Pharmacology Chapter 6 and 18
A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax?
For cutaneous anthrax, ciprofloxacin or doxycycline would be used. Ribavirin would be used for hemorrhagic fever; streptomycin or gentamicin would be used for tularemia.
A woman comes to the emergency department reporting that she thinks she was date raped. She states that she cannot remember anything and is extremely sleepy. "I think someone put something in my drink." What drug should the nurse suspect was most likely to be put in her drink?
Gamma hydroxybutyrate (GHB) causes memory loss and somnolence and is commonly used as a date rape drug. Ketamine causes disorientation and loss of sensation, but not memory loss. MDA or ecstasy causes loss of memory and hallucinations, but not memory loss. It is not commonly used as a date rape drug. Heroin does not cause amnesia and is not commonly used as a date rape drug.
Gardasil
HPV vaccine that can be given to girls betweent the ages of 9-26
A nurse is to administer a viral vaccine. A vaccine for what would be appropriate?
Hepatitis A would be a viral vaccine. Meningococcal is a bacterial vaccine. Haemophilus influenza B is a bacterial vaccine. Typhoid is a bacterial vaccine.
A nurse has admitted a client diagnosed with substance abuse intoxication to the unit. The nursing assessment will first be directed toward data regarding:
drug use. Substance dependence denotes a maladaptive pattern of use that demonstrates physiologic, cognitive, and behavioral indications that the person continues to use the drug despite the resulting negative effects.
Black cohosh
herbal supplement to treat menopause symptoms
Toxoid
inactivated toxin used in a vaccine
ProQuad vaccine
indicated for active immunization for the prevention of measles, mumps, rubella, and varicella in children 12 months through 12 years
antithymocyte immune globulin
is a concentrated anti-human T-lymphocyte immunoglobulin preparation derived from rabbits after immunization with a T-lympoblast cell line. ATG is an immunosuppressive product for the prevention and treatment of acute rejection following organ transplantation
arthralgia
joint pain
A client, being treated for the effects of alcoholism, has begun naltrexone therapy. When assessing this client's laboratory findings, the nurse should prioritize what diagnostic value?
liver function tests (LFTs)
The nurse is providing an in-service on alternative therapies for peers and explains that the term "alternative therapies" includes what?
nondrug measures
Based on your work as a nurse in a geriatric clinic, the nurse knows that older adults should receive a pneumococcal vaccine:
once at 65 years of age.
When educating a group of nursing students on immunologic agents, the nurse explains about a particular kind of immunity that develops by injecting ready-made antibodies found in the serum of immune individuals or animals. The nurse is referring to what kind of immunity?
passive immunity
A nurse is preparing a presentation to a local community group about biological weapons. The nurse would identify which disease as lacking an available vaccine?
plague
A toddler has been brought to the community clinic and will be administered the ProQuad vaccine. When educating the child's parents about this vaccine, the nurse should explain what benefits? Select all that apply.
protection against mumps and rubella protection against measles and varicella
Chlordiazepoxide
rade name Librium among others, is a sedative and hypnotic medication of the benzodiazepine class; it is used to treat anxiety, insomnia and symptoms of withdrawal from alcohol and other drugs. Chlordiazepoxide has a medium to long half-life but its active metabolite has a very long half-life.
When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for?
sedation
A health care worker has received an annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend?
acetaminophen
A nurse is watching television and sees an ad for a drug. The drug's indication is mentioned in the ad. Which would the nurse identify as also being required to include in the ad? (Select all that apply.)
adverse effects contraindications precautions
immune sera
antibodies found in immune globulin from animals or humans who have had a specific disease and have developed antibodies
The nurse is providing education to the family of a client recently admitted for treatment of a substance use disorder. How should the nurse best explain the etiology of this disorder?
"Substance abuse is multifactorial and involves genetics, personality, and culture."
The nurse is preparing to administer a dose of the human papillomavirus vaccine to a middle school student. What assessment question should the nurse prioritize when interacting with the student?
"What's your understanding of why you're getting this vaccination?"
For the first time, a 10 year-old female has received an IM injection of Gardasil. What follow-up education should the nurse provide?
"You'll have to get another shot in around 2 months."
A client has been deemed a candidate for methadone therapy. What instruction should the nurse provide when preparing the client for this treatment plan?
"You'll need to come to the clinic to get your daily dose of methadone."
A mother brings her 18-month-old into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the 18-month-old. What dosage will the nurse administer?
0.5 mL
What immunizations are recommended for older adults? (Select all that apply.)
A tetanus-diphtheria (Td) booster every 10 years An annual influenza vaccine A one-time administration of pneumococcal vaccine at 65 years of age
The nurse should be prepared to administer an infant's first dose of polio vaccine at what age?
2 months
The client has been on a systemic corticosteroid for the last 3 weeks. How long should the client wait before receiving a live virus vaccine?
3 months
MDA
3,4-Methylenedioxymethamphetamine, commonly known as ecstasy or molly, is a psychoactive drug primarily used for recreational purposes. The desired effects include altered sensations, increased energy, empathy, as well as pleasure. When taken by mouth, effects begin in 30 to 45 minutes and last 3 to 6 hours.
