Mod 12- Antivirals

Question 1

The only nucleoside that has been proven to be safe when used during pregnancy is

Answer 1

zidovudine

Question 2

Herpes virus infections can be treated with ____________________.

Answer 2

Acyclovir (Zovirax)

Question 3

_______________________________ prevent the HIV-1 virus from entering the cell by stopping fusion of the virus with the human cellular membrane.

Answer 3

fusion inhibitors

Question 4

T/F: Cidofovir (generic) is used to treat CMV retinitis in otherwise healthy patients.

Answer 4

FALSE

Tx of CMV retinitis in AIDS pts

Question 5

T/F: Drugs used for the treatment of herpes and CMV are safe to use in lactating patients.

Answer 5

FALSE
Drugs indicated for the treatment of herpes and CMV are highly toxic and should not be used during pregnancy or lactation to prevent adverse effects on the fetus or infant;

Question 6

____________ has been found to be effective in treating uncomplicated influenza infections if taken within 2 days of the onset of symptoms.

Answer 6

Oseltamivir (Tamiflu)

Question 7

T/F: Rimantadine (Flumadine) is a synthetic antiviral agent used to prevent and treat influenza A.

Answer 7

TRUE

Question 8

T/F: Protease inhibitors are effective by blocking the protease activity within HIV.

Answer 8

TRUE

Question 9

___________ are a class of drugs that function by competing with the naturally occurring nucleosides within the cell that the virus would use to build the DNA chain

Answer 9

Nucleosides

Question 10

T/F: Viruses survive by injecting their own DNA or RNA into a healthy cell and taking over its function.

Answer 10

TRUE

Question 11

A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to

Answer 11

stay well hydrated by drinking at least eight 8-oz glasses of water daily.

Question 12

A HIV-positive patient is being treated with didanosine as part of the antiretroviral therapy. Which of the following symptoms should the nurse monitor for and immediately report to the care provider?

Answer 12

Peripheral neuropathy
Explanation:
The nurse should immediately report symptoms of peripheral neuropathy to the care provider. Headache and taste alteration are some of the mild adverse effects of the drug and are not cause for immediate concern. Excoriation is an adverse effect of imiquimod and does not occur in patients being administered didanosine.

Question 13

A 58-year-old with HIV is starting treatment with Combivir. He currently has a CD4+ cell count of less than 200 cells/mL and a viral load greater than 45,000 copies/mL. The nurse treating the client knows that what is a sign of effective drug therapy?

Answer 13

Increased CD4+ cell counts

Question 14

A client is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the rationale when administering these medications together?

Answer 14

They have synergistic antiviral effects.

Question 15

A client 45-years-old just received a heart transplant. One of the clients medications is ganciclovir. The nurse knows this medication was prescribed why?

Answer 15

to prevent CMV infection.

Question 16

A client for whom antiretroviral therapy has been prescribed informs the nurse that the client is taking oral contraceptives. What should the nurse inform the client is one of the effects of combining birth control pills with antiretroviral therapy?

Answer 16

Decreases effectiveness of birth control pills

Question 17

To prevent viral infections, what precaution should the general public take?

Answer 17

Become vaccinated against prevalent virus infections.

Question 18

A nurse is explaining the rationale for the use of combination therapy in the treatment of HIV infections. Which would the nurse include as the primary reason?

Answer 18

The use of multiple drugs allows attack on the virus at different points in its life cycle

Question 19

In which clients are the use of cidofovir contraindicated?

Answer 19

clients with renal impairment
Explanation:
Clients with renal impairment should not be given cidofovir.

Question 20

A patient with chronic hepatitis B (HBV) infection is scheduled to begin a new treatment regimen that will include adefovir dipivoxil. What assessments should be prioritized before the initiation of this drug treatment?

Answer 20

Liver function testing and HIV testing
Explanation:
HIV testing should be offered to all patients prior to initiation of adefovir therapy and analysis of hepatic function should be performed, both in light of potential adverse drug effects and the etiology or HBV itself.

Question 21

A 45-year-old client is prescribed acyclovir for the treatment of genital herpes. Which is an expected outcome for this client?

Answer 21

The client will experience fewer recurrences

Question 22

A client comes to the health care facility reporting flulike symptoms. After a thorough assessment, the client is diagnosed with influenza and is to receive oseltamivir. The nurse understands that this drug has been prescribed because the client been symptomatic for less than:

Answer 22

2 days

Question 23

T/F: Children younger than the age of 12 years should not receive indinavir.

Answer 23

TRUE

Question 24

A 16-year-old has come to the clinic and asks to talk to a nurse. The nurse asks the teen what she needs and the teen responds that she has become sexually active and is concerned about getting HIV. The teen asks the nurse what she can do keep from getting HIV. What would be the nurse’s best response?

Answer 24

“Other than abstinence, only the consistent and correct use of condoms is effective in decreasing the risk of getting HIV.”

Question 25

An elderly female client is admitted to the medical floor with pustules on her body that travel along the nerve route in her legs and arms. The health care provider prescribes the drug acyclovir (Zovirax). What disease is this client demonstrating?

Answer 25

Shingles

Question 26

The nurse knows that pregnant caregivers should not inhale which medication while administering the medication to clients?

