NSG 3032 Pharmacology Saunders Nclex Exam 2 Questions & Answers with Rationale

NSG 3032 Pharmacology Saunders Nclex Exam 2 Questions & Answers with Rationale Antivirus Medication 1. The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine. The nurse interprets that the client may have the medication discontinued by the primary health care provider if which elevated result is noted? 1. Serum protein level 2. Blood glucose level 3. Serum amylase level 4. Serum creatinine level 2. A client who is human immunodeficiency virus seropositive has been taking stavudine. The nurse should monitor which most closely while the client is taking this medication? 1. Gait 2. Appetite 3. Level of consciousness 4. Gastrointestinal function 3. A client with acquired immunodeficiency syndrome (AIDS) has been started on therapy with zidovudine. The nurse should monitor the results of which laboratory blood study for adverse effects of therapy? 1. Creatinine level 2. Potassium concentration 3. Complete blood cell (CBC) count 4. Blood urea nitrogen (BUN) level A client is receiving zalcitabine. The nurse should monitor the results of which study to determine the effectiveness of the medication? 1. Western bolt 2. CD4+ cell count 3. Enzyme-linked immunosorbent assay (ELISA) 4. Complete blood call (CBC) count with differential Rationale: Acquired immunodeficiency syndrome is a viral disease caused by the human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy. Zalcitabine slows the progression of acquired immunodeficiency syndrome (AIDS) by improving the CD4+ cell count. The Western blot and the ELISA are performed to diagnose the infection initially. A CBC count with differential may be done as part of ongoing monitoring of the status of the client with AIDS and to detect adverse effects of other medications. The clinic nurse is discussing medication compliance with a client diagnosed with acquired immunodeficiency syndrome (AIDs). Which information should the nurse discuss with the client? (Select all that apply) 1. The availability of insurance to pay for the medications. 2. Whether the client wants to try to manage the disease without medications. 3. Including OTC herbs in the medication regimen. 4. The importance of taking multiple vitamins at least twice a day. 5. The ability to change the medication regimen if side effects are not tolerable. Rationale: 1. If the client does not have insurance to help pay for the medications, the client may have trouble complying with the regimen. The current regimens include four or more daily medication costing more then $6,000 per drug per year. 5. May antiretroviral therapies have sied effects that can be effectively treated; however, if the client cannot tolerate the side effects, the medication regimen can be altered. A client who has been receiving pentamidine intravenously now has a fever with a temperature of 102 F (38.9 C). Keeping in mind that the client has a diagnosis of acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci pneumonia, the nurse should interpret that this fever is most associated with which condition? 1. Inadequate thermoregulation 2. Insufficient medication dosing 3. Toxic nervous system effects from the medication 4. Infection caused by leukopenic effects of the medication Rationale: Acquired immunodeficiency syndrome is a viral disease caused by the human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy. Pneumocystis jiroveci pneumonia (PCP) is a fungal infection and is a common opportunistic infection. Adverse effects of pentamidine include leukopenia, thrombocytopenia, and anemia. The client should be routinely assessed for signs and symptoms of infection. The remaining options are inaccurate interpretations. The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine. The client develops a temperature of 101º F (38.3º C). The nurse continues to assess the client, knowing that this sign most likely indicates which condition? 1. That the dose of the medication is too low 2. That the client is experiencing toxic effects of the medication 3. That the client has developed inadequacy of thermoregulation 4. That the client has developed another infection caused by leukopenic effects of the medication Rationale: Frequent adverse effects of this medication include leukopenia, thrombocytopenia, and anemia. The client should be monitored routinely for signs and symptoms of infection. Options 1, 2, and 3 are inaccurate interpretations. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS) who is receiving foscarnet. The nurse should monitor the results of which laboratory study while the client is taking this medication? 1. CD4 cell count 2. Lymphocyte count 3. Serum albumin level 4. Serum creatine level Rationale: Acquired immunodeficiency syndrome is a viral disease caused by the human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy. Cytomegalovirus retinitis is an opportunistic viral infection of the eye. Foscarnet is an antiviral medication that is toxic to the kidneys. The serum creatinine level is monitored before therapy, 2 or 3 times per week during induction therapy, and at least weekly during maintenance therapy. Foscarnet also may cause decreased levels of calcium, magnesium, phosphorus, and potassium. Thus, these levels also are measured with the same frequency. The nurse is caring for a client who has cytomegalovirus retinitis and is receiving foscarnet. Which assessment finding, if reported by the client, indicates a need for follow-up? 1. Intact hearing capacity 2. Urine noted to be clear yellow 3. Urinary output of 30 mL per hour 4. Impaired balance while ambulating Rationale: Cytomegalovirus retinitis is an opportunistic viral infection of the eye. Foscarnet is an antiviral agent that is used to treat viral infections in the client with leukemia. Serious side and adverse effects, such as ototoxicity and nephrotoxicity, can occur as a result of this medication. Impaired balance while ambulating and impaired hearing are signs of ototoxicity. Intact hearing capacity, urine noted to be clear yellow, and a urinary output of 30 mL per hour are normal assessment findings. The client with acquired immunodeficiency syndrome (AIDS) has been prescribed raltegravir. The nurse determines that the client may be experiencing an adverse effect related to this medication if which assessment finding is noted? 