Marshalltown Community College - NURSING PNN101

Chapter 06: Antivirals and Antiretrovirals

MULTIPLE CHOICE

1)Which statement about antiviral drugs is true?

1. 1. Antiviral drugs kill viruses by altering viral DNA.
   2. Antiviral drugs work by stopping viral replication.
   3. Antiviral drugs alter the host immune system.
   4. Antiviral drugs are considered virucidal.

2. Which antiviral drug is only given by oral inhalation?
   1. Acyclovir (Zovirax)
   2. Zanamivir (Relenza)
   3. Oseltamivir (Tamiflu)
   4. Amantadine (Symmetrel)

3. Which antiviral drug is most likely to have more severe central nervous system side effects, including worsening of glaucoma?
   1. Acyclovir
   2. Amantadine
   3. Valacyclovir
   4. Zanamivir

4. A patient presents to the clinic with flu symptoms that began 3 days ago. The patient is wondering why the flu cannot be treated with an antiviral. What is your best response?
   1. “Antiviral drugs are not useful in combating influenza.”
   2. “Antiviral drugs are only used for prevention of influenza.”

1. 3. “Antiviral drugs can only be given to people who are immunocompromised.”
   4. “Antiviral drugs work best when given within 48 hours of the start of symptoms.”

5. A patient who is asymptomatic comes into the clinic complaining of being exposed to a coworker who has the flu. What drug would be most appropriate for this patient?
   1. Flumadine (rimantadine)
   2. Valtrex (valacyclovir)
   3. Crixivan (indinavir)
   4. Ziagen (abacavir)

6. Which drug is the only approved treatment for RSV?
   1. Ribavirin (Virazole)
   2. Cidofovir (Vistide)
   3. Foscarnet (Foscavir)
   4. Lamivudine (Epivir)
7. A 2-year-old patient with respiratory syncytial virus is prescribed aerosolized ribavirin (Virazole). Which visitor should you ensure is not in the patient’s room during the aerosol treatments?
   1. 16-year-old brother
   2. 81-year-old grandmother
   3. 32-year-old pregnant mother
   4. 36-year-old father who has diabetes

8. The oral antiviral drug acyclovir (Zovirax) has been ordered for a patient with genital herpes. What is your best action before giving this drug?
   1. Ask the patient if he/she is allergic to milk.
   2. Wear a gown, mask, and gloves to give this drug.
   3. Assess the patient for the presence of irregular pulse.
   4. Inform the patient that this drug can cause excessive thirst.

9. Which of the following is a sign or symptom of an allergic or anaphylactic response to an antiviral drug?
   1. Nausea
   2. Insomnia
   3. Intolerance to fatty foods
   4. Swelling of the face or throat

10. You are giving a patient who has hepatitis B an oral dose of the antiviral drug adefovir (Hepsera). What assessment should you perform before giving this drug to the patient?
    1. Assess the respiratory rate and pulse.
    2. Assess for signs of abnormal bleeding.
    3. Assess for yellowing of the skin and sclera.
    4. Assess for signs of lower extremity edema.

11. In what way does a retrovirus differ from other common viruses?
    1. Retroviruses lack specialized enzymes.
    2. Retroviruses use DNA instead of RNA in their genes.
    3. Retroviruses cannot leave the cell to infect new cells.
    4. Retroviruses transmit their own information into the cell’s DNA.

12. Which statement when made by a human immunodeficiency virus (HIV positive patient informs you that the patient needs additional teaching?
    1. “I may be more susceptible to opportunistic infections.”
    2. “By taking the antiretrovirals over time, I will be cured of HIV.”
    3. “I understand that I may take several different drugs for my HIV.”
    4. “Antiretrovirals interfere with the ability of the retrovirus to reproduce.”

13. Which drug classification works to limit the progression of human immunodeficiency virus (HIV)?
    1. Antiretrovirals
    2. Antivirals
    3. Antibiotics
    4. Antifungals

14. A patient diagnosed with human immunodeficiency virus (HIV) asks you about opportunistic infections. What is your best response?
    1. “This infection is a toxic effect of the virus.”
    2. “This infection is from drug-related toxicities.”
    3. “This infection is a first-generation metabolic infection.”
    4. “This infection is from damage to the body’s immune system.”

15. How do protease inhibitor (PI) drugs prevent viral replication?
    1. They are counterfeit bases that prevent reverse transcriptase from synthesizing the DNA needed for viral replication.

1. 2. They inactivate the enzyme that allows the viral genetic material to be integrated into the human host’s cellular DNA.
   3. They prevent the production of proteins needed for viral particles to leave the cell

and infect other cells.

