Question 1

The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results,the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. The nurse expects that the prescriber will manage these levels with:

A) lovastatin [Mevacor].
B) simvastatin [Zocor].
C) modified diet and exercise.
D) Pancrease.

Accepted Answer

The nurse should monitor the patient's CBC to determine whether the patient has anemia and neutropenia. Ketones are not an adverse effect of zidovudine. Nothing indicates a need to monitor the immunoglobulin levels or serum lactate dehydrogenase.

Question 2

The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results,the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. The nurse expects that the prescriber will manage these levels with:

A) lovastatin [Mevacor].
B) simvastatin [Zocor].
C) modified diet and exercise.
D) Pancrease.

modified diet and exercise.

Accepted Answer

All PIs can elevate plasma levels of cholesterol and triglycerides. Potential interventions for hyperlipidemia include modified diet,exercise,and lipid-lowering agents. Lovastatin and simvastatin should be avoided,because they can accumulate to dangerous levels. Pancrease is not indicated to lower triglycerides and cholesterol.

Question 3

A patient who is taking nelfinavir [Viracept] calls the nurse to report moderate to severe diarrhea. What will the nurse expect the provider to recommend?&#10;A) An over-the-counter antidiarrheal drug&#10;B) Immediate discontinuation of the nelfinavir&#10;C) Reducing the dose of nelfinavir by half&#10;D) Taking the nelfinavir with food to avoid side effects

Accepted Answer

A dose-limiting effect of nelfinavir is moderate to severe diarrhea,which can be managed with OTC antidiarrheal medications. Unless the symptoms become severe,withdrawing the nelfinavir is not indicated. Reducing the dose by half or taking it with food is not indicated.

Question 4

The nurse asks a graduate nurse,&#34;When a patient in the initial phase of HIV infection is assessed,which findings would you expect to see?&#34; The graduate nurse would be correct to respond with which conditions? (Select all that apply.)&#10;A) Respiratory distress&#10;B) Fever&#10;C) Myalgia&#10;D) Lymphadenopathy&#10;E) Insomnia

Accepted Answer

Fever,myalgia,and lymphadenopathy are early signs associated with HIV infection. Respiratory distress and insomnia are not consistent findings in the initial phase of HIV infection.

Question 5

The nurse is preparing to discharge a patient with HIV who will continue to take enfuvirtide [Fuzeon] at home. The nurse is providing patient education about the medication. What information about the administration of enfuvirtide is most appropriate for the patient?

A) The importance of injecting the drug into two alternating sites daily
B) How to reconstitute and self-administer a subcutaneous injection
C) The importance of taking the drug with high doses of vitamin E
D) Likely drug interactions between enfuvirtide and other antiretroviral drugs

Accepted Answer

The most appropriate information about the administration of enfuvirtide is how to reconstitute and self-administer a subcutaneous injection. The medication should never be injected into the same site or just between two sites. Vitamin E is not indicated for this medication. Enfuvirtide does not appear to cause significant drug interactions.

Question 6

The nurse is caring for a patient who is human immunodeficiency virus (HIV)positive and is taking high doses of zidovudine [Retrovir]. The nurse is providing patient education about the adverse effects of the medication. Which statement by the patient demonstrates a need for further teaching?

A) "I may experience fatigue from anemia."
B) "I may be more susceptible to infection from neutropenia."
C) "I may have a deficiency of vitamin B₆."
D) "I may have a deficiency of folic acid."

Accepted Answer

A deficiency of vitamin B₁₂,not vitamin B₆,would be expected; this statement indicates that further teaching is required. With high-dose zidovudine,the patient can expect anemia,neutropenia,and folic acid deficiency.

Question 7

After starting an antiviral protease inhibitor,a patient with HIV telephones the nurse,complaining,"I'm so hungry and thirsty all the time! I'm urinating 10 or 12 times a day." The nurse recognizes these findings to be consistent with:

A) pancreatic infiltration by HIV.
B) allergic reaction.
C) nonadherence to the antiviral regimen.
D) hyperglycemia.

Accepted Answer

Protease inhibitors have been associated with hyperglycemia,new-onset diabetes,abrupt exacerbation of existing diabetes,and diabetic ketoacidosis. These symptoms are not consistent with pancreatic infiltration or an allergic reaction. No evidence indicates that the patient is noncompliant.