1. Insomnia 2. Dizziness 3. Indigestion and belching 4. Temperature of 101.2º F (38.4º C) Rationale: Acquired immunodeficiency syndrome is a viral disease caused by the human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy. Human immunodeficiency virus (HIV) can cause acquired immunodeficiency syndrome, which is a viral disease that destroys T cells, thereby increasing susceptibility to infection and malignancy. Raltegravir is classified as an integrase inhibitor and acts by inhibiting human immunodeficiency virus (HIV) replication. Insomnia, dizziness, and indigestion are some side effects of the mediation. A temperature of 101.2º F is indicative of potential opportunistic infection, which is an adverse effect of this medication. The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS) who is receiving didanosine. The nurse understands that side and adverse effects associated with this medication include which findings? Select all that apply. 1. Fatigue 2. Diarrhea 3. Pancreatitis 4. Lactic acidosis 5. Peripheral neuropathy Rationale: Acquired immunodeficiency syndrome is a viral disease caused by the human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy. Human immunodeficiency virus (HIV) can cause acquired immunodeficiency syndrome, which is a viral disease that destroys T cells, thereby increasing susceptibility to infection and malignancy. Didanosine is a nucleoside-nucleotide reverse transcriptase inhibitor that is used to treat human immunodeficiency virus (HIV) infection. Side and adverse effects of this medication include diarrhea, pancreatitis, lactic acidosis, peripheral neuropathy, hepatic steatosis, chills or fever, and rash or pruritus. Fatigue can be a manifestation of AIDS but is not a side or adverse effect of this medication. A client with acquired immunodeficiency syndrome who is taking zidovudine 200 mg orally 3 times daily has severe neutropenia noted on follow-up laboratory studies. The nurse interprets that which change is likely to occur at this point? 1. The medication dose probably will be reduced. 2. Prednisone probably will added to the medication regimen 3. Epoetin alfa probably will be added to the medication regimen 4. The medication probably will be discontinued until laboratory results indicate bone marrow recovery. Rationale: Zidovudine is a nucleoside-nucleotide reverse transcriptase inhibitor. Hematological monitoring should be done every 2 weeks in the client taking zidovudine. If severe anemia or severe neutropenia develops, treatment should be discontinued until evidence of bone marrow recovery is noted. If anemia or neutropenia is mild, a reduction in dosage may be sufficient. The administration of prednisone may further alter the immune function. Epoetin alfa is administered to clients experiencing anemia. A client with acquired immunodeficiency syndrome (AIDS) experiences nausea, vomiting, and abdominal pain radiating to the back after taking didanosine. The ambulatory care nurse should provide which response as telephone advice to this client? 1. “Take crackers and milk with each dose of the medication” 2. “Decrease the dose of the medication until the next clinic visit” 3. This is an uncomfortable but expected side of adverse effect of the medication.” 4. “Report to the health care clinic to be seen by the primary health care provider.” Rationale: Acquired immunodeficiency syndrome is a viral disease caused by the human immunodeficiency virus (HIV), which destroys T cells, thereby increasing susceptibility to infection and malignancy. Didanosine is a nucleoside-nucleotide reverse transcriptase inhibitor. Pancreatitis, which can be fatal, is the major dose-limiting toxicity associated with the administration of didanosine. Clients should be monitored for indications of developing pancreatitis, which include increased serum amylase in association with increased serum triglycerides; decreased serum calcium; and nausea, vomiting, or abdominal pain radiating to the back. If evolving pancreatitis is diagnosed, the medication should be discontinued. The client should be seen by the primary health care provider. The nurse is monitoring a client who is receiving intravenous (IV) acyclovir. The nurse would monitor the client closely for which primary toxic effect of the medication? 1. Ototoxicity 2. Neurotoxicity 3. Cardiotoxicity 4. Nephrotoxicity Rationale: Acyclovir is an antiviral medication. Although the most common side and adverse reactions with this medication are phlebitis and inflammation at the IV site, reversible nephrotoxicity, evidenced by elevated serum creatinine and BUN levels, can occur in some clients. The cause of nephrotoxicity is deposition of acyclovir in the renal tubules. The risk of renal injury is increased by dehydration and the use of other nephrotoxic medications. Ototoxicity, neurotoxicity, and cardiotoxicity are not specific to this medication. A client with human immunodeficiency virus infection is taking indinavir. The nurse plans to provide the client with which direction when providing instructions about the use of this medication?