Deck 34: Drugs for Immune System Modulation

Question 1

A child has leukemia and is immunosuppressed due to chemotherapy. The mother frantically calls the clinic to say that her child was exposed to varicella (chickenpox). What does the best plan by the nurse include?

A) The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if he develops chickenpox.
B) The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.
C) The child should be brought to the clinic immediately to receive a vaccination for chickenpox.
D) The child should be kept away from other children to avoid further exposure to varicella.

Answer 1

The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.

Question 2

The client receives cyclosporine (Neoral). The nurse completes medication education and evaluates that learning has occurred when the client makes which statement?

A) "I must check my blood pressure; it can run low with this medication."
B) "I cannot have grapefruit while I am on this medication."
C) "Mealtimes will have no effect on when I take this medication."
D) "I might have an increased urine output with this medication."

Answer 2

"I cannot have grapefruit while I am on this medication."

Question 3

The nursing instructor is teaching student nurses about humoral and cell-mediated immune responses. What does the best teaching plan include?

A) Helper T cells are an important part of humoral immunity.
B) Humoral immunity refers to immune responses where targets are attacked by immune cells.
C) B lymphocytes are an important part of cell-mediated immunity.
D) Humoral immunity refers to immune responses that are mediated by antibodies.

Answer 3

Humoral immunity refers to immune responses that are mediated by antibodies.

Question 4

The nurse manages care for clients who have had organ transplants. What is the best information for the nurse to include when teaching the clients about body defenses?

A) Nonspecific body defense is effective primarily against bacteria.
B) Specific body defense usually only acts against a single organism.
C) Specific body defense includes the complement system.
D) Nonspecific body defense is also known as the immune response.

Question 5

A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT) immunization. What does the best action by the nurse include?

A) Administer only a pertussis-tetanus immunization.
B) Withhold this immunization and contact the physician.
C) Tell the mother to give the child acetaminophen (Tylenol) if another rash develops.
D) Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization.

Question 6

The client receives interferon alfa-2b (Intron-A) for treatment of Kaposi's sarcoma. Which question by the client would alert the nurse that additional assessment is necessary?

A) "I really feel sad; do I need to see a psychiatrist?"
B) "Is it safe to drink grapefruit juice with this medication?"
C) "Do I need to limit my fluids while on this medication?"
D) "Is it okay to use aspirin or ibuprofen products while on this medication?"

Question 7

The nurse is teaching a class on immunizations for women with newborn infants. The nurse evaluates that learning has occurred when the women make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected

A) "The immunizations are more effective if they are given closer together."
B) "Our babies might have a mild fever and be fussy for a few days."
C) "If our babies develop a fever, we must call the doctor immediately."
D) "We can give acetaminophen (Tylenol) if our babies have a mild fever."
E) "If our babies develop a mild fever, it means an allergic reaction."

Question 8

A mother comes to the clinic and tells the nurse, "I don't want my child to have any vaccinations. I have heard they cause diseases." What is the best response by the nurse?

A) "Vaccinations are safe; there is no reason to worry."
B) "Vaccinations have some risks, but the benefits outweigh the risks."
C) "People worry too much about vaccinations."
D) "Vaccinations are required by law; you really don't have a choice."

Question 9

The client receives interferon alfa-2b (Intron-A). The client tells the nurse that he gets very sleepy and thirsty every time he takes the medication. What is the best assessment question for the nurse to ask?

A) "Are you consuming at least eight glasses of water daily?"
B) "Are you including beverages with alcohol in your diet?"
C) "Have you had any flu symptoms lately?"
D) "How much time have you spent out in the sun?"

Question 10

Which of the following would the nurse identify as a component of the specific immune response?

A) Lymphocytes
B) Phagocytes
C) Epithelial lining of the skin
D) Gastrointestinal membrane

Question 11

Immunosuppressants include

A) gamma globulin.
B) glucocorticoids.
C) antipsychotics.
D) antifungals.

Question 12

The major difference between B cell lymphocytes and T cell lymphocytes is that

A) T cells produce clones.
B) B cells produce antibodies.
C) T cells produce antibodies.
D) B cells produce clones.

Question 13

The client receives an immunosuppressant medication. What is the priority information for the nurse to teach the client about this medication?

A) The client should get adequate exercise.
B) The client should drink plenty of fluids.
C) The client should eat plenty of fruits and vegetables.
D) The client should avoid crowds.

Question 14

Uence the vaccines are administered. In which order will the nurse discuss these vaccines?

A) Human papillomavirus
B) First dose hepatitis A
C) Meningococcal conjugate
D) First dose of diphtheria, tetanus, and pertussis
E) Second dose of measles, mumps, rubella

Question 15

An adult female client is beginning her series of hepatitis B immunizations. What does the best teaching by the nurse include?

A) "Contact your physician if you develop pain at the injection site, mild fever, or soreness."
B) "Practice reliable birth control for 3 months after the administration of the vaccinations."
C) "Immediately report any signs of bleeding such as hematuria, or bleeding from the gums."
D) "Avoid crowded areas where you might be exposed to an infectious disease."

Question 16

The nurse is teaching a class to clients who have recently undergone transplant surgery and are taking immunosuppressant drugs. The nurse evaluates that learning has occurred when the clients make which statements?

