question

A nurse is caring for several clients who came to the clinic for a seasonal influenza vaccination. Which of the following clients could receive the vaccine via nasal spray rather than an injection? A) A 1 year old with no health problems B) A 17 year old who has a hypersensitivity to penicillin C) A 25 year old who is pregnant D) A 52 year old who takes a multivitamin supplement

answer

B) A 17 year old who has a hypersensitivity to penicillin

question

A nurse is teaching a group of parents about immunizations. Which of the following vaccines should the nurse tell the parents is administered to children younger than 1 year of age and not to older children or adults? A) pneumococcal vaccine B) meningococcal vaccine C) Varicella vaccine D) Rotavirus vaccine

answer

D) Rotavirus vaccine

question

A 12 month old child has just received her first measles, mumps, and rubelle (MMR) vaccine. For which of the following possible reactions to this vaccine should the nurse teach the parents to monitor? (Select all that apply) A) Rash B) Redness and discomfort at injection site C) Bruising on multiple areas on the body D) Fainting E) Inconsolable crying

answer

A, B, C

question

A nurse is caring for a group of clients who are not protected against varicelle. Which of the following clients should receive a varicella vaccination at this time? A) A 24 year old woman in her third trimester of pregnancy B) A 3 year old who has Wilm's tumor and is receiving chemo C) A 2 month old infant who has no health problems D) A 32 year old man who has essential HTN

answer

D) A 32 year old man who has essential HTN

question

When caring for a patient who is taking flutamide to treat prostate cancer, the health care professional should monitor the patient for which of the following adverse effects of the drug? A) Dehydration B) Gynecomastia C) Constipation D) Tachycardia

answer

B) Gynecomastia

question

A health care professional is caring for a patient who is about to begin maraviroc (Selzentry) therapy. The health care professional should tell the patient to report which of the following adverse effects of the drug? (Select all that apply) A) Paresthesias B) Cough C) Tinnitus D) Jaundice E) Fever

answer

A, B, D, E

question

While assessing a patient who is receiving interferon alfa-2a (Roferon-A) to treat Kaposi's sarcoma, the health care professional should check for which of the following possible indications of an adverse reaction? A) Bradycardia B) Dilated pupils C) Fever D) Constipation

answer

C) Fever

question

When talking to a patient who is about to begin vincristine therapy to treat lymphoma, the healthcare professional should include which of the following instructions? A) Increase fiber intake B) Report tinnitus or vertigo C) Take the drug with 8 oz of water D) Allow 4 hr before taking an antacid

answer

A) Increase fiber intake

question

A health care professional should question the use of maraviroc (Selzentry) for a patient who has which of the following? A) DM B) Meningeal infection C) Pancreatitis D) Non-chemokine receptor 5 (CCR5)-tropic HIV-1

answer

D) Non-chemokine receptor 5 (CCR5)- tropic HIV-1

question

A health care professional should understand taht enfuvirtide (Fuzeon) is an appropriate choice for patients who have which of the following? A) Advanced prostate cancer B) Primary brain tumors C) Advanced HIV disease D) Metastatic ovarian cancer

answer

C) Advanced HIV disease

question

Unless there are any specific contraindications, which of the following immunizations should adults receive once each year? A) Varicella B) Tetanus C) Influenza D) Hepatitis B

answer

C) Influenza

question

A health care professional is caring for a patient who is about to begin intrathecal cytarabine (DepoCyt) therapy to treat meningeal leukemia. The health care professional should explain that the patient should also receive which of the following drugs to reduce the risk of neurotoxicity? A) Diphenhydramine B) Leucovorin C) Folic acid D) Dexamethasone

answer

D) Dexamethasone

question

A health care professional is caring for a patient who is about to begin delavirdine (Rescriptor) therapy to treat HIV-1. The health care professional should tell the patient to report which of the following adverse reactions to the drug? A) Rash B) Insomnia C) Rhinitis D) Alopecia

