Exam 3

A nurse is teaching a client who has a new prescription for combination oral NRTIs (abacavir, lamivudine, and zidovudine) for treatment of HIV. Which of the following statements should the nurse include? a. "These medications work by inhibiting enzymes to prevent HIV replication." b. "These medications work by weakening the cell wall of the HIV virus." c. "These medications work by preventing protein synthesis within the HIV cell." d. "These medications work by blocking HIV entry into cells."

a. "These medications work by inhibiting enzymes to prevent HIV replication."

A client has been prescribed rifampin for the treatment of tuberculosis and calls the nurse reporting orange-tinted tears. What are the correct responses to the client's concerns by the nurse? (select all that apply) a. "This is a harmless effect of the medication. Continue taking the rifampin." b. "You may need to replace your contact lenses, if you wear them." c. "Decrease your intake of carrots and other foods high in beta-carotene to reduce future discoloration of your tears." d. "This may be a sign of liver injury that is common with rifampin. Stop the medication immediately." e. "This is a sign that your tuberculosis has spread outside of your lungs. The dose of the medication will need to be increased."

a. "This is a harmless effect of the medication. Continue taking the rifampin." b. "You may need to replace your contact lenses, if you wear them."

A patient is diagnoses with an opportunistic infection after taking their antiretroviral therapy. Which of the following is considered an opportunistic infection? (select all that apply) a. CMV b. influenza c. kaposi sarcoma d. tuberculosis

a. CMV c. kaposi sarcoma d. tuberculosis

Tacrolimus is prescribed for a client who underwent a kidney transplant. Which instruction should the nurse include when teaching the client about this medication? a. Take the oral medication every 12 hours at the same times every day b. Eat at frequent intervals avoid hypoglycemia c. Change positions carefully due to risk of orthostatic hypotension d. Take the medication with a full glass of grapefruit juice

a. Take the oral medication every 12 hours at the same times every day

Prednisone, a corticosteroid, is given to a patient after an organ transplant. The patient is most likely experiencing what? a. acute transplant rejection b. an infection c. oxygen desaturations d. hypertension

a. acute transplant rejection

A pregnant patient is HIV positive. which of the following is true of antiretroviral therapy during pregnancy? a. combination antiretroviral drug therapy is the standard of care during pregnancy b. IV antiretroviral therapy is absolutely contraindicated c. to avoid toxicity to the fetus, antiretroviral therapy is discontinued during pregnancy d. to minimize toxicity to the fetus, antiretroviral monotherapy is used

a. combination antiretroviral drug therapy is the standard of care during pregnancy

A patient will take an anthelmintic medications and asks the nurse about side effects. The nurse will tell the patient that anthelmintic drugs a. commonly have gastrointestinal (GI) side effects b. have many serious adverse reactions c. cause orthostatic hypotension d. can cause hepatic toxicity

a. commonly have gastrointestinal (GI) side effects

Nurses are key to promoting adherence in transplant recipients. What factors influence whether a recipient adheres to a drug regimen? (Select all that apply) a. cost b. drug side effects c. past history of organ rejection d. understanding of the medication e. tobacco use

a. cost b. drug side effects c. past history of organ rejection d. understanding of the medication

When educating a patient on self care, post transplant, all of the following are good examples of neutropenic precautions. (Select all that apply) a. if a trip to the ED is necessary, inform them you are on immunosuppressant therapy to avoid prolonged stay in the waiting room b. select generic fresh fruits and vegetables c. scrub the house thoroughly with water to sterilize all surfaces d. clean teeth and gums with a soft toothbrush e. avoid crowded places and contact with people who are sick

a. if a trip to the ED is necessary, inform them you are on immunosuppressant therapy to avoid prolonged stay in the waiting room e. avoid crowded places and contact with people who are sick

Travelers visiting malaria-infested countries are instructed to a. take prophylactic antibiotics before traveling b. visit these countries only while in good health c. receive immunizations before travel d. avoid mosquitoes in these countries

a. take prophylactic antibiotics before traveling

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 information should the nurse teach the client about resistance? a. taking medication at the same time daily without missing doses minimizes resistance b. taking low dosage of antiretroviral medication minimizes resistance c. taking one antiretroviral medications at a time minimizes resistance d. changing the medication regime when adverse effects occur minimizes resistance

