Anti-Infectives: Antiviral Drugs

Understanding Pharmacology Essentials for Medication Safety

Nursing
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Questions

Q1
Free

How are viral infections different from bacterial infections?

Multiple Choice
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A) Bacterial infections can be spread from one person to another, whereas viral infections cannot be spread directly.
B) Bacterial infections can be cured by treatment with some anti-infective drugs, whereas viral infections are not cured by anti-infective therapy.
C) Viruses only cause disease in a person who is immunocompromised, whereas bacteria can cause disease even among immunocompetent people.
D) Viruses are the less mature form of a bacterium, so there is essentially no difference between viral infections and bacterial infections.
Answer:
B) Bacterial infections can be cured by treatment with some anti-infective drugs, whereas viral infections are not cured by anti-infective therapy.

Explanation:
Viral infections are not cured but are self-limiting, meaning that in a person with a healthy immune system, the illness only lasts for a limited time. If the persons immune system is working properly, the body fights off the infection by itself. If the persons immune system is weak or if the body has other health problems, the person may die of the effects of the disease.
Q2
Free

What is the purpose of antiviral drug therapy?

Multiple Choice
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A) To make the patient immune to infection by viruses
B) To reduce infection by killing the virus causing disease
C) To reduce illness duration by controlling viral reproduction
D) To prevent opportunistic infections in immunosuppressed patients
Answer:
C) To reduce illness duration by controlling viral reproduction

Explanation:
Antiviral drugs are only virustatic and reduce the number of viruses by preventing them from reproducing and growing. They are not virucidal and cannot kill the virus. By keeping the number of viruses low, antiviral drugs allow the bodys natural defenses to destroy, eliminate, or inactivate them.
Q3
Free

What is the most important precaution the nurse must teach a patient who is prescribed any antiviral drug?

Multiple Choice
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A) Take the drug exactly as prescribed and for as long as prescribed.
B) Never take any antibacterial drugs while you are on antiviral therapy.
C) Drink at least 3 L of water daily for the entire time you are taking this drug.
D) Avoid unnecessary exposure to this drug by stopping it when you have no symptoms for 24 hours.
Answer:
A) Take the drug exactly as prescribed and for as long as prescribed.

Explanation:
For effective antiviral therapy the patient must take the drug long enough to ensure suppression of viral reproduction. If the patient stops taking the drug as soon as he or she feels better, symptoms of infection may recur and resistant viruses may develop.
Q4

A patient is prescribed intravenous (IV) acyclovir (Zovirax). Which question is most important for the nurse to ask before giving the first dose of this drug?

Multiple Choice
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A) Do you have a hearing problem or any trouble with your ears?
B) Do you take medications for seizures?
C) Are you allergic to sulfa drugs?
D) Have you ever had asthma?
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Q5

What is the most important precaution for the nurse to teach a patient who is prescribed oral valacyclovir (Valtrex)?

Multiple Choice
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A) Avoid coffee and other caffeinated beverages.
B) Wear long sleeves and a hat when going outdoors.
C) Take this drug 1 hour before or 4 hours after eating a full meal.
D) Drink at least 3 L of water daily for the entire time you are taking this drug.
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Q6

A patient who has been prescribed amantadine (Symmetrel) has all of the following health problems. For which problem does the nurse contact the prescriber before giving the first dose?

Multiple Choice
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A) Asthma
B) Influenza
C) Glaucoma
D) Diabetes mellitus
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Q7

A 2-year-old patient with respiratory syncytial virus is prescribed aerosolized ribavirin (Virazole). Which visitor does the nurse ensure is not in the patients room during the aerosol treatments?

Multiple Choice
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A) 10-year-old brother
B) 81-year-old grandmother
C) 32-year-old pregnant mother
D) 36-year-old father who has diabetes
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Q8

A patient who is taking interferon is also prescribed ribavirin (Virazole). Which laboratory blood test result for this patient does the nurse report immediately to the prescriber?

Multiple Choice
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A) Red blood cells (RBCs) 2.2 million/mm3
B) White blood cells (WBCs) 6000/mm3
C) Sodium 134 mEq/L
D) International normalized ratio (INR) 1.6
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Q9

Which precaution about zanamivir (Relenza) therapy does the nurse teach a patient who also uses a bronchodilator for asthma control?

Multiple Choice
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A) Drink at least 3 L of water daily while using this drug.
B) Use the bronchodilator 15 minutes before taking the zanamivir.
C) Avoid taking the zanamivir within 2 hours of using the bronchodilator.
D) Take your pulse daily while on this drug because when taken with a bronchodilator heart rhythm problems are common.
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Q10

How are retroviruses different from common viruses?