Question 8

The nurse is providing education to a group of patients who are HIV positive. The nurse is discussing the various medications used to treat HIV infection. A patient asks about nevirapine [Viramune]. Which statements by the nurse most accurately reflect the facts about nevirapine? (Select all that apply.)

A) "Some herbal preparations can reduce the levels of this drug."
B) "This agent can damage the liver; therefore, liver function tests are needed periodically."
C) "Usually no adverse effects occur when this medication is used alone."
D) "The drug must be dosed five times per day at evenly spaced intervals."
E) "You should call your healthcare provider immediately if you develop a rash."

Accepted Answer

Some herbal preparations can reduce the levels of nevirapine,which can damage the liver. The patient should call the healthcare provider immediately if a rash develops. Many adverse effects are associated with the use of nevirapine. In adults,nevirapine is dosed once daily initially,not five times a day.

Question 9

A patient who is taking didanosine [Videx] reports nausea,vomiting,and abdominal pain. What will the nurse recommend to this patient?&#10;A) &#34;Take the drug with food to minimize these side effects.&#34;&#10;B) &#34;Stop taking the drug immediately and resume taking it once your symptoms subside.&#34;&#10;C) &#34;Take the medication in the evening to avoid experiencing these kinds of symptoms.&#34;&#10;D) &#34;You will need laboratory tests to determine if these are serious effects of the drug.&#34;

Accepted Answer

As with all NRTIs,pancreatitis may occur and may manifest as nausea,vomiting,and abdominal pain. The patient will need evaluation of serum amylase,triglycerides,and calcium. Taking the drug with food or at a different time of day are not indicated. It is not correct to discontinue the drug and to resume it when symptoms subside,since pancreatitis may be fatal.

Question 10

A patient taking stavudine [Zerit] telephones the clinic and reports numbness and tingling in the hands and feet. What should the nurse tell the patient?&#10;A) The numbness is an expected side effect of the medication and will diminish once the drug is withdrawn.&#10;B) The medication will probably be stopped, and the patient should come into the clinic for further evaluation.&#10;C) The dose may be too high, and the patient should cut the tablet in half.&#10;D) The patient should take the medication on a full stomach to reduce absorption of the drug.

Accepted Answer

The patient has early signs and symptoms of neuropathy,which may resolve if the drug is stopped. The patient should be taught early in treatment to report these symptoms immediately. Numbness is not an expected side effect and these symptoms may diminish once the drug is withdrawn. The patient should never be advised to cut the dose in half unless instructed to do so by a prescriber. Taking the medication on a full stomach will not affect the amount of medication absorbed.

Question 11

The nurse is performing a physical assessment on a patient who is receiving treatment with abacavir,zidovudine,and lamivudine [Trizivir]. The patient complains of fatigue. Upon further assessment,the nurse finds a rash and notes that the patient has a temperature of 101.1°F. What is the nurse's best course of action?

A) Tell the patient that this is an expected response to these medications and to continue the agents as prescribed.
B) Have the patient hold the medications and arrange for an immediate evaluation by the prescriber.
C) Have the patient continue the abacavir but discontinue the other two agents for 3 weeks.
D) Instruct the patient to continue all three medications and administer an antihistamine for the symptoms.

Accepted Answer

The answer of The nurse is performing a physical assessment...

Question 12

A patient starting therapy with efavirenz [Sustiva] asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the nurse provide?

A) The drug must be taken within 30 minutes after a meal.
B) The drug is best taken with a high-fat meal.
C) The drug can be taken anytime without regard to meals.
D) The drug should be taken once daily on an empty stomach.

Accepted Answer

The answer of A patient starting therapy with efavirenz [Sustiva]...

Question 13

A nurse is preparing to administer medications to a patient recently started on
Delavirdine [Rescriptor]. Which concurrent prescription should the nurse question before administration?

A) Alprazolam [Xanax]
B) Diphenhydramine [Benadryl]
C) Morphine
D) Penicillin

Accepted Answer

The answer of A nurse is preparing to administer medications...

Question 14

The nurse is caring for a patient who is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies,including didanosine [Videx]. Which laboratory findings would most concern the nurse?

A) Increased serum amylase and triglycerides and decreased serum calcium
B) Decreased serum amylase and serum triglycerides and increased serum calcium
C) Decreased hemoglobin and hematocrit
D) Increased serum amylase, decreased triglycerides, and increased platelets

Accepted Answer

The answer of The nurse is caring for a patient...

Deck 94: Antiviral Agents II: Drugs for HIV Infection and Related Opportunistic Infections