PHARMA MIDTERM

Question 1

: a group of drugs used to treat fungal infections

Answer 1

azoles:

Question 2

fungus that is normally found on mucous membranes; can cause
yeast infections or thrush of the gastrointestinal (GI) tract and vagina in
immunosuppressed patients

Answer 2

Candida:

Question 3

steroid-type protein found in the cell membrane of fungi;
similar in configuration to adrenal hormones and testosterone

Answer 3

ergosterol:

Question 4

a cellular organism with a hard cell wall that contains chitin and
many polysaccharides, as well as a cell membrane that contains
ergosterols

Answer 4

fungus:

Question 5

disease caused by a fungus

Answer 5

mycosis:

Question 6

: fungus called ringworm that causes such infections as athlete’s
foot, jock itch, and others

Answer 6

tinea

Question 7

for reducing the incidence of candidiasis in bone mar- row transplant recipients

Answer 7

prophylaxis

Question 8

Treatment of candidiasis, cryptococcal meningitis, other systemic fungal infections

Answer 8

fluconazole (Diflucan)

Question 9

Treatment of invasive aspergillosis, invasive mucormycosis

Answer 9

isavuconazonium (Cresemba)

Question 10

Treatment of blastomycosis, histoplasmosis, and aspergillosis

Answer 10

itraconazole (Sporanox)

Question 11

Treatment of aspergillosis, leishmaniasis, cryptococ- cosis, blastomycosis, moniliasis, coccidioidomy- cosis, histoplasmosis, and mucormycosis

Answer 11

ketoconazole (generic)

Question 12

Prophylaxis of invasive Aspergillus and Candida infections in adults and children >13 y who are immunosuppressed secondary to antineoplastic,

Answer 12

posaconazole (Noxafil)

Question 13

Treatment of onychomycosis of the fingernail or toenail caused by dermatophytes;

Answer 13

terbinafine (Lamisil

Question 14

Treatment of invasive aspergillosis; treatment of serious fungal infections caused by Scedosporium apiospermum or Fusarium spp.

Answer 14

voriconazole (Vfend)

Question 15

Treatment of candidemia (infection of the blood- stream) and other forms of Candida infection, intra- abdominal infections, and esophageal candidiasis

Answer 15

anidulafungin (Eraxis)

Question 16

Ketoconazole, fluconazole, and itraconazole work by

Answer 16

blocking the activity of
a sterol in the fungal wall

Question 17

are triazole antifungals that inhibit the synthesis of
ergostero

Answer 17

Posaconazole, voriconazole, and
isavuconazonium

Question 18

a similar drug that blocks the
formation of ergosterol

Answer 18

Terbinafine

Question 19

Ketoconazole is absorbed rapidly from the GI tract, with peak levels
occurring within

Answer 19

1 to 3 hours

Question 20

Fluconazole reaches peak levels within

Answer 20

1 to 2
hours after administration

Question 21

Ketoconazole and fluconazole strongly inhibit the CYP450 enzyme system in
the

Answer 21

liver

Question 22

are a large group of antifungals used to treat systemic and topical
fungal infections

Answer 22

azoles

Question 23

Posaconazole is given orally, has a rapid onset of action, and peaks within

Answer 23

3
to 5 hours

Question 24

ketoconazole is not the drug of choice for patients with

Answer 24

endocrine or fertility problems

Question 25

itraconazole has been associated with

Answer 25

hepatic failure

Question 26

have been associated with severe liver toxicity and are
contraindicated with liver failure

Answer 26

Terbinafine
and isavuconazonium

Question 27

work by inhibiting glucan synthesis.

Answer 27

echinocandins

Question 28

is an enzyme
that is present in the fungal cell wall but not in human cell walls.

Answer 28

Glucan

Question 29

is a less toxic drug that alters the cell membrane of
susceptible fungi, causing cell death

Answer 29

Flucytosine

Question 30

is an older antifungal that acts in much the same way,
changing cell membrane permeability and causing cell death.

Answer 30

Griseofulvin

Question 31

binds to sterols in the cell wall, changing membrane
permeability and allowing leaking of the cellular components

Answer 31

Nystatin

Question 32

is well absorbed from
the GI tract, with peak levels occurring in 2 hours

Answer 32

Flucytosine

Question 33

. Fungi that cause these
mycoses are called

Answer 33

dermatophytes.

Question 34

are often referred to as ringworm, although the causal
organism is a fungus, not a worm

Answer 34

tinea
infections,

Question 35

athlete’s foot

Answer 35

(tinea pedis)

Question 36

jock itch

Answer 36

(tinea cruris)

Question 37

yeast
infections of the mouth and vagina often caused by

Answer 37

Candida.

Question 38

Available OTC for treatment of vaginal Candida infections

Answer 38

butoconazole
(Gynazole)

Question 39

Available OTC for treatment of oral and vaginal Candida infections; tinea infections

Answer 39

clotrimazole (Lotrimin, Mycelex)

Question 40

Treatment of tinea

Answer 40

econazole (Spectazole)

Question 41

Treatment of onychomycosis of the toenails due to Trichophyton rubrum, Trichophyton mentagrophytes

Answer 41

efinaconazole (Jublia)

Question 42

Treatment of seborrheic dermatitis, tinea corporis, tinea cruris, tinea pedis

Answer 42

ketoconazole (Extina,
Xolegel)

Question 43

Treatment of interdigital tinea pedis, tinea cruris, tinea corporis

Answer 43

luliconazole (Luzu)

Question 44

Treatment of local, topical mycoses, including blad- der and vaginal infections and athlete’s foot

Answer 44

miconazole (Monistat-3)

Question 45

Short-term (up to 4 wk) treatment of topical mycosis

Answer 45

oxiconazole (Oxistat)

Question 46

Treatment of tinea pedis infections (up to 4 wk)

Answer 46

sertaconazole nitrate (Ertaczo)

Question 47

Treatment of tinea infections

Answer 47

sulconazole (Exelderm)

Question 48

Short-term (1-4 wk) treatment of topical mycosis: treatment of tinea infections

Answer 48

terbinafine (Lamisil)

Question 49

Local treatment of Candida infections

Answer 49

terconazole (Terazol)

Question 50

Treatment of recurrent vaginal Candida infections

Answer 50

tioconazole (Vagistat-1)

Question 51

Treatment of tinea infections

Answer 51

butenafine (Mentax)

Question 52

Treatment of topical tinea infections; solution for treatment of toenail and fingernail tinea infections caused by Trichophyton rubrum

Answer 52

ciclopirox (Loprox, Penlac Nail Lacquer)

Question 53

Treatment of topical mycosis

Answer 53

gentian violet (generic)

Question 54

Short-term treatment of severe topical mycosis (up to 4 wk)

Answer 54

naftifine (Naftin)

Question 55

Treatment of onychomycosis of the toenails

Answer 55

tavaborole (Kerydin)

Question 56

Available OTC for treatment of athlete’s foot

Answer 56

tolnaftate (generic)

Question 57

Available OTC for treatment of athlete’s foot, jock itch, diaper rash, burning, and chafing in the groin area

Answer 57

undecylenic acid (Cruex, Desenex)

Question 58

work to alter the cell permeability of the fungus,
causing prevention of replication and fungal death

Answer 58

topical antifungal drugs

Question 59

A patient with a fungal infection asks the nurse why she cannot take
antibiotics. The nurse explains that the reason for this is that a fungus is resistant to antibiotics because
a. a fungal cell wall has fewer but more selective protective layers.
b. the composition of the fungal cell wall is highly rigid and
protective.
c. a fungus does not reproduce by the usual methods of cell
division.
d. antibiotics are developed to affect only bacterial cell walls.

Answer 59

d. antibiotics are developed to affect only bacterial cell walls.

Question 60

When administering a systemic antifungal agent, the nurse
incorporates understanding that all systemic antifungal drugs
function to
a. break apart the fungus nucleus.
b. interfere with fungus DNA production.
c. alter cell permeability of the fungus, leading to cell death.
d. prevent the fungus from absorbing needed nutrients.

Answer 60

c. alter cell permeability of the fungus, leading to cell death.