Multiple Choice
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A) Retroviruses respond to antibacterial drugs but common viruses do not.
B) Retroviruses have a greater efficiency of infection than common viruses.
C) Common viral infections can be cured while retroviral infections can only be controlled.
D) Common viruses can infect anyone whereas retroviruses can only cause infection in an immunosuppressed host.
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Q11

Which statement about human immune deficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) is true?

Multiple Choice
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A) Everyone with AIDS has HIV infection but not everyone with HIV infection has AIDS.
B) Everyone with HIV infection eventually dies of it because the disease cannot be cured.
C) With successful antiretroviral therapy, HIV-infected patients become HIV-antibody negative.
D) When HIV disease becomes AIDS, the infection is in the blood and treatment must be given intravenously.
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Q12

A patient prescribed highly active antiretroviral therapy (HAART) is flying to a wedding and will be gone 1 day. The patient asks about skipping prescribed drug doses that day in order to avoid having to show them all at the airport. What is the nurses best response?

Multiple Choice
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A) Yes, just one day off your drugs will not make any difference.
B) Yes, as long as you avoid direct contact with anyone who is ill.
C) No, even one day off the drugs can help the virus become drug resistant.
D) No, even one day off the drugs increases the chance that you can spread the disease.
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Q13

A patient is prescribed to begin highly active antiretroviral therapy (HAART). What is the most important question the nurse asks this patient before beginning therapy?

Multiple Choice
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A) Do you have any symptoms now of active infection?
B) Is there any possibility that you are pregnant?
C) Are you currently sexually active?
D) What other drugs do you take?
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Q14

A patient taking highly active antiretroviral therapy (HAART) for a year has the following blood laboratory test values. Which value does the nurse report to the prescriber immediately?

Multiple Choice
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A) White blood cell count 3500 cells/mm3
B) Lactate dehydrogenase 990 IU/L
C) Sodium 132 mEq/L
D) Hematocrit 32%
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Q15

A patient has human immunodeficiency virus (HIV) disease and is taking a cocktail consisting of protease inhibitors, nucleoside analogue reverse transcriptase inhibitors, and nonnucleoside analogue reverse-transcriptase inhibitors. Which statement made by the patient indicates that more teaching about the drug therapy is needed?

Multiple Choice
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A) Using three drugs at the same time enhances suppression of viral replication.
B) There is no problem using these drugs during the last trimester of my pregnancy.
C) Because this drug combination kills HIV, I do not need to worry about transmitting the virus.
D) If the virus becomes resistant to this cocktail, another combination of drugs may be required to reduce my viral load.
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Q16

Which test results indicate to the nurse that a patients antiretroviral therapy is effective?

Multiple Choice
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A) White blood cell count 5000 cells/mm3
B) Blood urea nitrogen level 15 mg/dL
C) Blood positive for human immunodeficiency virus (HIV) antibodies
D) CD4+ to CD8+ ratio increased
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Q17

A human immunodeficiency virus (HIV)-positive patient taking highly active antiretroviral therapy informs the nurse she is now pregnant. What advice regarding drug therapy does the nurse give this patient?

Multiple Choice
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A) Stop taking these drugs for your entire pregnancy.
B) Stop taking these drugs for the first trimester and start again for the second and third trimesters.
C) Continue to take these drugs throughout your pregnancy exactly as they have been prescribed.
D) It will be necessary to double your dosages of these drugs to ensure your unborn baby is adequately protected.
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Q18

A child is prescribed emtricitabine (Emtriva) 120 mg orally. The drug on hand is emtricitabine suspension 10 mg/mL. How many mL does the nurse prepare?

Multiple Choice
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A) 2
B) 6
C) 12
D) 20
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Q19

A patient who is taking zidovudine (Retrovir) reports diarrhea. Which dietary change does the nurse suggest for this patient?

Multiple Choice
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A) Avoid fatty and fried foods.
B) Increase your intake of fiber.
C) Take an antacid 30 minutes before each meal.
D) Restrict your intake of fluids to 1 L per day.
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Q20

A patient who has been taking lamivudine (Epivir) for 6 months reports reduced sensation in the fingers and toes. What is the nurses best action?

Multiple Choice
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A) Document the report as the only action.
B) Hold the dose and notify the prescriber.
C) Remind the patient to continue the drug as usual and take a multiple vitamin daily.
D) Reassure the patient that this is an expected drug side effect and to use injury precautions.
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Q21

Which health problem must the nurse be specifically alert for in pregnant women who are prescribed any nucleoside analogue reverse transcriptase inhibitor (NRTI)?

