Chapter 37 Drugs for Viral Infections
1) The nurse provides client education about viruses. Which statement made by the client indicates an understanding of the information?
Note: Credit will be given only if all correct choices and no incorrect choices a
Answer: 1, 3, 4, 5
Explanation:
1. Viruses are nonliving agents that infect bacteria, plants, and animals.
2. The structure of viruses is quite primitive compared with the simplest cell.
3. Viruses can infect plants as well as animals.
4. A mature infecti
2) A client asks the nurse why there aren't better drugs for HIV infection when so much money is spent on research. Which response should the nurse provide?
1. "Antiviral drugs are difficult to create."
2. "Developing new drugs is difficult because the vi
Answer: 2
Explanation:
1. Over 20 new antiretroviral drugs have been developed.
2. Antiviral pharmacotherapy can be extremely challenging because of the rapid mutation rate of viruses, which can quickly render drugs ineffective.
3. AIDS is still a worldwi
3) Which adverse effects should the nurse monitor for in a client receiving acyclovir (Zovirax)?
1. Auditory and visual hallucinations
2. Increased serum creatinine
3. Respiratory distress
4. Thrombocytopenia
Answer: 2
Explanation:
1. Auditory and visual hallucinations are not adverse effects of acyclovir (Zovirax).
2. Acyclovir (Zovirax) is nephrotoxic, so serum creatinine should be monitored.
3. Respiratory distress is not an adverse effect of acyclovir (Zov
4) Which outcome should the nurse anticipate for a client with herpes receiving acyclovir (Zovirax)?
1. Absence of a reoccurrence of infection in the affected area.
2. Identification of the names of the client's sexual contacts in the past month.
3. Repor
Answer: 3
Explanation:
1. It is not possible to prevent reoccurrence.
2. It is not necessary to provide the names of sexual contacts, and this is not related to acyclovir (Zovirax).
3. Pain is a major problem associated with this infection; the best outco
5) The nurse has completed the teaching for a client with HIV prescribed zidovudine (Retrovir). Which statement made by the client indicates further teaching is required?
1. "Zidovudine (Retrovir) will need to be stopped if bone marrow depression occurs.
Answer: 3
Explanation:
1. Zidovudine treatment will be stopped if bone marrow depression occurs to allow the bone marrow time to recover.
2. The drug only slows the disease; it will not cure it.
3. Zidovudine will slow the progression of the disease; it w
6) Which laboratory test should the nurse use to evaluate the efficacy of the treatment with antiviral prescriptions?
1. CD4 T-cell count
2. Viral load
3. T4 lymphocyte count
4. Viral cultures
Answer: 2
Explanation:
1. The CD4 T-cell count is an indicator of immune function because it shows the actual degree of immune system damage caused by the virus.
2. The viral load is the most important indicator of how the virus is replicating in the body
7) Which should the nurse recognize as the primary factor for nonadherence to the prescribed treatment for clients with AIDS?
1. The necessity of having to take multiple medications throughout the day
2. A lack of understanding of the reason for taking th
Answer: 1
Explanation:
1. Multiple medications are required throughout the day. The higher the number of medications to be taken daily, the higher is the noncompliance rate.
2. A lack of understanding could be a factor, but it is the schedule of taking mu
8) A client has just been prescribed highly active antiretroviral therapy (HAART) for the treatment of AIDS. Which teaching point is a priority for this client?
1. Medications must be taken for 3 years after viral load is not measurable.
2. The goal of hi
Answer: 3
Explanation:
1. Medications must be continued for the lifetime of the client.
2. The goal of highly active antiretroviral therapy (HAART) is to reduce plasma human immunodeficiency virus (HIV), but this is not as important as medication complian
9) A client with AIDS asks the nurse why he must take so many prescriptions. Which response should the nurse provide the client?
1. "To decrease the possibility of the virus developing resistance to the medications."
2. "Research has shown single medicati
Answer: 1
Explanation:
1. Decreasing the possibility of resistance is key; single drugs can be effective, but viral resistance is a problem.
2. Multiple medications will provide the best treatment, but this is not as good an answer as avoiding drug resist
10) The nurse has provided education for a client with AIDS prescribed antiviral treatment. Which statement made by the client indicates an understanding of the information?
1. "I will need to limit my travel to avoid people with other infections."
