Deck 48: Immunosuppressant Drugs

Question 1

A patient is about to undergo a kidney transplant. She will be given an immunosuppressant drug before, during, and after surgery to minimize organ rejection. During the preoperative teaching session, which information will the nurse include about the medication therapy?

A) Several days before the surgery, the medication will be administered orally.
B) The oral doses need to be taken 1 hour before meals to maximize absorption.
C) Mix the oral liquid with juice in a disposable Styrofoam cup just before administration.
D) Intramuscular injections of the medication will be needed for several days preceding surgery.

Answer 1

Several days before the surgery, the medication will be administered orally.

Question 2

The nurse is monitoring a patient who is receiving muromonab-CD3 (Orthoclone OKT3) after an organ transplant. Which effect is possible with muromonab-CD3 therapy?

A) Chest pain
B) Hypotension
C) Confusion
D) Dysuria

Answer 2

Chest pain

Question 3

The nurse follows which procedures when giving intravenous (IV) cyclosporine?

A) Administering it as a single IV bolus injection to minimize adverse effects
B) Using an infusion pump to administer this medication
C) Monitoring the patient for potential delayed adverse effects, which may be severe
D) Monitoring the patient closely for the first 30 minutes for severe adverse effects
E) Checking blood levels periodically during cyclosporine therapy
F) Performing frequent oral care during therapy

Answer 3

Using an infusion pump to administer this medication
Monitoring the patient closely for the first 30 minutes for severe adverse effects
Checking blood levels periodically during cyclosporine therapy
Performing frequent oral care during therapy

Question 4

The nurse is preparing to administer an injection of monoclonal antibodies. Which additional drug will the nurse administer to minimize adverse reactions to the monoclonal antibodies?

A) A nonsteroidal anti-inflammatory drug
B) A benzodiazepine
C) An opioid pain reliever
D) A corticosteroid

Question 5

Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect?

A) Nausea and vomiting
B) Fever and tremors
C) Agitation
D) Hypertension

Question 6

A patient who has had a recent organ transplant is taking sirolimus as part of the immunosuppressant therapy. Today, the patient realized that a dose was missed, and it is now time for the next dose. Which action is appropriate?

A) Just take the dose that is now due, not both doses.
B) Take the missed dose of sirolimus along with the next dose that is due.
C) Take half of the missed dose along with the current dose that is due.
D) Contact the transplant physician for instructions.

Question 7

A patient will be on a tacrolimus (Prograf) infusion after receiving a liver transplant. The order reads, "Give 0.03 mg/kg/day as a continuous IV infusion." The patient weighs 159 pounds, and the medication injection solution is available in a 5-mg/mL strength. Identify how many milliliters will the nurse draw up for this infusion. (record answer using two decimal places) _______

Question 8

A patient with multiple sclerosis will be starting therapy with an immunosuppressant drug. The nurse expects that which drug will be used?

A) Azathioprine (Imuran)
B) Glatiramer acetate (Copaxone)
C) Daclizumab (Zenapax)
D) Sirolimus (Rapamune)

Question 9

A patient must be treated immediately for acute organ transplant rejection. The nurse anticipates that muromonab-CD3 (Orthoclone OKT3) will be ordered. What is the priority assessment before beginning drug therapy with muromonab-CD3?

A) Serum potassium level
B) Fluid volume status
C) Electrocardiogram
D) Blood glucose level

Question 10

A patient has an order for cyclosporine (Sandimmune). The nurse finds that cyclosporine-modified product (Neoral) is available in the automated medication cabinet. Which action by the nurse is correct?

A) Hold the dose until the prescriber makes rounds.
B) Give the cyclosporine-modified drug.
C) Double-check the order, and then give the cyclosporine-modified drug.
D) Notify the pharmacy to obtain the Sandimmune form of the drug.

Question 11

When monitoring a patient who is on immunosuppressant therapy with azathioprine (Imuran), the nurse will monitor which laboratory results?

A) Serum potassium levels
B) White blood cell (leukocyte) count
C) Red blood cell count
D) Serum albumin levels

Question 12

When administering cyclosporine, the nurse notes that allopurinol is also ordered for the patient. What is a potential result of this drug interaction?

A) Reduced adverse effects of the cyclosporine
B) Increased levels of cyclosporine and toxicity
C) Reduced uric acid levels
D) Reduced nephrotoxic effects of cyclosporine

Question 13

A patient has started azathioprine (Imuran) therapy as part of renal transplant surgery. The nurse will monitor for which expected adverse effect of azathioprine therapy?

A) Tremors
B) Leukopenia
C) Diarrhea
D) Thrombocytopenia
E) Hepatotoxicity
F) Fluid retention