WorksheetsPharm Chap 33, 34 Drugs for Inflammation and immune Response
Total questions: 43
Worksheet time: 26mins
The client receives a nonsteroidal anti-inflammatory drug (NSAID) for treatment of arthritis. What is a priority for the nurse to include when doing medication education?
"Constipation is common; include roughage in your diet."
"Drink at least eight glasses of water a day."
"Take your medication with food."
"Take your medication on an empty stomach."
The nurse is managing care for clients who will receive ibuprofen (Advil) for long-term therapy. What are the primary laboratory tests the nurse will assess prior to initiation of therapy? Select all that apply.
Electrolytes
Hemoglobin and hematocrit
Bleeding times
Liver function tests
Serum amylase
The client experienced a sports-related injury to his leg. During the morning assessment, what signs of inflammation will the nurse most likely assess? Select all that apply.
Swelling
Pain
Warmth
Pallor
Pitting edema
The client has experienced a sports-related injury. He asks the nurse how long it will take for him to respond to treatment. What is the best response by the nurse?
"With proper care, it will take about a month for symptoms to resolve."
"It will depend on your response to the medications."
"It will take about a week and a half for symptoms to resolve."
"The inflammatory process is too complex to predict a time frame for healing."
The nurse conducts group education for clients with seasonal allergies and teaches about the role of histamine. The nurse evaluates that the education has been effective when the clients make which statement?
"Histamine is inhibited by nonsteroidal anti-inflammatory drugs (NSAIDs).
"Histamine dilates the vessels in the nose, so it is congested and stuffy."
"Histamine constricts vessels, causing capillaries to become more permeable."
"Histamine is primarily stored in phagocyte cells in the skin."
The client receives prednisone as treatment for his inflammatory disease. He has experienced great relief and asks the nurse if he can just keep taking this medication. What is the best response by the nurse?
"No, because this medication has serious adverse effects."
"No, your doctor said the best treatment for your illness is to alternate medications."
"No, your body would get used to it and it would lose its effectiveness."
"No, because your illness is in remission and you don't need medication now."
The nurse teaches a group of clients with arthritis about the use of ibuprofen (Motrin), emphasizing the maximum daily amount. The nurse evaluates that education has been most effective when the clients make which statement?
We cannot take over 4000 mg/day
We cannot take over 3600 mg/day
We cannot take over 3200 mg/day
We cannot take over 3000 mg/day
The nurse plans to teach a class on acetaminophen (Tylenol) to mothers with young children. What will the best plan by the nurse include?
"It is best to give your child acetaminophen (Tylenol) with a high-carbohydrate meal."
"Read the labels of all over-the-counter (OTC) medications for the amount of acetaminophen (Tylenol) in them."
"Acetaminophen (Tylenol) will only need to be given once a day because it is long-lasting."
"It is okay to substitute a baby aspirin for acetaminophen (Tylenol) if you run out of acetaminophen (Tylenol)."
The nurse plans care for an older adult receiving nonsteroidal anti-inflammatory drug (NSAID) therapy. What is the best outcome for this client as it relates to side effects of nonsteroidal anti-inflammatory drugs (NSAIDs)?
The client will refrain from taking other medications with the nonsteroidal anti-inflammatory drug (NSAID).
The client will avoid the use of caffeine while taking the nonsteroidal anti-inflammatory drug (NSAID).
The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID).
The client will report any mood changes while taking the nonsteroidal anti-inflammatory drug (NSAID).
The client has been taking hydrocortisone (Cortef) for a month and abruptly stops it. What will the best assessment by the nurse include?
Fatigue and anorexia
Hyperglycemia and depression
Dilated pupils and auditory hallucinations
Tachycardia and weight gain
The nurse teaches clients with rheumatoid arthritis about the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). The nurse evaluates that education has been effective when the clients make which statement?
"Blood tests may be necessary to monitor for side effects of this drug."
"We must be careful about falling with this medication because it can cause drowsiness."
"We must take the medicine just as the doctor said to take it."
"We must be sure and keep all scheduled doctors' appointments."
Which finding is a sign or symptom of inflammation?
Redness
Cyanosis
Dizziness
Cold skin
Histamine release product which response?
Bronchodilation
Vasoconstriction
Diarrhea
Vasodilation
Which finding is a common adverse effect of anti-inflammatory drugs, such as ibuprofen?