Question 61

After assessing a patient, the nurse would question an order for
amphotericin B to prevent the possibility of serious nephrotoxicity if
the patient was also receiving which of the following?
a. Digoxin
b. Oral anticoagulants
c. Phenytoin
d. Corticosteroids

Answer 61

a. Digoxin

Question 62

The nurse is describing fungi that cause infections of the skin and mucous membranes, appropriately calling these which of the
following?
a. Mycoses
b. Meningeal fungi
c. Dermatophytes
d. Worms

Answer 62

c. Dermatophytes

Question 63

After teaching a group of students about topical fungal infections,
the instructor determines that the students need additional instruction
when they identify which of the following as an example?
a. Athlete’s foot
b. Rocky Mountain spotted fever
c. Jock itch
d. Vaginal yeast infections

Answer 63

b. Rocky Mountain spotted fever

Question 64

Which of the following would the nurse recommend that a woman
with repeated vaginal yeast infections keep on hand?
a. Tolnaftate
b. Butenafine
c. Clotrimazole
d. Naftifine

Answer 64

c. Clotrimazole

Question 65

The nurse instructs the patient to use care when applying topical
antifungal agents to prevent systemic absorption because
a. the fungus is only on the surface.
b. these drugs are too toxic to be given systemically.
c. absorption would prevent drug effectiveness.
d. these drugs can cause serious local burning and pain.

Answer 65

b. these drugs are too toxic to be given systemically.

Question 66

A patient with a severe case of athlete’s foot is seen with lesions
between the toes, which are oozing blood and serum. After teaching
the patient, the nurse determines that the instruction was effective if
the patient states which of the following?
a. “I have to wear black socks and must be careful not to change
them very often because it could pull more skin off of my feet.”
b. “I need to apply a thick layer of the antifungal cream between
my toes, making sure that all of the lesions are full of cream.”
c. “I should wear white socks and keep my feet clean and dry. I
shouldn’t use the antifungal cream in areas where I have open
lesions.”
d. “After I apply the cream to my feet, I should cover my feet in
plastic wrap for several hours to make sure the drug is
absorbed.”

Answer 66

c. “I should wear white socks and keep my feet clean and dry. I
shouldn’t use the antifungal cream in areas where I have open
lesions.”

Question 67

which is caused by intestinal invasion of
the trophozoite stage of the protozoan Entamoeba histolytica

Answer 67

amebic dysentery

Question 68

type of mosquito that is essential to the life cycle of
Plasmodium; injects the protozoa into humans for further maturation

Answer 68

Anopheles mosquito

Question 69

syndrome of quinine toxicity characterized by nausea,
vomiting, tinnitus, and vertigo

Answer 69

cinchonism:

Question 70

protozoal intestinal infection that causes severe diarrhea and
epigastric distress; may lead to serious malnutrition

Answer 70

giardiasis:

Question 71

skin, mucous membrane, or visceral infection caused by a
protozoan passed to humans by the bites of sand flies

Answer 71

leishmaniasis:

Question 72

protozoal infection with Plasmodium, characterized by cyclic
fever and chills as the parasite is released from ruptured red blood
cells;

Answer 72

malaria:

Question 73

causes serious liver, central nervous system (CNS), heart, and
lung damage

Answer 73

malaria:

Question 74

a protozoan that causes malaria in humans; its life cycle
includes the Anopheles mosquito, which injects protozoa into humans

Answer 74

Plasmodium

Question 75

opportunistic infection that occurs
when the immune system is depressed;

Answer 75

Pneumocystis jiroveci pneumonia

Question 76

frequent cause of pneumonia
in patients with AIDS and in those who are receiving
immunosuppressive therapy

Answer 76

Pneumocystis jiroveci pneumonia

Question 77

single-celled organisms that pass through several stages in their
life cycle, including at least one phase as a human parasite;

Answer 77

protozoa

Question 78

found in
areas of poor sanitation and hygiene and crowded living conditions

Answer 78

protozoa

Question 79

infestation with a protozoan that causes vaginitis in
women but no signs or symptoms in men

Answer 79

trichomoniasis:

Question 80

a developing stage of a parasite, which uses the host for
essential nutrients needed for growth

Answer 80

trophozoite:

Question 81

African sleeping sickness, which is caused by a
protozoan that inflames the CNS and is spread to humans by the bite of
the tsetse fly

Answer 81

trypanosomiasis

Question 82

causes a serious
cardiomyopathy after the bite of the housefly

Answer 82

Chagas disease

Question 83

is considered to be the most dangerous type of
protozoan

Answer 83

Plasmodium falciparum

Question 84

causes a milder form of the disease, which seldom
results in death.

Answer 84

Plasmodium vivax

Question 85

is endemic in many tropical countries and causes
very mild signs and symptoms in the local population

Answer 85

Plasmodium malariae

Question 86

which is rarely seen, seems to be in the process of
being eradicated

Answer 86

Plasmodium ovale,

Question 87

are usually given in combination form to
attack the Plasmodium at various stages of its life cycle.

Answer 87

Antimalarial drugs

Question 88

was the first drug found to be
effective in the treatment of malaria;

Answer 88

Quinine (Qualaquin)

Question 89

Prevention and treatment of Plasmodium malaria; treatment of extraintestinal amebiasis

Answer 89

chloroquine (Aralen)

Question 90

Prevention and treatment of Plasmodium malaria in combination with other drugs

Answer 90

mefloquine (Lariam)

Question 91

Prevention of relapses of Plasmodium vivax and Plasmodium malariae infec- tions; radical cure of P. vivax malaria

Answer 91

primaquine (generic)

Question 92

Prevention of Plasmodium malaria, in combination with other agents to suppress transmission; treatment of toxoplasmosis

Answer 92

pyrimethamine (Daraprim)

Question 93

Treatment of uncomplicated malaria caused by Plasmodium falciparum

Answer 93

quinine (Qualaquin)

Question 94

increases the acidity of plasmodial food vacuoles, causing cell
rupture and death.

Answer 94

Mefloquine

Question 95

another very old drug for treating malaria, similar to quinine,
disrupts the mitochondria of the Plasmodium.

Answer 95

Primaquine

Question 96

is used in combination with agents that act more rapidly
to suppress malaria;

Answer 96

Pyrimethamine

Question 97

an intestinal infection caused by Entamoeba histolytica, is often
known as amebic dysentery

Answer 97

Amebiasis

Question 98

Prevention and treatment of
Pneumocystis jiroveci pneumonia; used in combination with proguanil for treat- ment of chloroquine-resistant malaria

Answer 98

atovaquone (Mepron)

Question 99

Treatment of pediatric patients with Chagas disease caused by Trypanosoma cruzi

Answer 99

benznidazole (generic)

Question 100

Treatment of amebiasis, trichomoniasis, giardiasis

Answer 100

metronidazole (Flagyl, MetroGel, Noritate)

Question 101

Treatment of diarrhea associated with Cryptosporidium parvum or Giardia lamblia

Answer 101

nitazoxanide (Alinia)

Question 102

As inhalation treatment of Pneumocystis jiroveci pneumonia; as a systemic agent in the treatment of trypanosomiasis and leishmaniasis

Answer 102

pentamidine (Pentam, NebuPent)

Question 103

Treatment of trichomoniasis, giardiasis, amebiasis

Answer 103

tinidazole (Tindamax)

Question 104

After a group of students is taught about protozoal infections, which
infection, if stated by the group as caused by an insect bite, would
indicate the need for additional teaching?
a. Malaria
b. Trypanosomiasis
c. Leishmaniasis
d. Giardiasis

Answer 104

d. Giardiasis

Question 105

When describing the development of malaria caused by the
Plasmodium protozoan the instructor would explain that the organism depends on
a. a snail to act as intermediary in the life cycle of the protozoan.
b. a mosquito and a red blood cell for maturation.
c. a human liver cell for cell division and reproduction.
d. stagnant water for maturation.

Answer 105

b. a mosquito and a red blood cell for maturation.

