Deck 13: Anti-Inflammatory, Antiallergic, and Immunologic Drugs

Question 1

A provider orders hydroxyzine for a patient with acute urticaria. What information will the provider include when teaching the patient about this drug?

A) The drug will reduce redness and itching but not edema.
B) This antihistamine is not likely to cause sedation.
C) Alcohol should be avoided while taking the drug.
D) Shortness of breath may occur while taking the drug.

Answer 1

Alcohol should be avoided while taking the drug.

Question 2

A 60-year-old female patient is about to begin long-term therapy with a glucocorticoid. Which intervention will the provider prescribe to help minimize the patient's risk of developing osteoporosis?

A) Baseline vitamin D level
B) Calcium and vitamin D supplements
C) Estrogen therapy
D) Skeletal x-rays before treatment

Answer 2

Calcium and vitamin D supplements

Question 3

A provider caring for a patient infected with the human immunodeficiency virus (HIV) will be most concerned about which lab result?

A) High level of eosinophils
B) Low neutrophil count
C) Decreased red blood cell (RBC) count
D) Very low helper T lymphocyte count

Answer 3

Very low helper T lymphocyte count

Question 4

A patient who has seasonal allergies works as a truck driver and needs the least sedating antihistamine to control symptoms. Which medication will the provider recommend?

A) Cetirizine
B) Fexofenadine
C) Levocetirizine
D) Loratadine

Question 5

A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct?

A) "Yes, but it is safe during only the second and third trimesters of pregnancy."
B) "Aspirin may cause premature closure of the ductus arteriosus in your baby so should be avoided."
C) "Aspirin may induce premature labor and should be avoided in the third trimester."
D) "No, you should use a first-generation nonsteroidal antiinflammatory medication."

Question 6

An older male patient takes furosemide and low-dose aspirin. Urine output is low despite the diuretic. Today's blood pressure is 140/80 mm Hg and the serum creatinine and blood urea nitrogen (BUN) levels are elevated. The patient has also gained 10-pounds over the past 3 months. What action will the provider discuss with the patient?

A) Adding an antihypertensive medication
B) Recheck the serum creatinine and BUN
C) Ordering a potassium-sparing diuretic
D) Withdrawing the aspirin

Question 7

A provider is about to prescribe prednisone to a patient for tendonitis. What item in the patient's medical history would cause the provider to reconsider that action?

A) Allergic rhinitis
B) Gouty arthritis
C) Seborrheic dermatitis
D) Systemic fungal infection

Question 8

A patient taking a glucocorticoid for arthritis reports feeling bloated and peripheral edema is noted. Which action by the provider is relevant to the care of this patient?

A) Asking the patient about sodium intake
B) Obtaining a blood glucose level
C) Suggesting the patient limit potassium intake
D) Discontinuing the drug

Question 9

A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls to report that the child has a temperature of 102.8 $\degree$ F. What action will the provider take?

A) File an adverse event report with the Vaccine Adverse Event Reporting System (VAERS).
B) Order a lab test to rule out thrombocytopenia.
C) Reassure the parent that fever can occur with the MMR vaccine.
D) Advise the parent to take the child to the emergency department.

Question 10

An adolescent is brought to the emergency department after consuming a bottle of extended-release acetaminophen tablets between 8 and 10 hours ago. Which intervention will the provider order?

A) Acetylcysteine administration
B) Activated charcoal administration
C) Hemodialysis
D) Gastric lavage

Question 11

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What action will the provider take?

A) Reducing the dose of the glucocorticoid medication
B) Encourage the patient to restrict sodium intake.
C) Reassure the patient that this is an expected side effect.
D) Discontinue the medication immediately.

Question 12

A provider prescribing vaccines to a child with an immune deficiency disorder will avoid ordering which vaccination?

A) Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine
B) Haemophilus influenzae type b (Hib) vaccine
C) Polio injection
D) Varicella virus vaccine

Question 13

A patient who takes aspirin for rheumatoid arthritis develops a headache and tinnitus. The patient's lab result includes a plasma salicylate level of 300 $\mu$ g/mL, and a urine pH of 6.0. What action will the provider take?

