Deck 34: Drugs for Immune System Modulation

Question 1

Which vaccine is initially administered in the scheduled series of vaccinations?

A) Hepatitis B
B) Meningococcal conjugate
C) Diphtheria, tetanus, and pertussis
D) Measles, mumps, and rubella

Answer 1

Hepatitis B

Question 2

Which are included in the class of immunosuppressants?

A) Gamma globulin
B) Glucocorticoids
C) Antipsychotics
D) Antifungals

Answer 2

Glucocorticoids

Question 3

Which information should the nurse include in the discussion with a client about humoral and cell-mediated immune responses?

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

Which describes the major difference between B cell lymphocytes and T cell lymphocytes?

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

Question 5

Which information should the nurse include when discussing the body's defense against an invading organism?

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 6

Which is produced by T cells?

A) Cytokines
B) Leukotrienes
C) Lymphocytes
D) Erythrocytes

Question 7

The nurse has provided parental education on infant immunization. Which statements made by the parent indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected Select all that apply.

A) "The immunizations are more effective if they are given closer together."
B) "The baby might have a mild fever and be fussy for a few days."
C) "I will call the healthcare provider immediately if the baby develops a fever."
D) "I can give acetaminophen (Tylenol) if the baby has a mild fever."
E) "I should be concerned that a mild fever may indicate an allergic reaction has occurred."

Question 8

A parent expressed concern to the nurse that their child does not have adequate immunity to chicken pox. Which response should the nurse provide?

A) "As long as your child has received all of their vaccinations, they should have adequate immunity."
B) "If you are concerned, we can administer a booster."
C) "It is unpredictable as to who will develop chicken pox."
D) "A titer can be drawn to determine if there is adequate immunity."

Question 9

The nurse has provided the education for a client prescribed cyclosporine (Neoral). Which statement made by the client indicates an understanding of the information?

A) "I should not have grapefruit."
B) "I will check my blood pressure as it may run low."
C) "I should take my prescription at mealtimes."
D) "I may experience an increased urine output."

Question 10

Which of the following should 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

A parent tells the nurse their child receiving leukemia chemotherapy has been exposed to varicella (chickenpox). Which instruction should the nurse provide the parent?

A) If the child develops chicken pox come into the clinic for an injection of varicella immune globulin.
B) Bring the child into the clinic as soon as possible to receive an injection of varicella immune globulin.
C) Bring the child to the clinic immediately to receive a vaccination for chickenpox.
D) Keep the child away from other children to avoid further exposure to varicella.

Question 12

A parent tells the nurse they do not want their child vaccinated because there are too many risks associated with the vaccines. Which response should the nurse provide the parent?

A) "Vaccinations are safe so there is no reason to worry."
B) "Vaccinations have some risks, but the benefits outweigh the risks."
C) "The community has been misinformed about the use of vaccines."
D) "Vaccinations will be required for your child to attend school."

Question 13

Which is the nurse's priority assessment for a client prescribed cyclosporine (Sandimmune)?

A) Infection
B) Peripheral edema
C) Headaches
D) Cardiac output

Question 14

A client receiving interferon alfa-2b (Intron-A) tells the nurse that they get very sleepy and thirsty every time they take the prescription. Which assessment question should the nurse ask the client?

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 15

Which is a priority assessment when planning care for a client receiving immunostimulant therapy?

A) Changes in weight
B) Intake and output
C) Hepatic enzymes
D) Vital signs

Question 16

Which is a nursing priority to include in the teaching for the client prescribed an immunosuppressant?

A) Obtain adequate exercise.
B) Drink plenty of fluids.
C) Eat plenty of fruits and vegetables.
D) Avoid large crowds.

Question 17

Which question by a client receiving interferon alfa-2b (Intron-A) indicates further 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 18

Which information should the nurse include when providing education for an adult female client that is beginning the series of hepatitis B immunizations?

A) "Contact your healthcare provider 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 19

The nurse has provided education for a client post-transplant surgery that is prescribed immunosuppressant drugs. Which statements made by the client indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I will report hair loss to my healthcare provider."
B) "I will wear a protective mask when going out in public."
C) "I will avoid exposure to individuals who have infections."
D) "I will make sure I use reliable contraception."
E) "I will avoid eating raw fruits and vegetables."

Question 20

The nurse is preparing to administer a second dose of diphtheria-pertussis-tetanus (DPT) when the parent expresses concern that their child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT) immunization. Which action should the nurse take?

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

Question 21

The educator has reviewed the use for immunosuppressants with a nurse. Which statements made by the nurse indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Immunosuppressants prevent tissue rejection."
B) "Immunosuppressants treat severe inflammatory diseases."
C) "Immunosuppressants dampen the immune response."
D) "Immunosuppressants stimulate new immunity."
E) "Immunosuppressants eradicate the immune system."

Question 22

A client asks the nurse why they need a booster vaccine. Which response should the nurse provide?

A) "Boosters provide sustained protection."
B) "Boosters reactivate your immunity."
C) "Boosters cover the new strains of viruses."
D) "Boosters stimulate the production of antibodies."

Question 23

A newly delivered obstetrical client with an A- blood type asks when she will get her Rh0(D) immune globulin (RhoGAM) injection. Which statement should the nurse provide?

A) "When we verify your blood type."
B) "When we verify your Rh factor."
C) "When we verify your infant's Rh factor."
D) "When we verify your infant's blood type."

Question 24

A parent asks the nurse when their infant will receive the hepatitis A vaccine. Which information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "The first dose will be administered 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 25

A client who had a kidney transplant 5 days prior says to the nurse, "I am glad I did not reject my kidney." Which information should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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 rejection does not occur until several days after transplant.
E) Transplant rejection is rare in kidney transplants.

Question 26

A parent tells the nurse, "I am breastfeeding, so my baby is receiving my immunity. I do not see why any other vaccinations are necessary." Which responses should the nurse include in the discussion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "You are correct that your baby will receive some passive immunity from you."
B) "The immunity your baby is receiving only lasts while you are breastfeeding."
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 completely stop breastfeeding."

Question 27

A parent expressed the concern that some vaccines contain live microbes. Which statements should the nurse include in the discussion with the parent? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "The microbes are live but are weakened."
B) "The microbes are not able to cause the disease."
C) "The measles, mumps, and rubella vaccine is an example."
D) "The microbes in the vaccines are killed."
E) "The microbes are only found in toxoid vaccines."

Question 28

Which information should the nurse include in the education for influenza vaccinations? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The influenza vaccine is administered as an injection.
B) Children should not receive influenza immunizations until age 10.
C) Intranasal vaccine is available for preschool children.
D) Many adults have a choice between injectable and intranasal forms of immunization.
E) A child will receive one dose at 6 months and then every year.

Question 29

A client tells the nurse they have been treated with interferon alfa-2b for cancer. Which types of cancer should the nurse recognize the client may have been treated for? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Breast cancer
B) Malignant melanoma
C) Kaposi's sarcoma
D) Bladder cancer
E) Oral cancer

Question 30

Which statement made by a client receiving interferon Alfa-2b (Intron-A) should the nurse recognize as adverse effects of the therapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I have been feeling dizzy."
B) "I have an itchy rash on my legs."
C) "I have lost my appetite."
D) "I am so frequently tired."
E) "My bones feel achy."