Active immunity
A form of acquired immunity in which the body produces its own antibodies against disease-causing antigens.
A hospitalized client is about to receive immunological therapy and asks the nurse to explain the difference between passive and active immunity. In order to provide complete information, the nurse knows to include which information during the teaching session?
Active immunity occurs when a client receives a killed or weakened antigen that stimulates antibodies. These antibodies fight the antigen (for example, chickenpox vaccine).
A parent brings a 12-month-old child into the clinic to receive the measles, mumps, and rubella (MMR) vaccine. What nursing action is most appropriate?
Administer 0.5 mL of the vaccine subcutaneously.
Which would a nurse expect to administer to a client who has not been immunized and has sustained a bite from an animal with rabies?
An immune globulin, specifically rabies immune globulin, would be used to prevent rabies in nonimmunized clients who are exposed to rabies. An antitoxin is used to treat poisonous substances released by invading pathogens, for example, botulism. Antivenin would be used to treat snake bites. Immune sera is a general term that includes immune globulins, antitoxins, and antivenins
Which is an example of naturally acquired active immunity? (Select all that apply.)
An individual who is exposed to chickenpox for the first time and has no immunity to the disease. An individual who is exposed to pertussis for the first time and has no immunity to the
How should the nurse best assess the client for physical dependence on alcohol?
Assess the client for signs and symptoms of alcohol withdrawal.
Which nursing interventions would the nurse implement to evaluate the therapeutic effects of chlordiazepoxide therapy? Select all that apply
Assess vital signs. Monitor for restlessness and agitation. Monitor the client for examples of disturbed thought processes.
When describing the action of vaccines, the nurse identifies their action as primarily affecting:
B lymphocytes
A patient with a history of chronic cough is suspected of having pulmonary tuberculosis. Which vaccination is used to prevent the condition?
BCG vaccine
The nurse is preparing to administer a client's prescribed dose of immune sera. How should the nurse describe this treatment to the client?
Bacterial antibodies in serum
The triage nurse in the emergency department admits a client in distress. The client's parents attribute the client's distress to amphetamine use. What assessment finding would best corroborate this parent's suspicion?
Blood pressure 196/117 mm Hg Increases in blood pressure, tachycardia, insomnia, and restlessness are symptoms of amphetamine abuse. Pupil response is not normally affected by amphetamines, unlike narcotics. The client is more likely to be agitated than drowsy.
Gamma hydroxybutyrate
CNS depressant that causes memory loss, respiratory distress, coma
A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order?
Chlordiazepoxide is a benzodiazepine used for withdrawal from alcohol and central nervous system (CNS) depressants. Varenicline and bupropion are used for smoking cessation. Cannabis is medical marijuana and not used for acute alcohol withdrawal.
Clients often do not mention the use of alternative therapies to the health care provider. Which is a likely reason they do not discuss alternative therapies? Select all that apply.
Clients fear that the health care provider will not approve of any alternative therapies. Clients think that if a product is "natural," including it in a list of medications does not make
Clients who use garlic with co-administration of antidiabetic drugs may run into which serious problem?
Diabetic clients who decide to use juniper berries, ginseng, garlic, fenugreek, coriander, dandelion root, or celery to "maintain their blood glucose level" may run into serious problems with hypoglycemia when they also use their prescription antidiabetic drugs.
Dextromethrophan (Robitussin)
Dextromethorphan is a medication most often used as a cough suppressant in over-the-counter cold and cough medicines. It is sold in syrup, tablet, spray, and lozenge forms. It is in the morphinan class of medications with sedative, dissociative, and stimulant properties (at lower doses).
A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?
Hepatitis B immune globulin would be used for post-exposure prophylaxis for hepatitis B. This vaccine would be used to prevent herpes zoster (shingles) in persons over the age of 60 years. Antivenin (crotalidae) would be used to neutralize the venom of pit vipers, rattlesnakes, and copperheads. BCG vaccine would be used to prevent tuberculosis in those with a high risk for exposure.
After teaching a group of students about the standard childhood immunizations given today, the instructor determines that the students need additional teaching when they identify which as a common disease for which immunizations are given?
Immunization for tuberculosis occurs worldwide, but it is not routinely used in the United States.
Naltrexone
It can help prevent relapses into alcohol or drug abuse.
When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?
It is administered at 12 to 15 months.
An infant is being administered an immunization. Which statement provides an accurate description of an immunization?
It is the administration of an antigen for an antibody response.
Ketamine
Ketamine is a medication primarily used for starting and maintaining anesthesia. It induces dissociative anesthesia, a trance-like state providing pain relief, sedation, and amnesia
A nurse is reviewing the influence of the media on drug therapy. What phenomenon should the nurse identify?
Medical segments on talk shows often share little information, and it is often presented out of context.
To prevent meningococcal infections, the nurse would administer:
Meningococcal infections would be prevented by a vaccine. A toxoid is a type of vaccine made from the toxins produced by the organism. Immune globulins and antivenin are examples of immune sera.
A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for:
Methamphetamine is a CNS stimulant that initially increases heart rate and blood pressure. This drug usually decreases appetite, energizes muscles, and causes some degree of mental and physical alertness.
