

A nurse is teaching a nursing student about a specific acquired immunity system. Which statement by the student indicates a need for further teaching? a. "Cell-mediated immunity and humoral immunity are both types of specific acquired immune responses." b. "Each exposure to an antigen causes a faster, more intense response." c. "Immune responses occur only after exposure to a foreign substance." d. "The skin is a factor in specific acquired immunity."

d. "The skin is a factor in specific acquired immunity."

An immigrant child is in the clinic for MMR vaccination. The nurse learns that the child has recently received an immune globulin injection for a viral infection, currently has an upper respiratory infection with a temperature of 100°F, and has a recent history of thrombocytopenia, which has resolved. What does the nurse tell the child's parents? a. "The vaccine is contraindicated in this child because of the history ofthrombocytopenia." b. "The child should be brought back for the vaccine when the temperature is back to normal." c. "The child is at increased risk of developing autism from this vaccine." d. "The vaccine must be postponed for 3 months after administration of the immune globulin."

d. "The vaccine must be postponed for 3 months after administration of the immune globulin."

The parent of a child who attends day care questions the need for Varivax. What will the nurse tell the parent? a. "Chickenpox is not as contagious as other communicable diseases." b. "The child will be protected by herd immunity and does not need the vaccine." c. "Varicella is an uncomfortable disease, but it is not that serious." d. "Varicella in adults can have serious consequences."

d. "Varicella in adults can have serious consequences."

A nurse is preparing to administer vaccines to a 1-year-old child. The parents ask the nurse to give the child acetaminophen before administering the vaccine to reduce the pain. Which response by the nurse is correct? a. "Children do not remember pain, so it is not necessary to give acetaminophen." b. "The small needles used to inject the vaccines cause hardly any discomfort." c. "You can apply a topical anesthetic when you get home to reduce pain fromthe injection." d. "Your child's immune response may not be as effective ifI give acetaminophen before the vaccine."

d. "Your child's immune response may not be as effective ifI give acetaminophen before the vaccine."

A nurse is caring for a patient who has undergone organ transplantation. Because the sequence of amino acids in the major histocompatibility complex (MHC) molecules of the donor is different from that of the patient, the nurse will expect to administer which class of drugs? a. Antibiotics b. Antihistamines c. Immune globulins d. Immunosuppressants

d. Immunosuppressants

A patient has a Type IV hypersensitivity (delayed-type hypersensitivity) response to an infection. The nurse understands which two types of cells are necessary for thisresponse? a. Antigen-presenting cells and mast cells b. Cytolytic T lymphocytes and target cells c. Immunoglobulin cells and dendriticcells d. Infected macrophages and CD4 helper T cells

d. Infected macrophages and CD4 helper T cells

A patient is about to receive prednisone for tendonitis. The nurse reviewing the chart would be concerned about which of the following in the patient's medical history? a. Asthma and allergic rhinitis b. Gouty arthritis c. Seborrheic dermatitis d. Systemic fungal infection

d. Systemic fungal infection

A nurse at an immunization clinic is providing vaccines to children. The parent of a child waiting to receive vaccines tells the nurse that the child has an immune deficiency disorder. The nurse understands which vaccine should not be administered to this child? a. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine b. Haemophilus influenzae type b (Hib) vaccine c. Polio injection d. Varicella virus vaccine

d. Varicella virus vaccine

A nurse is caring for a patient infected with the human immunodeficiency virus(HIV).Which finding would most concern the nurse? a. High level of macrophages b. Low neutrophil count c. Low red blood cell (RBC) count d. Very low helper T lymphocyte count

d. Very low helper T lymphocyte count

A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is 300 μg/mL, and the urine pH is 6.0. What will the nurse do? a. Increase the aspirin dose to treat the patient's headache. b. Notify the provider of possible renaltoxicity. c. Prepare to provide respiratory support, because the patient shows signs of overdose. d. Withhold the aspirin until the patient's symptoms have subsided.

d. Withhold the aspirin until the patient's symptoms have subsided.

An older male patient with an increased risk of MI is taking furosemide [Lasix] and low- doseaspirin. The patient is admitted to the hospital, and the nurse notes an initial blood pressure of140/80 mm Hg. The patient has had a 10-pound weight gain since a previous admission 3 months earlier. The patient has voided only a small amount of concentrated urine. The serum creatinine and blood urea nitrogen (BUN) levels are elevated. The nurse will contact the provider to discuss: a. adding an antihypertensive medication. b. obtaining serum electrolytes. c. ordering a potassium-sparing diuretic. d. withdrawing the aspirin.

d. withdrawing the aspirin.