2. "I
Answer: 3
Explanation:
1. There is no need to limit travel at this point.
2. A well-balanced diet is the best diet for a client with AIDS.
3. Precautions are still necessary to avoid spreading the virus to others.
4. A high-stress job is not ideal, but at
11) A pregnant client with AIDS asks the nurse if her baby will die of AIDS. Which response should the nurse provide?
1. "There are special tests that we can do to see if your unborn baby is positive."
2. "Acquired immune deficiency can be unpredictable i
Answer: 3
Explanation:
1. There is no prenatal test that can diagnose an unborn baby for AIDS.
2. Telling the parent that acquired immune deficiency is unpredictable in a newborn is not a therapeutic response.
3. Should pregnancy occur in a woman living w
12) The nurse notifies the supervisor after accidentally sticking herself with a needle while starting an intravenous (IV) line on a client with AIDS. Which response should the supervisor provide the nurse to decrease her anxiety?
1. "If you are started o
Answer: 4
Explanation:
1. Telling the nurse that prescriptive treatment will decrease the severity of the disease is inappropriate and will not reduce her anxiety.
2. Workers' compensation will cover the cost, but this response will not help reduce the nu
13) For which adverse effect should the nurse assess a client prescribed efavirenz (Sustiva)?
1. Cardiac arrest
2. Rash
3. Bone marrow suppression
4. Seizures
Answer: 2
Explanation:
1. Cardiac arrest is not an expected adverse effect of efavirenz.
2. A serious adverse effect of efavirenz is Stevens-Johnson rash, which is characterized by severe blistering or desquamation and can be life threatening.
3. Bone mar
14) Which describes a major characteristic of viruses?
1. Extracellular parasites
2. Intracellular parasites
3. Extracellular bacterial in nature
4. Intracellular bacterial in nature
Answer: 2
Explanation:
1. Viruses are not extracellular parasites.
2. Viruses are intracellular parasites. They must be inside a host cell to cause infection.
3. Viruses are not bacteria.
4. Viruses are not bacteria.
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Cognitive Level: Remembe
15) Which describes the primary purpose of general pharmacotherapy for the treatment of HIV/AIDS?
1. Eliminate viral load
2. Relieve symptoms for a longer period of time
3. Decrease general transmission
4. Stop the virus from replicating
Answer: 2
Explanation:
1. The viral load cannot be eliminated.
2. The primary purpose of general pharmacotherapy is to relieve the symptoms for a longer period of time.
3. Pharmacotherapy cannot decrease the transmission of the virus in all populations.
4
16) Which information should the nurse include in the teaching for the client prescribed ganciclovir (Cytovene)?
1. "This drug will need to be applied multiple times a day."
2. "You can expect some burning and stinging after the instillation of the prescr
Answer: 1
Explanation:
1. The client can expect to administer the prescription multiple times a day.
2. Stinging and burning are adverse effects of the prescription.
3. Photophobia is an adverse effect of the prescription.
4. Edema around the eyes is an a
17) Which laboratory test is used to evaluate the degree of damage to the immune system caused by HIV?
1. Platelets
2. Liver function studies
3. CD4 T-cell count
4. Complete blood count
Answer: 3
Explanation:
1. Platelets levels are not used to evaluate the effects of HIV on the immune system.
2. Liver function studies are not used to evaluate the damage to the immune system.
3. The CD4 T-cell count is used to evaluate the degree of dama
18) Which question should the nurse ask the client who has been receiving dolutegravir (DTG)?
1. "How have you been sleeping?"
2. "Are you having any trouble with constipation?"
3. "Are you experiencing any dizziness in the morning?"
4. "Have you had any
Answer: 1
Explanation:
1. Insomnia is a common adverse effect of dolutegravir.
2. Constipation is not an adverse effect of dolutegravir.
3. Dizziness is not an adverse effect of dolutegravir.
4. Difficulty urinating is not an adverse effect of dolutegravi
19) Which describes the primary purpose of the use of pharmacotherapy to treat herpes viruses?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Decreases the frequency of herpes episod
Answer: 1, 4
Explanation:
1. The pharmacotherapy for herpes viruses decreases the frequency of herpes episodes.
2. The pharmacotherapy for herpes viruses does not decrease the risk of secondary infections.
3. The pharmacotherapy for herpes viruses does no
20) Which information should the nurse include in the teaching for a client prescribed an antiretroviral agent?
