A 30-year-old woman returns from a business trip to a malaria-endemic area and has fever, chills, and sweating. She has no vaccination history. What is the most important epidemiologic factor to suspect malaria?

A patient is traveling for 3 weeks to a malaria-endemic region. The nurse teaches about chloroquine prophylaxis. Which instruction is correct?

A patient completed proper chloroquine prophylaxis (2 weeks before and 8 weeks after travel). The primary purpose of this regimen is to:

When assessing a patient with suspected malaria, which nursing action is a priority?

A patient presents with fever, chills, and fatigue. They have never traveled outside the country. To assess malaria risk, which question is best?

Do you keep pets at home?

A 7-year-old is diagnosed with pinworm infection. Parents ask why linen hygiene is important. Which explanation is best?

Which group of parasites is described as “parasitic worms”?

A child is diagnosed with Enterobius vermicularis. Which statement is correct?

A patient receives an anthelmintic drug. Usual treatment duration is:

A patient takes a single dose of an anthelmintic drug; the provider says treatment usually lasts 1–3 days. What is the main goal of this medication?

Which of the following best describes metronidazole?

A woman with foul-smelling vaginal discharge and itching is diagnosed with Trichomonas vaginitis. The first-line drug in the lecture is:

A patient is treated with metronidazole for Trichomonas vaginitis. The primary treatment goal is to:

A patient taking metronidazole reports numbness and tingling in hands and feet. The nurse suspects:

A patient on metronidazole develops seizures. What is the priority nursing action?

A patient on metronidazole develops white patches on the tongue with itching and discomfort. The nurse suspects:

A patient receiving metronidazole develops profuse, foul-smelling diarrhea, raising concern for Clostridium difficile. The nurse interprets this as:

Which statement best describes HIV in the lecture?

The main consequence of HIV destroying CD4+ T cells is:

Which test is used to monitor “immune function” in HIV patients?

A high-risk patient asks, “Can I know right away if I caught HIV?” The best explanation of the HIV antibody test is:

A person exposed to HIV yesterday wants testing. The nurse explains the “window period” means:

In HIV treatment, an “undetectable viral load” means:

Antiretroviral drugs in HIV treatment are emphasized as needing:

The main goal of ART (antiretroviral therapy) is to:

A newly diagnosed HIV patient starts zidovudine (an NRTI). Which serious adverse effect related to the black box warning must be monitored?

A patient on zidovudine develops elevated liver enzymes, lactic acidosis, and muscle weakness. The nurse recognizes:

A patient taking efavirenz (an NNRTI) reports nightmares, dizziness, and feelings of euphoria. The nurse interprets these as:

When counseling a patient starting efavirenz, which CNS-related side effects should the nurse emphasize?

An HIV patient on atazanavir (a protease inhibitor) has elevated cholesterol and blood glucose. The nurse suspects:

A key metabolic adverse effect of protease inhibitors like atazanavir is:

After an occupational needle-stick exposure to HIV-positive blood, a nurse asks about timing of PEP. The best response is:

A hospitalized HIV patient asks why multiple antiretroviral drugs are used together. The best explanation is:

When educating an HIV patient about ART, which point is essential to prevent resistance?

An HIV patient has a CD4+ count within 500–1200/mm³. This suggests:

A patient is HIV-positive but has no symptoms. This stage is:

An HIV patient is admitted with Pneumocystis pneumonia and Kaposi sarcoma. Which stage is most appropriate?

A patient asks about HIV transmission. Which situation is a major transmission route emphasized in the lecture?

A patient asks, “Can I pass HIV to my baby through breast milk?” The answer based on the lecture is:

Malaria is a protozoal disease with an incubation period of about 10–35 days.

Viral load (HIV quantitative assay) is used to monitor the effectiveness of ART.

Chloroquine prophylaxis for malaria is started 2 weeks after returning from an endemic area.

When assessing a patient with suspected malaria, asking about travel to endemic areas is an important part of the nursing assessment.

Helminths is the term for viruses that parasitize the intestine.

Pinworms (Enterobius vermicularis) are the most common roundworm (pinworm) infection in the U.S.

Preventing pinworm transmission includes handwashing, daily showers, and changing bed linens and underwear every day.

Metronidazole only has antibacterial activity and no effect on protozoa.

Numbness and tingling in the extremities while taking metronidazole may indicate peripheral neuropathy.

