Deck 42: Immunostimulants and Immunosuppressants

Question 1

The nursing student correctly identifies what advantage of cyclosporine for the prevention of allograft rejection?

A)Increases white blood cell count
B)Can be administered subcutaneously
C)Decreases the risk of infection
D)Is less harmful to bone marrow

Answer 1

Is less harmful to bone marrow

Question 2

Adding polyethylene glycol (PEG)to an interferon has which pharmacologic effect on the interferon?

A)Increased protein binding
B)Increased drug half-life
C)Decreased cellular permeability
D)Decreased first-pass effect

Answer 2

Increased drug half-life

Question 3

The nurse demonstrates understanding of the appropriate use of immunostimulant therapy by anticipating its use in the client with which disorder?

A)Exophthalmus
B)Gout
C)Cancer
D)Rheumatoid arthritis

Answer 3

Cancer

Question 4

The nurse is explaining to a nursing student that allograft transplant clients need some form of immunosuppressant therapy.Which statement describes the pathophysiological reasoning behind this?

A)The treatment is indicated only if signs of transplant rejection are present.
B)The treatment is a precaution; rejection in allografts seldom occurs.
C)The treatment is designed to target chronic rejection,which does not occur for several weeks.
D)Despite accurate tissue matching,allografts contain antigens that trigger the client's immune response.

Question 5

What is the primary advantage of using monoclonal antibodies (MABs)rather than polyclonal antibodies?

A)Oral administration
B)Single dosing
C)Broad-spectrum use
D)Fewer side effects

Question 6

The cells of the immune system secrete substances that mediate the immune response that are called:

A)antigens.
B)masts.
C)cytokines.
D)antibodies.

Question 7

A single infusion of antithymocyte globulin can reduce the lymphocyte by:

A)85-90%.
B)60-70%.
C)40-50%.
D)50-60%.

Question 8

Concurrent use of azathioprine and an ACE inhibitor could result in which adverse effect?

A)Flulike symptoms
B)Hypercholesteremia
C)Hematuria
D)Anemia and leukopenia

Question 9

What is the expected outcome for the client receiving filgrastim (Neupogen)?

A)Increased white cell count
B)Reduction in tumor size
C)Reduction in paresthesia
D)Increased platelet count

Question 10

Which nursing intervention would help minimize side effects in a client receiving antithymocyte (Atgam)therapy?

A)Administering acetaminophen
B)Providing cough syrup
C)Limiting visitors
D)Limiting fluid intake

Question 11

A client is beginning aldesleukin (Proleukin)therapy for advanced renal carcinoma.The nurse should monitor the client for:

A)capillary leak syndrome.
B)hypertension.
C)hyperglycemia.
D)hyperuricemia.

Question 12

The nurse is establishing outcomes for a client with rheumatoid arthritis.What would be an appropriate outcome following three days of immunosuppressant therapy?

A)Decreased serum calcium
B)Reduced joint inflammation
C)Increased erythrocyte sedimentation rate
D)Increased white cell count

Question 13

The nurse preparing to administer the initial dose of an immunosuppressant agent for a client recovering from organ transplantation would make certain that screening has been performed to rule out:

A)electrolyte imbalance.
B)cardiomegaly.
C)anemia.
D)infectious processes.

Question 14

An advantage of the use of monoclonal antibodies over polyclonal antibodies is that monoclonal antibodies:
Select all that apply.

A)can be administered in the presence of fever.
B)have fewer side effects.
C)are administered by intramuscular administration.
D)are administered in a single dose.
E)can be administered in smaller doses.

Question 15

Which interferons have the greatest clinical utility?

A)Gamma interferons
B)Alpha interferons
C)Beta interferons
D)Mu interferons

Question 16

The nurse would recognize that additional teaching is necessary if the nurse finds the client taking cyclosporine while:

A)drinking milk.
B)eating fish.
C)drinking grapefruit juice.
D)eating leafy green vegetables.