Question 106

A patient who is receiving a combination drug to treat malaria asks
the nurse why. The nurse responds to the patient based on the
understanding that combination drugs are
a. associated with a much lower degree of toxicity when used in
combination.
b. absorbed more completely when administered and taken
together.
c. more effective in preventing mosquitoes from biting the
individual.
d. effective at various stages in the life cycle of the protozoan.

Answer 106

d. effective at various stages in the life cycle of the protozoan.

Question 107

A patient traveling to an area of the world where malaria is known to
be endemic should be taught to
a. avoid drinking the water.
b. begin prophylactic antimalarial therapy before traveling and
continue it through the visit and for 4 weeks after the visit.
c. take a supply of antimalarial drugs in case he or she gets a
mosquito bite.
d. begin prophylactic antimalarial therapy 2 weeks before traveling
and stop the drugs on arriving at the destination.

Answer 107

b. begin prophylactic antimalarial therapy before traveling and
continue it through the visit and for 4 weeks after the visit.

Question 108

Amebiasis or amebic dysentery
a. is seen only in Third World countries.
b. is caused by a protozoan that enters the body through an insect
bite.
c. is caused by a protozoan that can enter the body in the cyst stage
in water or food.
d. usually has no signs and symptoms.

Answer 108

c. is caused by a protozoan that can enter the body in the cyst stage
in water or food.

Question 109

Giardiasis is the most common intestinal parasite seen in the United
States, and it
a. does not respond to drug therapy.
b. can invade the liver and cause death.
c. is seen only in areas with no sanitation.
d. is associated with rotten egg–smelling stool, diarrhea, and
mucus-filled stool.

Answer 109

d. is associated with rotten egg–smelling stool, diarrhea, and
mucus-filled stool.

Question 110

Pneumocystis jiroveci pneumonia is
a. an endemic fungus found in the human respiratory system.
b. responsive to inhaled pentamidine.
c. an opportunistic bacterial infection.
d. frequently associated with children in day care settings.

Answer 110

b. responsive to inhaled pentamidine.

Question 111

Trypanosomiasis may assume which of the following two different
forms?
a. African sleeping sickness and Chagas disease
b. Elephantiasis and malaria
c. Dysentery and African sleeping sickness
d. Malaria and Chagas disease

Answer 111

a. African sleeping sickness and Chagas disease

Question 112

A nurse would note that a patient had a good understanding of his
antimalarial drug regimen if the patient reported,
a. “I keep these pills with me at all times while I’m away and take
them only when I have been bitten by a mosquito.”
b. “I will need to start these pills now and then continue to take
them every day for the rest of my life.”
c. “I’ll start the pills before my trip, keep taking them during the
trip, and for a period of time after I’m home.”
d. “I start taking these pills as soon as I arrive at my vacation
destination, but before I get off the plane.”

Answer 112

c. “I’ll start the pills before my trip, keep taking them during the
trip, and for a period of time after I’m home.”

Question 113

the most prevalent helminthic infection; fertilized roundworm
eggs are ingested, which hatch in the small intestine and then make
their way to the lungs, where they may cause cough, fever, and other
signs of a pulmonary infiltrate

Answer 113

Ascaris

Question 114

tapeworm with a head and segmented body parts that is capable
of growing to several yards in the human intestine

Answer 114

cestode

Question 115

infection of the blood and tissues of healthy individuals by
worm embryos or filariae

Answer 115

filariasis:

Question 116

worm that can cause disease by invading the human body

Answer 116

helminth:

Question 117

worms that attach themselves to the small intestine of
infected individuals, where they suck blood from the walls of the
intestine, damaging the intestinal wall and leading to severe anemia
with lethargy, weakness, and fatigue

Answer 117

hookworms:

Question 118

can cause intestinal obstruction as the
adult worms clog the intestinal lumen or severe pneumonia when the
larvae migrate to the lungs and form a pulmonary infiltrate

Answer 118

nematode:

Question 119

roundworms such as the commonly encountered pinworm,
whipworm, threadworm, Ascaris, or hookworm that cause a common
helminthic infection in humans;

Answer 119

nematode:

Question 120

nematode that causes a common helminthic infection in
humans; lives in the intestine and causes anal and possible vaginal
irritation and itching

Answer 120

pinworm:

Question 121

flatworms, including the cestodes or tapeworms; a worm
that can live in the human intestine or can invade other human tissues
(flukes)

Answer 121

platyhelminth

Question 122

infection with a blood fluke that is carried by a snail; it
poses a common problem in tropical countries, where the snail is the
intermediary in the life cycle of the worm

Answer 122

schistosomiasis

Question 123

where the snail is the
intermediary in the life cycle of the worm; larvae burrow into the skin
in fresh water and migrate throughout the human body, causing a rash,
diarrhea, and liver and brain inflammation

Answer 123

schistosomiasis

Question 124

pervasive nematode that can send larvae into the lungs,
liver, and central nervous system (CNS); can cause severe pneumonia
or liver abscess

Answer 124

threadworm:

Question 125

disease that results from ingestion of encysted roundworm
larvae in undercooked pork

Answer 125

trichinosis

Question 126

; larvae migrate throughout the body to
invade muscles, nerves, and other tissues; can cause pneumonia, heart
failure, and encephalitis

Answer 126

trichinosis

Question 127

worm that attaches itself to the intestinal mucosa and sucks
blood; may cause severe anemia and disintegration of the intestinal
mucosa

Answer 127

whipworm

Question 128

are usually transmitted when the worm eggs are ingested, either
by transfer by touching the eggs when they are shed to clothing, toys, or
bedding; or by the inhalation of eggs that become airborne and are then
swallowed.

Answer 128

Pinworms

Question 129

are transmitted when eggs found in the soil are ingested.

Answer 129

Whipworms

Question 130

can cause more damage to humans than most of the other
helminths. ________ are transmitted as larvae found in the soil and
inadvertently ingested

Answer 130

Threadworms

Question 131

is the most prevalent helminthic infection. It
may occur wherever sanitation is poor

Answer 131

ascaris

Question 132

The larvae penetrate the skin and
then enter the blood and within about a week reach the intestine

Answer 132

Hookworm

Question 133

are segmented flatworms with a head, or scolex, and a variable
number of segments that grow from the head

Answer 133

Cestodes

Question 134

enter the body as
larvae that are found in undercooked meat or fish; they sometimes form
worms that are several yards long.

Answer 134

Cestodes

Question 135

is the disease caused by ingestion of the encysted larvae of the
roundworm, Trichinella spiralis, in undercooked pork

Answer 135

Trichinosis

Question 136

refers to infection of the blood and tissues of healthy individuals
by worm embryos, which enter the body via insect bites

Answer 136

Filariasis

Question 137

are worms that cause disease by invading the human body.

Answer 137

Helminths

Question 138

are the most frequent cause of helminth infection in the
United States, and roundworms

Answer 138

Pinworms

Question 139

are the most frequent
cause of helminth infections throughout the world.

Answer 139

Ascaris

Question 140

is important for decreasing the stress and anxiety that
may occur when individuals are diagnosed with a worm minfestation

Answer 140

Patient teaching

Question 141

act on metabolic pathways that are
present in the invading worm but are absent or significantly different in the
human host

Answer 141

anthelmintic drugs

Question 142

To ensure effective treatment of pinworm infections, which
instruction would be most important to emphasize to the patient and
family?
a. Keeping nails long so cutting will not introduce more infection
b. Laundering undergarments, bed linens, and pajamas every day
c. Boiling all drinking water
d. Maintaining a clear liquid diet for at least 7 to 10 days

Answer 142

b. Laundering undergarments, bed linens, and pajamas every day

Question 143

Which of the following would the nurse expect to assess in a patient
who is suspected of having an Ascaris infection?
a. Cough and signs of pulmonary infestation
b. Cardiac arrhythmias and low blood pressure
c. Seizures and disorientation
d. Bloody diarrhea and excessive vomiting

Answer 143

a. Cough and signs of pulmonary infestation

Question 144

The nurse describes schistosomiasis to a group of students as an
infection caused by
a. a protozoan carried by a mosquito.
b. improperly cooked pork.
c. a fluke carried by a snail.
d. eating food contaminated by fecal material.

Answer 144

c. a fluke carried by a snail.

