Description
Pharmacology and the Nursing Process 6th Edition Lilley Collins Snyder Test Bank
ISBN-13: 978-0323055444
ISBN-10: 0323055443
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Lilley: Pharmacology and the Nursing Process, 6th Edition
Test Bank
Chapter 46: Immunizing Drugs and Biochemical Terrorism
MULTIPLE CHOICE
- Two patients arrive in the clinic; one is a young boy with sickle cell anemia, another is a 57-year-old woman with early stages of Hodgkin’s disease. The nurse notices that both patients need the same vaccine. What vaccine would that be?
A. | Varicella virus vaccine |
B. | Tetanus, diphtheria, and pertussis |
C. | Hepatitis B virus vaccine, inactivated |
D. | Haemophilus influenzae type b conjugate vaccine |
ANS: D
- H. influenzae type b conjugate vaccine is usually given to patients with one of the following disorders: sickle cell anemia, an immunodeficiency syndrome, Hodgkin’s disease, and others.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 713
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- The nurse is reviewing principles of immunity. What type of immunity occurs when the body is exposed to a relatively harmless form of an antigen, which imprints this information on the body’s memory bank and stimulates the body’s defenses to resist any subsequent exposures?
A. | Artificial active immunity |
B. | Attenuating immunity |
C. | Naturally acquired passive immunity |
D. | Artificially acquired passive immunity |
ANS: A
Artificial active immunity causes an antigen-antibody response and stimulates the body’s defenses to resist any subsequent exposures. Passive immunity is conferred bypassing the host’s immune system and injecting the person with antiserum or concentrated antibodies obtained from other humans or animals; this gives the host direct means of fighting off an invading microorganism. The host’s immune system therefore does not have to manufacture these antibodies. This process also occurs when antibodies pass from mother to infant during breast-feeding or through the placenta during pregnancy (natural passive immunization).
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 705
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- A 45-year-old man has received a series of equine-made immunizing drugs in preparation for a trip to a developing country. His wife brings him to the emergency department because he has developed edema of the face, tongue, and throat and is having trouble breathing. The nurse suspects that, based on his history and symptoms, he is experiencing which condition?
A. | Serum sickness |
B. | Cross-sensitivity |
C. | Thrombocytopenic purpura |
D. | Adenopathy |
ANS: A
Serum sickness sometimes occurs after repeated injections of equine-made immunizing drugs and is characterized edema of the face, tongue and throat, rash, urticaria, fever, flushing, dyspnea, and other symptoms.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 708
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to “feel better.” What should the nurse suggest?
A. | Apply an ice pack to the injection site. |
B. | Give the infant baaspirin for the pain. |
C. | Apply warm compresses to the injection site. |
D. | Observe the site for further swelling and redness. |
ANS: C
Applying warm compresses to the injection site and using acetaminophen (not aspirin, which carries the risk for Reye’s syndrome) should help to relieve the discomfort.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 719
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
- A housekeeper has experienced a needlestick a contaminated needle that was placed in a trash can. The nurse expects that which drug will be used to provide passive immunity to hepatitis B infection for this housekeeper?
A. | Hib vaccine |
B. | Varicella virus vaccine (Varivax) |
C. | Hepatitis B immunoglobulin |
D. | Recombivax HB |
ANS: C
Recombivax HB promotes active immunity to hepatitis B infection in people who are considered to be at high risk for potential exposure to the virus, whereas hepatitis B immunoglobulin provides passive immunity for the prophylaxis and postexposure treatment of people exposed to hepatitis B virus or HBs-Ag–positive materials, such as blood, plasma, or serum.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 715
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse is working in an immunization clinic. A new colleague asks, “When is the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) given?” The nurse knows that this series is started at what age?
A. | 3 weeks |
B. | 6 weeks |
C. | 3 months |
D. | 8 months |
ANS: B
The first dose of the series of three injections is given at age 6 weeks.
DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: Page 711
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A patient is in the urgent care center after experiencing a black widow spider bite. The nurse expects which to be used to treat this injury?
A. | Live vaccine |
B. | Antivenin or antisera |
C. | Tetanus immune globulin |
D. | Active immunizing drug |
ANS: B
Antivenins, also known as antisera, are used to prevent or minimize the effects of poisoning poisonous snakes and spiders. They provide the person who has been bitten with the substance needed to overcome the effects of the venom.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 708
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- The nurse is conducting a class on potential bioterrorism agents, and a participant asks, “Which one has three routes of exposure to humans?” Which agent will the nurse indicate?
A. | Anthrax |
B. | Smallpox |
C. | Botulism |
D. | Tularemia |
ANS: A
Infection with Bacillus anthracis, the cause of anthrax, can occur via three routes of exposure: cutaneous, gastrointestinal, and inhalation.
DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: Page 716
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A 72-year-old patient is to receive a pneumococcal vaccine, polyvalent (Pneumovax 23). The nurse recognizes that which of the following statements about this vaccine is true?
A. | It is given yearly to provide immunization against current strains of pneumococcal bacteria. |
B. | It is given deep intramuscular injection. |
C. | It is given subcutaneous injection. |
D. | The patient will have to return for a total of three injections. |
ANS: C
Pneumococcal vaccines are given subcutaneous injection, and only once.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 711
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A 30-year-old woman is in the clinic for her yearly gynecologic exam and asks the nurse about the “new vaccine that prevents HPV.” She wants to receive the papillomavirus vaccine (Gardasil). Which response the nurse is most appropriate?
A. | “Unfortunately, this vaccine is recommended for women aged 13 to 26 years.” |
B. | “We will need to make sure you are not pregnant first.” |
C. | “There will be a total of three injections.” |
D. | “I will check with your doctor then get the first dose of the vaccine ready.” |
ANS: A
It is important to make sure that a patient receiving Gardasil is not pregnant and that the patient knows that there are a total of three injections, but this particular patient is too old to receive the vaccine. The guidelines recommend the vaccine for women aged 13 to 26 years and for girls aged 11 to 12 years.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 714
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
- The nurse is reviewing the health history of a new patient who may need immunizations. Active immunizations are usually contraindicated in which patients? Select all that apply.
A. | Those with active infections |
B. | Children under the age of 1 |
C. | Elderly patients |
D. | Patients who are immunosuppressed |
E. | Those receiving cancer chemotherapy |
F. | Patients with AIDS |
ANS: A, D, E, F
Contraindications to the administration of immunizing drugs include active infections, febrile illnesses, a history of reactions to or serious adverse effects resulting from the drugs, and patients who are already immunosuppressed (patients with AIDS and patients receiving chemotherapy). Children under the age of 1 and the elderly may receive immunizing drugs.
DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 708
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
- The nurse is reviewing the information about the herpes zoster vaccine (Zostavax). Which statements about the vaccine are true? Select all that apply.
A. | The vaccine is given to children to prevent chickenpox. |
B. | The vaccine is recommended for patients 60 years or older. |
C. | The vaccine is used to prevent reactivation of the zoster virus that causes shingles. |
D. | It is also used to prevent postherpetic neuralgia. |
E. | It is contraindicated in patients who have already had shingles. |
F. | It is a one-time vaccine. |
ANS: B, C, F
Zoster vaccine (Zostavax) is used to prevent shingles; it also prevents reactivation of the zoster virus that causes shingles. It is given to patients age 60 years or older, and it is a one-time vaccine. It is not given to children to prevent chickenpox. It does not prevent postherpetic neuralgia, and it can be given to patients who have already had shingles.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 714
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Health Promotion and Maintenance