Exam 3 Test Bank
The patient is receiving ribavirin (Copegus) for treatment of chronic hepatitis B. Which manifestation, if present in the patient, would the nurse conclude is an adverse effect of this medication? 1. Neurologic symptoms such as headaches and dizziness. 2. Respiratory symptoms such as dyspnea and congestion. 3. Skin disruptions such as acne and ulcerations. 4. Hematologic symptoms such as excessive fatigue or dizziness.
Answer 4: Explanation: Ribavirin is associated with an increased risk of hemolytic anemia. Increased fatigue, dizziness, headache, abdominal pain, pallor, and chest pain are associated with this anemia.
The nurse knows that client education on drug interactions with doxorubicin has been successful when the client states: 1. "I can take acetaminophen if I get a fever." 2. "I can take my Celebrex for my arthritis." 3. "I can take ibuprofen for my back pain." 4. "I can take an aspirin for a headache."
Answer: 1 Explanation: Acetaminophen is appropriate to take, because it doesn't increase the risk of bleeding.
The client receives acyclovir (Zovirax) for treatment of genital herpes. What is a priority assessment by the nurse? 1. Increased serum creatinine 2. Thrombocytopenia 3. Respiratory distress 4. Auditory and visual hallucinations
Answer: 1 Explanation: Acyclovir (Zovirax) is nephrotoxic, so serum creatinine should be monitored.
The nurse caring for which client would question an order for acyclovir (Zovirax)? 1. Client with hepatitis B 2. Client with varicella-zoster 3. Client with herpes simplex 2 encephalitis 4. Client with cytomegalovirus
Answer: 1 Explanation: Acyclovir (Zovirax) is not used to treat hepatitis B.
Acyclovir (Zofirax) has been ordered intravenously for a patient with a herpes zoster infection to the upper torso and face. Which nursing intervention will help prevent a common adverse effect? 1. Administer the drug slowly IV over an hour, and encourage fluid intake throughout the day. 2. Keep skin areas dry to prevent fungal overgrowth. 3. Administer antihistamines 1 hour before giving the infusion to prevent itching. 4. Assess visual acuity periodically and provide for eye comfort such as lubricating eye drops.
Answer: 1 Explanation: Acyclovir is associated with nephrotoxicity, especially when given IV. The drug should be administered IV slowly, over a minimum of 1 hour, and increased fluid intake should be encouraged throughout the day to prevent adverse renal effects.
A client is concerned about contracting influenza and asks about vaccination. The best response by the nurse would be: 1. "Once you are vaccinated, protection with the vaccination begins after about 2 weeks." 2. "The infectious particles are not easily spread, and you can wait on vaccination until the flu becomes prevalent this season." 3. "You would only need to be vaccinated if you are older than 50." 4. "Once you are vaccinated, you will only need a booster every 2 years."
Answer: 1 Explanation: Adequate immunity is achieved about 2 weeks after vaccination.
The nurse assesses several clients for their potential risk for developing cancer. Which client does the nurse assess to be at greatest risk for developing cancer? 1. The client who is an alcoholic and eats a diet high in fatty foods 2. The client who frequently forgets breast self-exams but has routine mammograms 3. The client who is 10 pounds overweight but exercises regularly 4. The client who applies sunscreen when arriving at the beach
Answer: 1 Explanation: Alcoholism and a high-fat diet are lifestyle factors that put this client at risk for developing cancer.
The healthcare provider orders amantadine (Symmetrel) for a client with influenza. Which part of the client's health history would the nurse report to the healthcare provider prior to administering amantadine (Symmetrel)? 1. Epilepsy 2. Chronic obstructive pulmonary disease (COPD) 3. Diabetes mellitus 4. Allergy to shellfish
Answer: 1 Explanation: Amantadine (Symmetrel) is associated with seizures, and should not be administered to a client with epilepsy.
The client experiences nausea and vomiting soon after chemotherapy treatments. What is the best action by the nurse? 1. Administer an antiemetic 1 to 2 hours before chemotherapy. 2. Increase fluid intake to flush the kidneys prior to chemotherapy. 3. Restrict food on the day the client receives chemotherapy. 4. Administer a sleeping medication during chemotherapy.
Answer: 1 Explanation: An antiemetic is usually necessary to control nausea and vomiting.
A client with cancer asks the nurse where cancer comes from. What is the best explanation by the nurse? 1. "Cancer cells are body cells that have lost the ability to regulate growth." 2. "Cancer is caused primarily by viruses in the environment." 3. "Cancer is genetic; you inherited the predisposition for your cancer." 4. "Cigarette smoking and secondhand smoke are the primary causes of cancer."
Answer: 1 Explanation: Cancer is thought to result from damage to the genes that control cell growth.
Opportunistic infections, such as bacterial infections, associated with a client with HIV can be treated with which of the following? 1. Ciprofloxacin 2. Trimethoprim-sulfamethoxazole. 3. Fluconazole 4. Benzathine penicillin
Answer: 1 Explanation: Ciprofloxacin is the preferred drug for a client with HIV and a bacterial infection.
The client with AIDS asks the nurse why so many medications are prescribed. What is the best response by the nurse? 1. "To decrease the possibility of the virus developing resistance to the medications." 2. "Because the earlier we start multiple medications, the better for you." 3. "To provide you with the most effective treatment for your illness." 4. "Research has shown single medications to be ineffective."
Answer: 1 Explanation: Decreasing the possibility of resistance is the key.
A client who is HIV positive questions the nurse about a vaccine for HIV. Which response by the nurse is most accurate? 1. "Scientists are far from developing a vaccine to prevent HIV." 2. "The HIV vaccines developed can prevent fatal consequences of the virus." 3. "Scientists currently have many HIV vaccines in clinical trials." 4. "Scientists are close to discovering a vaccine for HIV."
Answer: 1 Explanation: Despite much research, scientists are far from developing a vaccine to prevent HIV.
During the second stage of pathogenesis of HIV, the virus converts its genetic material from: 1. RNA to DNA. 2. DNA to RNA. 3. DNA to CD4 receptors. 4. RNA to CD4 receptors.
Answer: 1 Explanation: HIV is called a retrovirus, because it converts RNA to DNA in the second stage of pathogenesis, whereas most other living organisms convert DNA to RNA.
Folic acid analogs can be toxic to normal cells as well as to cancer cells. Which drug will the nurse administer following the administration of methotrexate to "rescue" the normal cells, causing them to be able to continue replication and development? 1. Leucovorin 2. Iron therapy 3. Immunoglobulin 4. Vitamin B12
Answer: 1 Explanation: Leucovorin is given to rescue normal cells during methotrexate administration.
The nurse is collaborating with other members of the healthcare team regarding the care of the patient with a brain tumor. The nurse knows that the most common reason that subsequent rounds of chemotherapy may be delayed is due to what condition? 1. Myelosuppression 2. Alopecia 3. Mucositis 4. Cachexia
Answer: 1 Explanation: Myelosuppression is the most common dose-limiting adverse effect of chemotherapy and the one that most often causes discontinuation or delays of chemotherapy.
The patient will continue to take methotrexate (MTX, Rheumatrex, Trexall) for treatment of osteosarcoma. When teaching the patient prior to discharge, what over-the-counter drugs must not be taken concurrently with methotrexate? 1. Nonsteroidal anti-inflammatory drug pain relievers 2. Antihistamines 3. Laxatives 4. Cough suppressants
Answer: 1 Explanation: NSAIDs may cause severe and fatal myelosuppression when taken concurrently with methotrexate.
A client who has been hospitalized with a viral infection asks the nurse why the doctor did not prescribe a medication. The nurse explains that with some viruses, drug therapy is not warranted because: 1. some viruses are self-limiting, and adverse effects can occur. 2. the drugs are not strong enough for effective treatment. 3. most drugs work for only a short period. 4. some drugs work only on prevention, not treatment.
Answer: 1 Explanation: Some viruses are self-limiting, and the adverse effects of drug therapy can be worse than the symptoms of the viral infection itself.
A client is started on efavirenz, a NNRTI. Which medication should the nurse question before giving it with efavirenz? 1. Diazepam 2. Penicillin 3. Ibuprofen 4. Diphenhydramine
Answer: 1 Explanation: The CNS adverse effects of efavirenz are worsened if the client takes psychotropic drugs, such as diazepam.
The nurse states that the goal of HAART is: 1. reduction of the plasma level of HIV to the lowest level possible. 2. elimination of the virus from the lymph system. 3. reduction of side effects seen with other HIV-AIDS drugs. 4. elimination of the virus from the bloodstream.
Answer: 1 Explanation: The goal of HAART is to reduce the plasma level of HIV to the lowest possible level.
The nurse determines that the patient understands an important principle of chemotherapy when the patient makes which statement? 1. "The use of multiple chemotherapy drugs affects different stages of the cancer cell's lifecycle." 2. "Staging describes the process of determining how responsive the cancer is to the prescribed chemotherapy." 3. "Antineoplastic drugs kill the entire tumor, including the clones, and prevent repopulation." 4. "Combination chemotherapy requires higher dosages of each individual drug and increases toxicity."
Answer: 1 Explanation: The use of multiple drugs affects different stages of the cancer cell's lifecycle and attacks the various clones within the tumor via several mechanisms of action, thus increasing the percentage of cell kill. Combination chemotherapy also allows lower dosages of each individual drug, thus reducing toxicity and slowing the development of resistance.
Classification of antineoplastics is difficult because: 1. the drugs kill cancer cells by different mechanisms and have characteristics from more than one class. 2. the drugs cannot always kill the cancer cells. 3. the drugs only have characteristics from one class, even though they kill by different mechanisms. 4. the drugs have various adverse effects.
Answer: 1 Explanation: These are the reasons classification is so difficult.
The nurse is describing the mechanism of action for antibiotic antineoplastics to a client who is being treated for cancer. Which description by the nurse is most appropriate? 1. "They contain substances from bacteria that have the ability to kill cancer cells." 2. "They contain substances from plants that have the ability to kill cancer cells." 3. "They contain substances from viruses that have the ability to kill cancer cells." 4. "They contain substances from hormones that have the ability to kill cancer cells."
