Deck 9: Anti-Infectives: Antiviral Drugs

Question 1

A patient is prescribed intravenous (IV)acyclovir (Zovirax).Which question is most important to ask before giving the first dose of this drug?

A) "Do you have a hearing problem or any trouble with your ears?"
B) "Do you take medications for seizures?"
C) "Are you allergic to sulfa drugs?"
D) "Have you ever had asthma?"

Answer 1

"Do you take medications for seizures?"

Question 2

Which class of antiretroviral drugs works by preventing new viral particles from leaving the infected cell?

A) Entry inhibitors
B) Fusion inhibitors
C) Protease inhibitors
D) Reverse-transcriptase inhibitors

Answer 2

Protease inhibitors

Question 3

Which antiviral drug is only given by oral inhalation?

A) Cyclovir (Zovirax)
B) Zanamivir (Relenza)
C) Oseltamivir (Tamiflu)
D) Amantadine (Symmetrel)

Answer 3

Zanamivir (Relenza)

Question 4

Which specific virus causes mononucleosis?

A) Cytomegalovirus
B) Hantavirus
C) Epstein-Barr virus
D) West Nile virus

Question 5

Which problem is a sign or symptom of an allergic or anaphylactic response to an antiviral drug?

A) Nausea
B) Vivid dreams
C) Intolerance to fatty foods
D) Swelling of the face or throat

Question 6

What is the purpose of antiviral drug therapy?

A) To make the patient immune to infection by viruses.
B) To reduce infection by killing the virus causing disease.
C) To reduce illness duration by controlling viral reproduction.
D) To prevent opportunistic infections in immunosuppressed patients.

Question 7

Which antiviral drug is highly likely to cause birth defects when taken by a pregnant woman?

A) Acyclovir
B) Zanamivir
C) Rimantadine
D) Ribavirin

Question 8

What is the most important precaution to teach a patient who is prescribed oral valacyclovir (Valtrex)?

A) "Avoid coffee and other caffeinated beverages."
B) "Wear long sleeves and a hat when going outdoors."
C) "Take this drug 1 hour before or 4 hours after eating a full meal."
D) "Drink at least 3 L of water daily for the entire time you are taking this drug."

Question 9

Which statement about human immunodeficiency virus (HIV)and acquired immune deficiency syndrome (AIDS)is true?

A) Everyone with AIDS has HIV infection but not everyone with HIV infection has AIDS.
B) Everyone with HIV infection eventually dies of it because the disease cannot be cured.
C) With successful antiretroviral therapy,HIV-infected patients become HIV-antibody negative.
D) When HIV disease becomes AIDS,the infection is in the blood and treatment must be given intravenously.

Question 10

What is the most important precaution to teach a patient who is prescribed any antiviral drug?

A) "Take the drug exactly as prescribed and for as long as prescribed."
B) "Never take any antibacterial drugs while you are on antiviral therapy."
C) "Drink at least 3 L of water daily for the entire time you are taking this drug."
D) "Avoid unnecessary exposure to this drug by stopping it when you have no symptoms for 24 hours."

Question 11

Which drug can only be given by subcutaneous injection?

A) Atazanavir (Reytaz)
B) Enfuvirtide (Fuzeon)
C) Maraviroc (Selzentry)
D) Darunavir (Prezista)

Question 12

What does the term "host" mean?

A) The person infected by a virus.
B) The type of virus known as a retrovirus.
C) The type of virus known as a common virus.
D) The type of infection that occurs only in immunosuppressed people.

Question 13

What is the major difference between retroviruses and common viruses?

A) Retroviruses cannot be killed by antiviral therapy,but common viruses can.
B) A retrovirus usually can cause disease over and over again in the same person.
C) A retrovirus carries the enzyme reverse transcriptase,and common viruses do not.
D) Retroviruses will respond to antibacterial drugs as well as to all the antiviral drugs.

Question 14

Which drug does not work on all strains of the human immunodeficiency virus (HIV)and therefore the patient must be tested before using the drug to make sure it will work?

A) Atazanavir (Reytaz)
B) Enfuvirtide (Fuzeon)
C) Maraviroc (Selzentry)
D) Raltegravis (Issentra)

Question 15

Which drug increases the risk for muscle weakness in older patients who are also taking a "statin" type of lipid-lowering drug?

A) Atazanavir (Reytaz)
B) Enfuvirtide (Fuzeon)
C) Maraviroc (Selzentry)
D) Raltegravis (Issentra)

Question 16

Which antiretroviral drug is now prescribed for preexposure prophylaxis to prevent human immunodeficiency virus (HIV)infection?

