N329 Quiz 2 Review Questions

A nurse is instructing a client how to self-administer enfuvirtide. Which of the following instructions should the nurse include? A. "Allow the vial to sit until the solution is completely clear and without particulates." B. "After reconstituting with sterile water, vigorously shake the vial to mix the solution." C. "Use the medication immediately upon removing from the refrigerator." D. "Use the same location for five injections before rotating to a new site."

A. "Allow the vial to sit until the solution is completely clear and without particulates."

A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug? A. Black, tarry stools B. Polyuria C. Bone pain D. Dry mouth

A. Black, tarry stools

A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects? A. Bone marrow depression B. Thrombocythemia C. Double vision D. Constipation

A. Bone marrow depression

A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (Select all that apply.) A. Diaphoresis B. Palpitations C. Shortness of breath D. Nausea E. Diarrhea

A. Diaphoresis D. Nausea E. Diarrhea

A nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect? (Select all that apply.) A. Dizziness B. Diarrhea C. Jaundice D. Tinnitus E. Headache

A. Dizziness D. Tinnitus E. Headache

The nurse recognizes that a deficiency in a clotting factor may cause which finding(s)? (Select all that apply.) A. Easy bruising and cutaneous hematoma formation with minor trauma (e.g., an injection) B. Bleeding from the gums and prolonged bleeding following minor injuries or cuts C. Enhanced platelet aggregation and increased clumping of RBCs D. Fibrin molecules form fibrin threads to increase wound healing E. Yellowish skin color

A. Easy bruising and cutaneous hematoma formation with minor trauma (e.g., an injection) B. Bleeding from the gums and prolonged bleeding following minor injuries or cuts

A client is about to start taking ritonavir to treat HIV-1 infection. Which of the following instructions should you include when talking with the client about taking this drug? (Select all that apply.) A. Expect periodic blood glucose testing B. Take it on an empty stomach C. Watch for and report jaundice D. Increase weight-bearing activity E. Expect periodic cholesterol testing

A. Expect periodic blood glucose testing C. Watch for and report jaundice D. Increase weight-bearing activity E. Expect periodic cholesterol testing

A nurse is caring for a client who takes several antiretroviral medications, including the NRTI zidovudine, to treat HIV infection. The nurse should monitor for which of the following adverse effects of zidovudine? (Select all that apply.) A. Fatigue B. Blurred vision C. Ataxia D. Hyperventilation E. Vomiting

A. Fatigue D. Hyperventilation E. Vomiting

A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? (Select all that apply.) A. Fever B. Tinnitus C. Diaphoresis D. Thrombophlebitis E. Dizziness

A. Fever B. Tinnitus C. Diaphoresis E. Dizziness

Which of the following hematopoietic drugs exhibits this mechanism of action: "stimulate leukocyte production" A. Filgrastim B. Alteplase C. Epoetin alfa D. Clopidogrel

A. Filgrastim

The nurse knows that a patient in the acute infection phase of the HIV clinical course is likely to report which of the following symptoms? (Select all that apply.) A. Flu like symptoms B. Symptoms of an opportunistic infection C. Low grade fever D. Headache E. Rash F. CD4 count of 200 cells/mm3

A. Flu like symptoms C. Low grade fever D. Headache E. Rash

A client who has rheumatoid arthritis is taking methotrexate. Which of the following reduces toxicity from this drug? A. Folic acid B. Magnesium sulfate C. Ferrous sulfate D. Niacin

A. Folic acid Rationale: Folic acid may reduce the toxic effects of methotrexate. The client should take 5 mg or more of folic acid supplement per week.

A nurse is caring for a client who is prescribed zidovudine. Which of the following laboratory values should the nurse report to the provider? A. Hemoglobin 7.1 g/dL B. RBC count 5.2/mm3 C. Neutrophil 57% D. Triglycerides 125 mg/dL

A. Hemoglobin 7.1 g/dL

A nurse is caring for a client who has renal failure and is receiving epoetin. The nurse should monitor the client for which of the following adverse effects? A. Hypertension B. Muscle pain C. Edema D. Dry mouth

A. Hypertension Rationale: Epoetin, an erythropoietic growth factor, can cause hypertension. The nurse should monitor the client's BP before and during therapy and inform the provider if it increases.

A nurse is caring for a client who has a prescription for etanercept. The nurse should identify that etanercept treats RA by which of the following actions? A. Inactivation of tumor necrosis factor B. Inhibition of osteoclast activity C. Decreasing the reuptake of serotonin D. Interference with the production of lymphocytes

A. Inactivation of tumor necrosis factor

A nurse is teaching a client about a new prescription for celecoxib. Which of the following information should the nurse include in the teaching? A. Increases the risk for a myocardial infarction B. Decreases the risk of stroke C. Inhibits COX-1 D. Increases platelet aggregation

A. Increases the risk for a myocardial infarction

A nurse is caring for a client taking etanercept. Which of the following adverse effects is most important to mention when educating this client? A. Injection site reaction can occur B. Elevation of liver enzymes can occur C. Gastric perforation can occur D. Vision changes can occur

A. Injection site reaction can occur Rationale: Teach the client to look for localized reaction signs such as itching, erythema, swelling and pain.