Answer: 1 Explanation: They do contain substances from bacteria that can kill cancer cells.
Unlike alkylating agents, antitumor antibiotics: 1. are not given orally. 2. have severe adverse effects. 3. have no dose-limiting toxicities. 4. are not mitotic inhibitors.
Answer: 1 Explanation: They must be given intravenously, or through direct instillation via a catheter into a body cavity or organ.
Most chemotherapeutic medications are administered intermittently, using specific dosing schedules. A factor that does not affect the dosing schedule is: 1. the psychologic stage of the client. 2. the condition of the client. 3. the type of tumor. 4. the stage of the disease.
Answer: 1 Explanation: This is not a factor in determining the dosing schedule.
The acronym that the American Cancer Society recommends to help people remember what to look for when assessing themselves for cancer is: 1. CAUTION. 2. CANCER. 3. CHANGES. 4. PREVENTION.
Answer: 1 Explanation: This is the acronym the American Cancer Society recommends.
Many chemotherapy agents cause nausea and vomiting. The type and dose of antiemetic prescribed are based on: 1. the potential of specific antineoplastics to cause nausea and vomiting. 2. how many other medications the client is taking. 3. the severity of the client's symptoms. 4. the dose of the antineoplastics.
Answer: 1 Explanation: This is the correct answer.
When administering cyclophosphamide (Cytoxan), which has the potential adverse effect of cardiotoxicity, what is the best action by the nurse during treatment? 1. Obtain baseline and periodic ECGs. 2. Stop the drug if abnormal heart sounds are auscultated. 3. Obtain baseline and periodic echocardiograms. 4. Obtain baseline and periodic cardiac enzymes.
Answer: 1 Explanation: This is the correct answer.
A client shows a proper understanding of the adverse effects of vincristine when he states: 1. "I need to let my doctor know immediately if I have any weakness in my hands or feet." 2. "If I have swelling in my legs, I should keep them elevated for a while." 3. "I can take ibuprofen if I have any pain." 4. "I need to let my doctor know immediately if I took two pills instead of one."
Answer: 1 Explanation: This is the correct response.
The nurse is teaching a client about the standard drug therapy for HIV-AIDS. Which antiviral medications does the nurse include in the teaching plan? 1. Zidovudine (Retrovir, AZT) 2. Interferon-alfa 3. Rimantadine (Flumadine) 4. Acyclovir (Zovirax)
Answer: 1 Explanation: Zidovudine is indicated for therapy for HIV-AIDS.
The nurse is explaining the mechanisms of action for alkylating agents and states that alkylating agents kill cancer cells by: Select all that apply. 1. altering the shape of the DNA double helix. 2. preventing the DNA from duplicating during cell division. 3. becoming incorporated into the DNA of cancer cells. 4. interfering with DNA replication and function. 5. an unknown mechanism of action.
Answer: 1, 2 Explanation: Alkylating agents alter the shape of the DNA double helix. Alkylating agents prevent the DNA from duplicating during cell division.
Although research for a vaccine to prevent HIV infection has been unsuccessful, the nurse states that benefits of HIV vaccine research include: Select all that apply. 1. the development of new drugs. 2. advances on how to treat and control the disease. 3. ways to prevent transmission. 4. ethical treatment regimens. 5. vaccine cocktails.
Answer: 1, 2 Explanation: Many new medications have been discovered due to the research for an HIV vaccination. Research for a vaccination for HIV has led to advances in the treatment and control of HIV.
The nurse is reviewing medications that are similar to methotrexate. Which medications are closely related to methotrexate? Select all that apply. 1. Pemetrexed 2. Pralatrexate 3. Idarubicin 4. Plicamycin 5. Doxorubicin
Answer: 1, 2 Explanation: Pemetrexed is a medication that is similar in action to methotrexate. Pralatrexate is a medication that is similar in action to methotrexate.
The nurse is asked by a client which drug regimens have been shown to be the most successful for the initial therapy of HIV infection. The nurse responds: Select all that apply. 1. "An NNRTI-based regimen." 2. "PI-based regimens." 3. "An integrase inhibitor-based regimen." 4. "NRTIs/NtRTIs-based regimens." 5. "Entry inhibitor-based regimens."
Answer: 1, 2, 3 Explanation: An NNRTI-based regimen of efavirenz + tenofovir + emtricitabine has been shown to be a successful choice for the initial therapy of HIV infection. A PI-based regimen of atazanavir (ritonavir-boosted) + tenofovir + emtricitabine or darunavir (ritonavir-boosted) + tenofovir + emtricitabine has been shown to be a successful choice for the initial therapy of HIV infection. An integrase inhibitor—based regimen of raltegravir + tenofovir + emtricitabine has been shown to be a successful choice for the initial therapy of HIV infection.
The nurse is teaching a client about the use of hematopoietic growth factors to promote the formation of specific blood cells. Which medications will the nurse include in the teaching session? Select all that apply. 1. Epoetin alfa 2. Filgrastim 3. Sargramostim 4. Aldesleukin 5. IFN alfa-2b
Answer: 1, 2, 3 Explanation: Epoetin alfa is a medication that is used to promote the formation of specific blood cells. Filgrastim is a medication that is used to promote the formation of specific blood cells. Sargramostim is a medication that is used to promote the formation of specific blood cells.
OSHA has established guidelines for the safe handling of chemotherapeutic medications. The nurse correctly states that safe handling includes: Select all that apply. 1. safe medication storage. 2. safe medication disposal. 3. safe medication handling. 4. required days off. 5. appropriate charges for services.
Answer: 1, 2, 3 Explanation: OSHA has instituted specific guidelines for safe medication storage for chemotherapeutic agents. OSHA has instituted specific guidelines for safe medication disposal for chemotherapeutic agents. OSHA has instituted specific guidelines for safe medication handling for chemotherapeutic agents.
The nurse is planning a teaching session with a patient who will be receiving antiretroviral therapy (ART) therapy. Which of the following should be included in the teaching plan? Select all that apply. 1. Avoid crowds and other people with colds, flu, and other infections. 2. Notify the healthcare provider at the first sign of any rash. 3. The medications will reduce transmission of the disease. 4. The drugs will be stopped periodically to give the immune system a chance to respond. 5. Herbal supplements will not interfere with this therapy.
Answer: 1, 2, 3 Explanation: Patients receiving antiretroviral therapy are immunocompromised and should avoid sources of infection such as crowds and individuals who have infections. The patient should be instructed to notify the healthcare provider at the first sign of a rash. Several antiretroviral medications may cause SJS, a dermatologic adverse effect that can be fatal. Current research has shown that ART, especially when started early in HIV infection, significantly reduces viral load, reducing the chance of transmission. Transmission, however, is still possible and infection control measure should still be practiced.
The nurse is preparing to administer methotrexate by mouth to a client with cancer. For what reasons would the nurse use the PO route rather than the other routes of administration? Select all that apply. 1. The PO route is more acceptable to the client. 2. The PO route decreases the risk for phlebitis. 3. The PO route decreases the risk for tissue necrosis. 4. The PO route decreases the risk for nausea. 5. The PO route decreases the risk for vomiting.
Answer: 1, 2, 3 Explanation: The PO route is more acceptable to clients than the other routes of administration. Receiving chemotherapeutic agents by mouth rather than intravenously decreases the risk for phlebitis. Receiving chemotherapeutic agents by mouth rather than intravenously decreases the risk for tissue necrosis.
The nurse is teaching a client about anthracyclines. Which medications will the nurse include in the teaching session? Select all that apply. 1. Doxorubicin 2. Daunorubicin 3. Epirubicin 4. Bleomycin 5. Dactinomycin
Answer: 1, 2, 3 Explanation: The anthracyclines include doxorubicin. The anthracyclines include daunorubicin. The anthracyclines include epirubicin.
The nurse is caring for a client for myelosuppression. Which lab values would the nurse monitor for this client? Select all that apply. 1. RBC 2. WBC 3. Platelets 4. Potassium 5. Sodium
Answer: 1, 2, 3 Explanation: The nurse would monitor the client's RBCs. The nurse would monitor the client's WBCs. The nurse would monitor the client's platelet count.
During an in-service on viruses, the nurse describes the components of a viral envelope, including: Select all that apply. 1. phospholipids. 2. glycoprotein. 3. protein "spikes." 4. glucose. 5. carbohydrate.
Answer: 1, 2, 3 Explanation: The viral envelope consists partly of phospholipids. The viral envelope consists partly of glycoprotein. The viral envelope consists partly of protein "spikes."
The community health nurse is addressing a neighborhood group concerned about high rates of cancer. The nurse describes chemical carcinogens that contribute to the incidence of cancer, such as: Select all that apply. 1. tobacco. 2. alcohol. 3. asbestos. 4. ultraviolet light. 5. human papillomavirus (HPV).
Answer: 1, 2, 3 Explanation: Tobacco is considered a chemical carcinogen. Alcohol is considered a chemical carcinogen. Asbestos is considered a chemical carcinogen.
Many antineoplastic agents have characteristics of more than one class. Paclitaxel (Taxol) can be classified as: Select all that apply. 1. a natural product. 2. a taxane. 3. a mitotic inhibitor. 4. a cell cycle inhibitor. 5. an alkylating agent.
Answer: 1, 2, 3, 4 Explanation: Paclitaxel (Taxol) can be classified as a natural product (it was derived from a plant). Paclitaxel (Taxol) can be classified as a taxane (its chemical structure). Paclitaxel (Taxol) can be classified as a mitotic inhibitor (its mechanism of action). Paclitaxel (Taxol) can be classified as a cell cycle inhibitor.
The client asks the nurse how HIV is transmitted. The nurse explains that HIV is transmitted through: Select all that apply. 1. needlesticks. 2. sexual activity. 3. breastfeeding. 4. casual contact. 5. birth.
