NURS 498 Midterm 1 Exam Questions with Verified Solutions Latest Update 2026/2027
A patient with active HIV has been taking zidovudine (Retrovir®). Which potential adverse effect
may limit the length of time this medication can be taken? - Answers - Bone marrow
suppression.
- The major dose-limiting adverse effect of zidovudine is bone marrow suppression, and this is
often the reason a patient with an HIV infection must be switched to another anti-HIV
medication.
A patient has used buffered acetylsalicylic acid (Aspirin) for several years as a treatment for
osteoarthritis. However, the patient's symptoms are worsening, and now something stronger is
needed. The physician prescribes an NSAID and misoprostol. The patient asks the nurse why
two pills now have to be taken for arthritis. Which is the nurse's best response to the patient? -
Answers - Misoprostol may help to prevent gastric ulcers that may occur when taking NSAIDs.
- Misoprostol inhibits gastric acid secretions and stimulates mucous secretions and has proved
successful in preventing gastric ulcers that may occur in patients taking NSAIDs.
A patient with acquired immune deficiency syndrome (AIDS) has been taking zidovudine (AZT)
therapy for almost 1 year. The physician has decided to change the medication to a new ART
called didanosine (Videx EC®). The patient is very concerned about this medication change.
What is the nurse's best explanation to the patient? - Answers - The patient may have been
experiencing bone marrow suppression due to the zidovudine therapy. - Bone marrow
suppression is often the reason why a patient with a human immunodeficiency virus (HIV)
infection needs to be switched to another anti-HIV drug, such as didanosine. Zidovudine and
didanosine can be taken together by cutting back on the doses of both, thus decreasing the
likelihood of toxicity.
The nurse is teaching a client about immunosuppressant therapy after a kidney transplant about
the post-transplant drug regimen. Which of the following statements by the client should alert
the nurse that additional teaching is required? - Answers - After a couple of years, it is likely that
I will be able to stop taking the calcineurin inhibitor.
- The calcineurin inhibitor will need to be continued for life. The other client statements are
accurate and indicate that no further teaching is necessary about those topics.
Which potential problem is of most concern for a patient receiving immunosuppressant drugs? -
Answers Increased susceptibility to infections
Neurotoxicity and confusion may be a problem with some immunosuppressants but a
heightened susceptibility to opportunistic infections is a major risk factor for
immunosuppressed patients.
When providing patient education related to immunosuppressive therapy, which items of
, information will the nurse include? - Answers - It is important to have a 1-week supply of
medication.
- Tell the patient about the complexity of dosing and about the need to always have a 1-week
supply of medication available so that there is never a risk of running out. If a dose is missed,
the patient is to contact the health care provider. The medication cannot be taken with
grapefruit juice. Pills in blister packs normally have a characteristic odour.
A female patient has started azathioprine (Imuran®) therapy in preparation for her kidney
transplant surgery. Which expected adverse effect of azathioprine therapy should the nurse tell
the patient about? - Answers Leukopenia. Leukopenia is an expected adverse effect of
azathioprine therapy.
Before administering methotrexate to a patient, what is most important for the nurse to assess?
- Answers - Latent tuberculosis
- Before administering a DMARD, it is important for the nurse to assess the patient for
contraindications to the use of DMARDs, such as active bacterial infections, active herpes,
active or latent tuberculosis, and acute or chronic hepatitis B or C.
A 75-year-old female patient has been given naproxen sodium (Aleve®) for the treatment of
rheumatoid arthritis. Which type of medication will have a possible interaction with this NSAID? -
Answers Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because
of platelet inhibition and hypoprothrombinemia.
A 75-year-old female patient has been given naproxen sodium (Aleve®) for the treatment of
rheumatoid arthritis. Which type of medication will have a possible interaction with this NSAID? -
Answers Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because
of platelet inhibition and hypoprothrombinemia.
Corticosteroids have many actions. These include: - Answers - Reduces the release of
interleukin-1
- Promotes the production of glycogen in the liver
- Promote the redistribution of fat
- Decreases migration of WBCs
Corticosteroids can cause many adverse effects except which one? - Answers Lethargy
Which of the following is not a conventional disease-modifying antirheumatic drug (DMARD)? -
Answers Peginterferon alfa-2a
Which antiretroviral medication is offered during pregnancy to an HIV-positive woman? -
Answers Zidovudine (retrovir)
A patient with active HIV has been taking zidovudine (Retrovir®). Which potential adverse effect
may limit the length of time this medication can be taken? - Answers - Bone marrow
suppression.
