prep u/ week 11 pharm
A parent hears the health care provider using the word extravasation. The parent asks the nurse what extravasation means. What would be a correct answer? "Extravasation is when blood vessels are severed." "Extravasation is when fluid is pooled in one part of the body." "Extravasation is when fluid escapes from a blood vessel into the surrounding tissue." "Extravasation is a disease that causes shock."
"Extravasation is when fluid escapes from a blood vessel into the surrounding tissue." Explanation: Extravasation is the escape of fluid from a blood vessel into surrounding tissues. Blood vessels are not cut for this to happen. Edema is when fluid is pooled in one area of the body. Extravasation is not a disease. In some types of shock, extravasation occurs.
Which statement indicates that the client understands immunosuppressant therapy following a solid organ transplant? -"I know that I will need to stay on this medication for a few months." -"I know that I will need to stay on this medication for the rest of my life." -"I know that I will need to stay on my medication for at least 1 year." -"I do not need to worry about taking any special precautions."
"I know that I will need to stay on this medication for the rest of my life." Explanation: Infection is a major cause of morbidity and mortality, especially in patients who are neutropenic or who have had bone marrow or solid organ transplantation. For those with solid organ transplantation, who must continue lifelong immunosuppression to avoid graft rejection, serious infection is a constant hazard. If efforts to prevent infections are unsuccessful, infections may be fatal unless recognized promptly and treated aggressively.
A client is receiving mefloquine as part of a treatment for malaria asks the nurse about becoming pregnant. Which response by the nurse would be most appropriate? "You can plan to become pregnant once you complete the drug therapy regimen." "You need to avoid pregnancy during the therapy and for 2 months after completion." "You need to wait at least 6 months after starting the therapy before getting pregnant." "It's okay to become pregnant during therapy, but just don't plan to breast-feed."
"You need to avoid pregnancy during the therapy and for 2 months after completion." Explanation: Pregnancy should be avoided during treatment with any of the antimalarial agents. For mefloquine, the client should avoid pregnancy during therapy and for 2 months after the completion of therapy. Antimalarial agents are contraindicated for use with lactating women, so another method of feeding should be chosen if treatment is absolutely necessary.
A client has been diagnosed with malaria and will begin treatment promptly. How can the nurse best attack the Plasmodium protozoa at the different stages of its life cycle? Administer combination therapy as prescribed Supplement chloroquine with antifungal medications as prescribed Vary administration times throughout the course of treatment Administer larger doses in the morning and smaller ones in the evening, as prescribed
Administer combination therapy as prescribed Explanation: Antimalarial drugs are usually given in combination form to attack the Plasmodium at various stages of its life cycle. Using this approach, it is possible to prevent the acute malarial reaction in individuals who have been infected by the parasite. Antifungal have not therapeutic effect. Varying the time and dosage does not vary the effect on the protozoa's life cycle.
A nurse is preparing a presentation for a group of individuals who are receiving prophylactic treatment for malaria in preparation for a trip to an endemic area. What would the nurse include as the underlying cause of this disorder? Bite of an infected mosquito Consumption of food from contaminated soil Consumption of unpurified spring water Bite of an infected tsetse fly
Bite of an infected mosquito Explanation: Malaria results from the bite of an infected mosquito, most specifically the Anopheles mosquito. Consuming food grown in contaminated soil can lead to amebiasis. Consumption of unpurified spring water is associated with giardiasis. The bite of an infected tsetse fly leads to trypanosomiasis (African sleeping sickness).
A school nurse at a large high school is attempting to determine correct vaccine guidelines. What is the best source for current recommendations? Centers for Disease Control and Prevention American Medical Association American Nurses Association National Poison Control Center
Centers for Disease Control and Prevention Explanation: Recommendations regarding immunizations change periodically as additional information and new immunizing agents become available. Consequently, health care providers need to update their knowledge at least annually. The best source of information for current recommendations is the Centers for Disease Control and Prevention.
Which drug is currently the mainstay of antimalarial therapy and is directly toxic to parasites that absorb it? Chloroquine Hydroxychloroquine Mefloquine Primaquine
Chloroquine Explanation: Chloroquine is currently the mainstay of antimalarial therapy. This drug enters human red blood cells and changes the metabolic pathways necessary for the reproduction of the Plasmodium. In addition, this agent is directly toxic to parasites that absorb it; it is acidic, and it decreases the ability of the parasite to synthesize DNA, leading to a blockage of reproduction.