Answer: 1, 2, 3, 5 Explanation: HIV may be transmitted through contact of infected fluids with needles. HIV may be transmitted through sexual activity. Newborns of a mother who is infected with HIV may acquire the virus through breast milk. Newborns of a mother who is infected with HIV may acquire the virus during birth.
A client has been diagnosed with Stage IV pancreatic cancer. The family asks the nurse what staging is. The nurse explains that: Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. staging determines the location of the cancer. 2. the involvement of lymph nodes is assessed during staging. 3. staging changes as the cancer progresses. 4. the lower the stage of cancer at diagnosis, the better the prognosis. 5. staging examines cancerous cells under a microscope and compares them to normal cells.
Answer: 1, 2, 4 Explanation: Staging does determine the location of the cancer. When solid tumors are staged, diagnostic testing also determines the involvement of the lymph nodes. Clients with cancer at a lower stage have a better prognosis than those who are diagnosed at a higher stage.
The community health nurse is planning programs aimed at reducing the incidence of cancer. Which strategies would the nurse plan to implement as part of primary prevention? Select all that apply. 1. Providing health counseling and education 2. Reducing tobacco use 3. Providing annual Papanicolaou (Pap) smears 4. Instructing women in breast self-examination 5. Helping clients maintain weight within recommended levels
Answer: 1, 2, 5 Explanation: Health counseling and education are considered primary preventions against cancer. Reducing the use of tobacco is considered primary prevention against cancer. Maintaining a healthy weight is an example of primary prevention against cancer.
The nurse would anticipate administering antiviral medications to which clients in the emergency department? Select all that apply. 1. A client with an initial outbreak of the herpes simplex virus 2. A client with ringworm 3. An infant with respiratory syncytial virus (RSV) 4. A client with hepatitis 5. A client with methicillin-resistant Staphylococcus aureus (MRSA)
Answer: 1, 3, 4 Explanation: A client with herpes simplex virus would benefit from the administration of antiviral medications. An infant with RSV would benefit from the administration of antiviral medication. A client with hepatitis would benefit from the administration of antiviral medication.
A patient has been receiving vincristine (Oncovin) as one of the drugs in a chemotherapy regimen. What important findings will the nurse monitor to prevent or limit the main dose-related toxicity for this patient? Select all that apply. 1. Numbness of the hands or feet 2. Angina and dysrhythmias 3. Constipation 4. Diminished reflexes 5. Dyspnea and pleuritis
Answer: 1, 3, 4 Explanation: The main dose-limiting toxicity to occur with vincristine is neurotoxicity. Numbness of the hands and feet, constipation related to decreased peristalsis, and diminished reflexes are all signs of neurotoxicity.
For which groups of clients would the community nurse recommend vaccination for hepatitis B? Select all that apply. 1. All infants 2. Sexually active people in a monogamous relationship 3. IV drug abusers 4. Homosexual males 5. Individuals with end-stage renal disease
Answer: 1, 3, 4, 5 Explanation: All infants, beginning at birth, should be vaccinated against hepatitis B. IV drug abusers should be vaccinated against hepatitis B. Males who engage in sexual relations with other males should be vaccinated against hepatitis B. Individuals on dialysis are at increased risk.
Antiviral medications work by inhibiting or stopping a stage of viral replication. Which statements are descriptions of these stages? Select all that apply. 1. Attachment of the virus to the host cell 2. Destruction of host cell DNA. 3. Synthesis of the viral nucleic acid and proteins by the host cell 4. Assembly of all viral components, structural proteins, enzymes, and nucleic acids 5. Release of virions from the host cell
Answer: 1, 3, 4, 5 Explanation: The first stage of viral infection is the attachment of the virus to the host cell. The third stage of viral infection is synthesis of the viral nucleic acid and proteins by the host cell. The fourth stage of viral infection is assembly. All the viral components, structural proteins, enzymes, and nucleic acids are packaged and made ready to leave the cell. The fifth stage of viral infection is the release of the virions from the host cell.
A client with HIV has been started on zidovudine (AZT) as part of the pharmacotherapeutic regimen. What is appropriate for the nurse to teach the client who is on this medication? Select all that apply. 1. The appropriate use of condoms with sexual activity 2. The importance of taking St. John's wort in conjunction with AZT 3. The need to notify the healthcare provider if pregnancy occurs 4. That breastfeeding is safe when taking this medication 5. Not to discontinue the medication without notifying the healthcare provider
Answer: 1, 3, 5 Explanation: The nurse should teach the client the importance of using condoms with sexual activity because this medication is not a cure for HIV infection and it does not prevent the spread of HIV to others through sexual contact. Immediately notify the healthcare provider of any known or suspected pregnancy. Do not discontinue taking this medication without approval of the healthcare provider.
The nurse caring for a client who has been prescribed the antiretroviral medication emtricitabine explains that the advantages of this medication include: Select all that apply. 1. once-daily dosing. 2. once-weekly dosing. 3. fewer adverse effects. 4. can be taken with concurrent HBV infection. 5. safe for pregnant women with HIV
Answer: 1, 3, 5 Explanation: This medication should be taken once a day, which increases compliance. This medication is associated with fewer adverse effects than other antiretroviral medication. This medication is pregnancy category B and is safe to take during pregnancy.
Several clients are receiving the antiviral medication acyclovir. Which orders from the healthcare provider would the nurse question? Select all that apply. 1. Acyclovir IM 2. Acyclovir IV 3. Acyclovir cream 4. Acyclovir by mouth 5. Acyclovir subcutaneously
Answer: 1, 5 Explanation: Acyclovir cannot be administered by intramuscular injection. The nurse would question this order. Acyclovir cannot be administered by subcutaneous injection. The nurse would question this order.
An occupational health nurse is evaluating the risk of a healthcare worker exposed to HIV by a needlestick. The nurse initiates basic PEP because the source individual's viral load is below ________ HIV RNA copies/mL.
Answer: 1,500 Explanation: Basic PEP is initiated when the source individual is asymptomatic for HIV or is known to have a low viral load (below 1,500 HIV RNA copies/mL).
A client with HIV asks the nurse why medications used to treat the virus are not effective over long periods of time. The nurse states it is because an individual infected with HIV may produce as many as ________ billion new virions every day.
Answer: 10 Explanation: A client infected with HIV may produce as many as 10 billion new virions every day, and the immune system becomes overwhelmed by the infection. Medications grow resistant due to the rapid replication rate of the virus.
A client has a cold and asks for an antibiotic to treat the symptoms. The nurse states that a prescription is not needed for a cold because symptoms will resolve on their own in 7 to ________ days.
Answer: 10 Explanation: Some viral infections, such as the common cold, cause acute symptoms but are self-limiting. While symptoms may be annoying, they resolve in 7 to 10 days. Drug therapy is not warranted due to the expense and the possibility of producing adverse effects that may be worse than the symptoms of the infection itself.
The nurse states that the development of an HIV vaccination has been unsuccessful due to the large size of the HIV genome, which has ________ base pairs and leads to the high mutation rate of the virus.
Answer: 10,000 Explanation: It is estimated that, given the size of the HIV genome at 10,000 base pairs, every possible mutation probably occurs at every nucleotide daily in an untreated client. These errors create huge numbers of genetic variants, or mutant strains, with new and different characteristics from the original. It is not unusual to find dozens of genetic variants of HIV replicating within the same client. Thus, vaccine development, and indeed antiretroviral therapy, is trying to hit a "moving target" that is changing its genetic makeup literally every minute.
The nurse is caring for a pediatric client taking doxorubicin for the treatment of Wilms' tumor. The nurse anticipates the neutropenia nadir will occur on day 7 of administration and recover by ________ days.
Answer: 14 Explanation: Severe myelosuppression may occur, which is the major dose-limiting toxicity. It may manifest as thrombocytopenia, leukopenia (especially granulocytes), and anemia. The neutropenia nadir occurs at 7 days and recovers by 14 days.
A common theme among all the antineoplastic agents is: 1. their adverse effects. 2. their ability to kill cancer cells. 3. their drug interactions. 4. their mechanism of action.
Answer: 2 Explanation: A common theme of all antineoplastic agents is their toxicity-their ability to kill cancer cells.
The client receives cisplatin (Platinol) as therapy for cancer. Which assessment finding would prompt the nurse to contact the client's healthcare provider immediately? 1. Nausea and projectile vomiting 2. A temperature greater than 101°F 3. An elevation in blood glucose 4. A complaint of painful leg cramps
Answer: 2 Explanation: A temperature greater than 101°F can indicate an infection, which can be life threatening because low WBCs are an adverse effect of cisplatin (Platinol).
The nurse has just administered an influenza vaccine to a college student. The student asks how long it will take for the vaccine to become effective. The nurse responds that adequate immunity is achieved in ________ weeks after the injection is administered.
Answer: 2 Explanation: Adequate immunity is achieved about 2 weeks after vaccination and lasts for several months up to a year.
A large number of antineoplastic medications are absorbed through what route? 1. Fecal—oral 2. Skin and mucous membranes 3. Respiratory secretions 4. Hair follicles
Answer: 2 Explanation: Antineoplastic medications are absorbed via skin and mucous membranes.
The client receives several chemotherapeutic agents as treatments for cancer. The client asks the nurse why so many drugs are needed. What is the best response by the nurse? 1. "Using multiple drugs means a shorter treatment time." 2. "Using multiple drugs will help kill more of the cancer." 3. "Using multiple drugs is more cost effective in treating cancer." 4. "Using multiple drugs decreases the incidence of side effects."
Answer: 2 Explanation: By using multiple drugs in combination, more of the cancer cells are killed.
A priority system of assessment in a client recently started on efavirenz (Sustiva) includes: 1. pulmonary. 2. CNS. 3. GI. 4. cardiac.
Answer: 2 Explanation: CNS-adverse effects are observed in at least 50% of the clients when first starting therapy with efavirenz.
Cancer is a disease characterized by: 1. normal, controlled cell division. 2. abnormal, uncontrolled cell division. 3. normal, uncontrolled cell division. 4. abnormal, controlled cell division.