Common adverse effects of calcineurin inhibitors include: (Select all that apply.) A. Nephrotoxicity B. Infection C. Gingival hyperplasia D. Hirsutism E. Hypokalemia F. Pulmonary fibrosis

A. Nephrotoxicity B. Infection C. Gingival hyperplasia D. Hirsutism

A nurse is planning education about cyclosporine for a client who has a kidney transplant 2 days ago. Which of the following statements should the nurse plan to include? A. "You might have hair loss due to the medication therapy you'll be taking." B. "You will need to continue taking this medication to protect your new kidneys." C. "Use an over-the-counter anti-inflammatory medication for aches and pains." D. "Your risk for infection will increase if you stop taking this medication."

B. "You will need to continue taking this medication to protect your new kidneys."

The male patient presents to your ED with report of the condom breaking during anal intercourse with another man during a party. Which medication(s) would you expect to give to this patient? A. A combination of antiviral and antifungal medication with a shot of penicillin. B. A combination of a protease inhibitor and nucleoside reverse transcriptase inhibitors. C. Single-agent therapy with a non-nucleoside transcriptase inhibitor D. No medications are recommended at this time

B. A combination of a protease inhibitor and nucleoside reverse transcriptase inhibitors.

A nurse is administering epoetin intravenously to a client who has renal failure. Which of the following actions should the nurse take? A. Shake the vial before using. B. Administer via IV bolus over 1 to 3 min. C. Dilute the drug first with D5W. D. Save the used vial for the next dose.

B. Administer via IV bolus over 1 to 3 min.

A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? A. Tinnitus B. Chest pain C. Constipation D. Diaphoresis

B. Chest pain

A nurse is caring for a client who is about to begin receiving acyclovir IV to treat a viral infection. The nurse should recognize that cautious use of the drug is essential if the client also has which of the following conditions? A. Heart failure B. Dehydration C. Asthma D. Tinnitus

B. Dehydration Rationale: Acyclovir, an antiviral drug, can cause renal toxicity, especially in clients who are dehydrated. Hydration during and after IV infusion of the drug can help prevent crystalluria.

A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? (Select all that apply.) A. Reduce the dose during periods of stress. B. Discontinue the drug gradually. C. Report illness or infection. D. Increase intake of calcium and vitamin D. E. Monitor for signs of gastric bleeding.

B. Discontinue the drug gradually. C. Report illness or infection. D. Increase intake of calcium and vitamin D. E. Monitor for signs of gastric bleeding.

What hematological effects might you see with Ziduvodine (Retrovir, AZT)? A. Increase in platelets B. Drop in Hgb C. Increase in Hct D. Drop in platelets

B. Drop in Hgb

A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with sildenafil? A. Aspirin B. Isosorbide C. Clopidogrel D. Atorvastatin

B. Isosorbide

An adverse effect of bone pain is most commonly associated with which hematopoietic growth factor? A. Erythropoietic B. Leukopoietic C. Thrombopoietic

B. Leukopoietic

Common adverse effects of mTOR inhibitors include: (Select all that apply.) A. Tremors B. Nephrotoxicity C. Elevated cholesterol and triglycerides D. Hirsutism E. Increased risk of infection

B. Nephrotoxicity C. Elevated cholesterol and triglycerides E. Increased risk of infection

A nurse is caring for a client who has a new prescription for enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the adverse reactions of this medication? (Select all that apply.) A. Bleeding B. Pneumonia C. Cerebral edema D. Localized erythema E. Hypotension

B. Pneumonia D. Localized erythema E. Hypotension

The nurse is assigned to a patient with thrombocytopenia. What is the priority goal of nursing care? A. Prevention of infection B. Prevention of injury C. Prevention of dehydration D. Prevention of nutritional deficit

B. Prevention of injury

A nurse is teaching about self-administering methotrexate to a client who has rheumatoid arthritis. Which of the following statements should the nurse make? A. "Use a nonsteroidal anti-inflammatory drug to reduce toxicity." B. "If you miss a dose, go ahead and take it with the next scheduled dose." C. "Drink a minimum of 2 liters of water per day to promote the drug's excretion." D. "Take it in the morning to prevent insomnia."

C. "Drink a minimum of 2 liters of water per day to promote the drug's excretion." Rationale: Methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent kidney damage. Clients can also take sodium bicarbonate tablets to increase urine alkalinity and reduce the drug precipitation that can lead to kidney damage.

