NCLEX Pharmacology Quiz 50 Immunological Medications

1. Amikacin (Amikin) is given to a client with E-coli infection. The nurse advises the client to report which of the following symptoms immediately?

Muscle pain.

Constipation.

Fatigue.

Hearing loss.

Amikacin is an aminoglycoside. Side effects of this medication includes ototoxicity (Hearing loss). confusion. disorientation. gastrointestinal irritation. palpitations. blood pressure changes and nephrotoxicity.Options A. B. and C are not related with the medication.

Explanation

Amikacin is an aminoglycoside. Side effects of this medication includes ototoxicity (Hearing loss). confusion. disorientation. gastrointestinal irritation. palpitations. blood pressure changes and nephrotoxicity.Options A. B. and C are not related with the medication.

2. A post-kidney transplant client went to the health care facility to ask the nurse regarding vaccinations while on Tacrolimus (Prograf) a medication used to prevent organ rejection. Which of the following is an appropriate response of the nurse?

“Do not skip due doses of vaccination for this can help in your treatment”.

“You can have live vaccinations even without the approval of the physician”.

“Influenza can happen anytime. so a flu vaccine is a must.”

“Do not receive any live vaccinations while on this treatment”.

Tacrolimus may lower your body’s resistance and the vaccine may not work as well or the client may get the infection the vaccine is meant to prevent.

Explanation

Tacrolimus may lower your body’s resistance and the vaccine may not work as well or the client may get the infection the vaccine is meant to prevent.

3. A nurse is giving instructions to a client taking Ciprofloxacin (Cipro) for the treatment of gonorrhea. The nurse tells the client to?

Report any history of tendon problems.

Resume daily exercise such as biking.

Take an antacid 30 minutes prior.

Take it with a yogurt as part of the treatment.

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body). especially in the Achilles’ tendon of the heel. This can happen during treatment or up to several months after the client stop taking ciprofloxacin.Option B: This medication can cause dizziness so avoid any activity that requires alertness until the client is sure to perform such activities safely.Option C: Take ciprofloxacin at least 2 hours before or 6 hours after taking an antacid.Option D: Eating dairy products such as yogurt will impair the effectiveness of ciprofloxacin.

Explanation

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body). especially in the Achilles’ tendon of the heel. This can happen during treatment or up to several months after the client stop taking ciprofloxacin.Option B: This medication can cause dizziness so avoid any activity that requires alertness until the client is sure to perform such activities safely.Option C: Take ciprofloxacin at least 2 hours before or 6 hours after taking an antacid.Option D: Eating dairy products such as yogurt will impair the effectiveness of ciprofloxacin.

4. A nurse is giving instructions to a client who is receiving Mycophenolate mofetil (CellCept) and Mycophenolic acid (Myfortic) after undergoing a heart transplant. The nurse tells the client to anticipate the following side effects. except?

Insomnia.

Vomiting.

Hypertension.

Diarrhea.

These medications can cause diarrhea. vomiting. sepsis. back pain. neutropenia and hypertension.

Explanation

These medications can cause diarrhea. vomiting. sepsis. back pain. neutropenia and hypertension.

5. A client went to the emergency room with complaints of abdominal pain. nausea. diarrhea and mucoid stools. Upon the interview of the nurse. the client stated that he is taking Cefixime (Suprax) for the treatment of urinary tract infection. The nurse determines that the client is most likely suffering from?

Crohn’s disease.

Acute Gastroenteritis.

Acute appendicitis.

Pseudomembranous colitis.

Pseudomembranous colitis also called antibiotic-associated colitis or C. difficile colitis. is the inflammation of the colon associated with an overgrowth of the bacterium Clostridium difficile. This overgrowth of C. difficile is most often related to recent antibiotic use such as ampicillin. clindamycin. fluoroquinolones. and cephalosporins.Options A. B. and C may have the symptoms of the client but are not likely due to this case.

Explanation

Pseudomembranous colitis also called antibiotic-associated colitis or C. difficile colitis. is the inflammation of the colon associated with an overgrowth of the bacterium Clostridium difficile. This overgrowth of C. difficile is most often related to recent antibiotic use such as ampicillin. clindamycin. fluoroquinolones. and cephalosporins.Options A. B. and C may have the symptoms of the client but are not likely due to this case.