A) Acyclovir
B) Edurant
C) Crixivan
D) Truvada

Question 17

How are viral infections different from bacterial infections?

A) Bacterial infections can be spread from one person to another,whereas viral infections cannot be spread directly.
B) Bacterial infections can be cured by treatment with some anti-infective drugs,whereas viral infections are not cured by anti-infective therapy.
C) Viruses only cause disease in a person who is immunocompromised,whereas bacteria can cause disease even among immunocompetent people.
D) Viruses are the less mature form of a bacterium,so there is essentially no difference between viral infections and bacterial infections.

Question 18

Why do most people become ill with a specific viral infection only once?

A) Once a virus is killed by the body,it is gone from the earth forever.
B) During a viral infection,the body changes the virus to be less virulent.
C) Antiviral drugs change the viral DNA so it cannot infect the same person again.
D) During a specific viral infection,the person's immune system improves protection against that virus.

Question 19

Which antiviral drug is most likely to have more severe central nervous system side effects,including worsening of glaucoma?

A) Acyclovir
B) Amantadine
C) Valacyclovir
D) Zanamavir

Question 20

Which statement about antiviral drugs is true?

A) They are all most effective at killing viruses.
B) They are all effective against any type of infection.
C) They all work by slowing the replication of viruses.
D) They are all only effective in people with strong immune systems.

Question 21

What specific precaution would you teach the family of a patient prescribed amantadine?

A) "Be sure that the patient performs mouth care four to six times daily."
B) "Remind the patient that monthly follow-up lab tests will be needed."
C) "Contact the prescriber immediately for any worsening of depression or thoughts of suicide."
D) "Ensure that the patient takes in at least 1000 mL more fluids that he or she puts out."

Question 22

A patient who has been taking efavirenz (Sustiva)reports a sore throat,fever,and blisters.What is your best action?

A) Hold the dose and notify the prescriber.
B) Document the report as the only action.
C) Remind the patient that these are symptoms of opportunistic infection.
D) Reassure the patient that these are common and expected side effects of the drug.

Question 23

A patient taking highly active antiretroviral therapy (HAART)for a year has the following blood laboratory test values.Which value do you report to the prescriber immediately?

A) White blood cell count 3500 cells/mm³
B) Lactate dehydrogenase 990 IU/L
C) Sodium 132 mEq/L
D) Hematocrit 32%

Question 24

Which health problem must you be specifically alert for in pregnant women who are prescribed any nucleoside analogue reverse-transcriptase inhibitor (NRTI)?

A) Headache
B) Lactic acidosis
C) Diabetes mellitus
D) Nausea/vomiting

Question 25

A patient who is taking interferon is also prescribed ribavirin (Virazole).Which laboratory blood test result for this patient do you report immediately to the prescriber?

A) Red blood cells (RBCs)2.2 million/mm³
B) White blood cells (WBCs)6000/mm³
C) Sodium 134 mEq/L
D) International normalized ratio (INR)1.6

Question 26

What is the most important question to ask before giving the first dose of darunavir to a patient newly prescribed this drug?

A) "Do you have a hearing problem or any trouble with your ears?"
B) "Do you take medications for seizures?"
C) "Are you allergic to sulfa drugs?"
D) "Have you ever had asthma?"

Question 27

A 2-year-old patient with respiratory syncytial virus is prescribed aerosolized ribavirin (Virazole).Which visitor should you ensure is not in the patient's room during the aerosol treatments?

A) 16-year-old brother
B) 81-year-old grandmother
C) 32-year-old pregnant mother
D) 36-year-old father who has diabetes

Question 28

A patient who has been taking lamivudine (Epivir)for 6 months reports reduced sensation in the fingers and toes.What is your best action?

A) Document the report as the only action.
B) Hold the dose and notify the prescriber.
C) Remind the patient to continue the drug as usual and take a multiple vitamin daily.
D) Reassure the patient that this is an expected drug side effect and to use injury precautions.

Question 29

A patient is prescribed to begin highly active antiretroviral therapy (HAART).What is the most important question to ask this patient before beginning therapy?

A) "Do you have any symptoms now of active infection?"
B) "Is there any possibility that you are pregnant?"
C) "Are you currently sexually active?"
D) "What other drugs do you take?"

Question 30

A patient who is taking zidovudine (Retrovir)reports diarrhea.Which dietary change should you suggest for this patient?

