Deck 11: Drugs That Affect the Immune System

Question 1

A 75-year-old patient tells you he is not planning to receive a "flu shot" this year because he had one just a year ago.What is your best response?

A) "Because you are older and your immune system is more fragile,you should have one this year too as a booster."
B) "The virus causing influenza often changes each year and a new influenza vaccination is needed every flu season."
C) "The "flu shot" you had last year should still protect you for seasonal influenza,but you still need a vaccination for H1N1."
D) "The fact that you have been vaccinated by injection just last year makes you a candidate to use the nasal vaccination this year."

Answer 1

"The virus causing influenza often changes each year and a new influenza vaccination is needed every flu season."

Question 2

Why can antibody-mediated immunity be transferred from one person to another person?

A) White blood cells from one person are recognized as "foreign" by another person and trigger an immunologic response.
B) When antibodies bind to antigens,the entire complex can then be totally eliminated from the body.
C) Reexposure to the same microorganism results in greatly increased production of specific antibodies.
D) Formed antibodies are released as free substances into the blood and other body fluids.

Answer 2

Formed antibodies are released as free substances into the blood and other body fluids.

Question 3

Which antirejection drug works by inhibiting the mTOR pathway?

A) Azathioprine (Imuran)
B) Everolimus (Zortress)
C) Tacrolimus (Prograf)
D) Daclizumab (Zenapax)

Answer 3

Everolimus (Zortress)

Question 4

How are vaccination and immunization related?

A) They are actually the same thing.
B) They are completely unrelated to each other.
C) The outcome of successful vaccination is immunization.
D) The outcome of successful immunization is vaccination.

Question 5

What is definition of a toxoid that can be used for vaccination?

A) A vaccine containing antibodies that were produced by other animals in response to the administration of human white blood cells.
B) A vaccine that contains a modified toxin that an organism produces or a small part of the actual organism.
C) A vaccine designed to be toxic to or inhibit the excessive functioning of the immune system.
D) A vaccine that contains artificially created antibodies that will generate passive immunity.

Question 6

What is the role of the T lymphocyte (T cell)in the development of long-lasting antibody-mediated immunity?

A) Enhancing the sensitized B lymphocyte's production of antibodies on second and subsequent exposure to the same antigen
B) Preventing general immune responses from becoming excessive and leading to autoimmunity
C) Distinguishing sensitized B lymphocytes from unsensitized B lymphocytes
D) Assisting unsensitized B lymphocyte to recognize new antigens

Question 7

A child is receiving a seasonal influenza vaccination administered by nasal inhalation.What type of immunity is expected to develop as a result of this vaccination method?

A) Artificially acquired passive immunity
B) Artificially acquired active immunity
C) Naturally acquired passive immunity
D) Naturally acquired active immunity

Question 8

Which antirejection drug belongs to the antiproliferative class?

A) Basiliximab (Simulect)
B) Cyclosporine (Neoral)
C) Mycophenylate (CellCept)
D) Tacrolimus (Prograf)

Question 9

Why is a person who has already had chickenpox considered to be "immune" to developing the disease again even if he or she is heavily reexposed to the virus again?

A) On reexposure to the came virus,his or her sensitized B lymphocytes generate large amounts of antichickenpox antibodies.
B) This person's neutrophils and macrophages are able to recognize the virus sooner and make antibodies against it.
C) Once a person has had chickenpox,the virus can never enter his or her body again.
D) He or she has developed naturally acquired passive immunity to the virus.

Question 10

The activity of which specific immune system cell must be suppressed to reduce transplant rejection episodes?

A) Neutrophils
B) Macrophages
C) T lymphocytes
D) B lymphocytes

Question 11

Which exposure situation can lead to the development of "naturally acquired" immunity?

A) Receiving seasonal influenza vaccination every year
B) Taking a dose of oral polio vaccine
C) Breastfeeding an infant
D) Catching a cold

Question 12

Which drug is administered as an oral agent?

A) Antithymocyte globulin (Atgam)
B) Basiliximab (Simulect)
C) Sirolimus (Rapamune)
D) Daclizumab (Zenapax)

Question 13

A patient whose foot was cut deeply by a rusty tin can last received a tetanus toxoid vaccination 8 years ago.He is prescribed to now receive a tetanus toxoid injection.What type of immunity does this vaccination help provide?

A) Boosting of artificially acquired active immunity
B) Initiation of artificially acquired active immunity
C) Boosting of naturally acquired active immunity
D) Initiation of naturally acquired active immunity

Question 14

A woman whose father has shingles has a blood antibody titer to varicella zoster virus (VZV)of zero (0).What is the correct interpretation of this information?

A) The woman has full immunity against shingles.
B) The woman should receive the shingles vaccination.
C) The woman is highly likely to develop shingles from her father.
D) The woman is at risk for developing chickenpox from her father.

Question 15

For which patient should vaccination with an attenuated vaccine be avoided?

A) 18-month-old child who has asthma
B) 36-year-old woman who has taken insulin by injection for 25 years
C) 48-year-old man who has severe immunosuppression as a result of a stem cell transplant 1 month ago
D) 66-year-old woman who takes the anti-inflammatory drug meloxicam (Mobic)daily for severe arthritis

Question 16

Which condition would be a contraindication for giving RhoGam to an Rh-negative mother?