- The major dose-limiting adverse effect of zidovudine is bone marrow suppression, and this is
often the reason a patient with an HIV infection must be switched to another anti-HIV
medication.
A patient has used buffered acetylsalicylic acid (Aspirin) for several years as a treatment for
osteoarthritis. However, the patient's symptoms are worsening, and now something stronger is
needed. The physician prescribes an NSAID and misoprostol. The patient asks the nurse why
two pills now have to be taken for arthritis. Which is the nurse's best response to the patient? -
Answers - Misoprostol may help to prevent gastric ulcers that may occur when taking NSAIDs.
- Misoprostol inhibits gastric acid secretions and stimulates mucous secretions and has proved
successful in preventing gastric ulcers that may occur in patients taking NSAIDs.
A patient with acquired immune deficiency syndrome (AIDS) has been taking zidovudine (AZT)
therapy for almost 1 year. The physician has decided to change the medication to a new ART
called didanosine (Videx EC®). The patient is very concerned about this medication change.
What is the nurse's best explanation to the patient? - Answers - The patient may have been
experiencing bone marrow suppression due to the zidovudine therapy. - Bone marrow
suppression is often the reason why a patient with a human immunodeficiency virus (HIV)
infection needs to be switched to another anti-HIV drug, such as didanosine. Zidovudine and
didanosine can be taken together by cutting back on the doses of both, thus decreasing the
likelihood of toxicity.
The nurse is teaching a client about immunosuppressant therapy after a kidney transplant about
the post-transplant drug regimen. Which of the following statements by the client should alert
the nurse that additional teaching is required? - Answers - After a couple of years, it is likely that
I will be able to stop taking the calcineurin inhibitor.
- The calcineurin inhibitor will need to be continued for life. The other client statements are
accurate and indicate that no further teaching is necessary about those topics.
Which potential problem is of most concern for a patient receiving immunosuppressant drugs? -
Answers Increased susceptibility to infections
Neurotoxicity and confusion may be a problem with some immunosuppressants but a
heightened susceptibility to opportunistic infections is a major risk factor for
immunosuppressed patients.
When providing patient education related to immunosuppressive therapy, which items of
, information will the nurse include? - Answers - It is important to have a 1-week supply of
medication.
- Tell the patient about the complexity of dosing and about the need to always have a 1-week
supply of medication available so that there is never a risk of running out. If a dose is missed,
the patient is to contact the health care provider. The medication cannot be taken with
grapefruit juice. Pills in blister packs normally have a characteristic odour.
A female patient has started azathioprine (Imuran®) therapy in preparation for her kidney
transplant surgery. Which expected adverse effect of azathioprine therapy should the nurse tell
the patient about? - Answers Leukopenia. Leukopenia is an expected adverse effect of
azathioprine therapy.
Before administering methotrexate to a patient, what is most important for the nurse to assess?
- Answers - Latent tuberculosis
- Before administering a DMARD, it is important for the nurse to assess the patient for
contraindications to the use of DMARDs, such as active bacterial infections, active herpes,
active or latent tuberculosis, and acute or chronic hepatitis B or C.
A 75-year-old female patient has been given naproxen sodium (Aleve®) for the treatment of
rheumatoid arthritis. Which type of medication will have a possible interaction with this NSAID? -
Answers Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because
of platelet inhibition and hypoprothrombinemia.
A 75-year-old female patient has been given naproxen sodium (Aleve®) for the treatment of
rheumatoid arthritis. Which type of medication will have a possible interaction with this NSAID? -
Answers Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because
of platelet inhibition and hypoprothrombinemia.
Corticosteroids have many actions. These include: - Answers - Reduces the release of
interleukin-1
- Promotes the production of glycogen in the liver
- Promote the redistribution of fat
- Decreases migration of WBCs
Corticosteroids can cause many adverse effects except which one? - Answers Lethargy
Which of the following is not a conventional disease-modifying antirheumatic drug (DMARD)? -
Answers Peginterferon alfa-2a
Which antiretroviral medication is offered during pregnancy to an HIV-positive woman? -
Answers Zidovudine (retrovir)
