NCLEX Review about Immune System Disorders (31-35)

NCLEX Review about Immune System Disorders

31. The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir, azidothymidine, AZT, ZDV). The nurse carefully monitors which of the following laboratory results during treatment with this medication?

a) blood culture
b) blood glucose level
c) blood urea nitrogen level
d) complete blood count

32. The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that he client may have the medication discontinued by the physician if which of the following significantly elevated results is noted?

a) serum protein level
b) blood glucose level
c) serum amylase level
d) serum creatinine level

33. The nurse is caring for a post-renal transplantation client taking cyclosporin (Sandimmune, Gengraf, Neoral). Th nurse notes an increase in one of he client's vital signs and the client is complaining of a headache. What is the vital sign that is most likely increased?

a) pulse
b) respiration
c) blood pressure
d) pulse oximetry

34. Ketoconazole (Nizoral) is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse includes when administering this medication. Select all that apply

a) restrict fluid intake
b) instruct the client to avoid alcohol
c) monitor liver function studies
d) administer the medication with a antacid
e) instruct the client to avoid exposure to the sun
f) administer the medication on an empty stomach

35. The nurse has an order to begin administering foscarnet (Foscavir) to the client with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS). The nurse assesses the latest results of which laboratory study prior to administering the dose?

a) serum albumin level
b) serum creatinine level
c) CD4 count
d) lymphocyte count





NCLEX Review about Immune System Disorders:
ANSWERS AND RATIONALE

31) D

- Common side effects of this medication therapy are leukopenia and anemia. The nurse monitors the complete blood count results for these changes. Options A, B, and C are unrelated to the use of this medication.

32) C

- Didanosine (Videx) can cause pancreatitis. A serum amylase level that is increased to 1.5 to 2 times normal may signify pancreatitis in the client with acquired immunodeficiency syndrome and is potentially fatal. The medication may have to be discontinued. The medication is also hepatotoxic and can result in liver failure.

33) C

- Hypertension can occur in a client taking cyclosporine (Sandimmune, Gengraf, Neoral) and, because this client is also complaining of a headache, the blood pressure is the vital sign to be monitoring most closely. Other adverse effects include infection, nephrotoxicity, and hirsutism. Options A, B, and D are unrelated to the use of this medication.

34) B, C, E

- Ketoconazole (Nizoral) is an antifungal medication. It is administered with food (not on an empty stomach) and antacids are avoided for 2 hours after taking the medication to ensure absorption. The medication is hepatotoxic and the nurse monitors liver function studies. The client is instructed to avoid exposure to the sun because the medication increases photosensitivity. The client is also instructed to avoid alcohol. There is no reason for the client to restrict fluid intake. In fact, this could be harmful to the client.

35) B

- Foscarnet (Foscavir) is very toxic to the kidneys. The serum creatinine level is monitored prior to therapy, two or three times weekly during induction therapy, and at least weekly during maintenance therapy. It also may cause decreased levels of calcium, magnesium, phosphorus, and potassium. Thus, these levels are also measured with the same frequency.

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