HIV & Med Calc
A nurse is teaching a patient newly diagnosed with HIV about modes of transmission. Which statement by the patient indicates a need for further teaching?
A. “I can get HIV from sharing a razor with someone who has it.”
B. “HIV can be transmitted through hugging someone with HIV.”
C. “HIV can be spread through breast milk.”
D. “HIV can be passed from mother to baby during delivery.”
Answer: B. “HIV can be transmitted through hugging someone with HIV.”
Rationale: HIV is not spread by casual contact such as hugging. It is transmitted through blood, sexual fluids, and breast milk. Sharing razors and mother-to-child during birth are valid routes.
A nurse is educating a patient about the purpose of combination chemotherapy. Which statement by the patient indicates a correct understanding?
A. “It increases the effectiveness of treatment by attacking cancer cells in different ways.”
B. “It allows me to take fewer medications overall.”
C. “It reduces the chance I’ll lose my hair.”
D. “It decreases the need for hydration therapy.”
Answer: A. “It increases the effectiveness of treatment by attacking cancer cells in different ways.”
Rationale: Combination chemotherapy enhances tumoricidal activity, targets cells in different cell cycle phases, and reduces resistance.
A nurse is caring for a patient experiencing a pain level of 8/10 after abdominal surgery. Which medication would be most appropriate to administer?
A. Acetaminophen
B. Ibuprofen
C. Morphine
D. Aspirin
Answer: C. Morphine
Rationale: Opioid analgesics like morphine are used for moderate to severe pain (6–10). Acetaminophen and NSAIDs are indicated for mild to moderate pain.
The nurse is teaching a patient on allopurinol. Which instruction is most important to include?
A. “Take this medication only when you experience joint pain.”
B. “You should avoid high-fat foods while on this drug.”
C. “Be sure to have a yearly eye exam.”
D. “Discontinue if you develop dry skin.”
Answer: C. “Be sure to have a yearly eye exam.”
Rationale: Visual changes can occur with long-term allopurinol use. Patients should have annual eye exams to monitor for complications.
A nurse is monitoring a patient on clozapine for schizophrenia. Which assessment finding is the highest priority to report?
A. Dry mouth and sedation
B. Tremors and constipation
C. Blurred vision and tachycardia
D. Sore throat and fever
Answer: D. Sore throat and fever
Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBCs. Sore throat and fever indicate potential infection and must be reported immediately.
Order: Medication F 75mcg I.V. push once STAT.
Available: 100mcg/2mL
Round to the nearest tenth.
1.5 mL
A patient receiving high-dose cyclophosphamide reports pink-tinged urine and abdominal pain. What is the nurse’s priority intervention?
A. Encourage fluid intake to 3 liters per day
B. Administer antiemetic
C. Apply a heating pad to the abdomen
D. Document as an expected side effect
Answer: A. Encourage fluid intake to 3 liters per day
Rationale: Cyclophosphamide can cause hemorrhagic cystitis. Hydration is critical to flush the bladder and reduce toxicity.
A patient is taking aspirin daily for arthritis. Which of the following patient findings should be reported to the provider immediately?
A. Nausea
B. Tinnitus
C. Mild headache
D. Fatigue
Answer: B. Tinnitus
Rationale: Tinnitus is an early sign of aspirin toxicity. Aspirin toxicity is a serious adverse effect and requires prompt evaluation.
Which side effect is most associated with colchicine, used for gout?
A. Hypoglycemia
B. GI distress
C. Hearing loss
D. Rash
Answer: B. GI distress
Rationale: Gastrointestinal distress (e.g., nausea, vomiting, diarrhea) is the most common side effect of colchicine. It can be minimized by taking with food
A patient who recently started an SSRI reports agitation, tremors, muscle spasms, and confusion. What complication should the nurse suspect?
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. Serotonin syndrome
D. Lithium toxicity
Answer: C. Serotonin syndrome
Rationale: These are hallmark symptoms of serotonin syndrome, a life-threatening reaction caused by excess serotonin in the CNS.
A healthcare worker experiences a needlestick injury from a patient with HIV. Which action is most appropriate?
A. Wait for symptoms to appear before starting treatment
B. Monitor viral load weekly for the next month
C. Start post-exposure prophylaxis within 72 hours
D. Receive the HIV vaccine within 24 hours
Answer: C. Start post-exposure prophylaxis within 72 hours
Rationale: PEP should begin within 72 hours of possible HIV exposure and includes a 28-day regimen of 3 antiretroviral drugs. There is no HIV vaccine currently approved.
A nurse is preparing to administer doxorubicin to a patient. Which assessment is the highest priority prior to administration?
A. Skin turgor
B. Bowel sounds
C. Cardiac function and EKG
D. Neurological status
Answer: C. Cardiac function and EKG
Rationale: Doxorubicin is associated with cardiotoxicity and cardiomyopathy. Cardiac evaluation is required before starting and throughout treatment.
A parent asks how to assess pain in their 3-year-old child who is nonverbal. Which pain scale should the nurse recommend?
A. Numerical rating scale
B. Visual analog scale
C. FLACC scale
D. Faces pain scale
Answer: C. FLACC scale
Rationale: The FLACC scale is designed for infants and young children (up to age 7) who cannot self-report pain. It assesses Face, Legs, Activity, Cry, and Consolability.
A nurse is caring for a patient receiving Remicade (infliximab). Which finding requires immediate intervention?
