PATHO/PHARM: EXAM 4 REVIEW

the nurse is preparing to administer a hepatitis B vaccine to an infant born earlier in they day. which is the proper dosage and location to give this vaccine?

0.5 mL IM within 12 hours of birth in the vastus lateralis

a nurse is reviewing the MAR on a client who will receive gentamicin at 0900. when should the nurse draw the trough level

0830 *checking a trough level is important to make sure the dose is in the therapeutic range before the next dose is due. by drawing the trough at 0830 and the level is too high or too low, the dose can be adjusted for the 0900 dose

a child is prescribed permethrin 5% cream for scabies. the nurse would instruct the parents to apply the medication at which time?

at bedtime and wash off the next morning *permethrin is rubbed on the skin surface and left in place for 8 to 14 hours before it is washed off *must remain on for at least 8 hours to be effetive *if it is washed off before 8 hrs, does not provide a curative dose

a nurse is teaching a client who is beginning a course of metronidazole to treat an infection. which of the following findings is an adverse effect that the nurse should instruct the client is a priority to stop and notify the provider?

ataxia

a nurse is instructing a client who has a new prescription for timolol how to insert eye drops. the nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication?

nasolacrimal duct *pressing on the nasolacrimal duct blocks the lacrimal punctum and prevents systemic absorption of the med

what are examples of passive immunity?

natural maternal/breastmilk immunoglobins (IgG) short-term*

which type of immunity is acquired through the colostrum from mother to baby?

natural passive immunity

a male client recieving prolonged steroid therapy complains of always being thirsty and urinated frequently. which is the nurse's initial action?

performing a finger stick to check blood glucose *steroids can cause hyperglycemia *nurse's responsibility to check blood glucose - do not need MD order

which effect has resulted in the avoidance of tetracycline use in children under 8 years old?

permanent tooth discoloration

which action would the nurse take to avoid red man syndrome when preparing to administer a vancomycin infusion?

proper rate premedicate with an antihistamine

a nurse is caring for a client who has diabetes, pulmonary TB, and has a new prescription for isoniazid. which of the following supplements should the nurse expect to administer to prevent an adverse effect of isoniazid?

pyridoxine (Vit B) *prescribed to prevent peripheral neuropathy especially for clients who have increased risk factors

a nurse in the ED is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. which of the following findings are indicative of this condition?

severe pain around the eyes *acute glaucoma is painful and has a sudden onset

a client is prescribed acetazolamide, an antiglaucoma agent. which electrolytes should the nurse monitor?

sodium potassium

what do helper T-cells do?

stimulate humoral and cell-mediated response by releasing cytokines

which action by the client taking alendronate requires correction by the nurse?

taking the med twice a week taking the med before rising taking the med w/ breakfast taking the med before bedtime taking the med w/ apple juice *take on an empty stomach w/ 8oz tap water *given once a week, used for osteoporosis and Paget's disease *must remain upright for 30 min. after taking med to prevent esophageal ulceration *do not eat right before taking the med *do not take w/ other meds (wait at least 30-60 min)

a nurse is teaching a client who is beginning highly active antiretroviral therapy (HAART) for HIV infection about ways to prevent medication resistance. which of the following info should the nurse teach the client about resistance?

taking the medication at the same time daily without missing doses minimizes resistance

a client has primary open angle glaucoma. which ophthalmic preparation is indicated to manage the condition?

timolol *beta-adrenergic antagonist that decreases humor production and increases outflow thereby reducing intraocular pressure

what type of vaccine triggers the client's immune system to produce antitoxin?

toxoid vaccines

a nurse is obtaining a medication history from client who is to receive imipenem, a carbapenem antibiotic, to treat an infection. which of the following medications puts the client at risk to a med reaction?

valproic acid *decreases blood levels of valproic acid and puts the client at risk for seizures

what are examples of live vaccines?

varicella MMR RV flu

a client develops a systemic fungal infection and is prescribed amphotericin B. the nurse will monitor for which side effects?

