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?

Accepted Answer

Hydroxyzine is an antihistamine that can cause sedation, and alcohol can enhance this sedative effect, so patients are advised to avoid alcohol 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?

Accepted Answer

Calcium and vitamin D supplements are commonly recommended alongside long-term glucocorticoid therapy to help minimize the risk of developing osteoporosis. Glucocorticoids can decrease calcium absorption and increase bone resorption, leading to bone density loss.

Question 3

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

Accepted Answer

Very low helper T lymphocyte counts are a major concern in HIV-infected patients because these cells are crucial for the immune system's ability to fight infections. HIV specifically targets and destroys these cells, leading to immunodeficiency.

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?

Accepted Answer

Fexofenadine is known to be the least sedating antihistamine among the options provided, making it suitable for someone who needs to avoid drowsiness, such as a truck driver.

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?

Accepted Answer

Aspirin is known to potentially cause premature closure of the ductus arteriosus in the fetus, which is a critical concern during pregnancy, especially in the later stages. This is why it is generally recommended to avoid aspirin during pregnancy, particularly in the third trimester.

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?

Accepted Answer

The answer of An older male patient takes furosemide and...

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?

Accepted Answer

Prednisone is a corticosteroid that can suppress the immune system, making it potentially dangerous for patients with systemic fungal infections, as it could exacerbate the 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?

Accepted Answer

Glucocorticoids can cause fluid retention and edema, often related to increased sodium retention. Asking about sodium intake is relevant to managing these symptoms.

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?

Accepted Answer

Fever is a common side effect of the MMR vaccine, and parents can be reassured that this is a normal response.

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?

Accepted Answer

Acetylcysteine is the antidote for acetaminophen toxicity and can prevent liver damage if administered within 8 to 10 hours after ingestion.

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?

Accepted Answer

Glucocorticoid therapy, especially at high doses, can lead to muscle weakness as a side effect due to its catabolic effects on skeletal muscle. Reducing the dose can help mitigate this side effect while still providing the therapeutic benefits of the medication.

Question 12

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

Accepted Answer

Varicella virus vaccine is a live vaccine, which is generally contraindicated in individuals with immune deficiency disorders due to the risk of causing disease in these immunocompromised patients. The other vaccines listed are inactivated or subunit vaccines, which are generally considered safe for individuals with immune deficiencies.

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?

Accepted Answer

The symptoms of headache and tinnitus, along with a plasma salicylate level of 300 µg/mL, suggest salicylate toxicity, which is a common side effect of aspirin overdose. The appropriate action is to withhold the aspirin until the patient's symptoms have subsided to prevent further toxicity.

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?

Accepted Answer

The symptoms described are characteristic of pertussis, also known as whooping cough, which is a highly contagious respiratory disease known for uncontrollable, violent coughing which often makes it hard to breathe. Vaccination history for pertussis is crucial in this context, especially considering the patient's age and symptomatology.

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?

Accepted Answer

The answer of A 3-year-old child who has asthma is...

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?

Accepted Answer

Aspirin should be stopped at least 7-10 days before surgery to minimize the risk of bleeding, as it irreversibly inhibits platelet function.

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?

Accepted Answer

Usually, reactions to the DTaP vaccine are mild, with a low-grade fever being the most common side effect.

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?

Accepted Answer

Immunosuppressants are prescribed to organ transplant patients to prevent the immune system from attacking the transplanted organ, which is recognized as foreign due to differences in major histocompatibility complex (MHC) molecules between the donor and the recipient.

Question 19

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

Accepted Answer

Dimenhydrinate is commonly used to prevent and treat motion sickness in children.

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?

Accepted Answer

Cetirizine 5-mg chewable tablet once daily is an appropriate alternative for a child who dislikes syrup, and the dose is suitable for a 5-year-old.

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

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

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

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

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 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 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?

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

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 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 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 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 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?

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

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?

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

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

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

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

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 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 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?

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

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 μ\muμ g/mL, and a urine pH of 6.0. What action will the provider take?

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 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 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 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?

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

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 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 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?