A) "We must immediately report hair loss to the physician."
B) "We must wear a protective mask when going out in public."
C) "We must avoid exposure to individuals who have infections."
D) "We must practice reliable contraception."
E) "We must avoid eating raw fruits and vegetables."

Question 17

T cells produce

A) cytokines.
B) leukotrienes.
C) lymphocytes.
D) erythrocytes.

Question 18

A mother tells the nurse, "I am so concerned about my child. He may not have adequate immunity to chickenpox." What is the best response by the nurse?

A) "You don't have to worry as long as your child has received all of his vaccinations."
B) "We can give your child another booster if you would like."
C) "There really is no way to know if your child will develop chickenpox."
D) "We can draw a titer to determine if there is adequate immunity."

Question 19

When planning care for a patient receiving immunostimulant therapy, the nurse puts the highest priority on monitoring for which changes?

A) Weight
B) Intake and output
C) Hepatic enzymes
D) Vital signs

Question 20

The physician has ordered cyclosporine (Sandimmune) for the client who has undergone a kidney transplant. What will the nurse's priority assessment of this client include?

A) Assessing for infection
B) Assessing for peripheral edema
C) Assessing airway clearance
D) Assessing cardiac output

Question 21

The client had a liver transplant and asks the nurse if she really needs all of those medications. How should the nurse respond?"

A) "Yes, this is necessary for you to not reject the new liver, but in time you will be down to only one medication."
B) "Yes you need these medications so you won't reject your new liver, but with current cloning techniques in about 5 years you should be able to grow enough new liver cells to support your life."
C) "You need these medications because it is important to dampen your immune response so you won't reject your new liver."
D) "New research indicates that immunosuppressant drugs are only needed for 6 months after transplant."

Question 22

The patient has been prescribed an oral immunosuppressant medication. The nurse would evaluate the additional teaching is required when the patient makes which statement?

A) "When I mix my medicine with grapefruit juice, it doesn't taste as bad."
B) "I have a cute plastic cup I use to mix my medicine."
C) "It is okay to mix my medication with orange juice."
D) "I always rinse the cup and drink the rinse water."
E) "I have eliminated chocolate from my diet."

Question 23

A parent says, "I have heard that some of the vaccines contain the microbe that causes the actual disease. Can that be true?" How should the nurse respond?

A) "The microbes are live but are weakened."
B) "That is true, but they do not cause disease."
C) "The measles, mumps, and rubella vaccine is an example."
D) "No, all microbes used in vaccines are killed."
E) "This only occurs in toxoid vaccines."

Question 24

A new mother expresses concern about immunizing her infant saying, "I am breastfeeding, so I know that will pass my immunity to my baby. I don't see why anything else is necessary." How should the nurse respond?

A) "You are correct that your baby will receive some passive immunity from you."
B) "That immunity is called adapted immunity, and it only lasts for a few days."
C) "There are some diseases for which immunity is not passed from mother to child."
D) "Your baby will need the extra protection provided by standard immunizations."
E) "Vaccines are not indicated until you stop breastfeeding."

Question 25

A patient has taken two doses of interferon Alfa-2b (Intron-A). He comes to the clinic today with the following complaints. Which symptoms would the nurse identify as common adverse effects of this therapy?

A) "I am so dizzy."
B) "I have an itchy rash on my legs."
C) "I have no appetite."
D) "I am so tired."
E) "My bones ache."

Question 26

A client says, "I have been seeing so much about shingles vaccines on television. Do I need to get one?" The nurse replies, "You will not have this vaccine until you are age ____."
Standard Text: Record your answer rounding to the nearest whole number.

Question 27

During an admission interview the client says, "I was given interferon alfa-2b for cancer treatment." The nurse should look for evidence of which type of cancer in this client's history?

A) Breast cancer
B) Malignant melanoma
C) Kaposi's sarcoma
D) Bladder cancer
E) Cancer of the sinuses

Question 28

A new parent asks the nurse when her infant will receive the hepatitis A vaccine. How should the nurse reply?

A) "We will give the first dose before you take your baby home from the newborn nursery."
B) "It will be included in the series of immunizations given at 2 months, 4 months, and 6 months."
C) "Your child will receive the first dose at 12 months."
D) "Not until school age."
E) "About 6 to 12 months after the initial vaccine, a booster will be given."

Question 29

A nurse is presenting community education regarding vaccines for influenza. Which information should the nurse plan to include?

A) Everyone should receive an injection of influenza vaccine every year.
B) Children should not receive influenza immunizations until age 10.
C) Intranasal vaccine is available for infants.
D) Many adults have a choice between injectable and intranasal forms of immunization.
E) A child's first immunization will consist of two injections given 1 month apart.

Question 30

A patient who had a kidney transplant 5 days ago says, "I am glad I did not reject my kidney." What should the nurse consider when formulating a response to this statement?

A) Cell-mediated rejection takes place about 2 weeks after transplant.
B) Chronic rejection may occur months after transplant.
C) Chronic rejection may occur years after transplant.
D) Transplant does not occur until several days after transplant.
E) Transplant rejection is rare in kidney transplants.