1. Monitor your blood pressure daily.
2. Weigh yourself daily.
3. Use barrier protection when genital lesions are present.
4. Practice good han
Answer: 4
Explanation:
1. Monitoring daily blood pressures is not necessary.
2. Daily weights are not necessary.
3. The client should be instructed to abstain from any sexual contact if genital lesions are present.
4. Handwashing is a technique the client
21) For a client receiving zidovudine (Retrovir), for which adverse reactions should the nurse increase surveillance?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Fatigue and gener
Answer: 1, 2, 5
Explanation:
1. Fatigue and weakness are experienced by many clients taking zidovudine.
2. Headache will occur in the majority of clients taking this medication.
3. Diarrhea is a more expected adverse reaction.
4. Edema is not an expected
22) Which information should the nurse provide the client prescribed oseltamivir (Tamiflu)?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. This prescription is administered via inhal
Answer: 2, 4
Explanation:
1. Oseltamivir is administered orally.
2. The effects of oseltamivir are best if it is started within 48 hours of onset of symptoms.
3. This prescription reduces the length of illness but does not prevent the illness.
4. Oseltami
23) Which information should the nurse include in the client teaching about pharmacotherapy for influenza?
1. Antiviral prescriptions can increase resistance to other strains of the flu.
2. Antiviral prescriptions should be administered within 72 hours of
Answer: 4
Explanation:
1. Antivirals may be used to prevent influenza or decrease the severity of acute symptoms, but once administered are not intended to increase resistance to other strains of the flu.
2. Antiviral prescriptions should be administered
24) Which information should the nurse include in the teaching for a client prescribed hepatitis A immunoglobulin after being exposed to hepatitis A?
1. You will need another booster in 6 months.
2. If you plan on traveling out of the country, you will ne
Answer: 3
Explanation:
1. Boosters are given for immunizations, not treatments for a documented exposure.
2. The best treatment for hepatitis A is a vaccination followed up with a booster to facilitate active immunity. The hepatitis A immunoglobulin is us
25) Which individual should receive a hepatitis B vaccine?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. All newborn infants
2. Clients with HIV
3. International travelers
4. People
Answer: 1, 2, 4
Explanation:
1. All newborn infants should receive their first hepatitis B vaccine.
2. Client's with HIV should receive the hepatitis B vaccine.
3. Only international travelers to countries with high or intermediate levels of endemic HBV i
26) A client recovering from hepatitis B asks the nurse if he is immune to hepatitis B. Which information should the nurse provide the client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that ap
Answer: 1, 2
Explanation:
1. The patient is immune to a new case of hepatitis B.
2. Symptoms of chronic HBV may develop as long as 10 years following exposure.
3. There is no need to get a hepatitis B vaccine.
4. There is no need to get hepatitis immunogl
27) A client with hepatitis C asks the nurse what his chance is of developing chronic hepatitis C. Which information should the nurse provide?
1. "The risk of you developing chronic hepatitis C is based on your immunity."
2. "The risk of you developing ch
Answer: 2
Explanation:
1. The development of chronic hepatitis C is not based on the client's immunity.
2. About 70% of clients infected with HCV proceed to chronic hepatitis.
3. About 70% of clients infected with HCV proceed to chronic hepatitis.
4. The
28) A client suspected of having hepatitis C asks the nurse why cultures are being obtained when hepatitis is a virus. Which response should the nurse provide the client?
1. "Obtaining a culture will rule out a bacterial infection."
2. "There is a strain
Answer: 3
Explanation:
1. A culture is obtained to identify the hepatitis C virus.
2. Hepatitis C is a virus, not a combination of a virus and bacteria.
3. Viral cultures can be obtained to diagnose hepatitis C.
4. The cultures obtained are viral cultures
29) Which statements should the supervisor use to respond to a newly employed nurse who states, "I am not certain I want to get a hepatitis shot"?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all tha
Answer: 1, 3, 5
Explanation:
1. Working in a hospital increases the risk of being exposed to blood and body fluids, which is a primary means of transmission.
2. Hepatitis B injections are administered as series 3 injection series.
3. Childhood immunizatio
30) A pregnant client with HIV receiving zidovudine asks the nurse why they will not test the newborn for HIV immediately after birth. Which response should the nurse provide?
1. "Since you are taking zidovudine, a test at birth will not be accurate."
2.
Answer: 1
Explanation:
1. Testing can be done at birth if the mother is not taking zidovudine. If she is taking the medication, the test is not accurate.
2. A definitive diagnosis of HIV infection in an infant can be made by age 1 to 2 months through the