Diarrhea
Palpitation
Heartburn
Hypotension
Acetaminophen reduces fever by
directly acting on the hypothalamus
inhibiting prostaglandins
blocking impulses to the brain
affecting nerve fibers
A client presents with a rash and is prescribed an over-the-counter ointment for treatment. The client says, “I thought I would need a shot or an expensive prescription.” How should the nurse respond? Select all that apply.
“Medications that go on your skin don’t usually have as many side effects.”
“Mild rashes often respond well to topical ointments.”
“Many of the products used on the skin are available over-the-counter.”
“You should try to discover what caused your rash.”
“Prescription ointments are usually better at healing.”
A client presents with severe inflammation of the knee. The physician prescribes a corticosteroid and asks the client to return to the office in 10 days for follow-up. How does the nurse explain these instructions? Select all that apply.
“We need to check to see if this is the correct treatment.”
“We need to re-examine the knee after a few days of treatment.”
“Corticosteroids should only be taken for 1 to 3 weeks.”
“You may be able to change to an NSAID at that visit.”
“You may need a 3-month prescription for a stronger corticosteroid at that time.”
A client has just been prescribed ibuprofen for a mild ankle sprain. Which health history information should alert the nurse to question this prescription? Select all that apply.
The client has asthma
The client had a similar ankle strain a year ago
The client reports getting a rash when eating strawberries
The client is allergic to aspirin
The client reports having a peptic ulcer 6 months ago
Which client statement would the nurse evaluate as indicating the goal of treatment with an anti-inflammatory drug has been met? Select all that apply.
“My fever went away yesterday.”
“I’ve not been coughing up so much phlegm.”
“The skin over my knee is red and hot to the touch.”
“The pain in my shoulder is much relieved.”
“My rash is spreading.”
The nurse is explaining inflammation to a patient who has Crohn’s disease. Which information should the nurse provide? Select all that apply.
When cells are damaged nearby vessels get bigger
The vessels in the area allow fluids to escape
Inflammation produces pus
Inflammation causes bleeding and inability to clot
Inflammation causes pain
A patient has been prescribed a second 10-day course of a corticosteroid. The nurse should provide which medication education?
“Make certain you do weight-bearing exercises at least three times each week.”
“Weigh yourself every day.”
“Let us know if you development a fever.”
“Monitor the color of your urine.”
“If you feel jittery or anxious, discontinue the medication.”
A child has leukemia and is immunosuppressed due to chemotherapy. The mother frantically calls the clinic to say that her child was exposed to varicella (chickenpox). What does the best plan by the nurse include?
The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if he develops chickenpox.
The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.
The child should be brought to the clinic immediately to receive a vaccination for chickenpox.
The child should be kept away from other children to avoid further exposure to varicella.
A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT) immunization. What does the best action by the nurse include?
Administer only a pertussis-tetanus immunization
Withhold this immunization and contact the physician
Tell the mother to give the child acetaminophen (Tylenol) if another rash develops
Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization
The nurse is teaching a class on immunizations for women with newborn infants. The nurse evaluates that learning has occurred when the women make which statements? Select all that apply.
"The immunizations are more effective if they are given closer together."
"Our babies might have a mild fever and be fussy for a few days."
"If our babies develop a fever, we must call the doctor immediately."
"We can give acetaminophen (Tylenol) if our babies have a mild fever."
"If our babies develop a mild fever, it means an allergic reaction."
The physician has ordered cyclosporine (Sandimmune) for the client who has undergone a kidney transplant. What will the nurse's priority assessment of this client include?
Assessing for infection
Assessing for peripheral edema
Assessing airway clearance
Assessing cardiac output
The client receives an immunosuppressant medication. What is the priority information for the nurse to teach the client about this medication?
The client should get adequate exercise
The client should drink plenty of fluids
The client should eat plenty of fruits and vegetables
The client should avoid crowds
A mother comes to the clinic and tells the nurse, "I don't want my child to have any vaccinations. I have heard they cause diseases." What is the best response by the nurse?
"Vaccinations are safe; there is no reason to worry."
"Vaccinations have some risks, but the benefits outweigh the risks."
"People worry too much about vaccinations."
"Vaccinations are required by law; you really don't have a choice."
The client receives cyclosporine (Neoral). The nurse completes medication education and evaluates that learning has occurred when the client makes which statement?
"I must check my blood pressure; it can run low with this medication."
"I cannot have grapefruit while I am on this medication."
"Mealtimes will have no effect on when I take this medication.”
"I might have an increased urine output with this medication."
