Deck 93: Antiviral Agents I: Drugs for Non-HIV Viral Infections

Question 1

A patient has lamivudine-resistant hepatitis B and has been taking entecavir [Baraclude] for 2 years. The patient asks the nurse why the provider has recommended taking the drug for another year. What will the nurse tell the patient?

A) "Entecavir can reverse fibrosis and cirrhosis of the liver when taken long term."
B) "It is necessary to continue taking entecavir to avoid withdrawal symptoms."
C) "The drug will be given until the infection is completely eradicated."
D) "You will need to continue taking entecavir to prevent lactic acidosis and hepatotoxicity."

Answer 1

"Entecavir can reverse fibrosis and cirrhosis of the liver when taken long term."

Question 2

A patient has a positive test for influenza type A and tells the nurse that symptoms began 5 days before being tested. The prescriber has ordered oseltamivir [Tamiflu]. The nurse will tell the patient that oseltamivir:

A) may decrease symptom duration by 2 or 3 days.
B) may not be effective because of the delay in starting treatment.
C) may reduce the severity but not the duration of symptoms.
D) will alleviate symptoms within 24 hours of the start of therapy.

Answer 2

may not be effective because of the delay in starting treatment.

Question 3

The nurse is caring for a patient receiving intravenous acyclovir [Zovirax]. To prevent nephrotoxicity associated with intravenous acyclovir,the nurse will:

A) hydrate the patient during the infusion and for 2 hours after the infusion.
B) increase the patient's intake of foods rich in vitamin C.
C) monitor urinary output every 30 minutes.
D) provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.

Answer 3

hydrate the patient during the infusion and for 2 hours after the infusion.

Question 4

A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that:

A) antiviral medications are not safe during pregnancy.
B) intravenous antiviral agents will be used if an outbreak occurs.
C) oral acyclovir [Zovirax] may be used during pregnancy.
D) topical acyclovir [Zovirax] must be used to control outbreaks.

Question 5

A nurse is teaching a group of nursing students about influenza prevention. Which statement by a student indicates understanding of the teaching?

A) "I may develop a mild case of influenza if I receive the vaccine by injection."
B) "I should receive the vaccine every year in October or November."
C) "If I have a cold I should postpone getting the vaccine."
D) "The antiviral medications are as effective as the flu vaccine for preventing the flu."

Question 6

A patient with HIV contracts herpes simplex virus (HSV),and the prescriber orders acyclovir [Zovirax] 400 mg PO twice daily for 10 days. After 7 days of therapy,the patient reports having an increased number of lesions. The nurse will expect the provider to:

A) extend this patient's drug therapy to twice daily for 12 months.
B) give intravenous foscarnet every 8 hours for 2 to 3 weeks.
C) increase the acyclovir dose to 800 mg PO 5 times daily.
D) order intravenous valacyclovir [Valtrex] 1 gm PO twice daily for 10 days.

Question 7

A nursing student asks a nurse why pegylated interferon alfa is used instead of regular interferon for a patient with hepatitis C. The nurse will tell the student that pegylated interferon:

A) decreases the need for additional medications.
B) has fewer adverse effects than interferon.
C) is administered less frequently than interferon.
D) may be given orally to increase ease of use.

Question 8

A female patient who has hepatitis C is being treated with pegylated interferon alfa and ribavirin [Ribasphere]. It will be important for the nurse to teach this patient that:

A) if she gets pregnant, she should use the inhaled form of ribavirin [Virazole].
B) if she is taking oral contraceptives, she should also take a protease inhibitor.
C) she should use a hormonal contraceptive to avoid pregnancy.
D) she will need a monthly pregnancy test during her treatment.

Question 9

An immunocompromised child is exposed to chickenpox and the provider orders valacyclovir [Valtrex] to be given orally three times daily. The nurse will contact the provider to change this order for which reason?

A) Valacyclovir is not used as varicella prophylaxis.
B) The dosage is too high for this indication.
C) The drug may cause serious adverse effects in immunocompromised patients.
D) Valacyclovir is not approved for use in children.

Question 10

A patient with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks,the patient's dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What will the nurse do?

A) Notify the provider and request an order for a serum calcium level.
B) Notify the provider of potential foscarnet overdose.
C) Request an order for a creatinine clearance level.
D) Request an order of IV saline to be given before the next dose.

Question 11

A male patient with hepatitis C will begin triple drug therapy with pegylated interferon alfa 2a [Pegasys],ribavirin [Ribasphere],and boceprevir [Victrelis]. The patient tells the nurse that his wife is pregnant. What will the nurse tell him?

A) Boceprevir is contraindicated in males whose partners are pregnant.
B) He should use a barrier contraceptive when having sex.
C) He should use dual drug therapy with pegylated interferon alfa and ribavirin only.
D) This combination drug therapy is safe for him to use.

Question 12

A patient with hepatitis B begins treatment with adefovir [Hepsera] and asks the nurse how long the drug therapy will last. The nurse will tell the patient that the medication will need to be taken for:

A) a lifetime.
B) an indefinite, prolonged period of time.
C) 48 weeks.
D) until nephrotoxicity occurs.

Question 13

A patient has a positive test for hepatitis C and is admitted to the hospital. The admission laboratory tests reveal a normal ALT,and a liver biopsy is negative for hepatic fibrosis and inflammation. The nurse will prepare this patient for:

A) dual therapy with pegylated interferon alfa and ribavirin.
B) no medication therapy at this time.
C) pegylated interferon alfa only until ALT levels are elevated.
D) triple drug therapy with pegylated interferon alfa, ribavirin, and boceprevir.

Question 14

A nurse provides teaching for a patient with cytomegalovirus (CMV)retinitis who will receive the ganciclovir ocular implant [Vitrasert]. Which statement by the patient indicates a need for further teaching?

A) "My vision may be blurred for 2 to 4 weeks after receiving the implant."
B) "Surgical placement of the implant is an outpatient procedure."
C) "The implant will remain in place permanently."
D) "The implant will slow progression of CMV retinitis."

Question 15

A patient comes to the clinic and receives valacyclovir [Valtrex] for a herpes-zoster virus. The nurse instructs the patient to take the medication:

A) without regard to meals.
B) without any dairy products.
C) each morning.
D) on an empty stomach.