Answer: 2 Explanation: Cancer is characterized by abnormal, uncontrolled cell division.
A client is receiving a cell cycle specific medication for the treatment of leukemia. The nurse recognizes that in order for these drugs to kill the most cancer cells, they should be administered in: 1. divided, infrequent doses. 2. divided, frequent doses. 3. a single dose each day. 4. a large, one-time dose.
Answer: 2 Explanation: Cell cycle specific drugs kill the most cancer cells when administered in divided, frequent doses.
Which regimen is part of the protocol to reduce perinatal transmission of HIV? 1. Intravenous zidovudine administered to the mother during the postpartum period 2. Continuous infusion of zidovudine during labor. 3. Intravenous zidovudine administered to the newborn for the first 3 days of life. 4. Oral zidovudine administered to the newborn for 12 weeks following delivery.
Answer: 2 Explanation: Continuous infusion of zidovudine during labor is part of the protocol.
The nurse is discussing the use of tamoxifen with a client who has a family history of breast cancer. The nurse states that a unique approved use for tamoxifen is: 1. treatment for advanced lung cancer. 2. for prophylaxis of breast cancer. 3. treatment for estrogen receptor—negative cancers. 4. for the cure of advanced breast cancer.
Answer: 2 Explanation: It is approved for prophylaxis of breast cancer for high-risk clients who are at risk of developing the disease.
Postexposure prophylaxis (PEP) for occupational HIV exposure should be started within what time period after exposure to be most successful? 1. 2 weeks 2. 24 to 36 hours 3. 36 to 48 hours 4. 1 week
Answer: 2 Explanation: PEP should be started 24 to 36 hours after exposure to be most successful.
The nurse does health teaching with a client who has HIV who has been started on antiviral medications. The nurse recognizes teaching has been effective when the client makes which statement? 1. "I will need to be on a high-calorie diet to enhance the effect of the medication." 2. "I will still need to take precautions to avoid spreading the virus to others." 3. "I will not be able to continue working at my high-stress job anymore." 4. "I will need to limit my travel to avoid people with other infections."
Answer: 2 Explanation: Precautions are still necessary to avoid spreading the virus to others.
The nurse accidentally sticks herself with a needle after starting an intravenous line on a client with AIDS. The nurse tells the supervisor about the accident. What is the best initial response by the supervisor to decrease anxiety in the nurse? 1. "Workers' compensation will cover the cost of your illness and medications." 2. "Fortunately, the chances of you contracting human immunodeficiency virus after the stick are very small." 3. "If you are started on medications soon, it will decrease the severity of the disease." 4. "Did you use the hospital protocols for starting IV lines on a client with AIDS?"
Answer: 2 Explanation: Risk of transmission does exist, but is very small.
A client who is pregnant is taking ritonavir. When asking about the safety of this medication in pregnancy, the nurse informs the client that this drug is in pregnancy category: 1. X. 2. B. 3. C. 4. A.
Answer: 2 Explanation: Ritonavir is in pregnancy category B, so it is safe to use during pregnancy.
The client receives cyclophosphamide (Cytoxan) as treatment for cancer and experiences oral irritation as an adverse effect. What does the best plan of the nurse include to promote oral comfort? 1. Ice fluids before drinking. 2. Teach good oral hygiene, including rinsing the mouth with plain water after eating. 3. Teach the client to drink tea to keep tissues moist. 4. Teach the client to use a firm toothbrush for brushing teeth.
Answer: 2 Explanation: Simple rinsing of the mouth with plain water may help relieve symptoms.
A client has been prescribed tenofovir. What information should the nurse include in the client's education? 1. Double the next dose if a dose is missed. 2. Take the medicine on an empty stomach. 3. The risk of transmitting the disease through blood contamination is decreased. 4. The drug increases bone mineral density.
Answer: 2 Explanation: Taking this drug on an empty stomach helps increase absorption.
A patient with chronic hepatitis B has been prescribed tenofovir (Viread). The nurse will teach the patient to immediately report symptoms of what adverse and potentially life-threatening drug effect? 1. Systemic yeast infection 2. Lactic acidosis 3. Heart failure 4. Ventricular dysrhythmias
Answer: 2 Explanation: Tenofovir is known to cause lactic acidosis. Symptoms such as anxiety, fatigue, nausea, vomiting, palpitations, lethargy, rapid breathing and heart rate, weakness, chest pain or tightening, hypotension, or shortness of breath should be immediately reported to the provider.
A client wants to be vaccinated against viral hepatitis. The nurse would inform the client that a vaccine is available for: 1. hepatitis B only. 2. hepatitis A (HAV) and B (HAB). 3. hepatitis non-A non-B. 4. hepatitis B and C.
Answer: 2 Explanation: The best treatment for viral hepatitis is prevention through immunization, which is available for HAV and HBV.
A female client has experienced alopecia due to chemotherapy. She is distraught and feels that no one will want to look at her. How can the nurse best address the client's concerns? 1. Show the client photos of cancer survivors whose hair grew back more thickly. 2. Discuss the client's feelings about the effects of her hair loss. 3. Have a cancer survivor visit the client and discuss wearing a wig. 4. Tell the client that her hair will grow back in a few weeks.
Answer: 2 Explanation: The client needs to discuss and explore the meaning of her hair loss to deal with her feelings.
The nurse is preparing to administer cyclophosphamide (Cytoxan) and knows that the patient will experience nadir in approximately 9 to 14 days. Which laboratory values will indicate to the nurse that the patient has reached nadir? 1. Blood urea nitrogen and creatinine. 2. White blood cell count and absolute neutrophil count. 3. Ionized calcium. 4. Serum albumin.
Answer: 2 Explanation: The nadir indicates that myelosuppression has occurred and is indicated by decreased blood cell counts. WBC and ANC are sensitive indicators of the nadir.
If the nurse is caring for a client taking epoetin alfa and notices blood lab tests have dropped below normal, the best initial action would be to: 1. tell the client to take her normal dose that day, but come in for some lab work. 2. notify the healthcare provider. 3. tell the client to stop the drug and notify her healthcare provider. 4. tell the client to stop the drug for 3 days to give the body some time for the levels to rise back to normal.
Answer: 2 Explanation: The nurse would notify the healthcare provider because the dose of epoetin alfa should be increased so that the therapeutic effects can be achieved.
The preferred drug to be used in combination with zidovudine for perinatal transmission prevention is: 1. ritonavir. 2. lamivudine. 3. tenofovir. 4. didanosine.
Answer: 2 Explanation: The preferred drug to be used in combination with zidovudine for perinatal transmission prevention is lamivudine
When HIV progresses to AIDS, there is a gradual destruction of the immune system, measured by: 1. decline in CD4 receptors. 2. decline in CD4 lymphocytes. 3. decline in platelet count. 4. decline in red blood cells.
Answer: 2 Explanation: The progression to AIDS is measured by a decline in CD4 lymphocytes.
The nurse is teaching a client about the goals of drug therapy for HIV-AIDS. Which statement by the client indicates the need for further teaching? 1. "A goal of pharmacotherapy is an increased lifespan." 2. "A goal of pharmacotherapy is curing the disease." 3. "Increased quality of life is a goal of pharmacotherapy." 4. "Reduced HIV RNA in the blood is a goal of pharmacotherapy."
Answer: 2 Explanation: There are no drugs available currently that will cure HIV-AIDS.
Agents with antineoplastic activity that have been isolated from a number of plants work in what way? 1. They aid in attachment to the receptor sites on the cancer cell. 2. They arrest cell division, or mitosis. 3. They contain substances that have the ability to kill the cancer cells. 4. They prevent conversion from DNA to RNA.
Answer: 2 Explanation: They stop cell division, or mitosis.
When discussing the outcome of treatment with a client, the nurse states that theoretically the cancer has been "cured" when: 1. The client no longer experiences the physiologic effects of cancer. 2. Every single cancer cell in the tumor has been eliminated. 3. The tumor cannot be identified on a CT scan. 4. The client's absolute neutrophil rises back to a normal level.
Answer: 2 Explanation: This defines when a client is "cured."
The nurse is describing the mechanism of action of antimetabolites to a client with cancer. Which statement best describes how the antimetabolites kill cancer cells? 1. "They use the body's immune system to kill tumor cells." 2. "They disrupt metabolic pathways, slowing growth of cancer cells." 3. "They contain bacterial substances that can kill cancer cells." 4. "They change the shape of the DNA and prevent division of cancer cells."
Answer: 2 Explanation: This describes antimetabolites.
Which statement is not true of adjuvant chemotherapy? 1. Adjuvant therapy is the administration of antineoplastic drugs after surgery or radiation therapy. 2. Adjuvant therapy is the administration of antineoplastic drugs before surgery or radiation therapy. 3. A goal of adjuvant therapy is to treat any micrometastases that might be developing. 4. A goal of adjuvant therapy is to rid the body of any cancerous cells that were not removed during surgery.
Answer: 2 Explanation: This describes neoadjuvant chemotherapy.
Zidovudine (AZT, Retrovir) is prescribed for a patient. Which statement by the patient would indicate that further medication-related teaching is needed? 1. "Antiretroviral therapy must be continued for the remainder of my life." 2. "The human immunodeficiency virus vaccine creates only temporary immunity against the disease." 3. "The medication schedule can be adjusted daily depending on my activities." 4. "Many individuals infected with the human immunodeficiency virus are able to live symptom free due to the medication."
Answer: 2 Explanation: This is a false statement. No vaccine currently exists to provide immunity to HIV infection, although testing is ongoing.
A client is being prepared for the delivery of an intravenous chemotherapeutic agent. The client asks why the drug cannot be given by mouth. The nurse explains that an advantage to intravenous delivery is that: 1. it protects the client from environmental infections. 2. a consistent serum drug level can be obtained. 3. it is administered outside of the home. 4. it can protect the veins during administration.
Answer: 2 Explanation: This is an advantage of intravenous delivery.