Multiple Choice
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A) Headache
B) Lactic acidosis
C) Diabetes mellitus
D) Nausea and vomiting
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Q22

A patient who has been taking efavirenz (Sustiva) reports a sore throat, fever, and blisters. What is the nurses best action?

Multiple Choice
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A) Hold the dose and notify the prescriber.
B) Document the report as the only action.
C) Remind the patient that these are symptoms of opportunistic infection.
D) Reassure the patient that these are common and expected side effects of the drug.
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Q23

Which food, drink, or herbal supplement does the nurse warn a patient who is prescribed nevirapine (Viramune) to avoid?

Multiple Choice
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A) Caffeinated beverages
B) Grapefruit juice
C) St. Johns wort
D) Dairy products
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Q24

How do protease inhibitor (PI) drugs prevent viral replication?

Multiple Choice
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A) They are counterfeit bases that prevent reverse transcriptase from synthesizing the DNA needed for viral replication.
B) They inactivate the enzyme that allows the viral genetic material to be integrated into the human hosts cellular DNA.
C) They prevent the production of proteins needed for viral particles to leave the cell and infect other cells.
D) They prevent initial infection by blocking the receptor the virus uses to enter target cells.
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Q25

A patient who has been taking indinavir (Crixivan) for a year has just been told that the organism is now resistant to this drug. The patient expresses worry to the nurse that this means the disease will now progress to acquired immunodeficiency syndrome (AIDS) and death will soon follow. What is the nurses best response?

Multiple Choice
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A) Your health care provider can change this drug to the intravenous form, which prevents viral replication even in HIV that has developed drug resistance.
B) Although the HIV is now resistant to this drug, other antiretroviral drugs are likely to be effective in controlling your disease.
C) The HIV easily becomes drug resistant. That is why the drug combinations are switched so often.
D) That is a possibility because these drugs do not kill the virus. It is best to be prepared.
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Q26

A pediatric patient is prescribed nelfinavir (Viracept) 450 mg orally. The available drug is 50 mg/scoop. How many level scoops does the nurse measure into the patients pudding to administer the correct dose?

Multiple Choice
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A) 9
B) 6
C) 3
D) 2
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Q27

Which precaution is most important for the nurse to teach an older patient who is prescribed atazanavir (Reyataz)?

Multiple Choice
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A) Be sure to take this drug at least 1 hour before or 4 hours after taking an antacid.
B) Weigh yourself daily and notify your prescriber if you gain more than 2 pounds in 1 week.
C) Check your pulse for a full minute daily and notify your prescriber if it becomes irregular or slow.
D) Check your calves daily for swelling or redness. If these symptoms appear, go to the emergency department immediately.
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Q28

Which precaution is most important for the nurse to teach a patient who is prescribed enfuvirtide (Fuzeon)?

Multiple Choice
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A) After the drug is mixed, store it away from light.
B) Use sterile technique to draw up and inject the drug.
C) Do not take this drug if there is any possibility that you are pregnant.
D) Mix the drug with tap water, then rinse the drugs original container and add that fluid to the drug mixture.
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Q29

A 40-year-old patient infected with human immunodeficiency virus (HIV) asks the nurse why the new drug maraviroc (Selzentry) is not being prescribed for her. What is the nurses best response?

Multiple Choice
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A) This drug is very expensive and your insurance may not cover it.
B) This drug can cause birth defects and should not be prescribed for anyone who is pregnant or might become pregnant.
C) This drug is very toxic to the heart and lungs. It is prescribed only for patients who are young and have no other health problems.
D) This drug is not effective against all HIV subtypes and the HIV causing your infection does not have the target for this drug.
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Q30

Which precaution is most important for the nurse to teach older adults who are prescribed maraviroc (Selzentry)?

Multiple Choice
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A) If an injection site infection occurs, do not reuse that site until the skin has healed completely.
B) Take the drug with food or milk to reduce the likelihood of GI side effects.
C) Change positions slowly when moving from a sitting to a standing position.
D) Store the drug at room temperature.
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Q31

A patient prescribed raltegravir (Isentress) reports all of the following problems or changes since starting this drug. Which problem or change does the nurse report to the prescriber?

Multiple Choice
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A) Abdominal cramps and bloating
B) Muscle aches and weakness
C) Urinating more at night
D) Loss of taste for sweets
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Q32

[Multiple Response] Which patient outcomes are major goals of antiretroviral therapy? (Select all that apply.)
a. Prevention of opportunistic infections
b. Conversion to an HIV-negative antibody status
c. Reduction of the number of viral particles in the patients blood
d. Increase in CD4+ cells
e. Decrease in CD8+ cells
f. Prevention of disease spread

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