HIV is described as an RNA retrovirus that destroys CD4+ T cells and causes immunodeficiency.

The HIV antibody test can be positive within a few hours of infection; there is no window period.

Viral load (HIV quantitative assay) is used to monitor the effectiveness of ART.

The goal of ART is to achieve an undetectable viral load and maintain the CD4+ count.

Zidovudine has a black box warning for hepatotoxicity, lactic acidosis, myopathy, and bone marrow suppression.

Efavirenz can cause neuropsychiatric symptoms such as dizziness, drowsiness, nightmares, and euphoria.

A patient is suspected of having Giardia. Which statements about metronidazole for this patient are correct?

A patient is being treated with metronidazole. Which findings should the nurse instruct the patient to report immediately as possible serious adverse effects or superinfection?

When teaching a patient about HIV transmission, which routes should the nurse emphasize?

While monitoring a patient on zidovudine, which issues are related to its black box warning?

A healthcare worker has a needle-stick exposure to HIV-positive blood. Which statements about PEP are correct?

A 4-month-old infant comes for routine vaccines. The parent asks why so many injections are given at once. The best nursing response is:

Which action should the nurse take for a patient with a bladder issue?

The nurse cares for a patient on chemotherapy whose WBC count is 2,000/mm³. Which instruction is most important?

A client with MS is starting interferon-β1a. Which expected adverse effect should the nurse prepare the client for?

A parent of a 2-month-old asks where to find the official vaccine schedule. The nurse should refer them to:

A 60-year-old patient is to receive a live attenuated zoster vaccine. Which history finding requires the nurse to question the order?

A patient on doxorubicin reports new shortness of breath and swelling in ankles. Which complication is the nurse most concerned about?

A 6-year-old child with leukemia on chemo has petechiae and bleeding gums. What lab value is most likely abnormal?

A woman about to start tamoxifen asks why she needs this medication after breast cancer surgery. The best response is:

A client states, “I don’t want the flu shot because it will give me the flu.” The nurse’s best response is:

A nurse is preparing multiple vaccines at a visit. Which action is correct?

A patient receiving 5-fluorouracil reports painful mouth sores. Priority nursing action?

A patient scheduled for live attenuated intranasal flu vaccine (LAIV) mentions she is 8 weeks pregnant. What should the nurse do?

Switch to any other live vaccine

A child receiving chemo is at the nadir of their ANC (absolute neutrophil count). This typically occurs:

A client on epoetin alfa for chemo-induced anemia has a hemoglobin of 12.5 g/dL and history of stroke. Priority nursing action?

A parent asks why their 11-year-old needs the HPV vaccine. Best nurse response:

A chemo patient with Hgb 7.5 g/dL is fatigued and dyspneic. Which intervention may be prescribed to address anemia?

A patient reports low-grade fever and mild pain at vaccine injection site. Appropriate nursing advice:

A family asks where serious vaccine side effects should be reported. The nurse should direct them to:

Which is the correct system to report a vaccine adverse event?

A client on chemo has WBC 1,800/mm³ and oral temp 38.5°C (101.3°F). Priority nursing action:

A patient on vincristine reports numbness in hands and difficulty walking. The nurse suspects:

Which vaccine is most appropriate for a healthy 55-year-old with no prior shingles vaccine?

A patient about to receive an inactivated flu vaccine reports a history of anaphylaxis to eggs. Nursing action:

A chemo patient's platelet count is 40,000/mm³. Which statement indicates teaching was effective?

A patient on interferon-β1a for MS reports flu-like symptoms after injections. The nurse should recommend:

A child on chemo complains of painful, red mouth with white coating. Priority teaching includes:

A patient with anemia due to renal disease is starting epoetin alfa. Which finding would make the nurse question the order?

A client on chemo asks why they are losing hair. The best response:

A patient completes a vaccine visit. Before discharge, the nurse should:

A patient receiving methotrexate develops severe oral ulcers and GI upset. What is the likely cause?

Live attenuated vaccines (such as MMR and varicella) are contraindicated in pregnancy and immunocompromised clients.

Mild injection site pain and low-grade fever after vaccination are considered normal and usually managed with cold compresses and acetaminophen.

Chemotherapy selectively affects only cancer cells and does not damage normal tissues.

Bone marrow suppression from chemo can lead to anemia, leukopenia, and thrombocytopenia.

The nadir, or lowest blood counts, typically occurs 7–10 days after chemotherapy.