Which statement should the nurse include in a discussion about passive immunity?
Passive immunity provides temporary protection from disease.
A client reports that, "The alcohol treatment programs I've tried in the past have only helped for a little and then I start drinking again." This statement best describes which type of alcohol-related behavior?
Psychological dependence
A 15-year-old boy with a complex psychosocial history is being treated for inhalant abuse. When providing health education to a client being treated for inhalant abuse, the nurse should focus on which associated risk? Select all that apply.
Psychological dependence Physiologic withdrawal Organ damage Impaired brain development
Which agent would the nurse expect to administer to a pregnant woman to prevent Rh factor sensitization?
RHO immune globulin
Which statements best indicates the client understands recommended vaccines following the 65th birthday?
Recommended immunizations for older adults have usually consisted of a tetanus-diphtheria (Td) booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age. A second dose of pneumococcal vaccine may be given at 65 years if the first dose was given 5 years previously.
A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client?
Risk for birth defects
A client develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?
Serum sickness presents several days after the administration of a vaccine with symptoms of urticaria, fever, arthralgia, and enlarged lymph nodes. The presence of fever and arthralgia after the administration of an immunization is not noted as an infectious process, anaphylaxis, or distress syndrome.
An infant is seen in the clinic for first immunizations. When providing client teaching to the parent, which is no longer recommended for administration?
Smallpox vaccine
A client has been prescribed a selective serotonin reuptake inhibitor (SSRI) to treat depression. The regular use of which herbal supplement requires intervention by the nurse?
St. John's wort
A client has been prescribed both disulfiram and phenytoin. Based on the interaction of these two medications, the nurse should contact the health care provider regarding what potential adjustment to the medication therapies?
The client will require a reduced dose of phenytoin because disulfiram interferes with the metabolism of phenytoin. The client will not require more frequent administration of disulfiram. The client will not require a larger dose of disulfiram. The client will not require increased administration of phenytoin.
A healthy neonate will be discharged from the hospital 36 hours after birth. How should the nurse promote the neonate's immune function?
The only vaccination normally administered at birth is for hepatitis B. Varicella, MMR, and pneumococcal vaccines are given later in life.
A 65-year-old client has come to the clinic after receiving the shingles vaccine two weeks ago. The client asks the nurse how long the immunity will last. The nurse would include which information in the explanation?
The varicella virus (shingles) vaccine protects the recipient for several years or for life.
The nurse must administer which to a client prior to exposure to the disease-causing organism in order for the client to be protected against the disease?
Toxoids
A 1-year-old child will receive a scheduled MMR vaccination shortly. The nurse should teach the child's parents that the child may develop what possible adverse effect related to the administration of this medication?
cough and fever
Vaccines containing live organisms are not administered to clients taking which drugs as insufficient numbers of antibodies are produced to prevent the disease because these drugs suppress the immune system? (Select all that apply.)
Vaccines containing live organisms are not administered to clients taking corticosteroids (methylprednisolone and prednisolone), antineoplastic drugs (paclitaxel and vincristine), and radiation therapy as insufficient numbers of antibodies are produced to prevent the disease because these drugs suppress the immune system. Methylprednisolone (Medrol) Prednisolone (Orapred) Paclitaxel (Taxol) Vincristine (Oncovin)
A client has been conducting extensive online health research about diseases and medications. When teaching the client to evaluate websites, the nurse should encourage the client to ask what questions? (Select all that apply.)
Who owns and updates the site? How frequently is the information on the site updated?
A client has been prescribed prednisone 40 mg daily. What information about immunizations should the nurse include during client teaching?
You should wait at least 3 months after chemotherapy to obtain a live vaccine immunization."
An adult client is scheduled to receive the inactivated hepatitis A vaccine. The nurse should provide what education to the client?
You'll need another dose of the vaccine in six to 12 months from now."
A client was bitten by a poisonous snake. Which treatment would be most appropriate to administer?
antivenin
A client receives an immunization. The nurse interprets this as providing the client with which type of immunity?
artificially acquired active immunity
A landscaper has sought care because of a puncture wound to her foot and the provider has prescribed 250 units of the tetanus immune globulin. In preparation for administration, the nurse should:
assess the skin integrity of potential intramuscular injection sites.
Humoral immunity
specific immunity produced by B cells that produce antibodies that circulate in body fluids
The nurse is admitting a client who has been on a three-day binge of methamphetamine. The nurse should anticipate what sign or symptom?
tachycardia
Passive immunity
the short-term immunity that results from the introduction of antibodies from another person or animal.
A nurse prepares to administer antithymocyte immune globulin. The nurse understands that this is used to:
treat acute renal transplant rejection.
Cell-mediated immunity
type of immunity produced by T cells that attack infected or abnormal body cells
St. John's Wort (Hypericum perforatum)
• Used for mild to moderate depression, anxiety • Has fewer side effects than most prescription antidepressants • Can cause skin sensitivity to sunlight • Interacts with several medications, only take under guidance of health care professional • Side effects include: stomach upset, fatigue, restlessness, constipation