The nurse is teaching the parents of a child who is receiving a vaccine about possible adverse effects. Which would the nurse include as necessitating an immediate call to the health care provider? Pain at the injection site Moderate fever Difficulty breathing Nodule formation at the site
Difficulty breathing Explanation: Difficulty breathing may be a sign of a hypersensitivity reaction and should be reported immediately. Pain or nodule formation at the injection site and moderate fever are common and expected adverse effects that do not require notification of the health care provider.
The elderly client returns from a health care visit and asks the nurse why another flu shot was necessary this year because the client got one last year. The nurse's best response is: -Once a client turns 75, he needs vaccine boosters every 2 years. -The vaccine is good for 5 years, so he did not need another one yet. -The vaccine is given every 6 months to prevent the flu. -Each year a new vaccine is developed based on the strains most prevalent.
Each year a new vaccine is developed based on the strains most prevalent. Explanation: Immune serums are the biologic products used for passive immunity. They act rapidly to provide temporary (for 1-3 months) immunity in people exposed to or experiencing a particular disease. The goal of therapy is to prevent or modify the disease process; to do this, the most prevalent strains must be identified on an annual basis.
A patient is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab? Assess for cancer Avoid high-fat foods Have epinephrine available Administer a corticosteroid
Have epinephrine available Explanation: Health care providers should have medications and supplies available for treatment of anaphylaxis, should observe patients for at least 2 hours after an injection, and should teach patients how to self-administer emergency treatment. The patient will not require assessment for cancer with every dose administration. The patient will not need to avoid high-fat foods. The patient will not receive corticosteroid agents.
A nurse is caring for a patient who is receiving azathioprine following kidney transplant. For what serious adverse effect should the nurse monitor the patient? Respiratory distress Mental depression Infection Severe diarrhea
Infection Explanation: Azathioprine and other immunosuppressant drugs can increase the risk of infection.
A client diagnosed with anemia asks what the cause of anemia is. Which is the nurse's best response? It is caused by a variety of reasons. It is caused by inadequate production of WBCs. It is caused by a decrease in the number of RBCs. It is caused by an increase in the number of platelets.
It is caused by a decrease in the number of RBCs. Explanation: Anemia is a condition caused by an insufficient amount of hemoglobin delivering oxygen to the tissues. Causes of anemia include a decrease in the number of RBCs, a decrease in the amount of hemoglobin in RBCs, or both. A variety of reasons does not specify the causes of anemia. Anemia is not associated with WBCs or platelets.
A client is prescribed filgrastim. Which is the nurse's best explanation of how this drug works? It inhibits the growth of bacteria in the body. It functions like insulin, lowering the blood sugar. It aids in the development of platelets by the bone marrow. It stimulates growth and production of WBCs to fight off infection.
It stimulates growth and production of WBCs to fight off infection. Explanation: Filgrastim is a colony stimulating factor (CSF) that stimulates the growth and production of WBCs to assist the body in fighting off infection. Bacteriostatic medications inhibit the growth of bacteria in the body. Filgrastim does not aid in the development of platelets by the bone marrow.
A client receiving which agent should be instructed to avoid alcohol consumption? Pentamidine Atovaquone Metronidazole Nitazoxanide
Metronidazole Explanation: A client should not consume alcohol if he or she is taking metronidazole or tinidazole. Interaction with alcohol is not associated with pentamidine, atovaquone, or nitazoxanide use.
To help understand immunostimulant drug therapy, the client has come to the clinic for a class on thrombopoiesis. The nurse explains that the term means the formation of which types of blood cells? Red cells White cells Platelets C-reactive protein
Platelets Explanation: Thrombopoiesis is the formation of platelets. Red and white blood cells are not thrombocytes. C-reactive protein is a blood test.
The nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. When teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug? Prevention of organ rejection Prevention of infection due to immunocompromised status Preservation of remaining renal function Slowing of metabolic processes postoperatively to prevent an immune response
Prevention of organ rejection Explanation: Cyclosporine is used to prevent or suppress rejection in a variety of transplant situations, such as renal transplantation. The drug is an immunosuppressant so it would increase the child's risk for infection. The drug has no effect on renal function or metabolic processes
A nurse administers ondansetron to a client receiving chemotherapy for which reason? Reduce vomiting Prevent hypersensitivity Relieve inflammation Decrease secretions
Reduce vomiting Explanation: Ondansetron blocks serotonin receptors in the chemoreceptor trigger zone (CTZ) and is one of the most effective antiemetics. Antihistamines help to reduce the risk of hypersensitivity reactions and decrease secretions; corticosteroids help to relieve inflammation and may aid in reducing possible hypersensitivity.
What is an adverse effect of excessive immunosuppression? Graft-versus-host disease Respiratory depression Graft rejection Serious infection
Serious infection Explanation: Excessive immunosuppression significantly increases the risk of serious infection. Graft rejection and graft-versus-host disease result from inadequate immunosuppression.
When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify which cells as an example? Skin Breast Testicles Ovaries
Skin Explanation: Skin cells proceed very rapidly through the cell cycle. Breast cells proceed very slowly through the cell cycle. Cells of the testicles proceed very slowly through the cell cycle. The cells of the ovaries proceed very slowly through the cell cycle.
A child has been taking mebendazole for the past 3 weeks after being diagnosed with roundworm. The nurse will determine the efficacy of the child's treatment by referencing what diagnostic test? Liver enzymes Stool for ova and parasites Colonoscopy or sigmoidoscopy Rectal swab for culture
Stool for ova and parasites Explanation: The nurse obtains a stool sample for culture for ova and parasites after 3 weeks of drug administration. A negative stool culture is the optimum outcome of drug therapy since it confirms complete eradication of the parasite and that any "worm burden" is now nonexistent. Colonoscopy, liver enzyme levels, and rectal swabs are not used to ascertain whether treatment has been successful since they are not focused on the parasites themselves.
A man who was working on his outside deck comes to the emergency department after sustaining a puncture wound of his hand from a large nail. Which would the nurse expect to administer? Zoster vaccine Hepatitis A vaccine Lymphocyte immune globulin Tetanus toxoid
Tetanus toxoid Explanation: Tetanus toxoid is used to provide passive immunization against tetanus as the result of an injury that could potentially precipitate a tetanus infection, such as a puncture wound by a nail. Zoster vaccine would be indicated to prevent herpes zoster (shingles) in a person over age 60 years. Hepatitis A vaccine is indicated for prevention of hepatitis A infection. Lymphocyte immune globulin is indicated for the management of allograft rejection in a client with renal transplantation.
A client has presented to the emergency department with chills, diaphoresis, severe headache and a temperature of 101.8°F (38.8°C). When assessing the possibility that the client has malaria, what assessment should the nurse prioritize? The client's travel history The client's immunization status The client's recent sexual activity The client's hygiene
The client's travel history Explanation: Malaria is not endemic to North America, so travel history is an important component of an assessment. It is not sexually transmitted and their is no vaccine for it. Malaria is not spread by poor hygiene practices.
The nurse works with the client in a long-term care facility. What principle should guide the nurse's administration of influenza vaccinations? Influenza vaccinations should be administered to all residents under the age of 80. Unless contraindicated, residents should receive influenza vaccinations annually. Residents should be offered an influenza booster every 5 years. New residents should receive a one-time dose of influenza vaccine.
Unless contraindicated, residents should receive influenza vaccinations annually. Explanation: Older adults should be given the annual influenza vaccine unless directly contraindicated. This includes residents over the age of 80.
A client asks what neutropenia is. Which is the nurse's best response? -a problem associated with old age -a disease where the body has to fight infections -a condition when the neutrophil level is very low -an issue with red blood cells and their ability to carry oxygen
a condition when the neutrophil level is very low Explanation: Neutropenia is the term for the condition that results when the neutrophil level in the blood is low and infection is likely to occur. Neutropenia is not a disease and has nothing to do with the red blood cells and their ability to carry oxygen. Neutropenia is not a part of the aging process but is caused by agents that suppress the immune response.
When instructing the parents of a child who has received an immunization in the vastus lateralis, which reaction is most common in the days after the administration? nausea or diarrhea rash and local edema scab formation soreness and redness at the injection site
soreness and redness at the injection site Explanation: Pain, tenderness, and redness at the injection site are associated with the administration of immunizations. Nausea and diarrhea, scab formation, rash and edema, and weakness are not common reactions to immunizations.