A) Increase the aspirin dose to better treat the patient's headache.
B) Order lab work to identify possible renal toxicity.
C) Prepare to provide respiratory support, related to a possible overdose.
D) Withhold the aspirin until the patient's symptoms have subsided.

Question 14

A 2-month-old infant presents with a low-grade fever, runny nose, and severe bursts of coughing resulting in transient cyanosis. When taking a history, the provider will specifically inquire about the vaccination history for which condition?

A) Pertussis
B) Hepatitis B
C) Measles, mumps, and rubella (MMR)
D) Influenza

Question 15

A 3-year-old child who has asthma is in the clinic for a well-child checkup. The nurse notes that the child is up to date for the DTaP, hepatitis A, hepatitis B, and the MMR vaccines but has only had one each of the Hib, the rotavirus, and the PCV13 vaccines. Which vaccine will the provider prescribe for this child?

A) Hib
B) PCV13
C) PCV13 and Hib
D) Rotavirus

Question 16

A patient who takes aspirin daily is scheduled for surgery in 1 week. What action will the provider suggest to minimize the patient's risk for injury?

A) Continue to use aspirin as scheduled.
B) Reduce the aspirin dosage by half until after surgery.
C) Stop taking aspirin immediately.
D) Stop taking aspirin 3 days before surgery.

Question 17

A 2-month-old infant is scheduled to receive the first dose of DTaP. What information will the provider include in instructions given to the parents?

A) "Usually reactions are mild; a low-grade fever is most common."
B) "Most children do not experience any reaction."
C) "Seizures are common and may require anticonvulsant medication."
D) "The most common reaction is a rash that develops into itchy blisters."

Question 18

A provider is caring for a patient who has undergone organ transplantation. Because the major histocompatibility complex (MHC) molecules of the donor are different from those of the patient, the provider will prescribe a drug from which drug class?

A) Antibiotics
B) Antihistamines
C) Immune globulins
D) Immunosuppressants

Question 19

Parents report that their 5-year-old child has frequent motion sickness. Which antihistamine will the provider recommend?

A) Desloratadine
B) Dimenhydrinate
C) Hydroxyzine
D) Promethazine

Question 20

A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine syrup once daily. The parents tell the provider that the child does not like the syrup, and they do not think that the drug is effective. The provider will discuss which change in medication therapy?

A) Cetirizine 5-mg chewable tablet once daily
B) Loratadine 10-mg chewable tablet once daily
C) Fexofenadine syrup 5 mL twice daily
D) Desloratadine 5-mg rapid-disintegrating tablet once daily

Question 21

A patient who has been taking a glucocorticoid for several months arrives in the clinic. The patient's cheeks appear full and there is a prominent hump of fat present on the upper back. The provider will order which test?

A) Liver function tests
B) Serum electrolytes
C) Tuberculin skin test
D) Vitamin D levels

Question 22

An 11-year-old boy received all childhood immunizations before attending kindergarten. Which vaccines will the provider recommended for this child at his current age? (Select all that apply.)

A) Hepatitis B
B) PCV-23
C) Tdap
D) MCV4
E) HPV

Question 23

A patient will begin taking fexofenadine for hay fever. What information will the provider include in patient teaching?

A) Fexofenadine should be taken with food to prevent gastrointestinal symptoms.
B) The medication may be taken once or twice daily.
C) Tolerance to sedation will occur in a few weeks.
D) With renal impairment, this drug should be taken every other day.

Question 24

A provider is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?

A) "I should reduce the dose by half each day until I stop taking the drug."
B) "I will need to have cortisol levels monitored during the withdrawal process."
C) "The withdrawal schedule may take several months."
D) "If I have surgery, I may need to take the drug for a while, even after I have stopped."

Question 25

A patient who takes a glucocorticoid reports having tarry stools but denies gastric pain. After ruling out anemia and determining that the patient is not in danger, which action will the provider take?

A) Prescribing an antiulcer medication.
B) Counseling the patient to use over-the-counter antacids.
C) Reassuring the patient not to worry unless there is gastric pain.
D) Discontinuing the glucocorticoid immediately.