6. Amphotericin B (Fungizone) IV is given to a client with aspergillosis. a fungal infection. In order to prevent its side effects. the nurse anticipate administering which of the following prior. except?

Hydrocortisone.

Ketoconazole.

Diphenhydramine.

Meperidine.

Azole antifungals (eg. ketoconazole) decreases the effectiveness of amphotericin b.Options A and C: Fever. shaking. chills. flushing. loss of appetite. dizziness. nausea. vomiting. headache. shortness of breath. or fast breathing may occur 1 to 3 hours after the infusion is started. Medications such as acetaminophen. diphenhydramine. corticosteroids such as hydrocortisone) may be necessary to prevent these side effects.Option D: Meperidine (25 to 50 mg IV) has been shown in some patients to decrease the duration of shaking chills and fever that may accompany the infusion of amphotericin B.

Explanation

Azole antifungals (eg. ketoconazole) decreases the effectiveness of amphotericin b.Options A and C: Fever. shaking. chills. flushing. loss of appetite. dizziness. nausea. vomiting. headache. shortness of breath. or fast breathing may occur 1 to 3 hours after the infusion is started. Medications such as acetaminophen. diphenhydramine. corticosteroids such as hydrocortisone) may be necessary to prevent these side effects.Option D: Meperidine (25 to 50 mg IV) has been shown in some patients to decrease the duration of shaking chills and fever that may accompany the infusion of amphotericin B.

7. A client is recently diagnosed with HIV and a highly antiretroviral therapy is started. After the first week of therapy. the patient complains of headaches. dizziness. and nightmares. Which one of the following anti-retroviral drugs is most likely associated with these symptoms?

Lamivudine.

Efavirenz.

Tenofovir.

Saquinavir.

Efavirenz is a non-nucleoside reverse transcriptase inhibitor. Side effects include rash. dizziness. confusion. headache. and nightmares.Options A and C: Lamivudine and Tenofovir side effects includes headache. dizziness. nausea. diarrhea. or trouble sleeping.Option D: Saquinavir can cause headache. nausea. diarrhea. and photosensitivity.

Explanation

Efavirenz is a non-nucleoside reverse transcriptase inhibitor. Side effects include rash. dizziness. confusion. headache. and nightmares.Options A and C: Lamivudine and Tenofovir side effects includes headache. dizziness. nausea. diarrhea. or trouble sleeping.Option D: Saquinavir can cause headache. nausea. diarrhea. and photosensitivity.

8. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet (Foscavir). The nurse carefully monitors which of the following laboratory test during the treatment with this medication. except?

Serum creatinine.

Serum calcium.

Serum magnesium.

Serum sodium.

Renal impairment is the major toxicity involve in Foscarnet (Foscavir); This medicine also may cause decreased levels of calcium. magnesium. phosphorous. and potassium.

Explanation

Renal impairment is the major toxicity involve in Foscarnet (Foscavir); This medicine also may cause decreased levels of calcium. magnesium. phosphorous. and potassium.

9. Sirolimus (Rapamune) is prescribed to a post-renal transplantation client. Upon the review of the chart. the nurse expects which of the following laboratory results?

Elevated serum potassium.

Decreased cholesterol level.

Elevated platelet count.

Elevated triglyceride level.

Sirolimus (Rapamune) raises cholesterol and triglyceride levels. This medication also causes a decrease in potassium and platelet count.

Explanation

Sirolimus (Rapamune) raises cholesterol and triglyceride levels. This medication also causes a decrease in potassium and platelet count.

10. Tetracycline has been prescribed for a client with Chlamydia trachomatis infection. Select the side effect of the medication. Select all that apply?

Glossitis.

Tremors.

Urinary frequency.

Discoloration of the nails.

Photosensitivity.

Side effects of tetracycline include glossitis. discoloration of the nails. photosensitivity. anorexia. nausea. vomiting. diarrhea. bulky loose stools. stomatitis. sore throat. black hairy tongue.dysphagia.and hoarseness.

Explanation

Side effects of tetracycline include glossitis. discoloration of the nails. photosensitivity. anorexia. nausea. vomiting. diarrhea. bulky loose stools. stomatitis. sore throat. black hairy tongue.dysphagia.and hoarseness.

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