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Text Mode – Text version of the exam 1. An HIV-positive client who has been started on highly active antiretroviral therapy (HAART) came back for a follow-up checkup. Which of the following will be the most helpful in determining the response to the therapy? 2. A client with acquired immunodeficiency syndrome is prescribed with Zidovudine (Azidothymidine). Which of the following laboratory results should the nurse monitor while on this medication? 3. The client who is human immunodeficiency virus seropositive has been taking Saquinavir (Invirase). The nurse provides medication instructions and advises the client to: 4. Stavudine (Zerit) is prescribed to a client with human immunodeficiency virus seropositive. The nurse observes which of the following most closely while the client is taking the medication? 5. A nurse is evaluating a client who is HIV positive who is prescribed with Pentamidine (Pentam) IV for the treatment of Pneumocystis carinii pneumonia. Which of the following assessment after the administration is the most important to relay to the physician? 6. A client is prescribed with Pentamidine (Pentam) IV for the treatment of Pneumocystis carinii pneumonia. Suddenly, the client develops a temperature of 101.5°F. The nurse in charge knows that this sign would mostly indicate on which of the following? 7. While on Pentamidine (Pentam) infusion therapy. The nurse must anticipate doing which of the following? 8. The nurse is monitoring a post-renal transplantation client taking Cyclosporine (Neoral). The nurse observes an elevation in one of the client’s vital sign and the client is complaining of sweating and headache. Which of the following vital sign is most likely increased? 9. A nurse is doing an assessment data while completing an admission for a patient with a history of liver transplant who is receiving cyclosporine (Sandimmune), Prednisone (Orasone), and Azathioprine (Imuran). Which of the following information will give the nurse the most attention? 10. A client is admitted to the emergency room complaints of a difficulty of breathing and upon auscultation, the nurse noted that the patient has wheezes. An allergic reaction to penicillin was diagnosed. Which of the following medications should the nurse expect to administer first? 11. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet (Foscavir). The nurse carefully monitors which of the following laboratory test during the treatment with this medication, except? 12. A client is recently diagnosed with HIV and a highly antiretroviral therapy is started. After the first week of therapy, the patient complains of headaches, dizziness, and nightmares. Which one of the following anti-retroviral drugs is most likely associated with these symptoms? 13. Sirolimus (Rapamune) is prescribed to a post-renal transplantation client. Upon the review of the chart, the nurse expects which of the following laboratory results? 14. A post-kidney transplant client went to the health care facility to ask the nurse regarding vaccinations while on Tacrolimus (Prograf) a medication used to prevent organ rejection. Which of the following is an appropriate response of the nurse? 15. A nurse is giving instructions to a client who is receiving Mycophenolate mofetil (CellCept) and Mycophenolic acid (Myfortic) after undergoing a heart transplant. The nurse tells the client to anticipate the following side effects, except? 16. Amikacin (Amikin) is given to a client with E-coli infection. The nurse advises the client to report which of the following symptoms immediately? 17. A client went to the emergency room with complaints of abdominal pain, nausea, diarrhea and mucoid stools. Upon the interview of the nurse, the client stated that he is taking Cefixime (Suprax) for the treatment of urinary tract infection. The nurse determines that the client is most likely suffering from? 18. Amphotericin B (Fungizone) IV is given to a client with aspergillosis, a fungal infection. In order to prevent its side effects, the nurse anticipate administering which of the following prior, except? 19. A nurse is giving instructions to a client taking Ciprofloxacin (Cipro) for the treatment of gonorrhea. The nurse tells the client to? 20. Tetracycline has been prescribed for a client with Chlamydia trachomatis infection. Select the side effect of the medication. Select all that apply? 1. Answer: C. Viral load test. A viral load test helps provide information on the health status and how well antiretroviral therapy (ART – treatment with HIV medicines) is controlling the virus. 2. Answer: B. Complete blood count. Zidovudine may decrease the number of a certain type of white blood cell in the blood and cause anemia and muscle disorders. 3. Answer: D. Avoid being exposed to sunlight. Saquinavir (Invirase) is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in the body. This can cause photosensitivity so the nurse should instruct the client to avoid sun exposure. 4. Answer: D. Gait. One of the most serious side effects of Stavudine (Zerit) is peripheral neuropathy so the nurse should monitor the client’s gait while taking this medication. 5. Answer: C. Sudden sweating and hunger. Pentamidine can cause fatal hypoglycemia, so symptoms such as sudden sweating and hunger are indicative of a low blood sugar indicates a need for change in the treatment. 6. Answer: C. The client has developed another infection. Pentamidine can cause low white blood cells or low platelets in your blood, so the client is most likely developed another infection brought about these side effects. 7. Answer: A. Do a 12-lead ECG. Pentamidine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need an urgent medical attention. 8. Answer: D. Blood pressure. Hypertension is one of the side effects of taking cyclosporine (Neoral) and since the client is also complaining of sweating and headache, the blood pressure is the important sign to be monitored closely. 9. Answer: A. The client has a soft non-tender lump in the shoulder. A client taking immunosuppressive medications are at risk for development of cancer. A soft non-tender lump will indicate that the patient has lymphoma. 10. Answer: B. Albuterol (Ventolin HFA). Albuterol (Ventolin HFA) is the most rapidly acting of the medications among the choices. 11. Answer: D. Serum sodium. Renal impairment is the major toxicity involve in Foscarnet (Foscavir); This medicine also may cause decreased levels of calcium, magnesium, phosphorous, and potassium. 12. Answer: B. Efavirenz. Efavirenz is a non-nucleoside reverse transcriptase inhibitor. Side effects include rash, dizziness, confusion, headache, and nightmares. 13. Answer: D. Elevated triglyceride level. Sirolimus (Rapamune) raises cholesterol and triglyceride levels. This medication also causes a decrease in potassium and platelet count. 14. Answer: D. “Do not receive any live vaccinations while on this treatment”. Tacrolimus may lower your body’s resistance and the vaccine may not work as well or the client may get the infection the vaccine is meant to prevent. 15. Answer: A. Insomnia. These medications can cause diarrhea, vomiting, sepsis, back pain, neutropenia and hypertension. 16. Answer: D. Hearing loss. Amikacin is an aminoglycoside. Side effects of this medication includes ototoxicity (Hearing loss), confusion, disorientation, gastrointestinal irritation, palpitations, blood pressure changes and nephrotoxicity. 17. Answer: D. Pseudomembranous colitis. Pseudomembranous colitis also called antibiotic-associated colitis or C. difficile colitis, is the inflammation of the colon associated with an overgrowth of the bacterium Clostridium difficile. This overgrowth of C. difficile is most often related to recent antibiotic use such as ampicillin, clindamycin, fluoroquinolones, and cephalosporins. 18. Answer: B. Ketoconazole. Azole antifungals (eg, ketoconazole) decreases the effectiveness of amphotericin b. 19. Answer: A. Report any history of tendon problems. Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles’ tendon of the heel. This can happen during treatment or up to several months after the client stop taking ciprofloxacin 20. Answer: A. Glossitis., D. Discoloration of the nails., E. Photosensitivity. Side effects of tetracycline include glossitis, discoloration of the nails, photosensitivity, anorexia, nausea, vomiting, diarrhea, bulky loose stools, stomatitis, sore throat, black hairy tongue,dysphagia,and hoarseness.Practice Mode
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NCLEX Practice Exam for Pharmacology: Immunologic Medications
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