Question 17

A nurse caring for a client who has been on cyclosporine for six months following a renal allograft reviews the laboratory data and notes that the blood urea nitrogen and serum creatinine have shown a consistent elevation in the last two weeks.The nurse would correctly identify these findings as indicating which problem?

A)Metabolic acidosis
B)Metastatic carcinoma
C)An anaphylactic reaction
D)Cyclosporine side effects

Question 18

Cyclosporine (Sandimmune)and tacrolimus (Prograf)represent which category of immunosuppressants?

A)Calcineurin inhibitors
B)Glucocorticoids
C)Antimetabolites
D)Antibodies

Question 19

The nurse demonstrates understanding of the appropriate use of immunosuppressant therapy by anticipating its use in the client with which disorder?

A)Gout
B)Exophthalmus
C)Rheumatoid arthritis
D)Cancer

Question 20

The nurse is teaching a course in pathophysiology.The students understood the material correctly if they identify which options as properties of interferons?
Select all that apply.

A)Antifungal
B)Antiviral
C)Anti-inflammatory
D)Antineoplastic
E)Antibiotic

Question 21

A client is scheduled for kidney transplantation using an allograft.Which instruction should the nurse provide?
Select all that apply.

A)You will be monitored for acute rejection for the first 48 hours."
B)If your system has not rejected the kidney within 2 weeks of surgery,you will be out of danger."
C)You will take antirejection medication for at least several months after surgery."
D)You are in danger of developing chronic rejection for years after your surgery."
E)Rejection usually occurs immediately after surgery,generally before the client gets out of the recovery room."

Question 22

Methylprednisolone is added to a client's chemotherapeutic regimen.Which effects would the nurse expect if the drug is taken long term?
Select all that apply.

A)Hyperglycemia
B)Fluid retention
C)Hypotension
D)Osteoporosis
E)Mental status changes

Question 23

A 45-year-old woman has a primary brain tumor that has been refractory to treatment.Her health care providers have decided to prescribe thalidomide (Thalomid).What should the nurse teach the client about this drug?
Select all that apply.

A)A negative pregnancy test will be required before treatment is started.
B)There is a risk of clotting disorders with this drug.
C)The drug is available only in a limited number of pharmacies.
D)Irreversible graying of the skin may occur when taking this drug.
E)The drug must be handled only by the person taking it.

Question 24

A client reports taking corticosteroid therapy for the last 6 months to treat reactive airway disease.The client says,My doctor wouldn't refill my prescription so I went to a different doctor and just didn't say anything about taking corticosteroids." The nurse would pay particular attention to which assessment in this client?
Select all that apply.

A)Blood pressure
B)Weight
C)Visual acuity
D)Heart rhythm
E)Pedal pulses

Question 25

A client's medical history reveals vaccination with bacillus Calmette-Guérin (BCG)vaccine.The nurse is aware that this client has possibly had which condition?
Select all that apply.

A)Exposure to tuberculosis
B)Cervical cancer
C)Bladder cancer
D)Active tuberculosis
E)Hashimoto's thyroiditis

Question 26

A young woman who has been taking immunosuppressant therapy says,I'll be glad to be off these drugs.My husband and I would like to start a family." How should the nurse respond?
Select all that apply.

A)Be sure to wait until you are off the medication to stop using birth control."
B)Don't plan on breast-feeding,because use of this drug makes your success unlikely."
C)You should wait at least 4 months after taking this medication before you try to get pregnant."
D)You may not be able to get pregnant after taking this medication."
E)You may wish to consider adoption because taking this medication raises the risk of having a baby with congenital defects."

Question 27

A client has been prescribed immunosuppressant medication.Which nursing diagnoses would the nurse include in this client's care plan?
Select all that apply.

A)Social Isolation
B)Infection,Risk for
C)Nutrition,Imbalanced: Less than Body Requirements
D)Gas Exchange,Impaired
E)Caregiver Role Strain

Question 28

A client will be taking interferon alfa-2b (Intron A)as treatment for hairy cell leukemia.The nurse advises this client about which common adverse effects?
Select all that apply.

A)Nausea
B)Fever
C)Dizziness
D)Headache
E)Rash