Prep U Exam 1

Which is an example of naturally acquired active immunity? (Select all that apply.)

- An individual who is exposed to pertussis for the first time and has no immunity to the disease. - An individual who is exposed to chickenpox for the first time and has no immunity to the disease.

When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include?

the process of creating new blood vessels to supply oxygen and nutrients to the cells

A toddler has received the varicella vaccine at age 12 months, as scheduled. The nurse should teach the toddler's parents that a booster will be necessary at what age?

Age 4 to 6 years

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.

A client is receiving ferrous sulfate as treatment for iron deficiency anemia. After teaching the client, which statement indicates the need for additional teaching?

"I need to take an antacid with the pill to prevent an upset stomach."

A client diagnosed with iron deficiency anemia is learning about her prescribed iron supplement. Which additional information would the nurse include in the client's teaching plan?

"If constipation or diarrhea become severe, call your primary care provider."

A client received an injection of doxorubicin and is now observing a reddish urine. The client reports blood in the urine to the nurse. How should the nurse respond?

"The reddish urine is an expected response to the drug."

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

Sickle cell anemia is an inherited disorder marked by the characteristic sickling of red blood cells. What are triggers of an episode of sickling? Select all that apply.

- immune response - inflammatory responses - acute infections

A client who is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma will soon begin treatment with epoetin alfa. The nurse should be aware that this drug may be administered by which route? Select all that apply.

-intravenous -subcutaneous

The average lifespan of a red blood cell (RBC) is approximately:

120 days

A client has presented to the emergency department with a puncture wound suffered a few hours ago while demolishing an old house. The nurse's assessment reveals that the client is not in acute distress. The client's immunization status is unknown. What intervention should the nurse prioritize?

Administering tetanus immune globulin as prescribed

After teaching a group of students about anemias, the instructor determines that the teaching was effective when the students identify what as the critical issue?

Altered red blood cell production or deficient functioning of red blood cells

An adult client being treated for breast cancer inquired about required vaccinations. What information should the nurse provide to this client?

Avoid all live vaccines.

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

A client with a diagnosis of renal failure is being treated for anemia with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment?

CBC

A 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells?

Cancerous cells grow in an uncontrollable fashion.

What is the best source of information for current recommendations regarding immunizations and immunization schedules?

Centers for Disease Control and Prevention

When describing alkylating agents, the nurse would explain that this medication is seen as the prototype:

Chlorambucil

A nurse is working at a free vaccination clinic today and expects to give vaccinations to more than one hundred children. Which item is most important to have available?

Epinephrine pen

A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order?

Epoetin alfa

A patient is to be administered an erythropoiesis-stimulating agent. Which of the following drugs would the nurse administer?

Epoetin alfa

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ?

Every 10 years

A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect?

Flulike symptoms

After teaching a group of students about antineoplastic agents and their effect on cancer and healthy cells, the instructor determines that the teaching was successful when the students identify which drug as having the least effect on healthy cells?

Gefitinib

The perinatal nurse recognizes that what vaccine can be safely given to a neonate?

Hepatitis B

A 26-year-old man with testicular cancer is prescribed combination chemotherapy that involves using two drugs that are effective against testicular tumors. Combination drug therapy is superior to single-drug therapy because of:

Higher tumor response rates

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?

Hodgkin lymphoma

An elderly client has been given a tetanus-diphtheria (Td) booster after stepping on a rusty nail. Which statements indicate an understanding of vaccine schedules?

I know that this booster is good for 10 years.

A client's chemotherapy regimen has been deemed successful, but the client is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis?

Imbalanced nutrition: less than body requirements

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?

Immune globulin

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?

Impaired tissue oxygenation related to anemia

The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?

Increased RBC count

The nurse writes a care plan for a patient receiving vaccines. What would be an appropriate nursing diagnosis for this patient?

Ineffective tissue perfusion likely if severe reaction occurs

How can a nurse best prevent tissue damage caused by an antineoplastic extravasation?