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

The nurse is caring for a postrenal transplantation client taking cyclosporine. The nurse notes an increase in one of the patient's vital signs, and the client is complaining of a headache. What vital sign is most likely increased? a. respirations b. blood pressure c. pulse oximetry d. heart rate

b. blood pressure

A client has been started on long-term therapy with rifampin. The nurse should provide which information to the client about the medication? a. should always be taken with food or antacids b. causes orange discoloration of sweat, tears, and feces c. should be double-dosed if 1 dose is forgotten d. may be discontinued independently if symptoms are gone in 3 months

b. causes orange discoloration of sweat, tears, and feces

Which of the following antimalarials cause discoloration of the skin and nails? a. artemisinin b. chloroquine c. proguanil d. primaquine

b. chloroquine

To reduce the risk of nephrotoxicity caused by amphotericin, the nurse will avoid concurrent administration of which medications? (select all that apply) a. fexofenadine b. cyclosporine c. gentamicin d. ibuprofen e. acetaminophen

b. cyclosporine c. gentamicin d. ibuprofen

What would be considered a generally accepted overall indicator of a solid organ transplant failure. a. capillary refill of >5 seconds b. flu-like symptoms (fever and vomiting) c. core body temperature of 98.5 degrees Fahrenheit d. Hypertension

b. flu-like symptoms (fever and vomiting)

A nurse is administering IV amphotericin B to a client who has a systemic fungal infection. The nurse should monitor which of the following laboratory values? (select all that apply) a. serum amylase b. hematocrit c. serum potassium d. serum creatinine e. serum albumin

b. hematocrit c. serum potassium d. serum creatinine

Which of the following drugs is effective against influenza B? a. amantadine b. oseltamivir c. acyclovir d. rimantadine

b. oseltamivir

A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesia, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? a. impaired peripheral circulation b. peripheral neuropathy c. small blood vessel spasm d. hypercalcemia

b. peripheral neuropathy

The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet, an antiviral medication. The nurse should monitor the results of which laboratory tests while the client is taking this medication? a. BMP b. serum creatinine level c. serum albumin level d. CD4+ T cell count

b. serum creatinine level

A nurse is caring for a client who takes several antiretroviral medications, including the NRTI zidovudine, to treat a HIV infection. The nurse should monitor for which of the following adverse effects of zidovudine? (select all that apply) a. blurred vision b. vomiting c. ataxia d. fatigue e. leukopenia

b. vomiting d. fatigue e. leukopenia

A nurse is teaching a client who has active tuberculosis about his treatment regimen. The client asks why he must take four different medications. Which of the following responses should the nurse make? a. "Four medications decrease the risk for a severe allergic reaction." b. "Four medications decrease the chance of having a positive TB skin test." c. "Four medications reduce the chances that the bacteria will become resistant." d. "Four medications reduce the risk for adverse reactions."

c. "Four medications reduce the chances that the bacteria will become resistant."

which statement, made by a client prescribed metronidazole, would require the nurse to intervene? a. "My urine has been a bit darker than normal lately." b. "I've been nauseous for the past several days." c. "I enjoy having a small glass of wine with dinner at night." d. "I've increased my intake of green leafy vegetables this week."

c. "I enjoy having a small glass of wine with dinner at night."

A child is being treated for pinworms, and the parent asks the nurse how to prevent spreading this to other family members. What will the nurse tell the patient? a. "Wash your child's clothing in hot water" b. "Obtain a daily stool specimen from your child" c. "You child should wash hands well after using the toilet" d. "Give your child baths every day"

c. "You child should wash hands well after using the toilet"

A nurse is caring for a client who has diabetes mellitus, pulmonary tuberculosis, and a new prescription for isoniazid (INH). Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH? a. Cyanocobalamin b. Ascorbic acid c. Pyridoxine d. Folic Acid

c. Pyridoxine

Which is the most appropriate nursing intervention for a patient who is taking mefloquine and hydroxychloroquine? a. encourage female patients to have a Pap test every 6 months b. collect a stool specimen c. assess the patient's hearing d. advise the patient to take showers, not baths

c. assess the patient's hearing

Which information will the nurse include when teaching a patient about anthelminthic therapy? a. take a bath at least once a day b. change your sheets every day c. be aware that drowsiness may occur d. take the medication seven hours before meals

c. be aware that drowsiness may occur

Ethambutol is prescribed for a client with tuberculosis. Which assessment findings would alert the nurse that the client is experiencing adverse effects of this medication? (select all that apply) a. elevated blood glucose b. jaundice c. blurred vision d. nausea e. decreased visual acuity of colors

c. blurred vision e. decreased visual acuity of colors

A patient is being treated with isoniazid (INH), rifampin and pyrazinamide in phase 1 of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid? a. ciprofloxacin (cipro) b. streptomycin sulfate c. ethambutol (Myambutol) d. kanamycin

c. ethambutol (Myambutol)

