NCLEX Review about Immune System Disorders 36-40

NCLEX Review about Immune System Disorders

36. A home care nurse provides instructions to a client with systemic lupus erythematosus (SLE) about measures to manage fatigue. Which statement by the client indicates the need for further instruction?

a) I need to avoid long periods of rest
b) I need to sit whenever possible
c) I should take a hot bath every evening
d) I should engage in moderate low-impact exercise when I am not tired

37. A nurse is reviewing the results of serum laboratory studies for a client with acquired immunodeficiency syndrome (AIDS) who is receiving didanosine (Videx). The nurse interprets that the client may have the medication discontinued by the physician if which of the following laboratory test results is significantly elevated?

a) serum cholesterol level
b) serum amylase level
c) blood glucose concentration
d) serum protein concentration


38. A client with acquired immunodeficiency syndrome (AIDS) who is taking zidovudine (Retrovir) 200 mg orally three times daily has severe neutropenia noted on the follow-up laboratory studies. The nurse interprets that which of the following is likely to occur at this point?

a) prednisone (Deltasone) probably will be added to the medication regimen
b) epoetin (Epogen) probably will be added to the medication regimen
c) the medication dose probably will be reduced
d) the medication probably will be discontinued until laboratory results indicated bone marrow recovery

39. A client with human immunodeficiency virus (HIV) infection is taking indinavir (Crixivan). The nurse plans to tell the client which of the following when providing instructions about the use of this medication?

a) take the medication with water on an empty stomach
b) take the medication with a high-fat snack
c) take the medication with the large meal of the day
d) store the medication in the refrigerator

40. A client is receiving acyclovir (Zovirax) by the intravenous (IV) route for treatment of cytomegalovirus (CMV) infection. After reconstituting the powder dispensed by the pharmacy, the nurse administers this medication by:

a) continuous IV infusion over 12 hours
b) continuous IV infusion over 24 hours
c) rapid IV bolus over 5 minutes
d) slow IV infusion over 1 hour






NCLEX Review about Immune System Disorders:
ANSWERS AND RATIONALE

36) C

- To help reduce fatigue in the client with SLE, the nurse should instruct the client to sit whenever possible, to avoid hot baths, to schedule moderate low-impact exercises when not fatigued, and to maintain a balanced diet. The client is instructed not to rest for long periods because it promotes joint stiffness.

37) B

- A serum amylase level that is increased 1.5 to 2 times normal may signify pancreatitis from the medication, which can be potentially fatal. The medication may have to be discontinued. The medication also is hepatotoxic, which can result in liver failure. Options A, C, and D are not associated with this medication.

38) B

- Hematological monitoring should be done every 2 weeks in the client taking zidovudine. If severe anemia or severe neutropenia develops, treatment should be discontinued until evidence of bone marrow recovery is noted. If anemia or neutropenia is mild, a reduction in dosage may be sufficient. The administration of prednisone may further alter the immune function. Epoetin alfa is administered to clients experiencing anemia.

39) A

- To maximize absorption, the medication should be administered with water on an empty stomach. The medication can be taken 1 hour before a meal or 2 hours after a meal, or it can be administered with skim milk, coffee, tea, or a low-fat meal. It is not administered with a large meal. The medication should be stored at room temperature and protected from moisture, because moisture can degrade the medication.

40) D

- Acyclovir is dispensed as a powder to be reconstituted for IV administration and is administered by slow IV infusion over 1 hour. It is not given as an IV bolus or continuous infusion or by intramuscular or subcutaneous injection. To minimize the risk of renal damage, the client should be hydrated during the infusion and for 2 hours after the infusion.


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