NCLEX Pharmacology Quiz 49 Immunological Medications

1. A client with acquired immunodeficiency syndrome is prescribed with Zidovudine (Azidothymidine). Which of the following laboratory results should the nurse monitor while on this medication?

Throat swab gram stain.

Complete blood count.

Random blood sugar.

Blood uric acid.

Zidovudine may decrease the number of a certain type of white blood cell in the blood and cause anemia and muscle disorders.Options A. C. and D are not related to the medication.

Explanation

Zidovudine may decrease the number of a certain type of white blood cell in the blood and cause anemia and muscle disorders.Options A. C. and D are not related to the medication.

2. An HIV-positive client who has been started on highly active antiretroviral therapy (HAART) came back for a follow-up checkup. Which of the following will be the most helpful in determining the response to the therapy?

Rapid HIV antigen test.

Western Blot analysis.

Viral load test.

White blood cell count.

A viral load test helps provide information on the health status and how well antiretroviral therapy(ART – treatment with HIV medicines) is controlling the virus.Options A and B monitors the presence of antibodies to HIV. so these tests will yield a positive result after the patient is infected with HIV even if the drug therapy is effective.Option D will be used to assess the impact of HIV on immune function but will not directly measure the effectiveness of the medicines.

Explanation

A viral load test helps provide information on the health status and how well antiretroviral therapy(ART – treatment with HIV medicines) is controlling the virus.Options A and B monitors the presence of antibodies to HIV. so these tests will yield a positive result after the patient is infected with HIV even if the drug therapy is effective.Option D will be used to assess the impact of HIV on immune function but will not directly measure the effectiveness of the medicines.

3. The client who is human immunodeficiency virus seropositive has been taking Saquinavir (Invirase). The nurse provides medication instructions and advises the client to:

Take the medication in the morning before meals.

Include a low-fat diet.

Weight gain is expected.

Avoid being exposed to sunlight.

Saquinavir (Invirase) is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in the body. This can cause photosensitivity so the nurse should instruct the client to avoid sun exposure.Option A: The medicine is taken with food or within 2 hours after eating a full meal.Option B: The medicine is best absorbed with a high-fat meal.Option C: Weight loss instead is expected.

Explanation

Saquinavir (Invirase) is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in the body. This can cause photosensitivity so the nurse should instruct the client to avoid sun exposure.Option A: The medicine is taken with food or within 2 hours after eating a full meal.Option B: The medicine is best absorbed with a high-fat meal.Option C: Weight loss instead is expected.

4. A client is prescribed with Pentamidine (Pentam) IV for the treatment of Pneumocystis carinii pneumonia. Suddenly. the client develops a temperature of 101.5°F. The nurse in charge knows that this sign would mostly indicate on which of the following?

An overdosage of the medication.

The need for an additional dosage.

The client has developed another infection.

The client is experiencing the therapeutic effect of the medication.

Pentamidine can cause low white blood cells or low platelets in your blood. so the client is most likely developed another infection brought about these side effects.Options A. B. and D are inappropriate interpretation.

Explanation

Pentamidine can cause low white blood cells or low platelets in your blood. so the client is most likely developed another infection brought about these side effects.Options A. B. and D are inappropriate interpretation.

5. A nurse is evaluating a client who is HIV positive who is prescribed with Pentamidine (Pentam) IV for the treatment of Pneumocystis carinii pneumonia. Which of the following assessment after the administration is the most important to relay to the physician?

Blood pressure of 100/62 mm/Hg.

Redness and pain at the site of the infusion.

Sudden sweating and hunger.

Unusual taste or dryness in the mouth.

Pentamidine can cause fatal hypoglycemia. so symptoms such as sudden sweating and hunger are indicative of a low blood sugar indicates a need for change in the treatment.Option A: A low blood pressure may indicate the need of a slower infusion.Option B: Redness and Pain is a sign for the nurse to establish a new IV line.Option D: Dryness and unusual taste may happen at the start but do not need for an immediate notification of the physician.