answer

A) rash

question

A health care professional is caring for a patient who is about to start ritonavir (Norvir) and zidovudine (Retrovir) therapy to treat HIV-1. The health care professional should explain that the patient will receive ritonair along with at least once reverse transcriptase inhibitor to A) Prevent an infusion reaction B) Increase platelet production C) Protect healthy cells from the toxic effects of ritonavir D) Prevent drug resistance

answer

D) Prevent drug resistance

question

A health care professional is caring for a patient who is about to begin topotecan (Hycamtin), a topoisomerase inhibitor, therapy to treat resistant, small-cell lung cancer. The health care professional should caution the patient about 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 (Advil) D) Aluminum hydroxide (Amphojel)

answer

Ibuprofen (Advil)

question

When caring for a patient who is receiving vincristine, a vinca alkaloid to treat lung cancer, the health care professional should monitor for which of the following findings that indicate an adverse effect? A) Weak hand grasps B) Constricted pupils C) Bradycardia D) Crackles

answer

A) Weak hand grasps

question

A health care professional is caring for a patient who is about to begin taking mercaptopurine (Purinethol), a purine analog, to treat leukemia. Which of the following instructions should the health care professional include when talking with the patient about the drug? 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

answer

A, B, D, E

question

A health care professional is caring for a patient who is about to begin taking tamoxifen (Soltamox), an estrogen-receptor blocker, to treat breast cancer. The health care professional should recognize the need for cautious use of the drug if the patient also has which of the following? A) Cataracts B) COPD C) DM D) Alcohol use disorder

answer

A) Cataracts

question

When talking with a patient who is about to begin methotrexate (Trexall), a folic acid antagonist, therapy to treat non-Hodgkin lymphoma, the health care professional should include which of the following instructions? A) Take echinacea supplements B) Use a soft-bristled toothbrush C) Take aspirin to reduce muscle pain D) Urinate Q 4 hr

answer

B) Use a soft-bristled toothbrush

question

A health care professional is assessing a patient following a trastuzumab (Herceptin), a monoclonal antibody, infusion to treat metastatic breast cancer. Which of the following findings indicates an adverse reaction to the drug? A) Wheezing B) Dysrhythmias C) Hypotension D) Fever E) Ascites

answer

A, B, C, D

question

A health care professional is caring for a patient who is about to begin receiving cisplatin, a platinum compound, to treat testicular cancer. The health care professional should tell the patient to report which of the following adverse effects? A) Paresthesias B) Sore throat C) Flank pain D) Tinnitus E) Conjunctivitis

answer

A, B, C, D

question

A health care professional should question the use of anastrozole (Armidix), a aromatase inhibitor, for a patient who is A) allergic to salicylates B) premenopausal C) hearing impaired D) immunocompromised

answer

B) Premenopausal

question

A health care professional is caring for a patient who is receiving IV carmustine (BiCNU), a nitrosourea drug, to treat multiple myeloma. The health care professional should recognize that the patient is at the greatest risk for infection for which of the following lengths of time after the infusion? A) 24 hr B) 1 week C) 2 weeks D) 4-6 weeks

answer

D) 4-6 weeks

question

A health care professional should understand that raltegravir (Isentress), an integrate inhibitor, treats patients who have which of the following? A) Hairy cell leukemia B) Thyroid cancer C) Kaposi's sarcoma D) Resistant HIV disease

answer

D) Resistant HIV disease

question

A health care professional is about to administer enfuvirtide (Fuzeon), a fusion inhibitor, to a patient. The health care professional should perform which of the following actions? A) Administer the drug SubCut B) Discard unused portion C) Roll the vial gently to reconstitute the solution D) Inject the solution at room temp E) Expect a cloudy solution

answer

A, C, D

question

When considering drug therapy options for a patient who has metastatic breast cancer that is positive for human epidermal growth factor receptor 2 (HER2), the health care professional should choose which of the following drugs? A) Trastuzumab (Herceptin) B) Imaatinib (Gleevec) C) Leuprolide (Lupron) D) Flutamide

answer

A) Trastuzumab (Herceptin)