A) Having an allergy to peanuts and penicillin
B) Giving birth to an Rh-negative infant
C) Receiving a blood transfusion after delivery
D) Giving birth to twins

Question 17

Which vaccination is routinely administered to infants at ages 2 months,4 months,and 6 months?

A) HyperTET
B) RhoGAM
C) TdaP
D) DTaP

Question 18

With which disorder or organism is a killed vaccine used to trigger immunity?

A) Tetanus
B) Influenza
C) Hepatitis B
D) Human papilloma virus

Question 19

A mother of a 6-month-old infant who is to receive a vaccination against diphtheria,pertussis,and tetanus today asks why her baby needs this third injection when she has already received two previous vaccinations against these diseases.What is your best answer?

A) The first two injections provided your baby with passive immunity and this one will provide active immunity.
B) The first two injections provided protection against diphtheria and pertussis whereas this one is against tetanus.
C) Infants have some protection against these disorders because you had these vaccinations as a child,but now that protection is gone.
D) Infants have immature immune systems that are only capable of making a few antibodies at a time after vaccination and need frequent boosting.

Question 20

Which statement regarding artificially acquired active immunity is true?

A) It requires "boosting" on a regular schedule.
B) It is present in only children and not in adults.
C) It can be used for vaccinations but not for immunizations.
D) It has the shortest duration of effectiveness of any type of immunity.

Question 21

What specific direction should you teach a patient prescribed to take cyclosporine (Neoral)liquid suspension daily to prevent an acute rejection episode?

A) Rotate injection sites at least weekly.
B) Be sure to always take the capsule with grapefruit juice.
C) Rinse the container with milk or juice and drink the rinse.
D) Stop the drug immediately if you develop a high fever.

Question 22

Which precaution is most important to teach a patient taking an antiproliferative agent to manage an autoimmune disease?

A) Do not stop taking this drug for any reason or your organs will become atrophied.
B) Keep all health care appointments because your risk for cancer is now increased.
C) Avoid foods and drinks containing caffeine because your risk for high blood pressure is greatly increased.
D) Make certain someone is with you when you take this drug because allergic reactions are common and often delayed.

Question 23

A child who weighs 78 lb is prescribed to receive azathioprine (Imuran)2 mg/kg intravenously.The solution available is azathioprine 100 mg/10 mL.How many milliliters will you prepare for a correct dose?

Question 24

Which classes of antirejection and immunosuppressant drugs are included as standard,daily,antirejection drug therapy after a kidney transplant?

A) Antiproliferatives
B) Calcineurin inhibitors
C) Cytotoxic agents
D) Corticosteroids
E) Monoclonal antibodies

Question 25

Which patient is most likely to be taking azathioprine (Imuran)as a single agent daily instead of combination selective immunosuppressant therapy?

A) 30-year-old with rheumatoid arthritis
B) 35-year-old experiencing an acute rejection episode after a heart transplant
C) 50-year-old who received a donated kidney in a transplant 3 years ago
D) 70-year-old who has colon cancer that has metastasized to the liver

Question 26

What general precaution is most important to teach a patient taking any selective immunosuppressant agent?

A) Report a lightening of urine color to your prescriber immediately.
B) Eat a diet that is high in fruits and vegetables.
C) Drink at least 4 L of liquids every day.
D) Avoid crowds and people who are ill.

Question 27

Which action is essential to detect a common side effect after giving a calcineurin inhibitor?

A) Keep accurate intake and output records.
B) Check blood pressure every 4 to 8 hours.
C) Compare the patient's lower legs for swelling or redness.
D) Carefully check the patient for yellowing of skin or sclera.

Question 28

What would be the expected response in an Rh-positive infant who was accidentally injected with RhoGAM?

A) The infant would rapidly develop antibodies to Rh-positive red blood cells.
B) The infant would rapidly develop antibodies to Rh-negative red blood cells.
C) Some of the infant's Rh-positive red blood cells would be destroyed.
D) The infant's blood type would change from Rh-positive to Rh-negative.

Question 29

Why is an infusion of muromonab-CD3 (Orthoclone)more likely to result in an allergic reaction than an infusion of mycophenolate (CellCept)?

A) Muromonab-CD3 is administered for shorter time periods than is mycophenolate.
B) Muromonab-CD3 is administered in much higher dosages than is mycophenolate.
C) Mycophenolate is an antiproliferative agent and muromonab-CD3 is a polyclonal antibody.
D) Mycophenolate is a synthetically manufactured drug and muromonab-CD3 is produced using mouse proteins.

Question 30

What is the most important question to ask a 68-year-old adult who requests to receive the shingles vaccination?

A) Is there any possibility you might be pregnant?
B) Did you have chickenpox as a child or an adult?
C) Do you have either type 1 diabetes or type 2 diabetes?
D) Did you receive a seasonal influenza vaccination last year?

Question 31

With which drug is it important to assess the patient's lipid levels?

A) Azathioprine (Imuran)
B) Basiliximab (Simulect)
C) Tacrolimus (Prograf)
D) Sirolimus (Rapamune)