The nurse manages care for clients who have had organ transplants. What is the best information for the nurse to include when teaching the clients about body defenses?
Nonspecific body defense is effective primarily against bacteria.
Specific body defense usually only acts against a single organism.
Specific body defense includes the complement system.
Nonspecific body defense is also known as the immune response.
The nursing instructor is teaching student nurses about humoral and cell-mediated immune responses. What does the best teaching plan include?
Helper T cells are an important part of humoral immunity.
Humoral immunity refers to immune responses where targets are attacked by immune cells.
B lymphocytes are an important part of cell-mediated immunity.
Humoral immunity refers to immune responses that are mediated by antibodies.
The nurse is teaching a class to clients who have recently undergone transplant surgery and are taking immunosuppressant drugs. The nurse evaluates that learning has occurred when the clients make which statements? Select all that apply.
"We must immediately report hair loss to the physician."
"We must wear a protective mask when going out in public."
"We must avoid exposure to individuals who have infections."
"We must practice reliable contraception."
"We must avoid eating raw fruits and vegetables."
An adult female client is beginning her series of hepatitis B immunizations. What does the best teaching by the nurse include?
"Contact your physician if you develop pain at the injection site, mild fever, or soreness."
"Practice reliable birth control for 3 months after the administration of the vaccinations."
"Immediately report any signs of bleeding such as hematuria, or bleeding from the gums."
"Avoid crowded areas where you might be exposed to an infectious disease."
Which of the following would the nurse identify as a component of the specific immune response?
Lymphocytes
Phagocytes
Epithelial lining of the skin
Gastrointestinal membrane
The major difference between B cell lymphocytes and T cell lymphocytes is that
T cells produce clones
B cells produce antibodies
T cells produce antibodies
B cells produce clones
T cells produce
cytokines
leukotrienes
lymphocytes
erythrocytes
When planning care for a patient receiving immunostimulant therapy, the nurse puts the highest priority on monitoring for which changes?
Weight
Intakes and output
Hepatic enzymes
Vital signs
Immunosupressants include
gamma globulin
glucocorticoids
antipsychotics
antifungals
The nurse providing community education about vaccines plans to present information in the sequence the vaccines are administered. In which order will the nurse discuss these vaccines?
1. Human papillomavirus
2. First dose hepatitis A
3. Meningococcal conjugate
4. First dose of diphtheria, tetanus, and pertussis
5. Second dose of measles, mumps, rubella
(a)
A new parent asks the nurse when her infant will receive the hepatitis A vaccine. How should the nurse reply? Select all that apply.
“We will give the first dose before you take your baby home from the newborn nursery.”
“It will be included in the series of immunizations given at 2 months, 4 months, and 6 months.”
“Your child will receive the first dose at 12 months.”
“Not until school age.”
“About 6 to 12 months after the initial vaccine, a booster will be given.”
A new mother expresses concern about immunizing her infant saying, “I am breastfeeding, so I know that will pass my immunity to my baby. I don’t see why anything else is necessary.” How should the nurse respond? Select all that apply.
“You are correct that your baby will receive some passive immunity from you.”
“That immunity is called adapted immunity, and it only lasts for a few days.”
“There are some diseases for which immunity is not passed from mother to child.”
“Your baby will need the extra protection provided by standard immunizations.”
“Vaccines are not indicated until you stop breastfeeding.”
A nurse is presenting community education regarding vaccines for influenza. Which information should the nurse plan to include? Select all that apply.
Everyone should receive an injection of influenza vaccine every year
Children should not receive influenza immunizations until age 10.
Intranasal vaccine is available for infants.
Many adults have a choice between injectable and intranasal forms of immunization.
A child’s first immunization will consist of two injections given 1 month apart.
A parent says, “I have heard that some of the vaccines contain the microbe that causes the actual disease. Can that be true?” How should the nurse respond? Select all that apply.
“The microbes are live but are weakened.”
“That is true, but they do not cause disease.”
“The measles, mumps, and rubella vaccine is an example.”
“No, all microbes used in vaccines are killed.”
“This only occurs in toxoid vaccines.”
The patient has been prescribed an oral immunosuppressant medication. The nurse would evaluate the additional teaching is required when the patient makes which statement? Select all that apply.
“When I mix my medicine with grapefruit juice, it doesn’t taste as bad.”
“I have a cute plastic cup I use to mix my medicine.”
“It is okay to mix my medication with orange juice.”
“I always rinse the cup and drink the rinse water.”
“I have eliminated chocolate from my diet.”