question

A health care professional should question the use of cyclophosphamide, a nitrogen mustard, for a patient who has which of the following? A) Raynaud's syndrome B) Dehydration C) Jaundice D) Charcot-Marie-Tooth Syndrome

answer

B) Dehydration

question

A health care professional is about to administer IV paclitaxel (Taxol), an anti mitotic drug, to a patient who has ovarian cancer. Which of the following actions should the health care professional take? A) Give the patient 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

answer

A, C, D

question

A health care professional is caring for a patient who is about to begin imatinib (Gleevac), a targeted antineoplastic drug, to treat chronic myeloid leukemia. Which of the following instructions should the health care professional include when talking to the patient about taking the drug? A) Clean fruits and vegetables thoroughly B) Increase calcium intake C) Weight yourself daily D) Perform hand hygiene frequently E) Avoid herbal supplements

answer

A, C, D, E

question

Active Immunity

answer

pt produces own antibodies in response to their own antigens

question

Passive Immunity

answer

pt gets antibodies from external source

question

Natural Immunity

answer

pt develops antibodies produced by pt's own body or antibodies transferred to a fetus via placenta or breast milk

question

Artificial Immunity

answer

vaccine or direct injection of immunoglobulin

question

Natural Active Immunity

answer

pt exposed to disease and develops active infection

question

Artificial active immunity

answer

pt takes the vaccine exposing the pt to inactive form of disease which stimulates production of antibodies

question

Natural passive immunity

answer

communicable disease is conferred to an infant who is being breast fed by mom who has disease

question

Artificial passive immunity

answer

conferred to an individual exposed to disease without having a vaccination against it

question

Interventions to monitor for and care for someone with bone marrow suppression

answer

-Check CBC, Hgb, Hct before treatments (weekly) -Monitor for fever & infection during tx (neutropenia) -Monitor for s/s of thrombocytopenia -Monitor Liver function tests

question

Pt teaching with bone marrow suppression

answer

-Report fever, sore throat, easy bruising, unusual fatigue -Wash fresh fruits & veggies; cook foods well -Frequent oral care (soft toothbrush & electric razor) -Report oral ulceration and pain, blood in vomitus/stool -Avoid alcohol, report yellowing of skin & eyes, dyspnea, or SOB

question

Interventions for Neutropenic Precautions

answer

-Place pt in private room -Limit number of health care providers who enter the room and restrict ill visitors from entering -limit number of invasive procedures and use aseptic technique -*keep designated patient care equipment in pt's room*

question

Interventions for N/V that occur as a result of many of the chemotherapeutic drugs

answer

*GI Symptoms*: monitor GI symptoms, administer antiemtic as needed, monitor pt's weight & I/O, and report GI symptoms to provider Concurrent administration of dexamethasone & an antianxiety agent may increase effectiveness of the antiemetic

question

Precautions when administering vesicants

answer

-Use central venous catheter when possible -Monitor for thrombophlebitis or infiltration -Stop infusion STAT if infiltration is suspected -Slow IV rate for red streak along vein or skin flushing -Avoid starting IV in veins near joints of hand, AC space

question

Interventions when monitoring for nephrotoxicity & ototoxicty

answer

-Perform baseline audiometric and kidney function testing; repeat before each dose -Ensure adequate hydration before, during, and after administration -Monitor weight; notify provider of sudden increase -Expect decrease in dosage for signs of nephron or ototoxicity

question

Interventions when monitoring for liver toxicity

answer

-Monitor baseline and periodic levels of bilirubin and liver transaminase (ALT, AST) for elevations -Observe for jaundice -Dose may be reduced in hepatic toxicity

question

Interventions when monitoring for cardiac toxicity

answer

-Determine cardiac function prior to, during, and after treatment -Monitor for dysrhythmias; assess vital signs following treatment

question

Interventions when monitoring for peripheral neuropathy

answer

-Check deep tendon reflexes periodically, especially Achilles -Monitor for decreased in strength or movement of hands and feet -Expect decreased dose if peripheral neuropathy occurs

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