A) "Avoid fatty and fried foods."
B) "Increase your intake of fiber."
C) "Take an antacid 30 minutes before each meal."
D) "Restrict your intake of fluids to 1 L/day."

Question 31

A patient has human immunodeficiency virus (HIV)disease and is taking a "cocktail" consisting of protease inhibitors,nucleoside analogue reverse-transcriptase inhibitors,and nonnucleoside analogue reverse-transcriptase inhibitors.Which statement made by the patient indicates that more teaching about the drug therapy is needed?

A) "Using three drugs at the same time enhances suppression of viral replication."
B) "There is no problem using these drugs during the last trimester of my pregnancy."
C) "Because this drug combination kills HIV,I do not need to worry about transmitting the virus."
D) "If the virus becomes resistant to this cocktail,another combination of drugs may be required to reduce my viral load."

Question 32

For what reason does adefovir dipivoxil have a black box warning?

A) It induces type 2 diabetes mellitus.
B) It increases the severity of hepatitis B symptoms.
C) It is highly toxic to both the liver and the kidneys.
D) It has a high likelihood of increasing the risk for birth defects and fetal damage.

Question 33

Which test results indicate that a patient's antiretroviral therapy is effective?

A) White blood cell count 5000 cells/mm³
B) Blood urea nitrogen level 15 mg/dL
C) Blood positive for human immunodeficiency virus (HIV)antibodies
D) CD4+ to CD8+ ratio increased

Question 34

How are retroviruses different from common viruses?

A) Retroviruses respond to antibacterial drugs but common viruses do not.
B) Retroviruses have a greater efficiency of infection than common viruses.
C) Common viral infections can be cured while retroviral infections can only be controlled.
D) Common viruses can infect anyone whereas retroviruses can only cause infection in an immunosuppressed host.

Question 35

A human immunodeficiency virus (HIV)-positive patient taking highly active antiretroviral therapy informs you that she is now pregnant.What advice regarding drug therapy do you give this patient?

A) "Stop taking these drugs for your entire pregnancy."
B) "Stop taking these drugs for the first trimester and start again for the second and third trimesters."
C) "Continue to take these drugs throughout your pregnancy exactly as they have been prescribed."
D) "It will be necessary to double your dosages of these drugs to ensure your unborn baby is adequately protected."

Question 36

Which food,drink,or herbal supplement do you warn a patient who is prescribed nevirapine (Viramune)to avoid?

A) Caffeinated beverages
B) Grapefruit juice
C) St.John's wort
D) Dairy products

Question 37

Which common side effects should you watch for when a patient is taking adefovir dipivoxil?

A) Numbness and tingling in extremities
B) Nausea,vomiting,and abdominal pain
C) Dizziness and light-headedness
D) Increased confusion

Question 38

A patient who has been prescribed amantadine (Symmetrel)has all of the following health problems.For which problem should you contact the prescriber before giving the first dose?

A) Asthma
B) Influenza
C) Glaucoma
D) Diabetes mellitus

Question 39

Which precaution about zanamivir (Relenza)therapy do you teach a patient who also uses a bronchodilator for asthma control?

A) "Drink at least 3 L of water daily while using this drug."
B) "Use the bronchodilator 15 minutes before taking the zanamivir."
C) "Avoid taking the zanamivir within 2 hours of using the bronchodilator."
D) "Take your pulse daily while on this drug because when taken with a bronchodilator heart rhythm problems are common."

Question 40

A child is prescribed emtricitabine (Emtriva)120 mg orally.The drug on hand is emtricitabine suspension 10 mg/mL.How many milliliters do you prepare for a correct dose?

A) 2
B) 6
C) 12
D) 20

Question 41

A 40-year-old patient infected with human immunodeficiency virus (HIV)asks why the new drug maraviroc (Selzentry)is not being prescribed for her.What is your best response?

A) "This drug is very expensive and your insurance may not cover it."
B) "This drug can cause birth defects and should not be prescribed for anyone who is pregnant or might become pregnant."
C) "This drug is very toxic to the heart and lungs.It is prescribed only for patients who are young and have no other health problems."
D) "This drug is not effective against all HIV subtypes and the HIV causing your infection does not have the target for this drug."

Question 42

How do protease inhibitor (PI)drugs prevent viral replication?

