Question 1

Antiviral medications work by inhibiting or stopping a stage of viral replication. Which statements are descriptions of these stages?&#10;A) Attachment of the virus to the host cell&#10;B) Destruction of host cell DNA.&#10;C) Synthesis of the viral nucleic acid and proteins by the host cell&#10;D) Assembly of all viral components, structural proteins, enzymes, and nucleic acids&#10;E) Release of virions from the host cell&#10;

Accepted Answer

Rationale 1: The first stage of viral infection is the attachment of the virus to the host cell.
Rationale 2: Destruction of host cell DNA is not a stage of infection.
Rationale 3: The third stage of viral infection is synthesis of the viral nucleic acid and proteins by the host cell.
Rationale 4: The fourth stage of viral infection is assembly. All the viral components, structural proteins, enzymes, and nucleic acids are packaged and made ready to leave the cell.
Rationale 5: The fifth stage of viral infection is the release of the virions from the host cell.

Question 2

A client is seen in the clinic for treatment of herpes genital warts and is ordered acyclovir. What does the nurse include in her teaching?&#10;A) Report blood in the urine to your physician&#10;B) Apply cream once daily for the length of treatment&#10;C) Complete entire course of treatment&#10;D) May use cortisone cream to area to relieve burning&#10;E) Consult health care provider before taking any OTC medications&#10;

Accepted Answer

Rationale 1. Blood in the urine may be an indication of renal problems, acyclovir can be nephrotoxic
Rationale 2. Cream should be applied every three hours 6 x per day for 7 days
Rationale 3. Like all anti-infectives, the complete course must be finished in order for the treatment to be effective
Rationale 4. Clients should not use any other types of cream on the lesions when using acyclovir
Rationale 5. This is a correct statement, there are OTC medications that may interfere with the actions of acyclovir

Question 3

A client has been ordered Interferon alpha-2b for treatment of the HVC virus. What teaching does the nurse provide the client about this drug?&#10;A) Expect a period of flu like symptoms when starting this medication&#10;B) Complete the entire 7 day course, do not skip doses&#10;C) You should expect to see improvement in your kidney function with treatment.&#10;D) Blood pressure should be checked at regular intervals&#10;

Accepted Answer

Rationale 1 Like with many immunostimulants, the most common side effect is a flu-like syndrome of fever, chills, dizziness, and fatigue that usually diminishes as therapy progresses
Rationale 2. The course of treatment for HCV is usually 24 weeks
Rationale 3. The expected outcome for this drug would be an improvement in liver function.
Rationale 4. This drug might affect blood glucose, not blood pressure

Question 4

The nurse is providing discharge teaching to a client recently been diagnosed with HIV. Which of the following regarding the goals of treatment indicates understanding of the teaching provided?&#10;A) Prevent HIV-related morbidity.&#10;B) Prolong survival.&#10;C) Restore and preserve immunologic function.&#10;D) Increase viral load.&#10;E) Eliminate the potential for transmission from mother to child in pregnant clients who have HIV infection.&#10;

Accepted Answer

Rationale 1: A goal of HIV pharmacotherapy is to decrease HIV-related morbidity. It is not realistic to expect the therapy to prevent morbidity.
Rationale 2: A goal of HIV pharmacotherapy is to prolong survival with HIV.
Rationale 3: A goal of HIV pharmacotherapy is to restore and preserve immunologic function.
Rationale 4: A goal of HIV pharmacotherapy is to suppress the viral load, not increase it.
Rationale 5: It is impossible to eliminate the potential for transmission of HIV from a mother to a child in pregnant clients. It can, however, be reduced with HIV pharmacotherapy.

Question 5

The nurse accidentally sticks herself with a needle after starting an intravenous line on a client with AIDS. The nurse tells the supervisor about the accident. What is the best initial response by the supervisor to decrease anxiety in the nurse?

A) "Workers compensation will cover the cost of your illness and medications."
B) "Fortunately, the chances of you contracting human immunodeficiency virus after the stick are very small."
C) "If you are started on medications soon, it will decrease the severity of the disease."
D) "Did you use the hospital protocols for starting IV lines on a client with AIDS?"