A client is about to start therapy with methotrexate for rheumatoid arthritis. Knowing the adverse effects of methotrexate, you advise the client to watch for which of the following? A. Dysphagia B. Sore throat C. Edema D. Paresthesia

B. Sore throat Rationale: Methotrexate may cause bone marrow suppression. The client should report any sign of infection, such as a sore throat or fever.

A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? (Select all that apply.) A. Palpitations B. Sore throat C. Vertigo D. Bruising E. Vision changes

B. Sore throat C. Vertigo D. Bruising E. Vision changes

A nurse is caring for a client who has a prescription for methotrexate. Which of the following drugs would likely be prescribed in conjunction during the initial treatment for rheumatoid arthritis? A. Aspirin B. Salicylates C. Sulfonylureas D. Ibuprofen

D. Ibuprofen Rationale: NSAID analgesics, such as ibuprofen, are often prescribed along with methotrexate during the initial course of treatment for rheumatoid arthritis. It can take weeks for DMARDs to reach therapeutic levels and begin relieving joint inflammation and pain, so ibuprofen can be administered concurrently to help make the client more comfortable while waiting for methotrexate's therapeutic effects.

A provider prescribes prednisone for a client who has type 1 diabetes mellitus. Recognizing the risk for an adverse drug reaction to the prednisone, which of the following precautions should the primary care provider take for this client? A. Reduce the insulin dose B. Increase carbohydrate intake C. Reduce the prednisone dose D. Increase serum glucose monitoring

D. Increase serum glucose monitoring

A nurse is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibit platelet aggregation by which of the following mechanisms? A. Activating thromboxane A2 B. Blocking adenosine diphosphate receptor agonists C. Suppressing specific clotting factors D. Inhibiting cyclooxygenase action in platelets

D. Inhibiting cyclooxygenase action in platelets

The patient has been started on enfuvirtide (Fuzeon), a fusion inhibitor. What education would the nurse expect to provide? A. The importance of taking this medication with a high fat meal B. The importance of not taking any statins with this drug C. Instructions to let the medication dissolve completely under the tongue and avoid chewing it. D. Instructions how to inject the medication subcutaneously

D. Instructions how to inject the medication subcutaneously

The nurse assesses for which initial clinical manifestation in the patient diagnosed with gout? A. Pain and inflammation in the shoulder B. Pain and inflammation in the wrist C. Pain and inflammation in the knee D. Pain and inflammation in the great toe

D. Pain and inflammation in the great toe

A client is about to start taking aspirin to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin? A. Dyspnea B. Constipation C. Calf pain D. Petechiae

D. Petechiae

A nurse should recognize that raltegravir is used to treat clients who have which of the following conditions? A. Hairy cell leukemia B. Thyroid cancer C. Kaposi's sarcoma D. Resistant HIV

D. Resistant HIV Rationale: Raltegravir, an integrase inhibitor, along with other antiretroviral drugs, treats HIV that is resistant to other drugs. The nurse should administer raltegravir with other antiretroviral drugs.

A nurse in an emergency department is performing an admission assessment for a client who has severe aspirin toxicity. Which of the following findings should the nurse expect? A. Body temperature 35C (95F) B. Lung crackles C. Cool, dry skin D. Respiratory depression

D. Respiratory depression

A nurse is caring for a client who is taking etanercept for rheumatoid arthritis. The nurse should monitor the client for which of the following indications of a serious adverse reaction to the drug? A. Excessive salivation B. Increased thirst C. Blood in the urine D. Shortness of breath

D. Shortness of breath Rationale: Etanercept can cause heart failure, manifesting as shortness of breath, cough, elevated blood pressure and heart rate, and pink-tinged sputum.

The patient has been diagnosed with HIV and her CD4 count is 350/mm3. She has been prescribed a combination of a PI, a NNRTI, and 2 NRTIs. What is the rationale for this regimen? A. The combination is less expensive than hospitalization for opportunistic infections. B. Multiple medications are needed to eliminate the HIV infection C. Protease inhibitors counteract the side effects of the other medications D. The combination prevents or delays the patients complications from HIV infection.

D. The combination prevents or delays the patients complications from HIV infection.

A nurse is caring for a client who has a new prescription for ritonavir and zidovudine therapy to treat HIV-1. The nurse should inform the client that zidovudine is prescribed with ritonavir for which of the following reasons? A. To prevent an infusion reaction B. To increase platelet production C. To protect healthy cells from the toxic effects of ritonavir D. To prevent drug resistance

D. To prevent drug resistance

What is the role of erythropoietin in the regulation of red blood cells? A. To make Hgb capable of transporting oxygen B. To pick up carbon dioxide from the tissues and deliver it to the lungs C. To decrease RBC production D. To stimulate RBC production

D. To stimulate RBC production

The nurse knows that which of the following medications will best penetrate the CSF? A. Enfuvirtide (Fuzeon) B. Maraviroc (Selzentry) C. Efavirenz (Sustiva) D. Zidovudine (Retrovir, AZT)

D. Zidovudine (Retrovir, AZT)

T/F: It is safe to administer Allopurinol (medication to lower uric acid levels) along with Azathioprine (Imuran)

False

A nurse is evaluating teaching for a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following statements by the client indicates understanding of the teaching? A. "I will be sure to return to the office at least once a year to have my blood drawn while I'm taking methotrexate." B. "I can receive live-virus vaccines while taking this medication." C. "I'll let the doctor know if I develop sores in my mouth while I'm taking this medication." D. "I should stop taking oral contraceptives while I'm taking methotrexate."

