Pharm 3 exam 3

Fill in the blank: Healthcare workers have a ____% chance of infection if stuck with a needle containing HIV-infected blood

0.23%

How many days does the PEP regimen last?

28

How many medications are used in the PEP regimen?

3

When can antibody-allergen testing be done?

4 wks, 3 months, 6 months postexposure

If a healthcare worker is exposed to HIV, PEP should be initiated within how many hours?

72

Nurses are key to promoting adherence in transplant recipients. What factors influence whether a recipient adheres to a drug regimen? (Select all that apply.) a. Drug side effects b. Episodes of rejection c. Cost d. Infection e. Marital status

A, B, C, D

In collaboration with a patient on antiretroviral therapy, the nurse formulates a plan of care. Which items are appropriate to include in planning? (Select all that apply.) a. Viral load will become and remain undetectable. b. The patient will not experience secondary infection. c. New onset of symptoms and side effects will be promptly reported. d. Laboratory blood work will be within normal limits. e. The patient will adhere to the medication regimen and will report any difficulties related to adherence.

A, B, C, E

A patient is to start on efavirenz. Which points are important for the nurse to include in health teaching for this patient? (Select all that apply.) a. The dose is given at bedtime to minimize central nervous system adverse effects. b. Alcohol should be avoided because of adverse effects to the liver. c. The dose should be taken after breakfast to minimize central nervous system adverse effects. d. High-fat meals can increase absorption of the medication. e. Hyperglycemia, jaundice, and diabetes mellitus are side effects.

A, B, D

Acyclovir has been ordered for a patient with genital herpes. Which nursing interventions are appropriate for this patient? (Select all that apply.) a. Monitor the patient's blood urea nitrogen and creatinine. b. Monitor the patient's blood pressure for hypertension. c. Administer intravenous acyclovir over 30 minutes. d. Advise maintenance of adequate fluid intake. e. Monitor complete blood count for blood dyscrasias.

A, D, E

A patient has been diagnosed with tuberculosis and is to begin antitubercular therapy with isoniazid, rifampin, and ethambutol. Which actions are appropriate for the nurse to do? (Select all that apply.) a. Encourage periodic eye examinations. b. Instruct the patient to take medications with meals. c. Suggest that the patient take antacids with medications to prevent gastrointestinal distress. d. Advise the patient to report numbness and tingling of the hands or feet. e. Alert the patient that body fluids may develop a red-orange color. f. Teach the patient to avoid direct sunlight and to use sunblock.

A, D, E, F

What medications are used in the PEP regimen for both pregnant and nonpregnant healthcare workers exposed to HIV? How many times a day are the specific medications taken?

Emtricitabine once a day tenofovir disoproxil fumarate (Truvada) once a day raltegravir (Isentress) twice a day

What labs need to be monitored during PEP treatment? (3)

Hepatic & renal function CBC count & differential hyperglycemia

What is required to discontinue the medication?

Negative HIV test

What is used to treat healthcare professionals if they are exposed to HIV?

PEP

What is a major side effect of tenofovir?

Renal impairment

The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? a. "I must take the medication exactly as prescribed." b. "Once I start the medication, I will no longer be contagious.: c. "I will not get any colds or infections while taking this medication." d. "This medication has minimal side effects and I can return to normal activities."

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

A mother of two children was just diagnosed with hepatitis C virus. Which of the following is incorrect about hepatitis C virus? a. A vaccine has been available for 5 years. b. Hepatitis C virus can be transmitted by blood and body fluids. c. Hepatitis C virus can cause hepatic carcinoma. d. Persons with hepatitis C virus can become chronic carriers.

a. A vaccine has been available for 5 years.

A patient is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the patient which instruction? a. Do not skip doses. b. Take both drugs three times daily. c. Take an antacid with the drugs. d. Take rifampin initially.

a. Do not skip doses.

The nurse advises human immunodeficiency virus (HIV)-positive patients about blood draws to obtain a CD4+ count. Which information would be correct? a. Laboratory tests should be done at the same laboratory at approximately the same time of day b. A 10-hour fast is required for laboratory tests c. Laboratory tests will need to be obtained approximately 1 hour after taking antiretroviral medications d. It does not matter where the labs are conducted as long as it is done

a. Laboratory tests should be done at the same laboratory at approximately the same time of day

An international traveler diagnosed with malaria is admitted to the emergency department and is prescribed mefloquine hydrochloride. The nurse anticipates that which laboratory test will be ordered? a. Liver function test (LFT) b. Blood glucose c. Sputum culture and sensitivity d. White blood cell count

a. Liver function test (LFT)