Accepted Answer

Rationale 1: If the nurse did contract HIV, workers compensation would cover the cost, but the risk of HIV transmission is small. This response would not reduce anxiety.
Rationale 2: Risk of transmission does exist, but is very small.
Rationale 3: The risk of occupational transmission of HIV is very small. Telling the nurse to start on medication will not reduce anxiety.
Rationale 4: Asking the nurse if she used protocols is nontherapeutic at this point and will most likely increase anxiety.

Question 6

A pregnant client with HIV is anxious about her upcoming delivery. The nurse reviews with her plans for the client during delivery and plans for treatment of the infant after birth. What statement by the client indicates the need for further teaching?

A) " I will get an infusion of Retrovir during my labour."
B) " My baby will start treatment at 6 weeks old."
C) " I will know at birth whether my child is infected."
D) " Virological testing will confirm HIV infection between 1-2 weeks of age."
E) " Treatment should begin for infants within the first 12 hours of life"

Accepted Answer

Rationale 1. It is recommended that the woman receive a continuous infusion of zidovudine
during labour. Zidovudine rapidly crosses the placenta. This may provide some protection for the fetus because most perinatal transmission of HIV occurs near to or during labour and delivery.
Rationale 2. Therapy of neonates born to mothers infected with HIV should begin immediately after delivery, no later than 6 to 12 hours postpartum. beginning antiretroviral therapy more than 48 hours after birth has been shown to be ineffective in preventing the infection. It is recommended that zidovudine be given orally to the newborn for 6 weeks. In addition, three doses of nevirapine are given during the first week of life. 
Rationale 3. Although initial HIV antibody tests on the newborn may be positive, these antibodies may be due to maternal infection and not HIV infection in the child.
Rationale 4. HIV infection is established in infants by age 1 to 2 weeks. 
Rationale 5. Therapy of neonates born to mothers infected with HIV should begin immediately after delivery, no later than 6 to 12 hours postpartum.

Question 7

Student nurses have completed their module on pharmacotherapy to treat HIV and AIDS. A question on the final exam asks them to identify a primary reason why opportunistic infections are less prevalent now than in the early 1980s. Which of the following are correctly identified by the students?

A) HAART increases numbers of CD4 reducing profound immunosuppression.
B) Better antibiotics are available to treat the infections.
C) Mutations of the HIV virus compete for receptor sites with other microbes
D) The use of retrovir has significantly decreased incidence of OIs

Accepted Answer

Rationale 1. OIs still occur in clients with HIV-AIDS; however, they are less common and mortality is diminished. This is because HAART increases the numbers of CD4 lymphocytes, allowing clients with HIV infection to maintain a higher level of immunological defence. 
Rationale 2. With low numbers of CD4s, even antibiotics would not be able to mount a significant defence against the OIs.
Rationale 3. This is an untrue statement. 
Rationale 4 Retrovir alone is not responsible for decreased OIs, but the multiple medications used in HAART has significantly improved outcomes for HIV-AIDS clients.

Question 8

During assessment of a client's infection site, the nurse determines that the site is warm to the touch. How should the nurse explain this warmth to the client?&#10;A) &#34;Infection causes fluid overload in your body, so the infected site gets warm and red.&#34;&#10;B) &#34;Your lymphatic system has shut down to keep the infection from spreading, so the site gets warm and red.&#34;&#10;C) &#34;The little vessels around your infection are leaking, so the area gets warm and red.&#34;&#10;D) &#34;Your body is sending extra blood and white cells to the site to fight the infection.&#34;&#10;

Accepted Answer

Rationale 1: Fluid overload does not cause erythema.
Rationale 2: Blocked lymphatic drainage does not cause erythema.
Rationale 3: Increased capillary permeability does not cause erythema.
Rationale 4: Increased blood flow causes warmth and redness.

Question 9

A client is prescribed an antihistamine for an allergic reaction. The client asks, "Why am I getting this? What is a histamine anyway?" How can the nurse most accurately describe the action of histamine in the body?