The nurse recognizes that teaching about secondary prevention has been effective when the client states: 1. "If I stop smoking, I can decrease my risk of lung cancer." 2. "I need to have a Pap smear annually to detect any signs of cervical cancer." 3. "If I get a cancerous lesion removed early, I can prevent more areas of skin cancer." 4. "If I wear sunscreen, I can prevent skin cancer."
Answer: 2 Explanation: This is an example of secondary prevention.
The nurse is preparing to administer cyclophosphamide (Cytoxan), which can cause nausea and vomiting. The nurse can best manage this by: 1. giving the client bland foods during treatment. 2. administering antiemetic drugs as necessary. 3. withholding food during administration. 4. increasing fluids during administration.
Answer: 2 Explanation: This is the best way to manage nausea and vomiting.
When a client taking methotrexate notifies the nurse of a sudden onset of a rash, the nurse is alerted to what life-threatening adverse effect associated with methotrexate? 1. Peptic ulcer 2. Stevens—Johnson syndrome 3. Pancreatitis 4. Myocardial infarction
Answer: 2 Explanation: This is the correct answer.
Which statement is true regarding biologic response modifiers? 1. They are used to treat transplant rejections. 2. Some are immunostimulants and, when given with other antineoplastic agents, help limit severe myelosuppression. 3. They alter the body's defense system to decrease the removal of foreign cancer cells. 4. They are less toxic than are most classes of antineoplastics.
Answer: 2 Explanation: This is true regarding biologic response modifiers.
Which statement is true regarding grading of cancer cells? 1. Grading has very few limitations, because tumors contain cell types that are similar in appearance. 2. If the biopsy cells appear differentiated and similar to parent cells, the tumor receives a grade of 1. 3. Grading does not change much over time as the tumor evolves. 4. If the biopsy cells appear differentiated and similar to parent cells, the tumor receives a grade of 4.
Answer: 2 Explanation: This is true regarding grading.
Which statement most accurately describes the cell kill hypothesis? 1. It is a model that predicts the amount of normal cells that will be affected by antineoplastic drugs. 2. It is a model that predicts the ability of antineoplastic drugs to eliminate cancer cells. 3. It is a model that predicts how invasive a cancer has become. 4. It is a model that compares the appearance of potential cancer cells with that of normal parent cells.
Answer: 2 Explanation: This statement describes the cell kill hypothesis.
To minimize the potential for kidney damage associated with giving acyclovir intravenously, the nurse will: 1. decrease the client's protein intake 2 days before and 2 days after treatment. 2. hydrate the client intravenously during and for 2 hours after the infusion. 3. discontinue the infusion if there is any concern about a potential increase in levels of BUN. 4. limit oral fluids during infusion.
Answer: 2 Explanation: When given IV, acyclovir is associated with nephrotoxicity, so ensuring that the infusion is administered slowly and that the client is properly hydrated can lessen the potential for IV toxicity.
The nurse is providing discharge teaching to a client who has recently been diagnosed with HIV. The nurse knows the client has understood the instructions when the client states that a goal of HIV pharmacotherapy is to: Select all that apply. 1. prevent HIV-related morbidity. 2. prolong survival. 3. restore and preserve immunologic function. 4. increase viral load. 5. eliminate the potential for transmission from mother to child in pregnant clients who have HIV infection.
Answer: 2, 3 Explanation: A goal of HIV pharmacotherapy is to prolong survival with HIV. A goal of HIV pharmacotherapy is to restore and preserve immunologic function.
The strategies for managing and treating HIV infection during pregnancy have changed as more is learned about the disease. As the nurse teaching a group of new graduate nursing employees, which of the following information would you provide? Select all that apply. 1. Due to toxicities, HIV therapy will be initiated after delivery only after confirming the infant's viral load. 2. Mothers with HIV infection are started on ART as early as possible in pregnancy. 3. Infants born to mothers with HIV infection will start on HIV therapy as soon as possible after delivery. 4. Treatment of an infant born to a mother who was not on antiretroviral therapy during pregnancy will be continued for 6 months. 5. Due to toxicities, newborns should be breastfed only so that any drug therapy the mother is receiving will be passed to the infant through the breast milk.
Answer: 2, 3, Explanation: Drug therapy for women with HIV infection is begun as soon as possible once pregnancy is confirmed to decrease viral load and the potential to transmit the infection to the infant. Drug therapy is also started as soon as possibly in infants born to mothers with HIV infection.
The nurse is teaching a client about the different plants that can be used in the treatment of cancer. Which plants does the nurse include in the teaching session? Select all that apply. 1. Roses 2. Common periwinkle 3. Pacific yew 4. Mandrake 5. Tulips
Answer: 2, 3, 4 Explanation: Common periwinkle is a plant that can be used to treat cancer. Pacific yew is a plant that can be used to treat cancer. Mandrake is a plant that can be used to treat cancer.
The nurse is providing teaching to a client who has just been diagnosed with breast cancer. How would the nurse describe a malignant tumor? Select all that apply. 1. Slow growing 2. Invasive 3. Lethal if left untreated 4. May be classified as a carcinoma 5. May be classified as a sarcoma
Answer: 2, 3, 4, 5 Explanation: Malignant tumors are invasive. Malignant tumors can be lethal if left untreated. Malignant tumors are often classified as carcinomas. Malignant tumors are often classified as sarcomas.
Which assessment data would be most important for the nurse to monitor frequently in the patient receiving amantadine (Symmetrel)? Select all that apply. 1. White blood cell and platelet counts. 2. Serum creatinine and urine output. 3. Mental status and level of consciousness. 4. Sodium and potassium levels. 5. Lung sounds and signs of peripheral edema.
Answer: 2, 3, 5 Explanation: Amantadine is associated with nephrotoxicity; possible severe CNS effects including seizures, psychosis, and suicidal ideation; and peripheral edema and heart failure.
A patient has been taking lopinavir with ritonavir (Kaletra) for the past 8 years and has noticed a redistribution of body fat in his arms, legs, and abdomen (lipodystrophy). In addition to this effect, the nurse knows that this drug may be associated with which additional adverse effects? Select all that apply. 1. Chronic kidney disease 2. Hyperglycemia 3. Pancreatitis 4. Bone marrow suppression 5. Hepatic failure
Answer: 2, 3, 5 Explanation: Hyperglycemia, pancreatitis, and hepatic failure are adverse effects associated with lopinavir with ritonavir.
The nurse on an oncology unit anticipates that which clients are most likely to receive palliative cancer treatment? Select all that apply. 1. A client with Hodgkin's lymphoma 2. A client with osteosarcoma 3. A client with choriocarcinoma 4. A client with advanced pancreatic cancer 5. A client with Kaposi's sarcoma
Answer: 2, 4, 5 Explanation: A client with osteosarcoma will be treated with palliative chemotherapy. A client with advanced pancreatic cancer will be treated with palliative chemotherapy. A client with Kaposi's sarcoma will be treated with palliative chemotherapy.
A client has a 2-cm breast tumor, which is estimated to contain 2 billion cancer cells. The client has completed chemotherapy, and the healthcare provider indicates that 99% of these cancer cells have been killed. The nurse calculates that ________ cancer cells remain.
Answer: 2,000,000 Explanation: If the drug kills 99% of 2 billion cells, then 1%, or 2 million, remain.
The nurse is teaching a client with human papillomavirus (HPV) about the correlation between certain viruses and cancer. The nurse explains that viruses account for no more than ________% of all cancers.
Answer: 20 Explanation: It is estimated that viruses are associated with about 15% to 20% of all human cancers. Examples include herpes simplex types 1 and 2, Epstein-Barr, human papillomavirus (HPV), cytomegalovirus, and human T-lymphotrophic viruses.
A client has been prescribed acyclovir for recurrent attacks of herpes simplex. The nurse tells the client to take the prescribed medication within ________ hours after symptoms appear to decrease the length of future outbreaks.
Answer: 24 Explanation: Recurrent herpes lesions are usually mild and often require no drug treatment. If drug therapy is initiated within 24 hours after symptoms first appear, the length of the acute episode may be shortened or even prevented.
Which teaching point by the nurse is correct in regards to antiviral therapy? 1. Antiviral drug therapy can be challenging because of how slowly viruses become resistant to the drugs. 2. Antiviral drugs have a broad spectrum of activity. 3. It is difficult to administer adequate doses of medication to kill the virus without injuring normal cells. 4. Antiviral drugs must be given one at a time because of the possibility of severe side effects.
Answer: 3 Explanation: A challenge to antiviral therapy is that it is difficult to administer adequate doses of medication without injuring the normal cells.
The client receives delavirdine (Rescriptor) as treatment for AIDS. The nurse assesses the client for which serious side effect? 1. Cardiac arrest 2. Bone marrow suppression 3. Rash 4. Seizures
Answer: 3 Explanation: A serious adverse effect of delavirdine (Rescriptor) is Stevens—Johnson syndrome, which appears as a rash and can be life threatening.
It is crucial for the nurse to monitor which laboratory tests when a client is taking acyclovir (Zovirax)? 1. Fasting and postprandial blood glucose 2. White blood count (WBC) and aspartate aminotransferase (AST) 3. Blood urea nitrogen (BUN), creatinine, and complete blood count (CBC) 4. Viral culture and urinalysis
Answer: 3 Explanation: Acyclovir causes nephrotoxicity, hemolytic uremic syndrome, and thrombocytopenia purpura. These complications can be identified promptly by monitoring BUN, creatinine, and CBC frequently.
All six major classes of drugs used to manage HIV infection have the ability to: 1. prevent the virus from entering the host cell. 2. destroy the cell walls of the virus. 3. inhibit enzymes that are necessary for viral replication. 4. promote cell division only in uninfected cells.
Answer: 3 Explanation: All six major classes of drugs used to manage HIV infection inhibit enzymes necessary for viral replication.