A) They are counterfeit bases that prevent reverse transcriptase from synthesizing the DNA needed for viral replication.
B) They inactivate the enzyme that allows the viral genetic material to be integrated into the human host's cellular DNA.
C) They prevent the production of proteins needed for viral particles to leave the cell and infect other cells.
D) They prevent initial infection by blocking the receptor the virus uses to enter target cells.

Question 43

A patient on HAART that includes neviripine (Viramune)has all of the following side effects.Which one should you report to the prescriber immediately?

A) Nausea
B) 2 lb weight loss
C) Clay-colored stools
D) Dizziness on standing

Question 44

Which precaution is most important to teach a patient who is prescribed enfuvirtide (Fuzeon)?

A) "After the drug is mixed,store it away from light."
B) "Use sterile technique to draw up and inject the drug."
C) "Do not take this drug if there is any possibility that you are pregnant."
D) "Mix the drug with tap water,then rinse the drug's original container and add that fluid to the drug mixture."

Question 45

A patient is prescribed 45 mg of enfuvirtide by subcutaneous injection.The available drug is a premixed solution of enfuvirtide with a concentration of 90 mg/mL.

Question 46

A patient prescribed raltegravir (Isentress)reports all of the following problems or changes since starting this drug.Which problem or change do you report to the prescriber?

A) Abdominal cramps and bloating
B) Muscle aches and weakness
C) Urinating more at night
D) Loss of taste for sweets

Question 47

A pediatric patient is prescribed nelfinavir (Viracept)450 mg orally.The available drug is 50 mg/scoop.How many level scoops do you measure into the patient's pudding to administer the correct dose?

A) 9 scoops
B) 6 scoops
C) 3 scoops
D) 2 scoops

Question 48

Which precaution is most important to teach older adults who are prescribed maraviroc (Selzentry)?

A) "If an injection site infection occurs,do not reuse that site until the skin has healed completely."
B) "Take the drug with food or milk to reduce the likelihood of GI side effects."
C) "Change positions slowly when moving from a sitting to a standing position."
D) "Store the drug at room temperature."

Question 49

A patient is prescribed to receive 300 mg of ribavirin by oral suspension.The drug on hand is ribavirin oral suspension with a concentration of 50 mg/mL.How many milliliters will you prepare as the correct dose?

Question 50

Which antiretroviral drugs have greater effectiveness when administered with ritonavir? (select all that apply)

A) Edurant (rilpivirine)
B) Emtriva (emtricitabine)
C) Invirase (saquinavir)
D) Lexiva (fosamprenavir)
E) Prezista (darunavir)
F) Reyataz (atazanavir)

Question 51

Which precaution is most important to teach an older patient who is prescribed atazanavir (Reyataz)?

A) "Be sure to take this drug at least 1 hour before or 4 hours after taking an antacid."
B) "Weigh yourself daily and notify your prescriber if you gain more than 2 lb in 1 week."
C) "Check your pulse for a full minute daily and notify your prescriber if it becomes irregular or slow."
D) "Check your calves daily for swelling or redness.If these symptoms appear,go to the emergency department immediately."

Question 52

What precaution is most important to teach a patient newly prescribed to take Truvada?

A) "Continue to use safer sex practices."
B) "Avoid caffeine and any fatty or fried foods."
C) "Be sure to drink at least 3 L of fluids daily."
D) "If you develop muscle or joint aches,notify your prescriber immediately."

Question 53

A patient who has been taking indinavir (Crixivan)for a year has just been told that the organism is now resistant to this drug.The patient expresses worry to you that this means the disease will now progress to acquired immunodeficiency syndrome (AIDS)and death will soon follow.What is your best response?

A) "Your health care provider can change this drug to the intravenous form,which prevents viral replication even in HIV that has developed drug resistance."
B) "Although the HIV is now resistant to this drug,other antiretroviral drugs are likely to be effective in controlling your disease."
C) "The HIV easily becomes drug resistant.That is why the drug combinations are switched so often."
D) "That is a possibility because these drugs do not kill the virus.It is best to be prepared."

Question 54

Which patient outcomes are major goals of antiretroviral therapy? (select all that apply)

A) Prevention of opportunistic infections
B) Conversion to an HIV-negative antibody status
C) Reduction of the number of viral particles in the patient's blood
D) Increase in CD4+ cells
E) Decrease in CD8+ cells
F) Prevention of disease spread

Question 55

A child who is HIV positive and weighs 40 lb is prescribed to receive atazanavir (Reyataz)at a dose of 7 mg/kg.The drug on hand is a premixed oral suspension of 50 mg/60 mL.How many milliliters will you prepare as the correct dose?