Pharmacology Made Easy The Immune System

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 To prevent an infusion reaction INCORRECT Zidovudine, a nucleoside reverse transcriptase inhibitor, is unlikely to prevent an adverse reaction to an infusion of ritonavir, a protease inhibitor. Prior to the administration of paclitaxel, an antimitotic drug, administering an antihistamine, a proton-pump inhibitor, and a glucocorticoid can prevent. hypersensitivity reaction. To increase platelet production INCORRECT Zidovudine, a nucleoside reverse transcriptase inhibitor, is unlikely to increase the production of platelets. Filgrastim, a colony-stimulating drug, can increase neutrophil production. O To protect healthy cells from the toxic effects of ritonavir INCORRECT Zidovudine, a nucleoside reverse transcriptase inhibitor, is unlikely to protect healthy cells from the toxic effects of ritonavir. The nurse should administer leucovorin rescue within 12 hr of high doses of methotrexate to protect healthy cells from the toxic effects of that drug. To prevent drug resistance CORRECT My Answer The nurse should explain that zidovudine, a nucleoside reverse transcriptase inhibitor, is administered along with ritonavir, a protease inhibitor, to reduce the risk for drug resistance and to increase drug effectiveness. Monotherapy with zidovudine quickly results in drug resistance, as is also the case with monotherapy with ritonavir. A nurse is assessing a client following a trastuzumab infusion to treat metastatic breast cancer. Which of the following findings should the nurse recognize as an indication that the client is experiencing an adverse reaction to the drug? (Select all that apply). A. Wheezing B. Dysrhythmias C. Hypotension D. Fever E. Ascites - //A, B, C, D Wheezing is correct. Trastuzumab, a monoclonal antibody, can cause a severe allergic reaction, manifesting as hives, bronchospasm, dyspnea, and wheezing. The nurse should have epinephrine ready to treat anaphylaxis. Dysrhythmias is correct. Trastuzumab can cause cardiotoxicity, manifesting as ventricular dysfunction, heart failure, and dysrhythmias. The nurse should monitor the client's ECG. Hypotension is correct. Trastuzumab can cause a severe allergic reaction, manifesting as hives, dyspnea, hypotension, and hypoxia. The nurse should have epinephrine ready to treat anaphylaxis. Fever is correct. Trastuzumab can cause flu-like reactions, manifesting as fever, chills, nausea, and headache. The nurse should monitor the client's temperature. Ascites is incorrect. Trastuzumab is unlikely to cause ascites, although it can cause abdominal pain, nausea, and vomiting, The nurse should monitor the clients fluid and electrolyte balance. 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/mm^3 C. Neutrophil 57% D. Triglycerides 125 mg/dL - //A. Hemoglobin 7.1 g/dL Hemoglobin 7.1 g/dL CORRECT My Answer The provider might consider dose reduction, discontinuation of therapy, or blood transfusions if the client's hemoglobin is less than 7.5 g/dL or has a reduction of greater than 25% from baseline. RBC count 5.2/mm3 INCORRECT An RBC count of 5.2/mm" is within the expected reference range and does not need to be reported to the provider. Neutrophil 57% INCORRECT A neutrophil count of 57% is within the expected reference range and does not need to be reported to the provider. Triglycerides 125 mg/dL INCORRECT A triglyceride level of 125 mg/dL is within the expected reference range and does not need to be reported to the provider. A nurse is teaching a client about immunizations. Which of the following information should the nurse include in the teaching? A. "You should receive a tetanus booster every 10 years." B. "You should not receive the influenza immunization if you have a common cold." C. "You do not have to receive the shingles vaccine if you have received two doses of the varicella virus vaccine." D. "As long as you don't have risk factors, you will start receiving the pneumococcal vaccine when you are 50 years old." - //A. "You should receive a tetanus booster every 10 years." "You should receive a tetanus booster every 10 years." CORRECT My Answer The nurse should inform the client that the tetanus-diphtheria (Td) vaccine is recommended every 10 years. "You should not receive the influenza immunization if you have a common cold." INCORRECT The nurse should instruct the client to differ the influenza immunization if they have moderate to severe febrile illness. It is recommended to receive the influenza immunization with mild infections such the common cold. "You do not have to receive the shingles vaccine if you have received two doses of the varicella virus vaccine." INCORRECT The nurse should inform the client that it is recommended to receive the shingles vaccine regardless of previous varicella virus vaccine doses. "As long as you don't have risk factors, you will start receiving the pneumococcal vaccine when you are 50 years old." INCORRECT The nurse should inform the client that the pneumococcal vaccine is recommended beginning at age 65. A nurse is teaching a guardian of a child about the recommended age range to receive the human papillomavirus (HPV) vaccine. Which of the following age ranges should the nurse include? A. 11 to 12 years old B. 7 to 9 years old C. 13 to 15 years old D. 15 to 17 years old - //A. 11 to 12 years old 11 to 12 years old CORRECT My Answer Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old. 7 to 9 years old INCORRECT Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old. 13 to 15 years old INCORRECT Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old. 15 to 17 years old INCORRECT Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old. 