Question 145

A patient has traveled to Egypt and come home with
schistosomiasis. The family is very concerned about spreading the
disease. Which information would be most helpful to teach the
family?
a. Strict hand washing will stop the spread of the disease.
b. Isolating the patient will be necessary to stop the spread of the
disease.
c. Carefully cooking all of the patient’s food will help to stop the
spread of the disease.
d. The snail needed for the life cycle of this worm does not live in
this climate.

Answer 145

d. The snail needed for the life cycle of this worm does not live in
this climate.

Question 146

A patient is prescribed mebendazole. The nurse knows that this is
the most commonly used anthelmintic, being the drug of choice for
treating
a. pinworms, roundworms, whipworms, and hookworms.
b. trichinosis, flukes, cestodes, and hookworms.
c. pork tapeworm, threadworms, cestodes, and whipworms.
d. all stages of schistosomal infections.

Answer 146

a. pinworms, roundworms, whipworms, and hookworms.

Question 147

Patient teaching regarding the use of anthelmintics should include
counseling about
a. the use of oral contraceptives.
b. maintenance of nutrition during therapy.
c. the use of oral anticoagulants.
d. cardiac drug effects

Answer 147

b. maintenance of nutrition during therapy.

Question 148

Patients may experience anxiety about the diagnosis and treatment of
helminthic infections. Teaching may help to alleviate this anxiety
and should include
a. what they may experience if the worms are passed from the
body.
b. focus on the cleanliness of the home.
c. measures to isolate the organism in the home.
d. criticism of their personal hygiene practices.

Answer 148

a. what they may experience if the worms are passed from the
body.

Question 149

are
designed to fight neoplasms, or cancers

Answer 149

antineoplastic agents

Question 150

is a disease that can strike a person at any age. It remains second only
to coronary disease as the leading cause of death in the United States.

Answer 150

Cancer

Question 151

are responsible for the
characteristics seen in cancer cells.

Answer 151

oncogenes

Question 152

—a loss of
cellular differentiation and organization, which leads to a loss of their ability
to function normally

Answer 152

anaplasia

Question 153

growing without the usual
homeostatic restrictions that regulate cell growth and control.

Answer 153

autonomy

Question 154

traveling from the place of origin to develop new tumors in other areas of the
body where conditions are favorable for cell growth

Answer 154

metastasis,

Question 155

Cancers can be divided into two groups:

Answer 155

solid tumors

and

hematological malignancies

Question 156

tumors that originate
in epithelial cells

Answer 156

carcinomas

Question 157

tumors that originate in the mesenchyme
and are made up of embryonic connective tissue cells

Answer 157

sarcomas

Question 158

hair loss; a common adverse effect of many antineoplastic
drugs, which are more effective against rapidly multiplying cells, such
as those of hair follicles

Answer 158

alopecia:

Question 159

loss of organization and structure; property of cancer cells

Answer 159

anaplasia:

Question 160

the generation of new blood vessels; cancer cells release an
enzyme that will cause angiogenesis or the growth of new blood
vessels to feed the cancer cells

Answer 160

angiogenesis

Question 161

drug used to combat cancer or the growth of
neoplasms

Answer 161

antineoplastic agent:

Question 162

loss of the normal controls and reactions that inhibit growth
and spreading; property of cancer cells

Answer 162

autonomy:

Question 163

a common adverse effect of many antineoplastic
drugs, which are more effective against rapidly multiplying cells,

Answer 163

bone marrow suppression

Question 164

tumor that originates in epithelial cells

Answer 164

carcinoma:

Question 165

bility to enter the circulatory or lymphatic system and travel
to other areas of the body that are conducive to growth and survival

Answer 165

metastasis

Question 166

new or cancerous growth; occurs when abnormal cells have
the opportunity to multiply and grow

Answer 166

neoplasm

Question 167

tumor that originates in the mesenchyme and is made up of
embryonic connective tissue cells

Answer 167

sarcoma:

Question 168

an antiinflammatory drug,
is being studied in various cancer combination drug trials for this effect.

Answer 168

Celecoxib (Celebrex)

Question 169

or hair loss, related to effects on the
hair follicles, may also occur

Answer 169

alopecia

Question 170

may be hepatotoxic; increases the risk of hepatotoxicity
when taken with antineoplastics that are hepatotoxic

Answer 170

Echinacea

Question 171

—inhibits blood clotting, which can cause problems after
surgery or with bleeding neoplasms

Answer 171

Ginkgo

Question 172

may increase the effects of various estrogen hormones
and hormone modulators; advise patients taking such drugs to avoid
this herb

Answer 172

Saw palmetto

Question 173

can greatly increase photosensitivity, which can
cause problems with patients who have received radiation therapy or
are taking drugs that cause other dermatological effects;

Answer 173

St. John’s wort

Question 174

are drugs that kill cells as the process of
mitosis begins

Answer 174

Mitotic inhibitors

Question 175

act on specific enzymes that are
needed for protein building by specific tumor cells

Answer 175

protein kinase inhibitors

Question 176

Some properties of neoplastic cells are the same as the properties of
normal cells, including
a. anaplasia.
b. metastasis.
c. mitosis.
d. autonomy

Answer 176

c. mitosis

Question 177

Carcinomas are tumors that originate in
a. mesenchyme.
b. bone marrow.
c. striated muscle.
d. epithelial cells.

Answer 177

d. epithelial cells.

Question 178

The goal of traditional antineoplastic drug therapy is to
a. reduce the size of abnormal cell mass for immune system
destruction.
b. eradicate all of the abnormal cells that have developed.
c. destroy all cells of the originating type.
d. stimulate the immune system to destroy the neoplastic cells

Answer 178

a. reduce the size of abnormal cell mass for immune system
destruction.

Question 179

Cancer can be a difficult disease to treat because
a. cells no longer progress through the normal cell cycle.
b. cells can fail to develop resistance to drug therapy.
c. cells remain dormant, emerging months to years later.
d. the exact cause of cancer is not known.

Answer 179

c. cells remain dormant, emerging months to years later.

Question 180

Antineoplastic drugs destroy human cells. They are most likely to
cause cell death among healthy cells that
a. have poor cell membranes.
b. are rapidly turning over.
c. are in dormant tissues.
d. are across the blood–brain barrier.

Answer 180

b. are rapidly turning over.

Question 181

Cancer treatment usually occurs in several different treatment
phases. In assessing the appropriateness of another round of
chemotherapy for a particular patient, the nurse would evaluate
which as most important?
a. Hair loss
b. Bone marrow function
c. Anorexia
d. Heart rate

Answer 181

b. Bone marrow function

Question 182

It is important to explain to women that chemotherapeutic agents
should not be used during pregnancy because
a. the tendency to cause nausea and vomiting will be increased.
b. of potential serious adverse effects on the rapidly multiplying
cells of the fetus.
c. bone marrow toxicity could alter hormone levels.
d. patients may be weakened by the drug regimen.

Answer 182

b. of potential serious adverse effects on the rapidly multiplying
cells of the fetus

Question 183

Cancer drugs are given in combination and over a period of time
because it is difficult to affect
a. slowly growing cells.
b. cells in the dormant phase of the cell cycle.
c. cells that multiply rapidly and go through the cell cycle quickly.
d. cells that have moved from their normal site in the body.

Answer 183

b. cells in the dormant phase of the cell cycle.