C. "I'll let the doctor know if I develop sores in my mouth while I'm taking this medication." Rationale: Ulcerations in the mouth, tongue, or throat are often the first manifestations of methotrexate toxicity and should be reported to the provider immediately.

The nurse is teaching a patient about the need for multiple drug-therapy for HIV infection. Which statement, if made by the patients, would indicate a need for further teaching? A. "If I don't take all of the drugs as prescribed, the virus is more likely to become resistant to drugs." B. "The higher the number of viruses in my body, the greater the change one will become resistant." C. "The virus recognizes the antibiotic and is able to change to prevent being destroyed." D. "When the HIV is changing RNA into DNA within the host cell, genetic changes can occur spontaneously."

C. "The virus recognizes the antibiotic and is able to change to prevent being destroyed."

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

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

A nurse is caring for a client who has a new prescription for acyclovir to treat a herpes simplex infection. Which of the following laboratory values should the nurse monitor for this client? A. Prothrombin time B. Hct C. BUN D. Aspartate aminotransferase

C. BUN Rationale: Acyclovir, an antiviral drug, can cause renal toxicity due to drug accumulation in renal tubules. The nurse should monitor the client's urine output, BUN, and creatinine levels, and increase fluid intake to hydrate and flush the kidneys.

A nurse is teaching a client about methotrexate. The nurse should inform the client to monitor for which of the following as an adverse effect of this drug? A. Muscle pain B. Peripheral edema C. Black, tarry stools D. Redness in the calf

C. Black, tarry stools Rationale: Methotrexate can cause gastric intestinal ulceration, which can lead to perforation and bleeding. The client should monitor for blood in stools or emesis and report either to the provider immediately.

A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of RA. The nurse should monitor the client for which of the following adverse drug reactions? A. Pulmonary embolism B. Hepatitis C. Bone loss D. Breast cancer

C. Bone loss Rationale: Prednisone, a glucocorticoid, can cause osteoporosis, especially with long-term use. Clients who are taking the drug should increase weight-bearing activity and report back pain. The nurse should monitor the client's bone density.

Assuming no resistance, which of the following is the drug of choice for prophylaxis of malaria? A. Doxycycline B. Quinidine IV C. Chloroquine D. Mefloquine

C. Chloroquine

A client is about to start taking oprelvekin for thrombocytopenia. To assess for adverse effects of this drug, you should monitor which of the following carefully during drug therapy? A. Liver function B. Hearing C. ECG D. Level of consciousness

C. ECG Rationale: Oprelvekin, a thrombopoietic growth factor, can cause cardiac dysrhythmias, such as atrial fibrillation, atrial flutter, and tachycardia.

A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effects? A. Dusky nail beds B. Petechiae C. Enlarged spleen D. Swollen calf

C. Enlarged spleen Rationale: With long-term use, filgrastim, a leukopoietic growth factor, can cause an enlarged spleen. The nurse should tell the client to monitor and report abdominal pain or fullness.

Which of the following hematopoietic drugs exhibits this mechanism of action: "stimulates RBC production" A. Filgrastim B. Alteplase C. Epoetin alfa D. Clopidogrel

C. Epoetin alfa

A nurse is providing teaching for a client who has gout and a new prescription for allopurinol. For which of the following adverse effects should the client be taught to monitor? (Select all that apply.) A. Stomatitis B. Insomnia C. Nausea D. Rash E. Increased gout pain

C. Nausea D. Rash E. Increased gout pain

Which of the following drugs is a glucocorticoid? A. Morphine B. Naloxone C. Prednisone D. Ibuprofen

C. Prednisone

Which medication has a drug interaction with Sirolimus (Rapamune)? A. Beta blockers B. PPIs C. Statins D. Antidiarrheals

C. Statins

A nurse is reviewing the medical record of a client who has a prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? A. Rheumatoid arthritis B. Ankylosing spondylitis C. Sulfonamide allergy D. Adrenocortical insufficiency

C. Sulfonamide allergy Rationale: Clients who are allergic to sulfonamides can have severe allergic reactions to celecoxib, a COX-2 inhibitor. Clients who are allergic to salicylates can also react adversely to celecoxib.