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, C, D Administer the drug subcutaneously is correct. The nurse should administer enfuvirtide, a fusion inhibitor, subcutaneously, twice per day. This is the only appropriate route of administration for the drug. Discard the unused portion is incorrect. The nurse should refrigerate the unused portion. The nurse should also warm the solution to room temperature prior to giving the next dose out of the vial. Roll the vial gently to reconstitute the solution is correct. The nurse should roll the vial of enfuvirtide gently between the palms of the hands after adding sterile water for injection. This reconstitutes the drug. Inject the solution at room temperature is correct. The nurse can store unused solutions of enfuvirtide in a refrigerator up to 24 hr but should restore it to room temperature before injection. Expect a cloudy solution is incorrect. Enfuvirtide should be clear and without particulates after reconstitution. The nurse should not administer a cloudy solution. A nurse is caring for a client who has a new prescription for intrathecal cytarabine therapy to treat meningeal leukemia. The nurse should inform the client that they will also receive which of the following drugs to reduce the risk of neurotoxicity? A. Diphenhydramine B. Leucovorin C. Folic acid D. Dexamethasone - //D. Dexamethasone Diphenhydramine INCORRECT Diphenhydramine, an antihistamine, prevents or minimizes allergic reactions. It does not reduce the risk of neurotoxicity for clients who are receiving intrathecal cytarabine, an antimetabolite. Leucovorin INCORRECT Leucovorin, chemotherapeutic protectant, protects cells from the actions of folic acid antagonists, such as methotrexate. It does not reduce the risk of neurotoxicity for clients who are receiving intrathecal cytarabine, an antimetabolite. Folic acid INCORRECT Folic acid supplements help reduce the risk of toxicity from folic acid antagonists, such as methotrexate. It does not reduce the risk of neurotoxicity for clients who are receiving intrathecal cytarabine, an antimetabolite. Dexamethasone CORRECT My Answer Clients who have prescription for the intrathecal form of cytarabine should also receive dexamethasone, a glucocorticoid, to help decrease the inflammation of the arachnoid that the drug can cause. IV dexamethasone reduces the client's risk for neurotoxicity. A nurse is caring for a client who has a new prescription for topotecan therapy to treat resistant, small-cell lung cancer. The nurse should advise the client against taking which of the following types of over-the-counter drugs while receiving the therapy? A. Folic acid B. St. John's wort C. Ibuprofen D. Aluminum hydroxide - //C. Ibuprofen Folic acid INCORRECT Folic acid does not specifically interact with topotecan, a topoisomerase inhibitor. It can, however, change the response to methotrexate, another immune system drug. St. John's wort INCORRECT St. John's wort does not specifically interact with topotecan, topoisomerase inhibitor. It can, however, decrease the levels of maraviroc, another immune system drug. Ibuprofen CORRECT My Answer NSAIDs, anticoagulants, and antiplatelet drugs increase the client's risk for bleeding while receiving topotecan, a topoisomerase inhibitor. The nurse should advise the client against taking aspirin, ibuprofen, and other NSAIDs during therapy. Aluminum hydroxide INCORRECT Antacids, such as aluminum hydroxide, do not specifically interact with topotecan, a topoisomerase inhibitor. Antacids decrease the absorption of delavirdine, another immune system drug. A nurse is caring for a client who has a new prescription for maraviroc therapy. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply). A. Paresthesia B. Cough C. Tinnitus D. Jaundice E. Fever - //A, B, D, E Paresthesia is correct. Maraviroc, a chemokine receptor 5 antagonist, can cause paresthesia, dizziness, and musculoskeletal pain. Cough is correct. Maraviroc can cause a cough and upper respiratory infection. Tinnitus is incorrect. Maraviroc is unlikely to cause tinnitus. Cisplatin, a platinum compound, is an immune system drug that can cause ototoxicity and hearing loss. Jaundice is correct. Maraviroc can cause liver damage. The nurse should instruct the client to report an allergic reaction, such as a rash, because it can precede liver damage, manifested as jaundice or abdominal pain. Fever is correct. Maraviroc can cause a fever and sinus infection. A nurse should recognize that maraviroc is used in the treatment of which of the following conditions? A. Diabetes mellitus B. Meningeal infection C. Pancreatitis D. Chemokine receptor 5 (CCR5)- tropic HV-1 - //D. Chemokine receptor 5 (CCR5)tropic HV-1 Diabetes mellitus INCORRECT Maraviroc, chemokine receptor 5 (CCR5) antagonist is used in the treatment of drug resistant HIV to block the entry of HIV into host cells. It is not used to treat diabetes. The treatment of diabetes involves antidiabetic drugs. Meningeal infection INCORRECT Maraviroc, a chemokine receptor 5 (CCR5) antagonist is used in the treatment of drug resistant HIV to block the entry of HIV into host cells. It is not used to treat meningeal infections. The treatment of meningeal infections involves anti-viral drugs or antibiotics. Pancreatitis INCORRECT Maraviroc, a chemokine receptor 5 (CCR5) antagonist is used in the treatment of drug resistant HIV to block the entry of HIV into host cells. It is not used to treat of pancreatitis. The treatment of pancreatitis involves analgesics and acid-suppressive drugs in addition to parenteral nutrition. Chemokine receptor 5 (CCR5)-tropic HIV-1 CORRECT My Answer Maraviroc, a CCR5 antagonist, acts by binding to CCR5 and preventing HIV-1 from entering the cell. It is used in the treatment of clients who have CCR5-tropic HIV1. 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 Advanced prostate cancer INCORRECT Enfuvirtide, a fusion inhibitor, does not treat advanced prostate cancer. Flutamide, an androgen receptor blocker, treats early or metastatic prostate cancer. Primary brain tumors INCORRECT Enfuvirtide, a fusion inhibitor, does not treat primary brain tumors. Carmustine, a nitrosourea drug, treats primary and metastatic brain tumors. Advanced HIV CORRECT My Answer Enfuvirtide, a fusion inhibitor, treats HIV that is advanced or resistant to other types of treatment. The nurse should always administer the drug with other antiretroviral drugs. Metastatic ovarian cancer INCORRECT Enfuvirtide, a fusion inhibitor, does not treat early estrogen-receptor-positive ovarian cancer. Topotecan, a topoisomerase inhibitor, treats metastatic ovarian cancer. 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 Hairy cell leukemia INCORRECT Raltegravir, an integrase inhibitor, does not treat hairy cell leukemia. Interferon alfa-2a treats hairy cell leukemia and chronic myelogenous leukemia. Thyroid cancer INCORRECT Raltegravir, an integrase inhibitor, does not treat thyroid cancer. Doxorubicin, an anthracycline, treats thyroid cancer. Kaposi's sarcoma INCORRECT Raltegravir, an integrase inhibitor, does not treat Kaposi's sarcoma. Paclitaxel, a taxane, treats Kaposi's sarcoma. Resistant HIV CORRECT My Answer 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 is teaching the guardian of a 4-month-old infant about recommended immunizations for the infant. Which of the following immunizations should the nurse include? A. Haemophilus influenzae type B vaccine (Hib) B. Varicella vaccine C. Meningococcal conjugate vaccine (MCV4) D. Tetanus-diphtheria-acelluar pertussis vaccine (Tdap) - //A. Haemophilus influenzae type B vaccine (Hib) Haemophilus influenza type 3 vaccine (Hib) CORRECT My Answer The nurse should inform the guardian that the Haemophilus influenza type B vaccine (Hib) is recommended for infants and children to prevent a serious type of meningitis commonly seen in young children. Varicella vaccine INCORRECT The nurse should inform the guardian that the varicella vaccine is not given to infants under 12 months of age. The first dose iS given at 12 months with booster given between 4 and 6 years of age. Meningococcal conjugate vaccine (MCV4) INCORRECT The nurse should inform the guardian that the meningococcal conjugate vaccine is recommended for adolescents 11 to 18 years old. Adolescents should receive WO doses of MCV4. The first dose should be given at 11 or 12 years old, with a booster dose at age 16. ) Tetanus-diphtheria-acelluar pertussis vaccine (Tdap) INCORRECT The nurse should inform the guardian that the Tdap vaccine is given to adolescents between the ages of 11 and 12 years old as a booster to the DTaP vaccine. A nurse is preparing to administer paclitaxel IV to a client who has ovarian cancer. Which of the following actions should the nurse take? (Select all that apply). A. Give the client an antihistamine. B. Infuse the drug over 1 hr. C. Administer the drug through non-PVC tubing. D. Use an in-line filter. E. Add heparin to the paclitaxel solution. - //A, C, D Give the client an antihistamine is correct. Prior to administering paclitaxel, an antimitotic drug, the nurse should give the client an antihistamine, such as diphenhydramine, a proton-pump inhibitor, such as cimetidine, and a glucocorticoid, such as dexamethasone, to prevent a hypersensitivity reaction. Infuse the drug over 1 hr is incorrect. The nurse should infuse paclitaxel over 3 hr, not 1 hr. Administer