Patients who are receiving an immune stimulant ay experience any of the clinical signs of immune response activity, including: a. flu like symptoms b. diarrhea c. constipation d. headache

a. flu like symptoms

Nursing interventions for the patient receiving antiviral drugs for the treatment of HIV would include: a. monitoring renal and hepatic function periodically during therapy b. administering the drugs just once a day to increase drug effectiveness c. encouraging the patient to avoid eating if GI upset is severe d. stopping the drugs and notifying the prescriber is severe rash occurs

a. monitoring renal and hepatic function periodically during therapy

A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action? a) Use alcohol in small amounts only. b) Report yellow eyes or skin immediately. c) Increase intake of Swiss or aged cheeses. d) Avoid vitamin supplements during therapy.

b) Report yellow eyes or skin immediately.

Which of the following is a priority to evaluate in a patient being treated for Taenia solium (pork tapeworm)? a. Increased appetite b. Abdominal distension c. Fatigue d. Constipation

b. Abdominal distension

A nurse is infusing IV amphotericin B to a patient with a systemic fungal infection. Based on the adverse effects of the medication, which blood work would NOT need to be evaluated? a. CBC b. Albumin c. blood glucose d. renal funcion

b. Albumin

Your patient is receiving basiliximab and develops cytokine release syndrome. You would expect to see: a. Coughing b. Chills c. Tremors d. Weakness

b. Chills

Your patient taking belatacept becomes pregnant. After discussion with her partner, you, and her health care provider, she decides the best thing to do is continue taking the drug while pregnant. In addition to making this informed decision, what else should she do? a. Discontinue all other drugs b. Contact the pregnancy registry c. Ensure her blood level stays between 16 and 24 ng/mL d. Decrease her dose by 50%

b. Contact the pregnancy registry

HIV selectively enters which of the following cells? a. B clones b. Helper T cells c. Suppressor T cells d. Cytotoxic T cells

b. Helper T cells

A patient taking isoniazid is worried about the negative effects of the drug. The nurse provides information knowing that which is an adverse effect of the drug? a. Ototoxicity b. Hepatotoxicity c. Nephrotoxicity d. Optic nerve toxicity

b. Hepatotoxicity

To ensure effective treatment of pinworm infections, which instruction would be most important to emphasize to the patient and family? a. Keeping nails long so cutting will not introduce more infection b. Laundering undergarments, bed linens, and pajamas every day c. Boiling all drinking water d. Maintaining a clear liquid diet for at least 7 to 10 days

b. Laundering undergarments, bed linens, and pajamas every day

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

b. Peripheral neuritis

A patient is admitted to the hospital with multidrug-resistant urinary tract infection. Laboratory tests show Pseudomonas aeruginosa. Colistimethate sodium is ordered in powder form and must be diluted for intramuscular injection. The nurse understands that which of the following is the purpose for this drug? a. This drug prevents toxic adverse reactions. b. This drug treats gram-negative bacteria. c. This drug is safe for patients with renal impairments. d. This drug prevents antibiotic resistance.

b. This drug treats gram-negative bacteria.

A patient traveling to an area of the world where malaria is known to be endemic should be taught to: a. avoid drinking the water b. begin and complete the antimalarial therapy as prescribed c. pack a supply of antimalarial drugs in case they get a mosquito bite d. change the dates of their trip to when there is less risk of infection

b. begin and complete the antimalarial therapy as prescribed

Locally active antiviral agents can be used to treat a. HIV infection. b. warts. c. RSV. d. CMV systemic infections.

b. warts.

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

c. Causes orange discoloration of body fluids

Which of the following would the nurse recommend that a patient with repeated veinal yeast infections keep on hand? a. Tolnaflate b. Butenafine c. Clotrimazole d. Naftifine

c. Clotrimazole

The nurse teaches a patient taking amphotericin B to report which signs and symptoms to the health care provider? a. Change in sight b. Decrease in hearing c. Decrease in urine d. Painful red rash and blisters

c. Decrease in urine

The nurse is describing fungi that cause infections of the skin and mucous membranes, appropriately calling these which of the following? a. Mycoses b. Meningeal fungi c. Dermatophytes d. Worms

c. Dermatophytes

Which of the following is an important teaching point for the patient receiving an agent to treat herpes virus or CMV? a. stop taking the drug as soon as the lesions have disappeared b. Sexual intercourse is fine because as long as you are taking the drug, you are not contagious c. Drink plenty of fluids to decrease the drug's toxic effects on the kidneys d. There are few associated GI adverse effects