Question 184

immunoglobulins; produced by B-cell plasma cells and
memory cells in response to a specific protein; react with that protein
to cause its destruction directly or through activation of the
inflammatory response

Answer 184

antibodies:

Question 185

foreign protein

Answer 185

antigen

Question 186

released from injured cells to stimulate the
inflammatory response through activation of various chemical
substances

Answer 186

arachidonic acid

Question 187

a disorder that occurs when the body responds to
specific self-antigens to produce antibodies or cell-mediated responses
against its own cells

Answer 187

autoimmune disease:

Question 188

lymphocytes programmed to recognize specific proteins; when
activated, these cells cause the production of antibodies to react with
that protein

Answer 188

B cells:

Question 189

heat, one of the four cardinal signs of inflammation; caused by
activation of the inflammatory response

Answer 189

calor

Question 190

: property of drawing neutrophils to an area

Answer 190

chemotaxis

Question 191

series of cascading proteins that react with the
antigen–antibody complex to destroy the protein or stimulate an
inflammatory reaction

Answer 191

complement proteins:

Question 192

pain, one of the four cardinal signs of inflammation; caused by
activation of the inflammatory response

Answer 192

dolor

Question 193

first factor activated when a blood vessel or cell is
injured;

Answer 193

Hageman factor:

Question 194

tissue hormone that is released in response to viral invasion;
blocks viral replication

Answer 194

interferon:

Question 195

chemicals released by white blood cells (WBCs) to
communicate with other WBCs and to support the inflammatory and
immune reactions

Answer 195

interleukins:

Question 196

system activated by Hageman factor as part of the
inflammatory response; includes bradykinin

Answer 196

kinin system:

Question 197

white blood cells; can be neutrophils, basophils, or
eosinophils

Answer 197

leukocytes

Question 198

white blood cells with large, varied nuclei; can be T cells or
B cells

Answer 198

lymphocytes

Question 199

mature leukocytes that are capable of phagocytizing an
antigen (foreign protein); also called monocytes or mononuclear
phagocytes

Answer 199

macrophages

Question 200

the genetic identification code
carried on a chromosome; produces several proteins or antigens that
allow the body to recognize cells as being self-cells

Answer 200

major histocompatibility complex

Question 201

fixed basophils found in the respiratory and gastrointestinal
tracts and in the skin

Answer 201

mast cells

Question 202

leukocyte-producing cells in the bone marrow that can
develop into neutrophils, basophils, eosinophils, monocytes, or
macrophages

Answer 202

myelocytes:

Question 203

neutrophils and macrophages that are able to engulf and
digest foreign material

Answer 203

phagocytes:

Question 204

he process of engulfing and digesting foreign organic
materials

Answer 204

phagocytosis:

Question 205

fever-causing substance

Answer 205

pyrogen:

Question 206

redness, one of the four cardinal signs of inflammation; caused by
activation of the inflammatory response

Answer 206

rubor

Question 207

lymphocytes programmed in the thymus gland to recognize selfcells; may be effector T cells, helper T cells, or suppressor T cells

Answer 207

T cells:

Question 208

swelling, one of the four cardinal signs of inflammation; caused
by activation of the inflammatory response

Answer 208

tumor

Question 209

line the areas of the body that are exposed to external
influences but do not have the benefit of skin protection.

Answer 209

Mucous membranes

Question 210

. In humans, the genetic identification code is
carried on a chromosome and is called

Answer 210

major histocompatibility
complex

Question 211

are
located on the cell membrane and allow the body to recognize cells as being
self-cells

Answer 211

antigens

Question 212

are the
key components of the immune system

Answer 212

lymphocytes

Question 213

can develop into a number of different cell types that are
important in both the basic inflammatory response and the immune response.

Answer 213

myelocytes

Question 214

When the body is injured or invaded by a pathogen,
neutrophils are rapidly produced and move to the site of the insult, a property
called

Answer 214

chemtaxis

Question 215

are myelocytic leukocytes that are not capable of phagocytosis

Answer 215

Basophils

Question 216

Basophils that are fixed and do not circulate are called

Answer 216

mast cells

Question 217

are circulating myelocytic leukocytes whose exact function is not
understood.

Answer 217

Eosinophils

Question 218

is the local reaction of the body to invasion or
injury.

Answer 218

inflammatory response

Question 219

is responsible for activating at least
three systems in the body

Answer 219

Hageman factor

Question 220

the
clotting cascade, which initiates blood clotting

Answer 220

kinin system

Question 221

substance found in the local tissues,
which causes the precursor substance kininogen to be converted to
bradykinin and other kinins

Answer 221

kallikrein,

Question 222

is the precursor to many substances called
autocoids, including cyclooxygenase, prostacyclin, and thromboxane.

Answer 222

Arachidonic acid

Question 223

are chemicals that are secreted by cells that have been invaded
by viruses and possibly by other stimuli.

Answer 223

Interferons

Question 224

are chemicals secreted by active leukocytes to influence
other leukocytes.

Answer 224

Interleukins

Question 225

occurs when the body responds to specific selfantigens to produce antibodies or cell-mediated immune responses against its
own cells.

Answer 225

Autoimmune disease

Question 226

Antibodies
a. are carbohydrates.
b. are secreted by activated T cells.
c. are not found in circulating gamma globulins.
d. are effective only against specific antigens

Answer 226

d. are effective only against specific antigens

Question 227

B and T cells are similar in that they both
a. secrete antibodies.
b. play important roles in the immune response.
c. are activated in the thymus gland.
d. release cytotoxins to destroy cells

Answer 227

b. play important roles in the immune response.

Question 228

Which of the following is not a cytokine?
a. Interleukin 2
b. Antibody
c. Tumor necrosis factor
d. Interferon

Answer 228

b. Antibody

Question 229

As part of the nonspecific defense against infection,
a. blood flow and vascular permeability to proteins increase
throughout the circulatory system.
b. particles in the respiratory tract are engulfed by phagocytes.
c. B cells are released from the bone marrow.
d. neutrophils release lysosomes, heparin, and kininogen into the
extracellular fluid.

Answer 229

b. particles in the respiratory tract are engulfed by phagocytes.

Question 230

B cells respond to an initial antigen challenge by
a. reducing in size.
b. immediately producing antigen-specific antibodies.
c. producing a large number of cells that are unlike the original B
cell.
d. producing new cells that become plasma cells and memory cell

Answer 230

d. producing new cells that become plasma cells and memory cell

Question 231

Treating fevers remains a controversial subject because
a. fevers make people feel ill.
b. higher temperatures act as catalysts to many of the body’s
chemical reactions.
c. higher temperatures can suppress the body’s normal metabolism.
d. higher temperatures can alter the body’s hormone levels,
particularly that of progesterone.

Answer 231

b. higher temperatures act as catalysts to many of the body’s
chemical reactions.

Question 232

After describing the function of T cells, the nurse would identify the
need for additional teaching if the patient stated that T cells become
which type of cells?
a. Cytotoxic T cells
b. Helper T cells
c. Suppressor T cells
d. Antibody-secreting T cells

Answer 232

d. Antibody-secreting T cells

Question 233

Interleukins are
a. chemicals released when a virus enters a cell.
b. chemicals secreted by activated leukocytes.
c. part of the kinin system.
d. activated by arachidonic acid.

Answer 233

b. chemicals secreted by activated leukocytes.

Question 234

compound with pain-blocking properties, capable of producing
analgesia

Answer 234

analgesic:

Question 235

drugs that block the effects of the
inflammatory response

Answer 235

antiinflammatory agents:

Question 236

blocking fever, often by direct effects on the
thermoregulatory center in the hypothalamus or by blockade of
prostaglandin mediators

Answer 236

antipyretic:

Question 237

treatment with gold salts; gold is taken up by
macrophages, which then inhibit phagocytosis; it is reserved for use in
patients who are unresponsive to conventional therapy, and can be very
toxic

Answer 237

chrysotherapy

Question 238

the body’s nonspecific response to cell injury,
resulting in pain, swelling, heat, and redness in the affected area

Answer 238

inflammatory response:

Question 239

drugs that block
prostaglandin synthesis and act as antiinflammatory, antipyretic, and
analgesic agents

Answer 239

nonsteroidal antiinflammatory drugs (NSAIDs):

Question 240

salicylic acid compounds, used as antiinflammatory,
antipyretic, and analgesic agents; they block the prostaglandin system

Answer 240

salicylates:

Question 241

syndrome associated with high levels of salicylates—
dizziness, ringing in the ears, difficulty hearing, nausea, vomiting,
diarrhea, mental confusion, and lassitude

Answer 241

salicylism:

Question 242

A drug could be classified as an analgesic if it
a. reduces fever.
b. reduces swelling.
c. reduces redness.
d. reduces pain

Answer 242

d. reduces pain

Question 243

An antipyretic is a drug that can
a. block pain.
b. block swelling.
c. block fever.
d. block inflammation.