Which statement is not one of the reasons that clients undergoing chemotherapy usually receive several rounds of treatment spaced over time? 1. Side effects can occur, and the client needs time to recover. 2. The neutrophil count can decrease, so time between treatments is necessary for the body to make more neutrophils to boost the immune system. 3. The cost of treatments is very high. 4. Each round of chemotherapy kills only a set percentage of cancer cells.
Answer: 3 Explanation: Although treatments are expensive, this is not the reason that treatments are spaced over time.
Which statement regarding the adverse effects of antineoplastic drugs is the most accurate? 1. They produce the most, but a small range of, adverse effects. 2. They produce the same amount of adverse effects as any other medication. 3. They commonly produce serious adverse effects. 4. They produce the least amount of serious adverse effects of any medication.
Answer: 3 Explanation: Antineoplastic drugs commonly produce serious adverse effects that may affect the patient's ability or willingness to continue therapy.
The client asks the nurse why there aren't better drugs available to treat HIV infection when so much money is spent on research. What is the best response by the nurse? 1. "Developing new drugs is difficult because we still do not understand the virus." 2. "Developing new drugs is difficult because we still do not have enough money." 3. "Developing new drugs is difficult because the virus mutates so readily." 4. "Developing new drugs is difficult because people think AIDS is a 'gay' disease."
Answer: 3 Explanation: Antiviral pharmacotherapy can be extremely challenging because of the rapid mutation rate of viruses, which can render drugs ineffective quickly.
A client is being treated with antiviral pharmacotherapy. The nurse understands that treatment with antiviral drugs is extremely challenging because: 1. their broad spectrum causes severe adverse effects. 2. the drug scheduling makes compliance difficult. 3. the rapid mutation of viruses quickly makes drugs ineffective. 4. high doses of medication are required to achieve therapeutic effects.
Answer: 3 Explanation: Antiviral pharmacotherapy is extremely challenging because the rapid mutation of viruses quickly makes drugs ineffective.
A patient with acute lymphoblastic leukemia has started therapy with doxorubicin (Adriamycin). The nurse will assist the patient with what important intervention during the course of this treatment? 1. Perform active or assisted range-of-motion (ROM) exercises to maintain strength. 2. Participate in relaxation therapy to control pain. 3. Use daily mouth rinses as prescribed. 4. Maintain bed rest during treatment.
Answer: 3 Explanation: As with many chemotherapy drugs, doxorubicin is associated with mucositis. Daily mouth rinses will be prescribed to decrease the risk of opportunistic infections from yeast and mouth bacteria.
The nurse states that bone marrow toxicity does not suppress which type of cells? 1. White blood cells 2. Platelets 3. T cells 4. Red blood cells
Answer: 3 Explanation: Bone marrow toxicity does not specifically suppress T cells.
Which assessment finding would concern the nurse if found in the client receiving darunavir (Prezista)? 1. Nausea and vomiting 2. Constipation 3. Abdominal pain, headache, and rash 4. Complete numbness and tingling around the mouth
Answer: 3 Explanation: Darunavir is a protease inhibitor. The nurse would report signs of fever, abdominal pain, headache, and rash.
A patient receiving carboplatin (Paraplatin) is also receiving filgrastim (Neupogen). The nurse will explain to the patient that the filgrastim is used for what effect? 1. It boosts the effects of the carboplatin so a decreased dosage is needed. 2. It prevents the development of secondary cancers related to carboplatin. 3. It shortens the duration of neutropenia and associated infection risk related to carboplatin. 4. It prevents bone loss and osteoporosis.
Answer: 3 Explanation: Filgrastim increases neutrophil production and decreased the duration of neutropenia with associated infection risk.
Opportunistic infections have become less common, and mortality is diminished, because HAART: 1. decreases RNA replication. 2. increases the amount of red blood cells in the body. 3. increases the number of CD4 lymphocytes. 4. decreases the transmission of opportunistic infections from one individual to another.
Answer: 3 Explanation: HAART increases the number of CD4 lymphocytes, allowing clients with HIV infection to maintain a higher level of immunologic response.
Which statement by the nurse is true in regard to the development of a vaccine to prevent HIV? 1. HIV has a low number of genetic variants. 2. HIV has such a slow replication rate. 3. HIV has an extremely rapid replication rate. 4. There is a low mutation rate.
Answer: 3 Explanation: HIV has a rapid replication rate.
A client has genital herpes simplex 2. The nurse teaches the client that: 1. spermicides can help prevent transmission. 2. antiviral medication can cure this disease. 3. This infection is for life, but recurrences usually have a shorter course and are less severe. 4. HSV can only be transmitted when there are visible lesions.
Answer: 3 Explanation: Herpes simplex is not curable and is lifelong, but with treatment, the recurrent episodes usually have a shorter course and are less severe.
Considering potential harmful side effects, which system would the nurse address as a priority area of assessment when a client is given lamivudine (Epivir)? 1. Cardiac 2. Renal 3. Hepatic 4. Pulmonary
Answer: 3 Explanation: Lamivudine can cause an unusual type of liver abnormality called lactic acidosis and hepatomegaly with steatosis. This can result in death.
Lamivudine targets which stage in the pathogenesis of a viral infection? 1. Lamivudine inhibits the release of the virus. 2. Lamivudine inhibits penetration of the viral material. 3. Lamivudine inhibits viral replication. 4. Lamivudine inhibits attachment at the receptor site.
Answer: 3 Explanation: Lamivudine inhibits the viral replication stage in the pathogenesis of a viral infection.
Unlike most normal cells, cancerous cells are able to move to other places in the body, traveling to distant sites where they populate new tumors. This process is called: 1. grading. 2. carcinogenesis. 3. metastasis. 4. angiogenesis.
Answer: 3 Explanation: Metastasis occurs when cancerous cells travel to distant sites and populate new tumors.
Chemotherapy is being initiated for a patient with prostate cancer who is experiencing mucositis. Which health teaching would be most appropriate for this condition? 1. Use an over-the-counter mouthwash to eliminate bacteria. 2. Increase intake of citrus-containing foods and beverages. 3. Eat a bland diet with low roughage and use a soft toothbrush or plain water rinses for oral care. 4. This adverse effect is expected and will disappear in a few days.
Answer: 3 Explanation: Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, an adverse effect of chemotherapy and radiation treatment for cancer. Patients experiencing this adverse effect should be instructed to eat a bland diet low in roughage and to use a soft toothbrush or plain water rinses for oral care if the mucositis is severe.
The nurse teaches clients with acquired immune deficiency syndrome (AIDS) about the importance of taking their medications as prescribed. What does the nurse recognize as the primary factor for medication nonadherence in the AIDS population? 1. The difficulty with availability of medications to treat AIDS 2. A lack of understanding for the reason to take medications 3. The necessity of having to take multiple medications throughout the day 4. The unpleasant side effects associated with the medications
Answer: 3 Explanation: Multiple medications are required throughout the day. The more medications taken daily, the higher the noncompliance rate.
Protease inhibitor-based regimens have been shown to be one of the most successful choices for the initial therapy of HIV infection. Which adverse effects are common with this regimen? 1. Fatigue, generalized weakness, myalgia 2. Headache, diarrhea, nausea, fatigue, insomnia 3. Nausea, vomiting, diarrhea, abdominal pain, headache 4. Respiratory tract infections, cough, pyrexia, rash, dizziness
Answer: 3 Explanation: Nausea, vomiting, diarrhea, abdominal pain, and headache are common with pretense inhibitor regimens.
The healthcare provider has written in the patient's chart that the cancer is at Stage I. The nurse knows that the implications for this staging are that the: 1. Cancer is advanced and the patient has a poor prognosis. 2. Cancerous cells are only moderately differentiated from the parent cells. 3. Cancer has been detected at an early stage. 4. Tumor is large and is invading surrounding tissue.
Answer: 3 Explanation: Stage I suggests that the tumor is relatively small in size, has not invaded the surrounding tissue, and has not been detected in the surrounding lymph nodes; thus is has been detected in an early stage.
Which causes are not part of the etiology of cancer? 1. Biological causes 2. Chemical causes 3. Structural causes 4. Physical causes
Answer: 3 Explanation: Structural causes are not included in the etiology of cancer.
The client receives tamoxifen for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse? 1. "Tamoxifen works by inhibiting the metabolism of breast cancer cells." 2. "Tamoxifen works by inhibiting the cellular mitosis of breast cancer." 3. "Tamoxifen works by blocking estrogen receptors on breast tissue." 4. "Tamoxifen works by binding to the DNA of breast cancer cells."
Answer: 3 Explanation: Tamoxifen acts by blocking estrogen receptors.
When providing client and family education for the nucleoside reverse transcriptase inhibitor (NRTI) drugs for HIV-AIDS, the nurse would include instructions to: 1. take the medicine with apple juice to decrease the bad taste. 2. take the medicine with orange juice to increase absorption. 3. take the medicine on an empty stomach. 4. take the medicine on a full stomach.
Answer: 3 Explanation: The medicine should be taken on an empty stomach for better absorption.
The nurse understands that clients placed in reverse isolation might exhibit signs of depression because: 1. they often have additional side effects to therapy. 2. they often have a more severe form of cancer. 3. they might believe they are in isolation and that family will not want to visit because of the need to prevent infections that could be life threatening. 4. they always become claustrophobic.
Answer: 3 Explanation: This answer is true.
The nurse tells the client that alkylating agents kill cancer cells by: 1. containing substances from bacteria that can kill cancer cells. 2. disrupting critical cellular pathways of cancer cells. 3. changing the shape of the DNA double helix and preventing DNA from duplicating during cell division. 4. blocking substances necessary for continued growth of tumors.
Answer: 3 Explanation: This is the action of alkylating agents.
What would be the best response by the nurse to a client who says that her friends might not accept her now that she has had a mastectomy? 1. "It is just a mastectomy; don't worry so much." 2. "You should get some new friends." 3. "I understand your concerns about your body changes. Let's talk about it." 4. "It is normal to be worried about what other people think. Your friends will get over it."
Answer: 3 Explanation: This is the best therapeutic response.