What medication can we use to treat CMV retinitis? A. Acyclovir B. Bactrim C. Gancyclovir D. Oseltamivir

C. Gancyclovir

Which of the following lab results indicate effective antiretroviral therapy? A. CD4 count 400 cells/mm3 B. Platelet count 400,000 C. HIV RNA below 20 copies D. WBC 5000/ mm3

C. HIV RNA below 20 copies Rationale: Viral load is U=U (undetectable and untransmittable) when 20-75 copies are present in the blood.

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective? A. PT B. WBC C. Hgb D. Platelets

C. Hgb

Severe forms of malaria may be treated with: A. IV quinine B. IV chloroquine C. IV artesunate D. Oral quinidine gluconate with doxycycline

C. IV artesunate

Which of the following interventions may prevent a serious adverse reaction to acyclovir? A. Premedicate with a nonsteroidal inflammatory drug B. Ambulate after infusion C. Increase fluid intake D. Remain flat for 2 hr after infusion

C. Increase fluid intake

A nurse is administering IV acyclovir to a client who has varicella. Which of the following actions should the nurse take? A. Administer a stool softener B. Decrease fluid intake following infusion C. Infuse acyclovir over 1 hr D. Monitor for hypotension

C. Infuse acyclovir over 1 hr

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 low dosages of antiretroviral minimizes resistance B. Taking one antiretroviral at a time minimizes resistance C. Taking medication at the same times daily without missing doses minimizes resistance D. Changing the medication regimen when adverse effects occur minimizes resistance

C. Taking medication at the same times daily without missing doses minimizes resistance

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication? A. The leukocyte count B. The platelet count C. The hematocrit (Hct) D. The erythrocyte sedimentation rate (ESR)

C. The hematocrit (Hct)

After receiving an allograft liver transplant, a patient is prescribed cyclosporine ​[Sandimmune] oral solution. What is the most critical component of patient teaching that the nurse should stress? A. The medication will help prevent transplant rejection. B. The oral solution can be mixed with orange juice. C. The medication will be taken every day for life. D. The medication causes reversible increase of hair growth.

C. The medication will be taken every day for life. Rationale: Main patient education is letting them know they have to take it every day. Option A is the MOA, and is important, but not the most important.

A primary care provider prescribes etanercept to treat a client's rheumatoid arthritis. Prior to beginning the treatment, the client requires testing for which of the following? A. Pancreatitis B. Hepatitis C. Tuberculosis D. Gastritis

C. Tuberculosis

A nurse is taking a history for a client who reports taking aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by this client is contraindicated with aspirin? A. Digoxin B. Metformin C. Warfarin D. Nitroglycerin

C. Warfarin

A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions? A. Polyuria B. Bone pain C. Weight gain D. Infection

C. Weight gain Rationale: Aspirin use can cause renal impairment, which can result in the retention of salt and water. Clients should report reduced urine output, weight gain, edema, or bloating. The nurse should monitor BUN and creatinine levels and stop aspirin therapy for clients who develop signs of renal dysfunction.

The pregnant patient's HIV test is positive. Which medication should the patient take to prevent transmission of the virus to the fetus? A. Efavirenz (Sustiva), a non-nucleoside reverse transcriptase inhibitor B. Lopinavir (Kaletra), a protease inhibitor C. Zidovudine (AZT), a nucleoside reverse transcriptase inhibitor D. Ganciclovir (Cytovene), an antiviral

C. Zidovudine (AZT), a nucleoside reverse transcriptase inhibitor

Which statement by the patient with gout indicates that further teaching is needed? A. "Losing weight will help to reduce further gout attacks." B. "I should report my diagnosis of gout to my cardiologist because taking some forms of diuretics may increase gout flares." C. "Avoiding foods containing purines, such as red meats, seafood, and alcoholic beverages, will help to reduce the incidence of gout flares." D. "I can drink alcohol if I limit the number of beers I drink."

D. "I can drink alcohol if I limit the number of beers I drink."

Which of the following statements by a parent demonstrates understanding of the appropriate use of permethrin (Nix) for scabies treatment? A. "I should give this to my child to drink with breakfast." B. "I should apply this to my child's itchy spots today and again in 7 to 9 days." C. "I should apply this to my child's skin from head to toe and avoid mucus membranes and inside the ears. I can reapply if my child continues to itch." D. "I should apply this to my child's skin from head to toe, avoiding mucus membranes and inside the ears. My child might continue to itch afterward."

D. "I should apply this to my child's skin from head to toe, avoiding mucus membranes and inside the ears. My child might continue to itch afterward."

Adverse effects of primaquine include: A. Hepatotoxicity B. Increased bleeding time C. Nephrotoxicity D. Hemolysis

D. Hemolysis

A nurse is teaching a client about adverse effects of etanercept. Which of the following statements by the client indicates understanding of the teaching? A. "I will need to get my blood drawn periodically while on this medication." B. "I may lose part or all of my hair." C. "I may wake up with a very dry mouth." D. "I will leave the needle cap off during the time the medication comes to room temperature."