Answer 243

c. block fever.

Question 244

A nurse might not see a salicylate used as an antiinflammatory if a
drug was needed for its
a. antipyretic properties.
b. analgesic properties.
c. OTC availability.
d. parenteral availability

Answer 244

d. parenteral availability

Question 245

The nonsteroidal NSAIDs affect the COX-1 and COX-2 enzymes.
By blocking COX-2 enzymes the NSAIDs block inflammation and
the signs and symptoms of inflammation at the site of injury or
trauma. By blocking COX-1 enzymes, these drugs block
a. fever regulation.
b. prostaglandins that protect the stomach lining.
c. swelling in the periphery.
d. liver function

Answer 245

b. prostaglandins that protect the stomach lining.

Question 246

Your patient has been receiving ibuprofen for many years to relieve
the pain of osteoarthritis. Assessment of the patient should include
a. an electrocardiogram.
b. CBC with differential.
c. respiratory auscultation.
d. renal evaluation.

Answer 246

d. renal evaluation.

Question 247

Patients taking NSAIDs should be taught to avoid the use of OTC
medications without checking with their prescriber because
a. many of the OTC preparations contain NSAIDs, and inadvertent
toxicity could occur.
b. no one should take more than one type of pain reliever at a time.
c. increased GI upset could occur.
d. there is a risk of Reye syndrome

Answer 247

a. many of the OTC preparations contain NSAIDs, and inadvertent
toxicity could occur.

Question 248

Chronic or excessive activity by the inflammatory response can lead
to
a. loss of white blood cells.
b. coagulation problems.
c. release of lysosomal enzymes and tissue destruction.
d. adrenal suppression

Answer 248

c. release of lysosomal enzymes and tissue destruction.

Question 249

A patient with rheumatoid arthritis who is on a fixed income and
who is being treated with aspirin should be advised
a. to use only brand name aspirin.
b. to use only enteric-coated aspirin.
c. to use generic aspirin.
d. to switch to one of the NSAIDs.

Answer 249

c. to use generic aspirin.

Question 250

drug used to energize the immune system when it is
exhausted from fighting prolonged invasion or needs help fighting a
specific pathogen or cancer cell

Answer 250

immune stimulant

Question 251

drug used to block or suppress the actions of the T
cells and antibody production; used to prevent transplant rejection and
to treat autoimmune diseases

Answer 251

immune suppressant

Question 252

specific antibodies produced by a single clone of
B cells to react with a very specific antigen

Answer 252

monoclonal antibodies

Question 253

use of bacteria to produce chemicals
normally produced by human cells

Answer 253

recombinant DNA technology

Question 254

used to energize the immune
system when it is exhausted from fighting prolonged invasion or when the
immune system needs help fighting a specific pathogen or cancer cell.

Answer 254

immune stimulants

Question 255

are used to block the normal effects of the immune
system in cases of organ transplantation

Answer 255

immune suppresants

Question 256

substances naturally produced and released by human cells
that have been invaded by viruses.

Answer 256

interferons

Question 257

antibodies
produced by a single clone of B cells that react with specific antigens.

Answer 257

monoclonal antibodies—

Question 258

block the release of various cytokines involved in
the inflammatory response and activation of lymphocytes, decreasing
immune activity.

Answer 258

immune modulators

Question 259

stimulate cellular immunity and inhibit tumor growth; they
are used to treat very specific cancers.

Answer 259

Interleukins

Question 260

In which situation would the nurse least likely expect to administer
an immune suppressant?
a. Treatment of transplant rejection
b. Treatment of autoimmune disease
c. Reduction of number of relapses in multiple sclerosis
d. Treatment of aggressive cancers

Answer 260

d. Treatment of aggressive cancers

Question 261

The nurse would expect to administer interferon alfa-n3 (Alferon N)
as the drug of choice for
a. treatment of leukemias.
b. treatment of multiple sclerosis.
c. intralesional treatment of warts.
d. treatment of Kaposi sarcoma.

Answer 261

c. intralesional treatment of warts.

Question 262

Patient teaching for a patient receiving an interferon would include
a. proper use of oral contraceptives.
b. use of aspirin to control adverse effects.
c. importance of cardiovascular workouts.
d. proper methods injecting the drug.

Answer 262

d. proper methods injecting the drug.

Question 263

Patients who are receiving an immune stimulant may experience any
of the clinical signs of immune response activity, including
a. flu-like symptoms.
b. diarrhea.
c. constipation.
d. headache.

Answer 263

a. flu-like symptoms.

Question 264

Organ transplants are often rejected by the body because the T cells
recognize the transplanted cells as foreign and try to destroy them.
Treatment with an immune suppressant would
a. activate antibody production.
b. stimulate interleukin release.
c. stimulate thymus secretions.
d. block the initial damage to the transplanted cells.

Answer 264

d. block the initial damage to the transplanted cells.

Question 265

You might use a monoclonal antibody in treating
a. warts.
b. herpes zoster.
c. tumors that overexpress HER2.
d. Kaposi sarcoma.

Answer 265

c. tumors that overexpress HER2.

Question 266

the formation of antibodies secondary to exposure to a
specific antigen; leads to the formation of plasma cells, antibodies, and
memory cells to immediately produce antibodies if exposed to that
antigen in the future; imparts lifelong immunity

Answer 266

active immunity:

Question 267

immune sera that contain antibodies to specific toxins
produced by invaders; may prevent the toxin from adhering to body
tissues and causing disease

Answer 267

antitoxins:

Question 268

immune sera that contain antibodies to specific venins
produced by poisonous snakes or spiders; may prevent the venom from
causing cell death

Answer 268

antivenins:

Question 269

vaccines, immune sera, and antitoxins that are used to
stimulate the production of antibodies, to provide preformed antibodies
to facilitate an immune reaction, or to react specifically with the toxins
produced by an invading pathogen

Answer 269

biological:

Question 270

preformed antibodies found in immune globulin from
animals or humans who have had a specific disease and developed
antibodies to it

Answer 270

immune sera:

Question 271

the injection of preformed antibodies into a host at
high risk for exposure to a specific disease; immunity is limited by the
amount of circulating antibody

Answer 271

passive immunity:

Question 272

reaction of a host to injected antibodies or foreign sera;
host cells make antibodies to the foreign proteins, and a massive
immune reaction can occur

Answer 272

serum sickness:

Question 273

immunization containing weakened or altered protein antigens to
stimulate a specific antibody formation against a specific disease;
refers to a product used to stimulate active immunity

Answer 273

vaccine:

Question 274

Vaccines and immune sera, including antivenins and antitoxins, are usually
referred to as _______

Answer 274

biologicals.

Question 275

occurs when the body recognizes a foreign protein and
begins producing antibodies to react with that specific protein or antigen.

Answer 275

Active immunity

Question 276

occurs when preformed antibodies are injected into
the system and react with a specific antigen.

Answer 276

Passive immunity

Question 277

a
massive immune reaction manifested by fever, arthritis, flank pain, myalgia,
and arthralgia

Answer 277

serum sickness,

Question 278

is the process of artificially stimulating active immunity by
exposing the body to weakened or less toxic proteins associated with specific
disease-causing organisms.

Answer 278

immunizations

Question 279

provide preformed antibodies to specific proteins for
people who have been exposed to them or are at high risk for exposure.

Answer 279

Immune sera

Question 280

When preparing a presentation for a local parent group about
vaccines, the nurse would describe vaccines as being used to
stimulate
a. passive immunity to a foreign protein.
b. active immunity to a foreign protein.
c. serum sickness.
d. a mild disease in healthy people.

Answer 280

b. active immunity to a foreign protein.