the drug through non-PVC tubing is correct. Paclitaxel is incompatible with PVC tubing. Use an in-line filter is correct. Paclitaxel requires administration through an in-line filter. Add heparin to the paclitaxel solution is incorrect. The nurse should not mix paclitaxel with any other drugs. Heparin and other anticoagulants increase the risk for bleeding. A nurse is teaching a client who has a new diagnosis of breast cancer about the drug tamoxifen. The nurse should tell the client that which of the following conditions is a contraindication for taking tamoxifen? A. Deep-vein thrombosis B. COPD C. Diabetes mellitus D. Alcohol use disorder - //A. Deep-vein thrombosis Deep-vein thrombosis CORRECT My Answer Tamoxifen, an estrogen receptor blocker, can cause thromboembolism. Its use requires cautious use with clients who have deep-vein thrombosis. COPD INCORRECT Clients who have COPD can take tamoxifen, an estrogen receptor blocker. Trastuzumab is an immune system drug that requires cautious use with clients who have pulmonary disease. Diabetes mellitus INCORRECT Clients who have diabetes can take tamoxifen, an estrogen-receptor blocker. Interferon Alfa-2a is an immune system drug that requires cautious use with clients who have diabetes. Alcohol use disorder INCORRECT Clients who have alcohol use disorder can take tamoxifen, an estrogen-receptor blocker. Zidovudine is an immune system drug that requires cautious use with clients who have alcohol use disorder. A nurse is caring for a client who has a new prescription for cisplatin to treat testicular cancer. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply). A. Paresthesia B. Sore throat C. Flank pain D. Tinnitus E. Conjunctivitis - //A, B, C, D Paresthesia is correct. Cisplatin, a platinum compound, can cause peripheral neuropathy. The nurse should tell the client to report numbness, tingling, or decreased sensation in the hands or feet. Sore throat is correct. Cisplatin can cause bone marrow depression. The nurse should tell the client to report fever, sore throat, bruising, or fatigue. Flank pain is correct. Cisplatin can cause kidney toxicity. Prior to therapy, the nurse should hydrate the client with to 2 L of IV fluid and continue for 24 hr following therapy to flush the kidneys and help prevent kidney toxicity. Tinnitus is correct. Cisplatin can cause ototoxicity. The nurse should monitor the client's hearing and instruct the client to report hearing loss, vertigo, or tinnitus. Conjunctivitis is incorrect. Cisplatin is unlikely to cause conjunctivitis, although it can cause blurred vision, papilledema, and optic neuritis. 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 Rash CORRECT My Answer 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 lifethreatening complication. Insomnia INCORRECT Delavirdine, a non-nucleoside reverse transcriptase inhibitor, is more likely to cause fatigue and dizziness than insomnia. Rhinitis INCORRECT Delavirdine, a non-nucleoside reverse transcriptase inhibitor, is more likely to cause bronchitis than rhinitis. Alopecia INCORRECT Delavirdine, a non-nucleoside reverse transcriptase inhibitor, is unlikely to cause alopecia. Vincristine, an antimitotic, is an immune system drug that iS can cause alopecia. A nurse is teaching a client who has a new prescription for mercaptopurine to treat leukemia. Which of the following instructions should the nurse include? (Select all that apply). A. Use contraception if pregnancy is a risk. B. Perform oral hygiene frequently. C. Avoid activities that require mental alertness. D. Perform hand hygiene frequently. E. Avoid activities that can cause injury. - //A, B, D, E Use contraception if pregnancy is a risk is correct. Mercaptopurine, a purine analog, is : pregnancy risk category D drug. Clients of childbearing age who take the drug should use contraception, and the nurse should confirm nonpregnancy before starting therapy. Perform oral hygiene frequently is correct. Mercaptopurine can cause stomatitis. The nurse should instruct the client to perform frequent oral hygiene to help prevent or minimize this adverse effect. Avoid activities that require mental alertness is incorrect. Mercaptopurine is unlikely to cause sedation or dizziness. Trastuzumab, a monoclonal antibody, is an immune system drug that can cause dizziness, which would require the client to avoid activities that require mental acuity. Perform hand hygiene frequently is correct. Mercaptopurine can cause neutropenia. The nurse should instruct the client to wash hands thoroughly or use an an alcohol-based hand rub frequently and to avoid crowds and contact with people who have communicable infections. Avoid activities that can cause injury is correct. Mercaptopurine can cause thrombocytopenia. The nurse should monitor the client's CBC throughout treatment and instruct the client to avoid activities that can cause injury and report any unexplained bruising or bleeding. A nurse is teaching a client about maraviroc. Which of the following instructions should the nurse include?