c. Drink plenty of fluids to decrease the drug's toxic effects on the kidneys

Which virus has been associated with posttransplant lymphoproliferative disorder? a. Cytomegalovirus b. Herpes simplex virus c. Epstein-Barr virus d. Human immunodeficiency virus

c. Epstein-Barr virus

A client with TB is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse ensures that which baseline study has been completed? a. Electrolyte levels b. Coagulation times c. Liver enzyme levels d. Serum creatinine level

c. Liver enzyme levels

A 30-year-old woman presents with a recurrence of Trichomonas vaginalis infection, and metronidazole is ordered. The patient's history reveals which of the following contraindications? a. A recent pregnancy test is negative. b. She previously took metronidazole and had no side effects. c. She drinks a glass of wine before bedtime. d. She takes an oral contraceptive.

c. She drinks a glass of wine before bedtime.

What is the mechanism of action of systemic antifungal medications? a. breaking apart the fungus nucleus b. interfering with fungus DNA production c. altering cell permeability of the fungus leading to cell death d. preventing the fungus from absorbing needed nutrients

c. altering cell permeability of the fungus leading to cell death

A patient with a history of malaria who is being treated with chloroquine is in the clinic for a follow-up visit. What should the nurse advise the patient to do? a. Get frequent hearing checks. b. Take antimalarials before meals. c. Get frequent testing of stool specimens. d. Avoid sun exposure.

d. Avoid sun exposure.

The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands that instructions if the client states that he or she will immediately report which finding? a. Impaired sense of hearing b. GI side effects c. Orange-red discolorations of body fluids d. Difficulty in discriminating the color red from green

d. Difficulty in discriminating the color red from green

A recent laboratory results indicated an "undetectable" human immunodeficiency virus viral load. Which response is best by the nurse? a. Inform the patient that they must be seen immediately because the undetectable viral load indicates that the medication stopped working. b. Have the patient reschedule the clinic visit. c. Congratulate the patient on the treatment success. d. Educate the patient about the continued need for medications and ongoing laboratory monitoring.

d. Educate the patient about the continued need for medications and ongoing laboratory monitoring.

Zanamivir is ordered for a patient with which disorder? a. Herpes simplex virus type 2 b. Herpes simplex virus type 1 c. Varicella-zoster virus d. Hepatitis B virus

d. Hepatitis B virus

All transplant drugs have the same advisory, to use caution when administering them with another immunosuppressant drug because of the increased risk for: a. Nausea and vomiting b. Edema c. Anemia d. Infection

d. Infection

After assessing a patient, the nurse would question an order for amphotericin B to prevent possibility of serious nephrotoxicity if the patient was also receiving which of the following medications? a. Digoxin b. Oral anticoagulants c. Phenytoin d. Loop diuretic

d. Loop diuretic

During routine prenatal testing, a patient is diagnosed with human immunodeficiency virus infection. To help prevent perinatal transmission of human immunodeficiency virus to the fetus, which nursing action is best? a. Provide the patient with contact information for an acquired immunodeficiency syndrome support group. b. Educate the patient about the risks of human immunodeficiency virus disease to the fetus. c. Notify the Centers for Disease Control and Prevention of the patient's diagnosis. d. Provide written and oral education about the use of antiretroviral therapy during pregnancy.

d. Provide written and oral education about the use of antiretroviral therapy during pregnancy.

A 50-year-old woman is being discharged from the hospital after treatment for malaria. Which teaching topic would best inform the patient about adverse reactions? a. The occurrence of headaches b. Experiencing dizziness c. Developing mild pruritus d. Skin and eyes that appear yellowish

d. Skin and eyes that appear yellowish

In which situation would the nurse least likely expect to administer an immune suppressant? a. Treatment of transplant rejection b. Treatment of autoimmune disease c. Reduction of number of relapses in MS d. Treatment of aggressive cancers

d. Treatment of aggressive cancers

Organ transplants are often rejected by the body because the T cells recognize the transplanted cells as foreign and try to destroy them. Treatment with an immune suppressant would: a. activate antibody production b. stimulate interleukin release c. stimulate thymus secretions d. block the initial damage to the transplanted cells

d. block the initial damage to the transplanted cells

T or F: Systemic antifungal agents are easily tolerated by patients with a low risk of toxicity

false

What additional side effects that usually subside within a few weeks should you educate the patient about?

nausea, abdominal pain, diarrhea, and headaches

What precautions can healthcare workers take to protect themselves again potentially infectious body fluids?

use of gloves, goggles, and other safety devices