Question 281

After teaching a parent about common adverse effects associated
with routine immunizations, which of the following, if stated by the
parent, would indicate the need for additional teaching?
a. Difficulty breathing and fainting
b. Fever and rash
c. Drowsiness and fretfulness
d. Swelling and nodule formation at the site of injection

Answer 281

a. Difficulty breathing and fainting

Question 282

Which vaccine would the nurse be least likely to recommend for a 6-
month-old child?
a. Diphtheria, tetanus, pertussis vaccine
b. Haemophilus influenzae b vaccine
c. Poliovirus vaccine
d. Chickenpox vaccine

Answer 282

d. Chickenpox vaccine

Question 283

It is now recommended that all people over the age of 6 months
should receive a flu vaccine every fall based on the understanding
that the vaccine is repeated because
a. the immunity wears off after a year.
b. the strains of virus predicted to cause the flu change every year.
c. a booster shot will activate the immune system.
d. flu shots do not produce good antibodies.

Answer 283

b. the strains of virus predicted to cause the flu change every year.

Question 284

The nurse reviews a patient’s record to make sure that tetanus
booster shots have been given
a. only with exposure to anaerobic bacteria.
b. every 2 years.
c. every 5 years.
d. every 10 years

Answer 284

d. every 10 years

Question 285

A nurse suffers a needlestick after injecting a patient with suspected
hepatitis B. The nurse should
a. have repeated titers to determine whether she was exposed to
hepatitis B and if she was have hepatitis immune globulin.
b. immediately receive hepatitis immune globulin and begin
hepatitis B vaccines if she has not already received them.
c. start antibiotic therapy immediately.
d. go on sick leave until all screening tests are negative.

Answer 285

b. immediately receive hepatitis immune globulin and begin
hepatitis B vaccines if she has not already received them.

Question 286

A patient is to receive immune globulin after exposure to hepatitis
A. The patient has a previous history of allergies to various drugs.
Before giving the immune globulin, the nurse should
a. have emergency equipment readily available.
b. premedicate the patient with aspirin.
c. make sure all of the patient’s vaccinations are up to date.
d. make sure the patient has a ride home.

Answer 286

a. have emergency equipment readily available.

Question 287

sudden change in electrical charge of a nerve cell
membrane; the electrical signal by which neurons send information

Answer 287

action potential:

Question 288

neurons or groups of neurons that bring information to the
central nervous system; sensory nerve

Answer 288

afferent:

Question 289

long projection from a neuron that carries information from one
nerve to another nerve or effector

Answer 289

axon

Question 290

short projection on a neuron that transmits information

Answer 290

dendrite

Question 291

opening of the sodium channels in a nerve membrane to
allow the influx of positive sodium ions, reversing the membrane
charge so it is no longer polarized

Answer 291

depolarization

Question 292

cell stimulated by a nerve; may be a muscle, a gland, or
another nerve cell

Answer 292

effector cell

Question 293

neurons or groups of neurons that carry information from the
central nervous system to an effector; motor neurons are ____

Answer 293

efferent

Question 294

short-term memory made up of a reverberating electrical circuit
of action potentials

Answer 294

engram

Question 295

upper level of the brain; consists of the two cerebral
hemispheres, where thinking and coordination of sensory and motor
activity occur, contains the hypothalamus and thalamus and the area of
the limbic system

Answer 295

forebrain

Question 296

a group of nerve bodies

Answer 296

ganglia

Question 297

: most primitive area of the brain, the brainstem; consists of the
pons and medulla, which control basic, vital functions, and the
cerebellum, which controls motor functions that regulate balance

Answer 297

hindbrain

Question 298

area in the forebrain that is rich in epinephrine,
norepinephrine, and serotonin and seems to control emotions

Answer 298

limbic system

Question 299

area in the forebrain that is rich in epinephrine,
norepinephrine, and serotonin and seems to control emotions

Answer 299

midbrain

Question 300

structural unit of the nervous system

Answer 300

neuronn

Question 301

chemical produced by a nerve and released when the
nerve is stimulated; reacts with a specific receptor site to cause a
reaction

Answer 301

neurotransmitter

Question 302

return of a membrane to a resting state, with more sodium
ions outside the membrane and a relatively negative charge inside the
membrane

Answer 302

repolarization

Question 303

insulating cell found on nerve axons; allows “leaping”
electrical conduction to speed the transmission of information and
prevent tiring of the neuronsc

Answer 303

schwann cell

Question 304

cell body of a neuron; contains the nucleus, cytoplasm, and various
granules

Answer 304

soma

Question 305

junction between a nerve and an effector; consists of the
presynaptic nerve ending, a space called the synaptic cleft, and the
postsynaptic cell

Answer 305

synapse

Question 306

fibers are nerve axons that
run from peripheral receptors into the CNS

Answer 306

afferent

Question 307

fibers are
nerve axons that carry nerve impulses from the CNS to the periphery to
stimulate muscles or glands.

Answer 307

efferent

Question 308

groups of nerve bodies

Answer 308

ganglia

Question 309

Nerves send messages by conducting electrical impulses called ______

Answer 309

action
potentials.

Question 310

that the sodium channels open in response to the stimulus, and sodium ions
rush into the cell, following the established concentration gradient.

Answer 310

depolarization

Question 311

sodium–potassium pump, the cell then returns that
section of membrane to the resting membrane potential, a process called

Answer 311

repolarization

Question 312

stimulate postsynaptic cells either by exciting or by
inhibiting them.

Answer 312

Neurotransmitters

Question 313

is responsible for the expression of emotion,
and the thalamus and hypothalamus coordinate internal and external
responses and direct information into the cerebral cortex.

Answer 313

limbic system

Question 314

The cerebellum
a. initiates voluntary muscle movement.
b. helps regulate the tone of skeletal muscles.
c. if destroyed, would result in the loss of all voluntary skeletal
activity.
d. contains the centers responsible for the regulation of body
temperature

Answer 314

b. helps regulate the tone of skeletal muscles

Question 315

At those regions of the nerve membrane where myelin is present,
there is
a. low resistance to electrical current.
b. high resistance to electrical current.
c. high conductance of electrical current.
d. energy loss for the cell.

Answer 315

b. high resistance to electrical current

Question 316

The nerve synapse
a. is not resistant to electrical current.
b. cannot become exhausted.
c. has a synaptic cleft.
d. transfers information at the speed of electricity.

Answer 316

c. has a synaptic cleft.

Question 317

Which could result in the initiation of an action potential?
a. Depolarizing the membrane
b. Decreasing the extracellular potassium concentration
c. Increasing the activity of the sodium–potassium active transport
system
d. Stimulating the nerve with a threshold electrical stimulus during
the absolute refractory period of the membrane

Answer 317

a. Depolarizing the membrane

Question 318

Neurotransmitters are
a. produced in the muscle to communicate with nerves.
b. the chemicals used to stimulate or suppress effectors at the nerve
synapse.
c. usually found in the diet.
d. nonspecific in their action on various nerves.

Answer 318

b. the chemicals used to stimulate or suppress effectors at the nerve
synapse.

Question 319

The limbic system is an area of the brain that
a. is responsible for coordination of movement.
b. is responsible for the special senses.
c. is responsible for the expression of emotions.
d. controls sleep.

Answer 319

c. is responsible for the expression of emotions.

Question 320

The most primitive area of the brain, the brainstem, contains areas
responsible for
a. vomiting, swallowing, respiration, arousal, and sleep.
b. learning.
c. motivation and memory.
d. taste, sight, hearing, and balance

Answer 320

a. vomiting, swallowing, respiration, arousal, and sleep.

Question 321

A clinical indication of poor blood supply to the brain, particularly
to the higher levels where learning takes place, would be
a. loss of long-term memory.
b. loss of short-term memory.
c. loss of coordinated movement.
d. insomnia.

Answer 321

b. loss of short-term memory

Question 322

unpleasant feeling of tension, fear, or nervousness in response to
an environmental stimulus, whether real or imaginary

Answer 322

anxiety

Question 323

drug used to depress the central nervous system (CNS);
prevents or reduces the signs and symptoms of anxiety

Answer 323

anxiolytic:

Question 324

former mainstay class of drug used for the treatment of
anxiety and for sedation and sleep induction;

Answer 324

barbiturate:

Question 325

class of drug that acts in the limbic system and the
reticular activating system to make gamma-aminobutyric acid
(GABA),

Answer 325

benzodiazepine

Question 326

extreme sedation resulting in CNS depression and sleep

Answer 326

hypnosis:

Question 327

drug used to depress the CNS; causes sleep

Answer 327

hypnotic:

Question 328

loss of awareness of and reaction to environmental stimuli

Answer 328

sedation

Question 329

drug that depresses the CNS; produces a loss of awareness of
and reaction to the environment

Answer 329

sedative

Question 330

once called minor tranquilizers, are drugs used to treat
anxiety by depressing the CNS.