hepatotoxicity nephrotoxicity bone marrow suppression

what are examples of active immunity?

immunizations antibodies memory b cells

what is cell-mediated immunity?

infected cell cytotoxic T-cell (CD8) helper T-cell (CD4)

a nurse is planning to administer ciprofloxacin IV to a client who has cystitis. which of the following actions should the nurse take?

infuse the cipro over 60 minutes *do not give to children younger than 18 *increases risk of getting C diff and yeast infections *monitor kidney function *avoid sun exposure

which of the following immunity is called the first line of defense?

innate (natural) immunity

immune globulin (IgG) is prescribed for a client with nephrotic syndrome. which info will the nurse include when teaching the client about this med?

it provides immediate, passive, short-term immunity

what type of vaccines are not given to immunocompromised clients?

live (attenuated)

the parents of a newborn ask the nurse, except for Hep B, why the immunization schedule does not start until the infant is 2 months old? how should the nurse respond?

maternal antibodies interfere with the development of active antibodies by the infant when immunized

a nursing student studying for a pharm exam is reviewing gentamicin, an aminoglycoside. what should the student remember about gentamicin?

may cause vertigo and ataxia monitor for signs of hematuria monitor peak and trough levels *is ototoxic and nephrotoxic *given IM or IV

allopurinol is prescribed when the client with type 2 diabetes develops gout. when teaching about the admin of allopurinol which instructions will the nurse provide?

monitor blood glucose levels more frequently *can increase effects of hypoglycemia *treats CHRONIC gout

a nurse caring for a client who is being treated with interferon alfa-2b for malignant melanoma. which of the following adverse effects should the nurse monitor?

muscle aches peripheral neuropathy depression

a client with TB is started on rifampin. the nurse evaluates that the teaching about rifampin is effective when the client makes which statement?

my sweat will turn orange from this medication *not nephrotoxic

what must the nurse do before giving any vaccine?

educate about vaccine and provide the Vaccination Information Sheet (VIS)

which statement regarding treatment with interferon indicates that the client understands the nurse's teaching?

I will drink 2 to 3 liters of fluid a day *prevents nephrotoxicity *side effects: confusion, dizziness, hallucinations, fatigue, flu-like symptoms

sulfamethaoxazole is prescribed for a child w/ a UTI. which statement by the parent indicates the nurse's instruction about administration has been understood?

I will make sure to give each pill with 6 to 8 oz of fluid *Water is encouraged to prevent urine crystalizations in the kidneys

when is Hep B vaccine given?

first shot at birth second shot one month after 1st dose third shot 6 months after 1st dose

what is humoral immunity?

antibody-mediated B cells lymphocytes memory B cells

a client is started on tetracycline antibiotic therapy. which action would the nurse take when administering this med?

administer the medication at least one hour before ingestion of any milk products *milk interferes w/ the absorption of tetracycline

which medication is used to treat H. pylori infection?

amoxicillin tetracycline acyclovir

a nurse is caring for a group of clients who are receiving antimicrobial therapy. the nurse should identify that which of the following clients is at risk for medication toxicity?

an older adult with prostatitis *children and older adults are at higher risk for toxicity due to age related reduction in metabolism and excretion of medication

a post-menopausal woman has been administered raloxifene for osteoporosis. which parameter would the nurse assess to ensure the efficacy of the med and continuation of use?

bone density *selective estrogen receptor modulator *increase in bone density indicates a good therapeutic response

which assessment would the nurse perform before administering a dose of vancomycin to a client?

check creatinine level obtain trough level hearing ability check IV site check blood urea nitrogen

which medication when prescribed for a client after a kidney transplant surgery may require the client to visit the dentist on a regular basis?

cyclosporine *immunosuppressant that can cause gingival hyperplasia

a client is taking an immunosuppressant med after receiving an organ transplant. the client has developed hypertension, nephrotoxicity, and gingival hyperplasia, which med may cause these disorders?

cyclosporine *primary med to prevent organ rejection *side effects: hirsutism, gingival hyperplasia, nephrotoxic, hypertension, risk of infection