Inspect the site frequently for redness or swelling

A client who was diagnosed with iron deficiency anemia is worried because she does not know why she was prescribed iron supplements. The nurse teaches the client about which action of oral iron administration?

Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia.

A young mother asks the clinic nurse about the "chickenpox" vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the chickenpox vaccine?

It is recommended for all children who have not been exposed to the varicella virus.

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.

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?

M

A male client is informed that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the health care provider to do?

Monitor the client closely and repeat LFTs routinely.

Adverse effects of epoetin and darbepoetin include increased risks of what condition?

Myocardial infarction

The school nurse is participating in a program to immunize students against human papillomavirus (HPV). What benefit should the nurse describe to students and their families?

Reduced risk for cervical cancer

The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse?

Reports of calf pain on dorsiflexion of the foot

A nurse is participating in an influenza vaccination clinic on a college campus. What action will best prepare the nurse for this role?

Review the procedure for intramuscular injection

A client develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this?

Serum sickness

After reviewing the major types of anemia, students demonstrate understanding of the information when they identify what as an example of a hemolytic anemia?

Sickle cell anemia

A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?

Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.

A male client is being assessed after consuming packaged salad that is known to have been contaminated with hepatitis A. The use of hepatitis A immune globulin is being considered by the care team. What assessment finding should the nurse prioritize for communicating to the client's provider?

The client received hepatitis A immune globulin under similar circumstances one year ago

To prevent meningococcal infections, the nurse would administer:

Vaccine

When administering iron injections, which method would the nurse use?

Z-track intramuscular

A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster?

Zoster vaccine

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?

allopurinol

A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition?

anemia

What recommendation concerning vaccinations should the nurse provide a 50-year-old adult?

annual influenza vaccination

A nurse works in a geriatric clinic and knows that patients over age 65, especially those with chronic diseases, should receive a pneumococcal pneumonia immunization:

as a one-time dose.

A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum?

blood pressure

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

Many times a combination of antineoplastic medications are used to:

decrease the development of cell resistance.

A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing:

dyspnea.

A client who was bitten by a pit viper is to receive antivenin. What is the nurse's best action?

establish IV access

Which would a nurse identify as the primary issue associated with anemias?

ineffective red blood cells

The nurse is assessing a 6-month-old infant prior to scheduled immunizations. What finding would the nurse immediately recognize as a reason to reschedule administration?

low-grade fever

A client is receiving darbepoetin alfa. The nurse would inform the client that he will be receiving this drug at which frequency?

once a week

A client with chronic renal failure is prescribed to begin subcutaneous epoetin alfa injections. Which laboratory value will the nurse ensure is measured before starting the medication?

serum ferritin

The nurse is providing medication education to a client with breast cancer who has been prescribed tamoxifen. How should the nurse explain the action of the drug?

slows the growth of cancer cells

All hematopoietic and immune blood cells are derived from which cells in the bone marrow?

stem cells

The community health nurse is planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home. What health education topic should the nurse emphasize?

techniques for safely handling the drug

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

There is a risk of antibody production with the use of epoetin.

true

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

use an effective contraceptive.

A nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS?

vitamin b12

Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy?

A 62-year-old male with cancer

What would the nurse identify as a vaccine that is a toxoid?

Tetanus

The nurse is administering epoetin alfa (Epogen). Which administration technique would not be considered appropriate for the patient identified?

The nurse administers epoetin alfa (Epogen) via IM injection.

The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need?

Time is needed to replace many of the healthy body cells killed by chemotherapy.

A 79-year-old woman has recently moved to a long-term care facility, and the nurse at the facility is conducting a medication reconciliation. The nurse notes that the woman has recently been taking tamoxifen. The nurse is justified in concluding that the woman has a history of what malignancy?

breast cancer

A patient is receiving carboplatin. The nurse would expect to administer this drug by which route?

intravenous

A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with:

iron deficiency anemia.

A female client is ending an extensive chemotherapeutic regimen that included cytotoxic antineoplastic drugs. What does the nurse understand about bone marrow toxicity in this client?

it is a common adverse effect of her treatment

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client?

proliferation

Cancer is considered the second leading cause of death in the United States.

true

Cyanocobalamin is a vitamin B12 in a nasal formulation.

true

A client prescribed epoetin alfa asks how the medication works. Which is the nurse's best response?