A. "I will need to get my blood drawn periodically while on this medication."

A nurse is teaching a client about methotrexate therapy for RA. Which of the following statements by the client indicates understanding of the teaching? A. "I will take a birth control pill every day." B. "Methotrexate decreases my chances of developing an infection." C. "I take methotrexate every day with breakfast." D. "I will aim to drink five 8-ounce glasses of water per day."

A. "I will take a birth control pill every day." Rationale: Methotrexate is teratogenic to a fetus and is contraindicated during pregnancy. Therefore, a client of childbearing age should use birth control while on this medication.

Which patient would you use caution with when giving Epoetin Alfa? A. BP 150/90 B. A patient with CKD C. A patient with a nonmyeloid tumor D. A patient with bone pain E. A patient with bone marrow suppression F. A patient with a Hgb of 10.7

A. BP 150/90 F. A patient with a Hgb of 10.7 Rationale: This drug can cause hypotension. Cardiovascular adverse effects occur more often as the Hgb approaches 11.

Which statement made by a patient who is currently asymptomatic with an HSV-2 infection indicates the need for more education about the disease? A. "It's okay to have intercourse with my partner as long as we use a barrier method of protection and I take my antiviral medications." B. "It's more likely that I could spread the HSV-2 infection if I have sexual relations when I have open ulcers and pain." C. "When I get pregnant, I will be certain to tell my gynecologist about my HSV-2 infection." D. "I understand that I could still transmit the virus if I don't have symptoms."

A. "It's okay to have intercourse with my partner as long as we use a barrier method of protection and I take my antiviral medications."

A nurse is admitting a client to the hospital following acetaminophen toxicity. Which of the following medications should the nurse expect to administer to this client? A. Acetylcysteine B. Pegfilgrastim C. Misoprostol D. Naltrexone

A. Acetylcysteine

A nurse is caring for a client who has a new prescription for etanercept. Which of the following actions should the nurse take? A. Administer a tuberculin skin test prior to starting the medication. B. Teach the client that fevers are common while taking this medication. C. Determine if the client has chronic hypertension. D. Mix the medication with methotrexate prior to administration.

A. Administer a tuberculin skin test prior to starting the medication.

A nurse is preparing to administer enfuvirtide to a client. Which of the following actions should the nurse plan to perform? (Select all that apply.) A. Administer the drug subcutaneously. B. Discard the unused portion. C. Roll the vial gently to reconstitute the solution. D. Inject the solution at room temperature. E. Expect a cloudy solution.

A. Administer the drug subcutaneously. C. Roll the vial gently to reconstitute the solution. D. Inject the solution at room temperature.

A nurse is screening patients for their risk of developing HIV. The nurse should consider which patient at greatest risk? A. African American man B. Asian woman C. Caucasian man D. Latino woman

A. African American man

A nurse is teaching a client about methotrexate therapy for RA. Which of the following information should the nurse include? (Select all that apply.) A. Avoid being near people who are sick with a communicable illness. B. Periodic laboratory tests are required. C. The drug's effects are immediate. D. Report bruising or petechiae. E. Avoid drinking alcohol.

A. Avoid being near people who are sick with a communicable illness. B. Periodic laboratory tests are required. D. Report bruising or petechiae. E. Avoid drinking alcohol.

A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? A. Avoid driving or activities that require mental alertness. B. Avoid crushing the tablets. C. Limit fluid intake during therapy. D. Limit potassium while taking allopurinol.

A. Avoid driving or activities that require mental alertness. Rationale: Allopurinol can cause drowsiness.

Which new assessment finding would be of greatest priority to report to the prescriber when a patient is receiving epoetin alpha (Procrit)? A. Chest pain B. Fatigue C. Pallor D. Weak dorsalis pedis pulse

A. Chest pain

The nurse recognizes which statement as correct about blood cell formation? A. It occurs mostly in the marrow found in flat bones such as the sternum, ribs, and pelvis B. It occurs mostly in the marrow found in the shaft of long bones C. It occurs outside the marrow, once it enters the circulatory system D. It occurs after birth until late adolescence

A. It occurs mostly in the marrow found in flat bones such as the sternum, ribs, and pelvis

What are the meds that can be used for chloroquine resistance? (Select all that apply.) A. Mefloquine B. Metronidazole C. Quinine D. Malarone E. Erythromycin

A. Mefloquine C. Quinine D. Malarone

Which of the following drugs is a opioid analgesic? A. Morphine B. Naloxone C. Prednisone D. Ibuprofen

A. Morphine

Which of the following drugs can be used to treat the hepatic stage of malaria? (Select all that apply.) A. Primaquine B. Doxycycline C. Atovaquone/Proguanil (Malarone) D. Chorloquine