A nurse is caring for a client who is taking ritonavir, a protease inhibitor, to treat HIV infection. Which of the following is an adverse effect of this medication? a. increased TSH level b. decreased ALT level c. hyperlipidemia d. hypoglycemia

c. hyperlipidemia

All transplant drugs have the same advisory, to use caution when administering them with another immunosuppressant drug because of the increased risk for: a. anemia b. nausea and vomiting c. infection d. edema

c. infection

A patient will take an anthelmintic medication and asks the nurse about common side effects. The nurse will tell the patient that anthelminthic drugs: a. can cause hepatic toxicity b. have many serious adverse reactions c. most commonly results in gastrointestinal (GI) side effects d. most commonly cause orthostatic hypotension

c. most commonly results in gastrointestinal (GI) side effects

Which of the following are principles of immunosuppression? a. monotherapy reduces risk of organ rejection b. drugs which increase T-cell response reduce rejection c. multiple drug therapy reduces risk of drug toxicity d. drugs that activate lymphocytes reduce risk of rejections

c. multiple drug therapy reduces risk of drug toxicity

A female client with genital herpes simplex becomes pregnant. What statement made by the client concerning her prescribed acyclovir would indicate that teaching by the nurse has been effective? a. "In need to switch to the topical formulation of this medication now that I am pregnant." b. "It is best to discontinue the use of this medication until I delivery the baby." c. "I should only take this medication during an active outbreak of my herpes." d. "I may continue the acyclovir throughout the course of my pregnancy."

d. "I may continue the acyclovir throughout the course of my pregnancy."

The nurse is teaching a client who is beginning antiviral therapy for influenza. Which statement by the client indicates an understanding of the instructions? a. "This medication has minimal side effects and I can return to normal activities." b. "Once I start the medication, I will no longer be contagious." c. "I will not get any colds of infections while taking this medication." d. "I must take the medication exactly as prescribed."

d. "I must take the medication exactly as prescribed."

A nurse would note that a patient had a good understanding of their antimalarial drug regimen if the patient reported: a. "I will start taking these pills as soon as I arrive at my vacation destination, before I get off the plane." b. "I keep these pills with me at all times while I'm away and take them only when I have been bitten by a mosquito." c. "I will need to start these pills now and then continue to take them every day for the rest of my life." d. "I'll start the pills before my trip and will keep taking them during the trip and for a period of time after I'm home."

d. "I'll start the pills before my trip and will keep taking them during the trip and for a period of time after I'm home."

A client diagnosed with latent tuberculosis is prescribed isoniazid. The client asks the nurse why other medications have not been prescribed along with isoniazid. What is the correct response by the nurse? a. "treatment begins with one drug, and then a second drug is added after you have adjusted to the first drug." b. "your gram stain shows that your strain of tuberculosis is sensitive only to isoniazid." c. "this is an error, you should also be prescribed rifapentine." d. "your tuberculosis is not active, therefore one-drug therapy is prescribed".

d. "your tuberculosis is not active, therefore one-drug therapy is prescribed".

Which of the following drugs is the drug choice for serious systemic fungal infections? a. caspofungin b. itraconazole c. 5-fluorocytosine d. amphotericin B

d. amphotericin B

A patient is prescribed an antifungal medication to treat their diagnosis of candidiasis. What education should the nurse include when discussing this medication class with the patient? a. restrict fluid intake b. administer the medication with an antacid c. administer on an empty stomach d. avoid consuming alcohol

d. avoid consuming alcohol

A nurse is infusing IV Amphotericin B to a client who has a systemic fungal infection. The nurse should monitor the client for which of the following adverse effects of this medication? a. hyperkalemia b. constipation c. hypoglycemia d. fever

d. fever