"Increases the release of cells to increase the hemoglobin and hematocrit levels."

A client is diagnosed with a brain tumor. The client is told that the cancer cells proliferate. The client asks the nurse what this means. What is the nurse's best response?

"The proliferation is the growth of cancer cells and the rate of growth."

Antivenins are used for passive, transient protection from which bites? (Select all that apply.)

- rattlesnake - copperhead - black widow

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

The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide?

Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.

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?

Ciprofloxacin

A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated?

Client taking steroid therapy

Which agent would the nurse expect to be administered orally?

Methotrexate

The anemia that occurs with chronic renal failure is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic renal failure?

Produce erythropoietin

A child who is recovering from a chickenpox infection is given aspirin for the fever. Which condition develops following the simultaneous administration of salicylates and the varicella vaccine?

Reye syndrome

A patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen?

Risk for Infection related to bone marrow suppression

A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?

Risk for Infection related to suppressed bone marrow function

A 65-year-old male client lives in a long-term care facility. The infection control nurse identifies a cluster of clients on the unit diagnosed with shingles. What would the nurse expect the client's prescriber to order?

Shingles vaccine

A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents?

The use of three agents decreases the development of cell resistance.

A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond?

This medication is destroyed in the stomach and can only be given by injection.

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?

Tuberculosis

A male client is prescribed interferon. What is his probable diagnosis?

Viral hepatitis

What measure protects the nurse when preparing cytotoxic drugs?

Wearing protective equipment such as gloves, mask, and gown

A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to:

drink a lot of water.

A male client is self-administering epoetin in the home. The nurse encourages him to include what supplements as part of his daily medication regimen?

iron

A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug?

menopausal effects

The component of the red blood cell that is not recycled is bilirubin.

true

After teaching a patient who is receiving ferrous sulfate about the drug therapy regimen, which patient statement indicates that the teaching was successful?

"My stools might turn dark or green."

Which is an example of artificially acquired active immunity? (Select all that apply.)

- Administration of the influenza vaccine to an individual who has no immunity to the disease. - Administration of the varicella vaccine to an individual who has no immunity to the disease. - Administration of the rubella vaccine to an individual who has no immunity to the disease.

An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of what?

BUN and creatinine

Which would the nurse identify as an antineoplastic antibiotic?

Mitomycin

The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose her hair. Why would the nurse suggest that she get a wig or use appropriate head cover?

Most of the heat is lost through the head and it is important to cover it during extremes in temperature

A client has come to the clinic requesting a hepatitis A and B vaccination before leaving on a tropical vacation. After assessing the client, the nurse should prioritize what finding to communicate to the provider?

The client takes corticosteroids to treat rheumatoid arthritis

A nurse is teaching a group of clients about immunizations . What benefit of immunization should the nurse describe?

They provide the person with active immunity.

The nurse is educating an older adult client on routine vaccines. Which statement best describes the recommended vaccination schedule for an older adult client?

a tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

A nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. What typically triggers protooncogenes to differentiate into oncogenes?

exposure to carcinogens

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for:

neurotoxicity

An oncology nurse is performing patient teaching for a woman who is scheduled to begin treatment with a targeted therapy. The woman is unfamiliar with this class of drugs. How should the nurse best describe targeted therapies to this patient?

"These drugs are capable of controlling the signals that tell cancer cells to grow and divide."

The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response?

"What are some of the safety risks that most concern you?"

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?"

A client's current medical condition is suggestive of impaired erythropoiesis. Which laboratory study would be most clinically relevant in diagnosing this health problem?

RBC, hemoglobin, and hematocrit

A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do?

Reassure the client that it is a harmless and expected response to the drug.

What potential benefit is unique to biologic agent therapies?

They may affect cancer cells while leaving normal body cells unaffected.

The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication?

Uncontrolled hypertension