Explanation

Pentamidine can cause fatal hypoglycemia. so symptoms such as sudden sweating and hunger are indicative of a low blood sugar indicates a need for change in the treatment.Option A: A low blood pressure may indicate the need of a slower infusion.Option B: Redness and Pain is a sign for the nurse to establish a new IV line.Option D: Dryness and unusual taste may happen at the start but do not need for an immediate notification of the physician.

6. The nurse is monitoring a post-renal transplantation client taking Cyclosporine (Neoral). The nurse observes an elevation in one of the client's vital sign and the client is complaining of sweating and headache. Which of the following vital sign is most likely increased?

Respiratory rate.

Pulse rate.

Temperature.

Blood pressure.

Hypertension is one of the side effects of taking cyclosporine (Neoral) and since the client is also complaining of sweating and headache. the blood pressure is the important sign to be monitored closely.

Explanation

Hypertension is one of the side effects of taking cyclosporine (Neoral) and since the client is also complaining of sweating and headache. the blood pressure is the important sign to be monitored closely.

7. A client is admitted to the emergency room complaints of a difficulty of breathing and upon auscultation. the nurse noted that the patient has wheezes. An allergic reaction to penicillin was diagnosed. Which of the following medications should the nurse expect to administer first?

Aminophylline (Theophylline).

Albuterol (Ventolin HFA).

Methylprednisolone (Solu-Medrol).

Pulmicort (Budesonide).

Albuterol (Ventolin HFA) is the most rapidly acting of the medications among the choices.Option A is not the first line treatment for a bronchospasm.Options C and D are corticosteroids that are used during allergic reaction but are not rapidly acting.

Explanation

Albuterol (Ventolin HFA) is the most rapidly acting of the medications among the choices.Option A is not the first line treatment for a bronchospasm.Options C and D are corticosteroids that are used during allergic reaction but are not rapidly acting.

8. While on Pentamidine (Pentam) infusion therapy. The nurse must anticipate doing which of the following?

Obtain a 12-lead ECG.

Observe for signs of retinal damage.

Instruct the client on a low potassium diet.

Instruct the client on limit fluid intake.

Pentamidine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious fast/irregular heartbeat and other symptoms (such as severe dizziness. fainting) that need an urgent medical attention.Options B and D are not related to the use of the medication.Option C: Low levels of potassium in the blood can increase the risk of QT prolongation.

Explanation

Pentamidine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious fast/irregular heartbeat and other symptoms (such as severe dizziness. fainting) that need an urgent medical attention.Options B and D are not related to the use of the medication.Option C: Low levels of potassium in the blood can increase the risk of QT prolongation.

9. Stavudine (Zerit) is prescribed to a client with human immunodeficiency virus seropositive. The nurse observes which of the following most closely while the client is taking the medication?

Orientation.

Gag reflex.

Appetite.

Gait.

One of the most serious side effects of Stavudine (Zerit) is peripheral neuropathy so the nurse should monitor the client’s gait while taking this medication.Options A. B. and C are not related to the use of the medication.

Explanation

One of the most serious side effects of Stavudine (Zerit) is peripheral neuropathy so the nurse should monitor the client’s gait while taking this medication.Options A. B. and C are not related to the use of the medication.

10. A nurse is doing an assessment data while completing an admission for a patient with a history of liver transplant who is receiving cyclosporine (Sandimmune). Prednisone (Orasone). and Azathioprine (Imuran). Which of the following information will give the nurse the most attention?

The client has a soft non-tender lump in the shoulder.

An increase cholesterol level.

Grade 1+ pitting edema in the feet.

Swollen and pinkish gums noted.

A client taking immunosuppressive medications are at risk for development of cancer. A soft non-tender lump will indicate that the patient has lymphoma.Options B. C. and D are common side effects of the immunosuppressive medications.

Explanation

A client taking immunosuppressive medications are at risk for development of cancer. A soft non-tender lump will indicate that the patient has lymphoma.Options B. C. and D are common side effects of the immunosuppressive medications.