A. Mild diarrhea
B. Flatulence
C. Rash and chills
D. Chest pain and hypotension
Answer: D. Chest pain and hypotension
Rationale: Chest pain and hypotension are serious adverse effects of Remicade, indicating a potential anaphylactic or cardiovascular reaction, and require urgent evaluation.
A patient taking lithium for bipolar disorder presents with confusion, slurred speech, tremors, and nausea. What is the nurse’s priority action?
A. Provide salt-free snacks
B. Encourage fluid intake
C. Check serum lithium level
D. Administer next dose with food
Answer: C. Check serum lithium level
Rationale: These are signs of early lithium toxicity (level >1.5 mEq/L). The nurse must assess the serum lithium level before taking further action.
Order: Medication G elixir, 250mg p.o. b.i.d.
Available: 500mg per 5mL. How many teaspoons should be given?
Round to the nearest tenth.
0.5 tsp
The nurse is caring for a patient on filgrastim (Neupogen). Which lab value indicates the desired therapeutic effect?
A. Hemoglobin of 14 g/dL
B. WBC count of 5,000/mm³
C. Platelet count of 120,000/mm³
D. Neutrophil count of 2,000/mm³
Answer: D. Neutrophil count of 2,000/mm³
Rationale: Filgrastim stimulates neutrophil production. A neutrophil count ≥2,000/mm³ reflects therapeutic success in neutropenic patients.
A nurse is administering IV hydromorphone (Dilaudid). Which action is most appropriate?
A. Push 2 mg rapidly over 10 seconds
B. Administer undiluted via IV push
C. Dilute with saline and administer slowly over 2 minutes
D. Administer sublingually for faster action
Answer: C. Dilute with saline and administer slowly over 2 minutes
Rationale: Hydromorphone should be diluted with saline and pushed slowly (2 mg over 2 minutes) to reduce risk of respiratory depression and hypotension.
A patient is receiving long-term prednisone therapy. Which of the following findings should be reported to the provider?
A. Sudden discontinuation of the drug
B. Fat redistribution and hyperglycemia
C. Insomnia and sweating
D. Increased appetite and mild flushing
Answer: A. Sudden discontinuation of the drug
Rationale: Abrupt withdrawal of corticosteroids like prednisone can cause adrenal insufficiency, which is life-threatening and must be avoided.
A nurse is caring for a patient taking an MAOI who suddenly develops a severe headache and elevated blood pressure after eating aged cheese and sausage. What is the nurse’s priority action?
A. Administer PRN acetaminophen
B. Give the next MAOI dose early
C. Notify the provider immediately
D. Encourage rest and fluid intake
Answer: C
Rationale: This patient is likely experiencing a hypertensive crisis due to a tyramine-food interaction, which is a known serious complication of MAOIs.
A patient is struggling to adhere to their antiretroviral regimen. Which strategy should the nurse implement first?
A. Refer the patient to a psychiatrist
B. Emphasize the risk of death due to non-adherence
C. Ask the patient about barriers to adherence and collaborate on solutions
D. Switch the patient to intravenous therapy
Answer: C. Ask the patient about barriers to adherence and collaborate on solutions
Rationale: The nurse should assess for barriers and work collaboratively to improve adherence. Strategies include medication maps, reminders, and building a therapeutic relationship. >95% adherence is critical.
A patient is prescribed epoetin for chemotherapy-induced anemia. Which action should the nurse take?
A. Expect thrombocytopenia as a common side effect
B. Shake the vial thoroughly before administration
C. Administer orally with food
D. Hold the dose if hemoglobin exceeds 11 g/dL
Answer: D. Hold the dose if hemoglobin exceeds 11 g/dL
Rationale: Epoetin can increase the risk of MI, stroke, and tumor progression. Therapy should be held if Hgb exceeds 11 g/dL to reduce these risks.
A patient who takes acetaminophen daily asks about safe dosing. Which response by the nurse is most appropriate?
A. “You can take up to 6 grams per day if needed.”
B. “You can safely take up to 4 grams per day.”
C. “Do not exceed 3 grams per week.”
D. “The max daily dose is 2 grams regardless of use.”
Answer: B. “You can safely take up to 4 grams per day.”
Rationale: The maximum safe daily dose of acetaminophen is 4 grams, but it is reduced to 2 grams/day for those taking it chronically or with liver concerns.
A patient taking celecoxib (Celebrex) reports a history of myocardial infarction and peptic ulcer disease. Which action should the nurse take?
A. Notify the healthcare provider immediately
B. Continue the medication as prescribed
C. Administer the drug with a full glass of milk
D. Educate the patient to avoid spicy foods
Answer: A. Notify the healthcare provider immediately
Rationale: Celecoxib has a black box warning for increased risk of cardiovascular thrombotic events and GI bleeding, especially in patients with a history of MI or peptic ulcers.
A nurse is educating a patient about benzodiazepine withdrawal. Which statement by the patient requires further teaching?
A. “I should not stop this medication suddenly.”
B. “I might feel shaky or anxious if I stop too quickly.”
C. “I should expect some mild cravings when I stop.”
D. “It’s okay to stop taking it once I feel better.”
Answer: D. “It’s okay to stop taking it once I feel better.”
Rationale: Benzodiazepines must be tapered gradually. Stopping abruptly can cause withdrawal symptoms like paranoia, delirium, and seizures.