Answer 330

Anxiolytics

Question 331

Drugs that are best used to cause a patient to sleep are called
a. hypnotics.
b. sedatives.
c. antiepileptics.
d. anxiolytics.

Answer 331

a. hypnotics.

Question 332

The benzodiazepines are the most frequently used anxiolytic drugs
because
a. they are anxiolytic at doses much lower than those needed for
sedation or hypnosis.
b. they can also be stimulating.
c. they are more likely to cause physical dependence than older
anxiolytic drugs.
d. they do not affect any neurotransmitters

Answer 332

a. they are anxiolytic at doses much lower than those needed for
sedation or hypnosis.

Question 333

Barbiturates cause liver enzyme induction, which could lead to
a. rapid metabolism and loss of effectiveness of other drugs
metabolized by those enzymes.
b. increased bile production.
c. CNS depression.
d. the need to periodically lower the barbiturate dose to avoid
toxicity

Answer 333

a. rapid metabolism and loss of effectiveness of other drugs
metabolized by those enzymes.

Question 334

A person who could benefit from an anxiolytic drug for short-term
treatment of insomnia would not be prescribed
a. zolpidem.
b. zaleplon.
c. buspirone.
d. meprobamate.

Answer 334

c. buspirone.

Question 335

Anxiolytic drugs block the awareness of and reaction to the
environment. This effect would not be beneficial
a. to relieve extreme fear.
b. to moderate anxiety related to unknown causes.
c. in treating a patient who must drive a vehicle for a living.
d. in treating a patient who is experiencing a stress reaction.

Answer 335

c. in treating a patient who must drive a vehicle for a living.

Question 336

Mr. Jones is the chief executive officer of a large company and has
been experiencing acute anxiety attacks. His physical examination
was normal, and he was diagnosed with anxiety. Considering his
occupation and his need to be alert and present to large groups on a
regular basis, which anxiolytic would be the drug of choice for Mr.
Jones?
a. Phenobarbital
b. Diazepam
c. Clorazepate
d. Buspirone

Answer 336

d. Buspirone

Question 337

The benzodiazepines react with
a. GABA receptor sites in the RAS to cause inhibition of neural
arousal.
b. norepinephrine receptor sites in the sympathetic nervous system.
c. acetylcholine receptor sites in the parasympathetic nervous
system.
d. monoamine oxidase to increase norepinephrine breakdown.

Answer 337

a. GABA receptor sites in the RAS to cause inhibition of neural
arousal.

Question 338

A pediatric patient is prescribed phenobarbital preoperatively to
relieve anxiety and produce sedation. After giving the injection, you
should assess the patient for
a. acute Stevens-Johnson syndrome.
b. bone marrow depression.
c. paradoxical excitement.
d. withdrawal syndrome.

Answer 338

c. paradoxical excitement.

Question 339

feeling that a person experiences when he or she responds
emotionally to the environment

Answer 339

affect:

Question 340

one of the neurotransmitters norepinephrine, serotonin,
or dopamine; it is thought that a deficiency of these substances in key
areas of the brain results in depression

Answer 340

biogenic amine:

Question 341

affective disorder in which a person experiences sadness that
is much more severe and longer lasting than is warranted by the event
that seems to have precipitated it, with a more intense mood

Answer 341

depression:

Question 342

drug that prevents the enzyme
monoamine oxidase from breaking down norepinephrine (NE),
serotonin (5HT), and dopamine (DA), leading to increased
neurotransmitter levels in the synaptic cleft; relieves depression and
also causes sympathomimetic effects

Answer 342

monoamine oxidase inhibitor (MAOI)

Question 343

drug that specifically
blocks the reuptake of serotonin and increases its concentration in the
synaptic cleft; relieves depression and is not associated with
anticholinergic or sympathomimetic adverse effects

Answer 343

selective serotonin reuptake inhibitor (SSRI)

Question 344

drug that increases both
serotonin and norepinephrine concentrations in synaptic cleft; relieves
depression with varying serotonergic or noradrenergic activity

Answer 344

serotonin norepinephrine inhibitors (SNRIs):

Question 345

drug that blocks the reuptake of
norepinephrine and serotonin; relieves depression and has
anticholinergic and sedative effects

Answer 345

tricyclic antidepressants (TCAs):

Question 346

an amine found in food that causes vasoconstriction and raises
blood pressure;

Answer 346

tyramine

Question 347

The biogenic amine theory of depression states that depression is a
result of
a. an unpleasant childhood.
b. gamma-aminobutyric acid (GABA) inhibition.
c. deficiency of NE, dopamine, or 5HT in key areas of the brain.
d. blockages within the limbic system, which controls emotions and
affect.

Answer 347

c. deficiency of NE, dopamine, or 5HT in key areas of the brain.

Question 348

When teaching a patient receiving TCAs, it is important to
remember that TCAs are associated with many anticholinergic
adverse effects. Teaching about these drugs should include
anticipation of
a. increased libido and increased appetite.
b. polyuria and polydipsia.
c. urinary retention, arrhythmias, and constipation.
d. hearing changes, cataracts, and nightmares.

Answer 348

c. urinary retention, arrhythmias, and constipation.

Question 349

Adverse effects may limit the usefulness of TCAs with some
patients. Nursing interventions that could alleviate some of the
unpleasant aspects of these adverse effects include
a. always administering the drug when the patient has an empty
stomach.
b. reminding the patient not to void before taking the drug.
c. increasing the dose to override the adverse effects.
d. taking the major portion of the dose at bedtime to avoid
experiencing drowsiness and the unpleasant anticholinergic
effects

Answer 349

d. taking the major portion of the dose at bedtime to avoid
experiencing drowsiness and the unpleasant anticholinergic
effects

Question 350

You might question an order for a MAOI as a first step in the
treatment of depression remembering that these drugs are reserved
for use in cases in which there has been no response to other agents
because MAOIs
a. can cause hair loss.
b. are associated with potentially serious drug–food interactions.
c. are mostly recommended for use in surgical patients.
d. are more expensive than other agents.

Answer 350

b. are associated with potentially serious drug–food interactions.

Question 351

Your patient is being treated for depression and is started on a
regimen of fluoxetine (Prozac). She calls you 10 days after the drug
therapy has started to report that nothing has changed and she wants
to try a different drug. You should
a. tell her to try sertraline (Zoloft) because some patients respond to
one SSRI and not another.
b. ask her to try a few days without the drug to see whether there is
any difference.
c. add an MAOI to her drug regimen to get an increased
antidepressant effect.
d. encourage her to keep taking the drug as prescribed because it
usually takes up to 4 weeks to see the full antidepressant effect.

Answer 351

d. encourage her to keep taking the drug as prescribed because it
usually takes up to 4 weeks to see the full antidepressant effect.

Question 352

Which of the following medications is NOT indicated for obsessive–
compulsive disorder, depression, and panic disorder?
a. citalopram (Celexa)
b. paroxetine (Paxil)
c. fluvoxamine (Luvox)
d. vortioxetine (Brintellix)

Answer 352

d. vortioxetine (Brintellix)

Question 353

Venlafaxine (Effexor) is an antidepressant that might be very
effective for use in patients who
a. are being treated effectively with a SSRI.
b. can tolerate multiple side effects.
c. are reliable at taking multiple daily dosings.
d. have not responded to other antidepressants and would benefit
from once-a-day dosing

Answer 353

d. have not responded to other antidepressants and would benefit
from once-a-day dosing

Question 354

Depression is an affective disorder that is
a. always precipitated by a specific event.
b. most common in patients with head injuries.
c. characterized by overwhelming sadness, despair, and
hopelessness.
d. very evident and easy to diagnose in the clinical setting.

Answer 354

c. characterized by overwhelming sadness, despair, and
hopelessness.