A) "Histamine causes your blood vessels to dilate and leak. That is why you are swollen and itchy."
B) "Histamine stimulates production of the clotting parts of your blood. That is why you are blotchy."
C) "Histamine stimulates production of white blood cells to fight off infection. That is why you feel flushed."
D) "Histamine stimulates production of the red cells of your blood. That is why you are red."

Accepted Answer

Rationale 1: Histamine is responsible for vasodilation and increased vascular permeability.
Rationale 2: Histamine does not stimulate platelet production.
Rationale 3: Histamine does not stimulate white blood cell production.
Rationale 4: Histamine does not stimulate red blood cell production.

Question 10

The infection control (IC) nurse has completed teaching newly hired nurses about the innate body defence. Which statements by one of the participants would indicate the need for further instruction?&#10;A) &#34;Fever is one of the process barriers we can expect our clients to demonstrate.&#34;&#10;B) &#34;Complement is a component of the adaptive immune response.&#34;&#10;C) &#34;I should try to keep my client's skin and mucous membranes intact.&#34;&#10;D) &#34;Dendritic cells are part of the nervous system involved in keeping the immune system strong.&#34;&#10;E) &#34;Phagocytes are cells that kill invading bacteria.&#34;&#10;

Accepted Answer

Rationale 1: Fever is a process barrier of the innate body defences.
Rationale 2: Complement is one of the process barriers of the innate body defences.
Rationale 3: Skin and mucous membranes act as physical barriers to invasion by pathogens.
Rationale 4: Dendritic cells are one of the cellular barriers. Dendrites are part of the nervous system, but are not specifically charged with keeping the immune system strong.
Rationale 5: Phagocytes do kill invading bacteria.

Question 11

A client scheduled to undergo a lymph node biopsy asks, &#34;If lymph nodes are so prone to cancer, why don't they just take them all out?&#34; How should the nurse respond?&#10;A) &#34;Lymph nodes filter out all kinds of debris and are essential to our good health.&#34;&#10;B) &#34;The surgeon will probably take out a majority of the nodes in the region where the biopsy will be done.&#34;&#10;C) &#34;The cells that are in the lymph nodes actually help protect us from cancer.&#34;&#10;D) &#34;The lymph nodes make up one of our best defences against infection.&#34;&#10;E) &#34;They usually do take out all the lymph nodes if the client has lymphoma.&#34;&#10;

Accepted Answer

The answer of A client scheduled to undergo a lymph...

Question 12

The newly licensed nurse tells her clinical educator, "I thought that interferons were medications, but I heard the doctor tell my client that his interferons were suppressed." How should the educator respond?

A) "Interferons are proteins produced in the body."
B) "Interferons can be produced to use as medications to fight cancer."
C) "The doctor probably said your client's immune system was depressed."
D) "Interferons help to stimulate other cells of the immune system."
E) "Interferons made by the body are the same as natural killer cells."

Accepted Answer

The answer of The newly licensed nurse tells her clinical...

Question 13

A client is scheduled for kidney transplantation using an allograft. Which instruction should the nurse provide?&#10;A) &#34;You will be monitored for acute rejection for the first 48 hours.&#34;&#10;B) &#34;If your system has not rejected the kidney within 2 weeks of surgery, you will be out of danger.&#34;&#10;C) &#34;You will take antirejection medication for at least several months after surgery.&#34;&#10;D) &#34;You are in danger of developing chronic rejection for years after your surgery.&#34;&#10;E) &#34;Rejection usually occurs immediately after surgery, generally before the client gets out of the recovery room.&#34;&#10;

Accepted Answer

The answer of A client is scheduled for kidney transplantation...

Question 14

Community health nurses are running an immunization clinic. Which of the following children would not be immunized at this time?&#10;A) A 6 month old who is teething&#10;B) A 2 month old with diaper rash&#10;C) A 12 month old with diarrhea&#10;D) A 18 month old recently stung by a bee.&#10;

Accepted Answer

The answer of Community health nurses are running an immunization...

Deck 18: Pharmacology of Non-Hiv Viral Infections