The nurse anticipates administering which drug to stimulate neutrophil production in clients with myelosuppression? 1. Epoetin 2. Interferon alfa 3. Filgrastim 4. Oprelvekin
Answer: 3 Explanation: This is the correct answer.
The nurse determines that instruction of a client taking ganciclovir (Cytovene) is effective when the client states: 1. "I can take this medication on an empty stomach." 2. "This medication is OK to take during pregnancy." 3. "I should avoid becoming pregnant while on this medication." 4. "I can stop taking the medication when my symptoms are gone."
Answer: 3 Explanation: This response is correct. Ganciclovir is in pregnancy category C and should be avoided during pregnancy.
The nurse who has received special training to administer chemotherapy is called: 1. an antineoplastic administrator. 2. a chemotherapy nurse. 3. an oncology nurse. 4. an IV therapy nurse.
Answer: 3 Explanation: This type of nurse is called an oncology nurse.
The nurse teaches a client that the transmission of HIV infection occurs by: 1. exposure to respiratory secretions. 2. exposure to fecal material. 3. exposure to blood or semen. 4. exposure to contaminated food.
Answer: 3 Explanation: Transmission of HIV infection occurs by exposure to contaminated body fluids, most commonly blood or semen.
The patient is receiving elbasvir-grazoprevir (Zepatier) for hepatitis C virus. Which statement by the nurse is correct? 1. "Neither the topical nor the intravenous form of Zepatier will prevent the spread of hepatitis C virus." 2. "The patient will receive a 12- to 16-month course of therapy with Zepatier." 3. "Zepatier may be used in combination with ribavirin." 4." The most common adverse effects of Zepatier are fatigue, rash, and dizziness."
Answer: 3 Explanation: Zepatier may be used in combination with ribavirin.
The nurse on an oncology unit is planning care for clients with various types of cancer. The nurse recognizes that certain cancer cells have a low growth fraction and are less sensitive to chemotherapeutic agents, including: Select all that apply. 1. leukemia cells. 2. lymphoma cells. 3. breast cancer cells. 4. lung cancer cells. 5. bone marrow cells.
Answer: 3, 4 Explanation: Breast cancer cells have a low growth fraction and are less sensitive to cell cycle specific chemotherapeutic agents. Lung cancer cells have a low growth fraction and are less sensitive to cell cycle specific chemotherapeutic agents.
The nurse is providing discharge education to a client who has been prescribed lopinavir with ritonavir (Kaletra) for the treatment of HIV. Which information should the nurse include in the teaching plan for this client? Select all that apply. 1. Take on an empty stomach. 2. Take the medication with herbal supplements to enhance absorption. 3. Discontinue your statin drug. 4. Practice safe sex while taking this drug. 5. Discontinue medication if bothersome side effects occur.
Answer: 3, 4 Explanation: The client should be advised not take statin drugs while taking this medication. Understand that this medication is not a cure for HIV infection, and it does not prevent the spread of HIV to others through sexual contact.
The nurse is teaching a client about medications that can be taken to treat the diarrhea that often accompanies chemotherapy. Which medications would be appropriate for the nurse to include in the teaching session? Select all that apply. 1. Polyethylene glycol 3350 (MiraLAX) 2. Psyllium (Metamucil) 3. Atropine (Lomotil) 4. Loperamide (Imodium) 5. Bismuth salts (Pepto Bismol)
Answer: 3, 4, 5 Explanation: This medication can be used to stop or decrease diarrhea. This medication can be used to stop or decrease diarrhea. This medication can be used to stop or decrease diarrhea.
The nurse is preparing to administer lamivudine to a client with HIV. The nurse knows that the appropriate dose for this client is ________ mg/day. Record your answer rounding to the nearest whole number.
Answer: 300 Explanation: The dose recommended for treating HIV (300 mg/day) is much greater than for HBV (100 mg/day).
A client who is receiving chemotherapy frequently complains of headache. The most effective nursing intervention would be to administer: 1. ibuprofen. 2. naproxen. 3. aspirin. 4. acetaminophen.
Answer: 4 Explanation: Acetaminophen is the preferred drug for chemotherapy clients because it does not precipitate bleeding.
A client with HIV asks if there is a vaccine to prevent transmission to the client's significant other. What is the nurse's best response? 1. "This virus has challenged scientists and they have created a pseudo vaccine." 2. "There is a vaccine that prevents the older adults from getting the HIV infection." 3. "A vaccine has been developed but it only assists young children." 4. "At present, there is no vaccine to prevent HIV transmission."
Answer: 4 Explanation: After decades of research, the FDA has not approved a single effective vaccine.
A client telephones the nurse to report fatigue since starting ribavirin therapy 4 months ago. The client has also developed shortness of breath during the past week, which has been worsening. What should the nurse tell the client? 1. "This is a normal adverse effect of this medication. Take it easy, and your symptoms will resolve." 2. "Stop taking the medication. Your healthcare provider will try another medication for hepatitis treatment." 3. "These symptoms could be signs of an allergy to the medication. Take an antihistamine and see if you notice improvement." 4. "You should come into the office to have some blood work done for possible hemolytic anemia."
Answer: 4 Explanation: An adverse effect of ribavirin can be hemolytic anemia. The client should be evaluated immediately with a complete blood count.
A client has been started on efavirenz (Sustiva) for the treatment of HIV. The client is reporting nightmares, dizziness, and a reduced ability to concentrate. The nurse tells the client that these CNS symptoms should diminish in 3 to ________ weeks.
Answer: 4 Explanation: CNS adverse effects are observed in at least 50% of clients when first initiating efavirenz therapy, including sleep disorders, nightmares, dizziness, reduced ability to concentrate, and delusions. The CNS adverse effects usually diminish after 3 to 4 weeks of therapy.
When discussing antiviral drug resistance with a client initiating pharmacotherapy, the nurse explains that most of the reasons for drug resistance in certain medicines are related to: 1. the viral load. 2. the lymphocyte count. 3. the suppressor T cells. 4. the mutations that can occur in the virus.
Answer: 4 Explanation: Drug resistance is related to genetic mutations that can occur, producing resistant strains in HIV.
When the client is started on antiretroviral drugs for HIV, what important information should the nurse teach the client? 1. This drug is readily available all over the world for treatment. 2. This type of drug will be used prior to vaccines. 3. This drug will cure the disease over a period of time. 4. This drug will not cure the disease, but could extend life expectancy.
Answer: 4 Explanation: Drug therapy has not produced a cure but has resulted in a number of therapeutic successes.
Which drug used to treat HIV-AIDS is a nonnucleoside reverse transcriptase inhibitor (NNRTI)? 1. Lamivudine (Epivir, 3TC) 2. Zidovudine (Retrovir, AZT) 3. Indinavir (Crixivan) 4. Efavirenz (Sustiva)
Answer: 4 Explanation: Efavirenz is an NNRTI.
Emtricitabine (Emtriva) is included as part of an antiretroviral therapy (ART) regimen for a patient newly diagnosed with HIV. While lower in toxicity than other nucleoside reverse transcriptase inhibitors (NRTIs), a potentially fatal adverse effect known to occur is: 1. Ventricular cardiac dysrhythmias. 2. Pulmonary fibrosis. 3. Necrotic bowel syndrome. 4. Lactic acidosis.
Answer: 4 Explanation: Lactic acidosis is known to occur with all NRTIs, although the risk with emtricitabine is less than that of some drugs. It is one of the preferred drugs for initial HIV therapy.
The nurse is caring for a client with cancer. The family asks the nurse to explain the differences between benign and malignant tumors. Which statement best describes the difference between benign and malignant tumors? 1. "Benign tumors are fast growing, remain localized, and can kill the host." 2. "Malignant tumors are slow growing but invasive, and they can kill the host." 3. "Benign tumors are slow growing but invasive." 4. "Malignant tumors are rapidly growing and invasive, and they can kill the host."
Answer: 4 Explanation: Malignant tumors grow rapidly, are invasive, and can kill the host.
A patient with cancer is started on a drug that is a known vesicant. The nurse performs which priority activity related to the drug? Monitor the patient's: 1. Response to anti nausea drugs. 2. Intake of calcium-rich foods. 3. Respiratory status for cough. 4. IV port site for redness, swelling, and pain.
Answer: 4 Explanation: Many antineoplastics are classified as vesicant drugs that can cause serious tissue injury if they leak into the surrounding tissue from an artery or vein during an infusion or injection. The nurse should closely monitor the infusion site for swelling and pain.
Which statement is accurate regarding non-HIV antiviral drugs? 1. Antivirals decrease the effects of the host cell's biological processes. 2. Research on antivirals has yielded more useful results than has research on antibacterials. 3. Antivirals have fewer adverse effects than antibiotics. 4. Antivirals have a narrow spectrum of coverage.
Answer: 4 Explanation: Non-HIV antiviral drugs have a very narrow spectrum of activity.
The nurse is aware that to achieve the most therapeutic effects, the best time to administer oseltamivir (Tamiflu) or zanamivir (Relenza) is: 1. as soon as the client has been exposed to someone with influenza. 2. any time during the course of the illness. 3. at the same time as the vaccine. 4. within 48 hours of the onset of symptoms.
Answer: 4 Explanation: Oseltamivir (Tamiflu) and zanamivir (Relenza) are examples of a new classification of drugs called neuraminidase inhibitors that are used to treat active influenza infection. When given within 48 hours of the onset of symptoms, their use can shorten the normal 7-day course of influenza to 5 days.
Why is PEP initiated only if exposure was severe, and the source of fluid is known or strongly suspected to contain HIV? 1. The cost and anxiety associated with taking the drugs are high. 2. There is not enough research supporting this treatment. 3. The cost of the drugs is high, and there are many ethical issues surrounding their use. 4. The cost of the drugs is high, and there are many adverse effects.
Answer: 4 Explanation: PEP is initiated only in severe cases, and when the source of fluid is known to be or strongly suspicious of HIV, due to the expense of the drugs and the dangerous side effects.