A. Primaquine C. Atovaquone/Proguanil (Malarone)

Principles of treating HIV- positive pregnant women include which of the following? (Select all that apply.) A. Prophylaxis is recommended for the newborn. B. Benefits of treatment normally outweighs the risks. C. Antiretroviral therapy should not be used during pregnancy D. The antiretrovirals are safe and are not teratogenic E. The drug regimen should only include one drug at a time

A. Prophylaxis is recommended for the newborn. B. Benefits of treatment normally outweighs the risks.

A nurse is caring for a client who has a new prescription for delavirdine therapy to treat HIV-1. The nurse should instruct the client to report which of the following adverse reactions to the drug? A. Rash B. Insomnia C. Rhinitis D. Alopecia

A. Rash Rationale: Delavirdine, a non-nucleoside reverse transcriptase inhibitor, can cause a rash. The nurse should instruct the client to report a rash, which can occur 1 to 3 weeks after therapy, because it can develop into Stevens-Johnson syndrome, a potentially life-threatening complication.

A patient is prescribed sirolimus ​[Rapamune] and cyclosporine​ [Sandimmune] after renal transplantation. It is most important for the nurse to closely monitor which value? A. Serum creatinine B. Aspartate aminotransferase (AST) C. Serum potassium D. Partial thromboplastin time

A. Serum creatinine

A nurse is teaching a client who is taking etanercept for rheumatoid arthritis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug? A. Skin rash B. Tinnitus C. Diarrhea D. Dysphagia

A. Skin rash Rationale: Etanercept can cause serious skin infections. Clients should immediately report any skin rashes or blisters, because an infection can cause a serious reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis.

A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications? A. Uncontrolled bleeding B. Myocardial infarction C. Respiratory depression D. Decreased renal perfusion

A. Uncontrolled bleeding Rationale: Aspirin is a salicylate (antiplatelet) that irreversibly binds to and inhibits platelet activation. Because the lifespan of a platelet is 7 to 10 days, this is the average span of time needed after discontinuing antiplatelet therapy with aspirin before its effects are no longer present and the chance of an uncontrolled bleeding event is decreased.

A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drugs interacts with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide

A. Warfarin

A nurse is caring for a client who is taking ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication? A. Increased TSH level B. Decreased ALT level C. Hypoglycemia D. Hyperlipidemia

D. Hyperlipidemia

A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? A. Hypercalcemia B. Hypoglycemia C. Hypothermia D. Hypokalemia

D. Hypokalemia

A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks about taking ibuprofen to treat RA. Which of the following responses should the nurse make? A. "Ibuprofen will increase your risk for developing salicylism." B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." C. "Low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen." D. "Low-dose aspirin will reduce the analgesic effects of ibuprofen."

B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin."

A nurse is teaching a client who has a new prescription for etanercept. Which of the following statements should the nurse make? A. "You will inject this medication once a week in your thigh muscle." B. "You should report signs of infection to your provider immediately." C. "You will need to avoid taking ibuprofen while on this medication." D. "You will need to receive a MMR vaccine 1 month after starting this medication."

B. "You should report signs of infection to your provider immediately."

Which of the following drugs is a nonsteroidal anti-inflammatory drug? A. Morphine B. Naloxone C. Prednisone D. Ibuprofen

D. Ibuprofen

The nurse knows that which of the following statements regarding laboratory values and RA are true? (Select all that apply.) A. Patients with a positive rheumatoid factor definitely have RA. B. An elevated CRP is indicative of inflammation but is not specific only for RA. C. Certain DMARD therapies may cause laboratory abnormalities such as elevated liver enzymes, thrombocytopenia, and leukocytopenia. D. Approximately 25% to 30% of patients who have RA do not have a positive rheumatoid factor. E. Patients with RA have elevated cardiac enzymes due to pharmacological therapy.

B. An elevated CRP is indicative of inflammation but is not specific only for RA. C. Certain DMARD therapies may cause laboratory abnormalities such as elevated liver enzymes, thrombocytopenia, and leukocytopenia. D. Approximately 25% to 30% of patients who have RA do not have a positive rheumatoid factor.