Answer 26

Ribavirin
Explanation:
Ribavirin is a category X drug for women of childbearing age due to the possible toxic effects to the fetus.

Question 27

A nursing student is reading a journal article about highly active antiretroviral therapy (HAART). The nurse would expect to find which condition as being treated with this therapy?

Answer 27

human immunodeficiency virus (HIV)

Question 28

A client with active AIDS is infected with a retrovirus. This virus is better known as which?

Answer 28

HIV

Question 29

A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient?

Answer 29

Combination antiretroviral therapy

Question 30

A 70-year-old man is being treated for herpes zoster virus. He has been prescribed acyclovir (Zovirax). The clinic nurse should prioritize assessments of which of the following?

Answer 30

Renal function

Question 31

What can the nurse do to maximize a patient’s adherence to the medication regimen?

Answer 31

As an advocate of the patient, discuss benefits and risks of antiretroviral therapy as well as administration

Question 32

A client has been treated with abacavir for the past 6 weeks. The client contacts the physician’s office with reports of diarrhea, abdominal pain, sore throat, cough, and shortness of breath. Which is the appropriate action to take for this situation?

Answer 32

Discontinue the therapy.
Explanation:
Hypersensitivity is a common adverse effect of abacavir that usually appears within 6 weeks of beginning therapy. Abacavir treatment should be discontinued if any signs of hypersensitivity occur. Reintroducing the drug after a hypersensitivity reaction may result in fatal hypotension and is therefore not advised. Reducing the dose and administration of the drug at bedtime will not minimize this adverse effect.

Question 33

The nurse is caring for a 3-year-old with HIV. The nurse knows that, when administering antiviral drug therapy in young children with HIV, dosage calculations are typically based on:

Answer 33

the client’s weight.

Question 34

A nurse is preparing to administer famciclovir to a client with a herpes virus infection. The nurse should expect to administer this drug by which route?

Answer 34

Oral

Question 35

A client is receiving nevirapine as part of a treatment for HIV infection. The nurse would instruct the client about which adverse effects as most commonly experienced?

Answer 35

Dry mouth and dyspepsia
Explanation:
Nevirapine is associated with gastrointestinal related effects, most commonly dry mouth, dyspepsia, constipation or diarrhea, nausea, and abdominal pain.

Question 36

Rimantadine is commonly associated with what ADE?

Answer 36

light-headedness and dizziness.

Question 37

Tenofovir and fosamprenavir are associated with what ADE?

Answer 37

changes in body fat distribution, leading to buffalo hump and thin arms and legs

Question 38

Maraviroc is associated with what ADE?

Answer 38

paresthesias and fever.

Question 39

A client with AIDS develops cytomegalovirus retinitis. The health care provider orders cidofovir. The nurse would prepare the client for administration of the drug by which route?

Answer 39

Intravenous
Explanation:
Cidofovir is given by intravenous infusion over 1 hour. It is not given orally, topically, or subcutaneously.

Question 40

A 23-year-old client is prescribed zidovudine for treatment of human immunodeficiency virus (HIV). Which statement indicates that the client has understood the client teaching regarding the action of this medication?

Answer 40

“Zidovudine slows the progression of the disease but does not cure it.”

Question 41

A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with cytomegalovirus (CMV). The nurse explains to the woman that this infection is caused by a common organism that normally does not cause infection in someone who is not what?

Answer 41

Immunocompromised

Question 42

The nursing student asks the instructor why it is more difficult to develop antiviral drugs than anti-infectives. The nursing instructor’s best reply would be which?

Answer 42

Viruses are tiny and replicate inside cells.

Question 43

Which of the following drug classes is included as part of HAART? (two nerds)

Answer 43

2 NRTIs (Nucleoside Reverse Transcriptase Inhibitors)

HAART is initiated with treatment of 2 NRTI medications. These 2 drugs are then combined with a third medication. NRTI medications work by inhibiting binding of nucleotides to reverse transcriptase and by terminating the DNA chain.

Question 44

HAART should include both 2 NRTIs and one adjunctive drug, either an NNRTI __________________

Answer 44

or Protease Inhibitor
Explanation
The third drug used in HAART can be a protease inhibitor. This drug works by preventing the maturation of the new HIV virus from within the host cell.

Question 45

How many medications are part of a typical HAART therapy?

Answer 45

3 Drugs

Question 46

HAART should include both 2 NRTIs and one adjunctive drug. Which of the following is acceptable adjunctive therapy? (non-nun)

Answer 46

NNRTI (Non-Nucleoside Reverse Transcriptase Inhibitor)
Explanation
The third drug used in HAART can be an NNRTI, which is a drug that treats HIV by inhibiting nucleotide binding to reverse transcriptase at a different site of action than NRTIs.

Question 47

Which of the following is the appropriate time most likely associated with beginning HAART?

Answer 47

Begin at Diagnosis

Question 48

Which of the following diseases or disorders is most likely associated with HAART therapy?

Answer 48

HIV

Question 49

HAART should include both 2 NRTIs and one adjunctive drug, either an NNRTI _________________ (integra w/ chains)

Answer 49

Integrase Inhibitor
Explanation
The third medication used in HAART, along with the NRTIs, can be an integrase inhibitor. Medications in this class work by inhibiting HIV genome integration into the host cell.