The nurse on an oncology unit recognizes that a patient with which type of advanced cancer would most likely require palliation therapy? 1. Bladder cancer 2. Liver cancer 3. Skin cancer 4. Pancreatic cancer
Answer: 4 Explanation: Pancreatic cancer benefits from palliation therapy.
Receiving the HPV vaccine to prevent cervical cancer is an example of what type of prevention? 1. Secondary 2. Tertiary 3. Palliation 4. Primary
Answer: 4 Explanation: Receiving the HPV vaccine to prevent cervical cancer is an example of primary prevention.
A client with HIV has been on an antiviral protease inhibitor for 2 months and recently complains of being hungry and thirsty and urinating more frequently. Knowing the adverse effects of protease inhibitors, the nurse should assess for: 1. pancreatitis. 2. kidney failure. 3. hepatomegaly. 4. hyperglycemia.
Answer: 4 Explanation: Some of the protease inhibitors are associated with hyperglycemia, and can cause diabetes or worsen existing diabetes. Worsening diabetes can be indicated by increased hunger and thirst along with more frequent urination.
The staging and grading of cancer are performed: 1. after the last chemotherapy treatment is completed. 2. when the client's symptoms start to worsen. 3. after the first chemotherapy treatment is completed. 4. upon initial diagnosis of cancer.
Answer: 4 Explanation: Staging and grading are performed upon initial diagnosis of cancer to determine the best course of therapy and to predict client outcomes.
A nurse is caring for a patient who is receiving tamoxifen for treatment of breast cancer. The nurse will teach the patient that post chemotherapy monitoring will be necessary to detect or treat which drug associated adverse effect? 1. Paralytic ileus 2. Alopecia 3. Pulmonary fibrosis 4. Endometrial cancer
Answer: 4 Explanation: Tamoxifen is associated with an increased risk of endometrial cancer and monitoring will be necessary to detect early changes that may indicate that this adverse effect has occurred.
A client receiving antineoplastic agents in the treatment of lung cancer has been told that treatment options are limited. The nurse explains that lung cancer has a decreased sensitivity to antineoplastic agents because lung cancer cells: 1. have a very erratic cell cycle, and there is little difference between the number of replicating and resting cells. 2. grow for a long time before detection and are therefore less sensitive to antineoplastic agents. 3. grow in a high-oxygen environment and are therefore not very sensitive to antineoplastic agents. 4. have a low growth fraction, so there is little difference between the number of replicating and resting cells.
Answer: 4 Explanation: The growth fraction is the ratio of the number of replicating cells to the number of resting cells. Antineoplastic drugs are much more toxic to tissues and tumors with high growth fractions. Breast and lung cancers have a low growth fraction.
The nurse is preparing to administer a dose of methotrexate to a client in the treatment of non-Hodgkin's lymphoma. The nurse expects the client to experience adverse effects from 1 to ________ hours after the medication is administered by mouth.
Answer: 4 Explanation: The onset of action for this medication is 1 to 4 hours when it is administered by mouth. The nurse would expect the client to experience adverse effects when the medication begins to act on the body.
The role of the capsid in the viral structure includes: 1. facilitating viral replication involving RNA and DNA. 2. allowing for release of the viral infection from the host. 3. triggering body defenses to remove the invader. 4. helping the virus attach to the cell membrane of the host.
Answer: 4 Explanation: The role of the capsid is to help the virus attach to the cell membrane of the host.
When administering vincristine, the nurse knows that its dose-limiting toxicity primarily affects what system? 1. Renal 2. Pulmonary 3. Cardiac 4. Central nervous system
Answer: 4 Explanation: The system primarily affected by the dose-limiting toxicity of vincristine is the central nervous system.
The synthesis stage of viral replication for viruses includes: 1. the virus living dormant in the environment for months to years. 2. the cell bursting and releasing viral particles throughout the host. 3. the virus penetrating the host cell in order to "inject" its genetic material into the host. 4. the virus replicating by making viral capsid proteins and enzymes.
Answer: 4 Explanation: This accurately describes the synthesis stage.
Which statement is true regarding hormone antagonists? 1. They are cytotoxic. 2. They enhance substances essential for hormone growth. 3. They produce debilitating adverse effects similar to those produced by the other antineoplastics. 4. They can produce debilitating adverse effects at high doses for prolonged periods.
Answer: 4 Explanation: This classification of medications can produce debilitating adverse effects when given at high doses for prolonged periods of time.
An inaccurate statement about the process of staging cancer is that staging: 1. determines where the cancer is located. 2. determines the extent of the cancer invasion. 3. helps the healthcare provider determine the best course of treatment. 4. compares the appearance of cancer cells with that of normal cells.
Answer: 4 Explanation: This describes grading.
Which statement most accurately describes the action that occurs during stage S (synthesis) of the cell cycle? 1. The cell undergoes prophase, metaphase, anaphase, and telophase. 2. The cell makes additional proteins that are necessary for cell division. 3. The cell conducts metabolism, impulse conduction, contraction, or secretion. 4. The cell duplicates its DNA.
Answer: 4 Explanation: This describes stage S (synthesis).
A client was recently given a prescription for enfuvirtide (Fuzeon). What educational information should be in the teaching plan? 1. Inject the drug into the same abdominal site area daily. 2. Take this drug with vitamin D to help absorption. 3. Some serious drug interactions could occur. 4. Inject the drug subcutaneously twice daily.
Answer: 4 Explanation: This drug is to be given as a subcutaneous injection twice daily.
Which statement best explains the mechanism of action of monoclonal antibodies? 1. They alter the DNA of the tumor cells. 2. They prevent replication of the tumor cells. 3. They stimulate immune cell function. 4. They attack antigens on the surface of specific tumor cells.
Answer: 4 Explanation: This is the correct mechanism of action of monoclonal antibodies.
A client is receiving chemotherapy in the treatment of breast cancer. The nurse explains that although chemotherapy has several goals, it does not attempt to: 1. control the cancer. 2. provide palliation. 3. cure the cancer. 4. prevent transmission of the cancer.
Answer: 4 Explanation: Transmission prevention is not a goal of chemotherapy.
The nurse teaches a client with genital herpes that a virus is known as an intracellular parasite because: 1. it is surrounded by a protein coat called a capsid. 2. it affects only one species of living organism. 3. it contains DNA or RNA, but not necessarily both. 4. it is incapable of causing infection unless it has invaded a host cell.
Answer: 4 Explanation: Viruses must be inside a host cell to cause infection. They do not have the cellular equipment necessary for self-survival.
The patient has received a prescription for zanamivir (Relenza) for flu symptoms but tells the nurse, "I think I can hold off on starting this, I don't feel that bad yet." What would be the nurse's best response? 1. "That should be fine and the drug has a stable shelf-life so it can be saved for later infections." 2. "It can be saved for later but you will also require an additional antibiotic to treat the symptoms at that point." 3. "It can be started within 2 weeks after the onset of symptoms." 4. "To be effective, it must be starts within 48 hours after the onset of symptoms."
Answer: 4 Explanation: Zanamivir must be started within 48 hours after the onset of symptoms to be effective.
The nurse is caring for a client with AIDS who has just learned she is pregnant. She tearfully asks the nurse if her baby will die of AIDS. What is the best course of action for this client? 1. The client will take tipranavir (Aptivus) as prescribed. 2. The client will take raltegravir (Isentress) as prescribed. 3. The client will take indinavir (Crixivan) as prescribed. 4. The client will take zidovudine (Retrovir) as prescribed.
Answer: 4 Explanation: Zidovudine (Retrovir) is part of the recommended regimen for pregnant women.
Which of the following statements made by the patient who is undergoing chemotherapy would be of concern to the nurse? Select all that apply. 1. "I attended a meeting of a cancer support group this week." 2. "My husband and I are planning a short trip next week." 3. "I try to eat 6 small meals a day plus two protein shakes each day." 4. "I am taking my 15-month-old granddaughter to the pediatrician next week for her baby shots." 5. "I am going to go shopping at the mall next week."
Answer: 4, 5 Explanation: Patients and family members should avoid receiving live virus vaccinations or exposure to chickenpox. Varicella (chickenpox) vaccination is usually given to children between the ages of 12 and 18 months and the patient should not care for her granddaughter if immunization with live virus vaccines is planned. the patient should also avoid crows, especially in enclosed areas, to minimize the risk of infection.
While discussing the pharmacotherapy of HIV with a group of nursing students, the nurse states that the goal of antiretroviral therapy is to reduce plasma HIV RNA to less than ________ copies/mL.
Answer: 48 Explanation: HIV RNA levels are determined every 3 to 6 months to monitor progression of the disease and to assess the degree of success of antiretroviral therapy. The goal of antiretroviral therapy is to reduce plasma HIV RNA to less than 48 copies/mL. For most patients, 12 to 24 weeks of HIV pharmacotherapy is required to achieve this level.
The nurse is teaching a client about tamoxifen therapy in the treatment of breast cancer. The nurse tells the client that the total length of endocrine therapy is ________ years.
Answer: 5 Explanation: The American Society of Clinical Oncology (ASCO) recommends aromatase inhibitor therapy with exemestane (Aromasin) as an option for all postmenopausal women with ER-positive breast cancer. Aromatase inhibitors can be started as primary therapy, or instituted after the completion of 2 to 3 years of tamoxifen therapy. For most patients, the total length of endocrine therapy (tamoxifen plus aromatase inhibitor) is 5 years.
In preparing a client for radiation therapy, the nurse explains that ________% of clients undergo radiation as part of their cancer treatment.
Answer: 50 Explanation: Approximately 50% of clients with cancer receive radiation therapy as part of their treatment.
The nurse is discussing the risk of transmission of HIV to a pregnant woman who is concerned her baby will become infected. The nurse states that by following the prescribed treatment regimen transmission can be reduced by approximately ________%.
Answer: 70 Explanation: A reduction of approximately 70% in transmission from mother to infant was achieved in clinical trials in 1994 with a zidovudine regimen.