1. 4. They prevent initial infection by blocking the receptor the virus uses to enter target cells.

16. You are teaching a patient about the action of a newly prescribed antiretroviral drug. Which statement explains the action of antiretrovirals?
    1. “These drugs act by boosting the body’s T-cell production.”
    2. “These drugs act by interfering with replication of the retrovirus.”
    3. “These drugs act by using the DNA of the host cell kill the virus.”
    4. “These drugs act by producing artificially acquired active immunity.”

17. A patient beginning antiretroviral therapy for HIV infection asks you why it is important to report all other drugs that the patient is taking. What is your best response?
    1. “The antiretroviral and other drugs must be taken together.”
    2. “The antiretroviral and other drugs must be taken with milk.”
    3. “The antiretroviral should be taken with water 30 min before eating.”
    4. “The antiretroviral should be taken alone and not with other drugs.”

18. A female with human immunodeficiency virus (HIV) who is taking a combination of a nucleoside reverse transcriptase inhibitor, nonnucleoside reverse transcriptase inhibitor, and protease inhibitor tells you she is now pregnant. What advice regarding her drug therapy would be appropriate?
    1. “Keep taking the drug regimen exactly as ordered throughout your pregnancy.”
    2. “Stop the drug regimen during the first trimester, as this is when the fetus forms.”
    3. “This drug regimen is only given the last trimester to protect the baby during birth.”
    4. “Keep taking the drug regimen as prescribed until delavirdine or efavirenz is added.”

19. You suspect that a patient on antiretroviral therapy may have drug-related toxicity. Which of the following laboratory tests would alert you to a drug toxicity?
    1. Elevated glucose level
    2. Decreased hemoglobin
    3. Elevated liver enzymes
    4. Decreased amylase and lipase

20. A patient taking cART therapy for human immunodeficiency virus (HIV) infection develops severe upper abdominal pain that radiates to the back. What complication of this therapy may this patient be experiencing?
    1. Pancreatitis
    2. Kidney failure
    3. Vertebral fracture
    4. Acute gallbladder infection

21. A patient with human immunodeficiency virus (HIV) infection tells you that she has been only partially compliant with cART drugs because she is tired of taking so many pills. What is your best response?
    1. “I will let your healthcare provider know so your regimen can be changed.”
    2. “You need only take the drug regimen 50% of the time for it to be effective.”
    3. “You can stop the drugs for a short 2-week “drug holiday” then resume them.”
    4. “You should always take your drug therapy as prescribed or it may not be effective.”

22. A patient who has been taking subcutaneous enfuvirtide (Fuzeon) for 6 months reports reduced sensation in the fingers and toes. What is your best action?
    1. Document the report as the only action.
    2. Hold the dose and notify the prescriber.
    3. Remind the patient to take a multiple vitamin daily.
    4. Reassure the patient that this is an expected drug side effect.

23. You are teaching a patient who has been prescribed atazanavir (Reyataz) about this drug. What should be included in this patient’s teaching plan?
    1. “Take this drug only with fruit juice.”
    2. “Be sure to chew this drug thoroughly.”
    3. “Take your pulse daily before taking this drug.”
    4. “Change positions carefully as this drug can lower your blood pressure.”

24. A diabetic patient who is receiving treatment for HIV with raltegravir (Isentress) asks you how this drug may affect his diabetes. What is your best response?
    1. “This drug will not interact with your diabetic drugs.”
    2. “You will need to increase your carbohydrate intake while on this drug.”
    3. “Monitor your glucose levels, as this drug can increase blood glucose levels.”
    4. “Keep hard candy with you at all times, as this drug can cause hypoglycemia.”

25. A patient who has been taking efavirenz (Sustiva) reports a sore throat, fever, and blisters. What is your best action?
    1. Hold the dose and notify the prescriber.
    2. Document the report as the only action.
    3. Remind the patient that these are symptoms of opportunistic infection.
    4. Reassure the patient that these are common and expected side effects of the drug.

MULTIPLE RESPONSE

1. Which drug classes are used in the treatment of hepatitis B virus? (Select all that apply.)
   1. Interferon
   2. Uncoating inhibitors
   3. Neuraminidase inhibitors
   4. DNA polymerase inhibitors
   5. Nucleoside reverse transcriptase inhibitors
   6. Nonnucleoside reverse transcriptase inhibitors

2. A patient diagnosed with human immunodeficiency virus (HIV) infection taking antiretroviral therapy appears less depressed and more talkative. The patient tells you the drugs seem to be working, and she is certain she is now cured. What are your best responses? (Select all that apply.)
   1. “You started the drug early enough to be cured.”