NURS 498 MIDTERM 1 QUESTIONS AND ANSWERS | NURS 498
STUDY GUIDE & PRACTICE TEST 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? - correct answer ✔✔- 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? - correct answer ✔✔-
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? - correct answer ✔✔- 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? - correct answer ✔✔- 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? - correct
answer ✔✔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? - correct answer ✔✔- 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? -
correct answer ✔✔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? - correct
answer ✔✔- 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? - correct answer
✔✔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? - correct answer
✔✔Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because of platelet
inhibition and hypoprothrombinemia.
Corticosteroids have many actions. These include: - correct answer ✔✔- 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? - correct answer ✔✔Lethargy
Which of the following is not a conventional disease-modifying antirheumatic drug (DMARD)? - correct
answer ✔✔Peginterferon alfa-2a
Which antiretroviral medication is offered during pregnancy to an HIV-positive woman? - correct answer
✔✔Zidovudine (retrovir)
A person on immunosuppressant therapy has an increased risk for cancer? T/F - correct answer
✔✔TRUE
A patient with RA is taking cyclosporine. What treatment should we avoid? - correct answer ✔✔Varicella
zoster vaccine
Which of the following class of medications is not an antiretroviral used for HIV? - correct answer
✔✔Calcineurin
What baseline assessment is a top priority for a person starting immunosuppressant therapy? - correct
answer ✔✔TB test
Biological DMARDs include - correct answer ✔✔Monoclonal antibodies
STUDY GUIDE & PRACTICE TEST 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? - correct answer ✔✔- 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? - correct answer ✔✔-
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? - correct answer ✔✔- 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? - correct answer ✔✔- 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? - correct
answer ✔✔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? - correct answer ✔✔- 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? -
correct answer ✔✔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? - correct
answer ✔✔- 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? - correct answer
✔✔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? - correct answer
✔✔Anticoagulants taken with NSAIDs may cause increased bleeding tendencies because of platelet
inhibition and hypoprothrombinemia.
Corticosteroids have many actions. These include: - correct answer ✔✔- 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? - correct answer ✔✔Lethargy
Which of the following is not a conventional disease-modifying antirheumatic drug (DMARD)? - correct
answer ✔✔Peginterferon alfa-2a
Which antiretroviral medication is offered during pregnancy to an HIV-positive woman? - correct answer
✔✔Zidovudine (retrovir)
A person on immunosuppressant therapy has an increased risk for cancer? T/F - correct answer
✔✔TRUE
A patient with RA is taking cyclosporine. What treatment should we avoid? - correct answer ✔✔Varicella
zoster vaccine
Which of the following class of medications is not an antiretroviral used for HIV? - correct answer
✔✔Calcineurin
What baseline assessment is a top priority for a person starting immunosuppressant therapy? - correct
answer ✔✔TB test
Biological DMARDs include - correct answer ✔✔Monoclonal antibodies
