Question 1

The nurse will be administering daclizumab (Zenapax)to a patient.Before administering this drug,which of the following should the nurse assess for?&#10;A)Respirations&#10;B)Blood pressure&#10;C)Alanine aminotransferase (ALT) levels&#10;D)Pain level

Accepted Answer

Daclizumab requires assessment of baseline vital signs.The nurse need to pay special attention to the patient's pulse and blood pressure.

Question 2

A patient on immunosuppressant therapy is having monthly laboratory studies.The drug should be discontinued if the patient's leukocyte count drops below which of the following?&#10;A)3.0&#215;10&#8313; /L&#10;B)5.0&#215;10&#8313; /L&#10;C)10.0&#215;10&#8313; /L&#10;D)15.0&#215;10&#8313; /L

Accepted Answer

Laboratory studies should be performed monthly for patients on immunosuppressant therapy.If the leukocyte count drops below 3.0×10⁹/L,the drug should be discontinued.

Question 3

A female patient has started azathioprine (Imuran)therapy in preparation for her renal transplant surgery.Which expected adverse effect of azathioprine therapy should the nurse tell the patient about?&#10;A)Tremors&#10;B)Diarrhea&#10;C)Leukopenia&#10;D)Fluid retention

Accepted Answer

Leukopenia is an expected adverse effect of azathioprine therapy.

Question 4

Which of the following is a true statement regarding cyclosporine?&#10;A)Refrigerate any leftover solution.&#10;B)Mix with water only.&#10;C)Avoid the use of Styrofoam containers.&#10;D)It can only be given intravenously.

Accepted Answer

Styrofoam containers should be avoided because the drug has been found to adhere to the inside of the cup.
Oral solutions may be mixed with chocolate milk,regular milk,or orange juice and served at room temperature.After the solution is mixed,the patient must drink it immediately.Oral solutions should not be refrigerated.Cyclosporine can be given orally or intravenously.

Question 5

A patient is about to undergo a kidney transplant.She will be given azathioprine (Imuran)to minimize organ rejection.What important preoperative information should the nurse tell the patient about this drug?

A)Before the surgery,the medication will be administered orally.
B)The oral doses should be taken 1 hour before meals to maximize absorption.
C)Blood pressure should be monitored for development of moderate hypertension.
D)The patient will need to visit the office daily for intramuscular (IM)injections several days preceding surgery.

Accepted Answer

Several days before transplant surgery,immunosuppressant drugs should be taken by the oral route,if possible,to avoid IM injections and the risk of the injections causing infections.

Question 6

How is cyclosporine (Neoral)usually given intravenously?&#10;A)In a single intravenous (IV)injectable form to minimize adverse effects&#10;B)Initiated by an oral test dose;then,after 2 hours,an IV infusion is begun&#10;C)Diluted with normal saline or 5% dextrose in water and infused over 2 to 6 hours&#10;D)Given as an IV bolus for the first dose,then with an infusion pump for following doses

Accepted Answer

Cyclosporine is normally diluted with normal saline or 5% dextrose and infused over 2 to 6 hours with an infusion pump.
Cyclosporine is not given by using an IV bolus or with an oral test dose.

Question 7

Which of the following drugs may increase the action of azathioprine (Imuran)?&#10;A)nafcillin (Nafcil)&#10;B)rifampin (Rifadin)&#10;C)allopurinol (Alloprim)&#10;D)phenobarbital (Luminal)

Accepted Answer

Allopurinol may increase the action of azathioprine.

Question 8

The use of sirolimus (Rapamune)can increase the chances of which of the following?&#10;A)Lymphoma&#10;B)Leukemia&#10;C)Breast cancer&#10;D)Bowel cancer

Accepted Answer

The development of lymphoma can occur with the use of sirolimus.

Question 9

Which immunosuppressant is the only one currently indicated for the treatment of multiple sclerosis?&#10;A)azathioprine (Imuran)&#10;B)glatiramer acetate (Copaxone)&#10;C)daclizumab (Zenapax)&#10;D)sirolimus (Rapamune)

Accepted Answer

Glatiramer acetate is the only immunosuppressant currently indicated for the treatment of multiple sclerosis.

Deck 46: Immunosuppressant Drugs