What labs should you monitor with protease inhibitors? A. CBC B. Blood glucose C. INR D. Creatinine kinase

B. Blood glucose

Match the correct drug with the following therapeutic use: "advanced or resistant HIV disease". A. Flutamide B. Enfuvirtide C. Tamoxifen D. Delavirdine

B. Enfuvirtide

A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? A. Muscle pain B. Fever C. Anxiety D. Tremors

B. Fever

Which of the following are clinical manifestations of malaria? (Select all that apply.) A. Pancreatitis B. Headache C. Fever/chills/malaise D. Nausea/vomiting

B. Headache C. Fever/chills/malaise D. Nausea/vomiting

A patient with a history of DMT2 and CKD is receiving epoetin alpha (Procrit) because her failing kidneys do not produce adequate amounts of erythropoietin and she has become anemic. What would be a realistic goal for therapy? A. Hgb 8 g/dL B. Hgb 10 g/dL C. Hgb 12 g/dL D. Hgb 14 g/dL

B. Hgb 10 g/dL

A client who is receiving chemotherapy takes allopurinol prior to the chemotherapy to reduce the risk for which condition? A. Agranulocytosis B. Hyperuricemia C. Aplastic anemia D. Thrombocytopenia

B. Hyperuricemia

A nurse should identify that a client who has diabetes mellitus and is taking etanercept is at an increased risk for which of the following adverse effects? A. Kidney toxicity B. Infection C. Gout D. DVT

B. Infection Rationale: Etanercept increases the risk of developing a serious infection. Providers should not prescribe etanercept for clients who have an existing infection and should use it cautiously with clients who have diabetes mellitus because the disease itself already causes an increased risk for infection.

A nurse is planning care for a client who has cancer and is taking a glucocorticoid as an adjuvant medication for pain control. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Monitor for urinary retention B. Monitor blood glucose C. Monitor blood potassium level D. Monitor for gastric bleeding E. Monitor for respiratory depression

B. Monitor blood glucose C. Monitor blood potassium level D. Monitor for gastric bleeding

Which of the following drugs is a opioid antagonist? A. Morphine B. Naloxone C. Prednisone D. Ibuprofen

B. Naloxone

A nurse is caring for a client who has a new prescription for adalimumab for rheumatoid arthritis. Based on the route of administration of adalimumab and other drugs of the same class, which of the following should the nurse plan to monitor? A. The vein for thrombophlebitis during IV admin B. The subcutaneous site for redness following injection C. The oral mucosa for ulceration after PO admin D. The skin for irritation following removal of transdermal patch

B. The subcutaneous site for redness following injection

Which of the following statements regarding viral replication is correct? A. Endotoxin and/or exotoxin is required for viral proliferation. B. The virus must use host white blood cells for viral proliferation. C. Pathogenic replication is facilitated by the administration of antivirals. D. The virus replicates by preventing phagocytosis by white blood cells.

B. The virus must use host white blood cells for viral proliferation.

A nurse is caring for a client who is currently taking methotrexate for RA. The nurse should identify that which of the following is an adverse effect of this medication? A. Hypertension B. Thrombocytopenia C. Glaucoma D. Edema

B. Thrombocytopenia

You are caring for a client who is pregnant and is HIV positive. Which of the following drugs helps prevent the transfer of HIV to the fetus? A. Anastrozole (Arimidex) B. Zidovudine (Retrovir) C. Tamoxifen (Soltamox) D. Trastuzumab (Herceptin)

B. Zidovudine (Retrovir)

A client arrives at the emergency room immediately following an acetaminophen overdose. Which drug should you prepare to administer? A. Atropine B. Naloxone C. Acetylcysteine D. Flumazenil

C. Acetylcysteine

A patient infected with HIV has been prescribed a regimen including the NNRTI efavirenz (Sustiva). He complains of drowsiness and dizziness. Which of the following interventions should the nurse expect to provide? A. Discontinue all drugs and wait for an Infectious Disease consult. B. Discontinue efavirenz but continue the rest of the drugs in the regimen. C. Administer the efavirenz at bedtime and use safety precautions. D. Administer the efavirenz with food and use safety precautions.

C. Administer the efavirenz at bedtime and use safety precautions.

A nurse should recognize that enfuvirtide can be prescribed to clients who have which of the following conditions? A. Advanced prostate cancer B. Primary brain tumors C. Advanced HIV D. Metastatic ovarian cancer

C. Advanced HIV

Weight-bearing exercise and calcium supplements are most important for the patient who is taking: A. A fusion inhibitor B. An NRTI C. An NNRTI D. A protease inhibitor

D. A protease inhibitor

A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? A. Asthma B. Diabetes mellitus C. Heart failure D. Alcohol use disorder

D. Alcohol use disorder

A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? A. Butorphanol B. Acetaminophen C. Tramadol D. Aspirin

D. Aspirin

The nurse is caring for a patient diagnosed with HIV infection. Which data suggests the need for prophylaxis with sulfamethoxazole trimethoprim (Bactrim)? A. WBC 6,000/mm3 B. A productive cough and dyspnea on exertion C. HIV viral load of 1,000,000 copies/mL D. CD4 count of 150 cells/mm3.

D. CD4 count of 150 cells/mm3.

Match the correct drug with the following therapeutic use: "HIV-1 infection". A. Flutamide B. Enfuvirtide C. Tamoxifen D. Delavirdine

D. Delavirdine

T/F: Cytotoxic drugs have more profound immunosuppressive effects

True