Deck 32: Drugs for Immune System Modulation

Question 1

An adult female client is beginning her series of Hepatitis B immunizations.What does the best teaching by the nurse include?
1)"Contact your physician if you develop pain at the injection site,mild fever,or soreness."
2)"Practice reliable birth control for three months after the administration of the vaccinations."
3)"Immediately report any signs of bleeding such as hematuria,or bleeding from the gums."
4)"Avoid crowed areas where you might be exposed to an infectious disease."

Answer 1

2

Question 2

A mother tells the nurse,"I am so concerned about my child.He may not have adequate immunity to chicken pox." What is the best response by the nurse?
1)"You don't have to worry as long as your child has received all of his vaccinations."
2)"We can give your child another booster if you would like."
3)"There really is no way to know if your child will develop chicken pox."
4)"We can draw a titer to determine if there is adequate immunity."

Answer 2

4

Question 3

The client receives cyclosporine (Neoral).The nurse completes medication education and evaluates that learning has occurred when the client makes which statement?
1)"I must check my blood pressure;it can run low with this medication."
2)"I cannot have grapefruit while I am on this medication."
3)"Mealtimes will have no effect on when I take this medication."
4)"I might have an increased urine output with this medication."

Answer 3

2

Question 4

The client receives an immunostimulant.The client tells the nurse that he gets very sleepy and thirsty every time he takes the medication.What is the best assessment for the nurse to ask?
1)"Are you consuming at least eight glasses of water daily?"
2)"Have you been drinking any alcohol?"
3)"Have you had any flu symptoms lately?"
4)"How much time have you spent out in the sun?"

Question 5

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?
1)Nonspecific body defense is effective primarily against bacteria.
2)Specific body defense usually only acts against a single organism.
3)Specific body defense includes the complement system.
4)Nonspecific body defense is also known as the immune response.

Question 6

The major difference between B cell lymphocytes and T cell lymphocytes is that
1)T cells produce clones.
2)B cells produce antibodies.
3)T cells produce antibodies.
4)B cells produce clones.

Question 7

A key part of the nursing process when caring for a client who is receiving immunosuppressant therapy should be to
1)assess nutritional status.
2)monitor vital signs.
3)assess renal function.
4)monitor liver function studies.

Question 8

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?
1)Assessing for infection
2)Assessing for peripheral edema
3)Assessing airway clearance
4)Assessing cardiac output

Question 9

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"We must immediately report hair loss to the physician."
2)"We must wear a protective mask when going out in public."
3)"We must avoid exposure to individuals who have infections."
4)"We must practice reliable contraception."
5)"We must avoid eating raw fruits and vegetables."

Question 10

T cells produce
1)cytokines.
2)leukotrienes.
3)lymphocytes.
4)erythrocytes.

Question 11

The client receives infliximab (Remicade),an immunosuppressant medication.What is the priority information for the nurse to teach the client about this medication?
1)The client should get adequate exercise.
2)The client should drink plenty of fluids.
3)The client should eat plenty of fruits and vegetables.
4)The client should avoid crowds.

Question 12

All of the following are associated with non-specific immune response except
1)lymphocytes.
2)phagocytes.
3)epithelial lining of the skin.
4)gastrointestinal membrane.

Question 13

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? Credit will be given only if all correct choices and no incorrect choices are selected
1)"The immunizations are more effective if they are given closer together."
2)"Our babies might have a mild fever and be fussy for a few days."
3)"If our babies develop a fever,we must call the doctor immediately."
4)"We can give acetaminophen (Tylenol)if our babies have a mild fever."
5)"If our babies develop a mild fever,it means an allergic reaction."

Question 14

The most important nursing consideration when a client is receiving immunostimulant therapy is to
1)monitor for changes in mental status.
2)monitor intake and output.
3)monitor for changes in hepatic enzymes.
4)monitor vital signs.

Question 15

The nursing instructor is teaching student nurses about humoral and cell-mediated immune responses.What does the best teaching plan include?
1)Helper T cells are an important part of humoral immunity.
2)Humoral immunity refers to immune responses where targets are attacked by immune cells.
3)B lymphocytes are an important part of cell-mediated immunity.
4)Humoral immunity refers to immune responses that are mediated by antibodies.

Question 16

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 autism." What is the best response by the nurse?
1)"Vaccinations are safe;there is no reason to worry."
2)"Vaccinations have some risks,but the benefits outweigh the risks."
3)"I understand what you are saying;this is really your choice."
4)"Vaccinations are required by law;you really don't have a choice."

Question 17

The client receives interferon alfa-2b (Intron-A)for treatment of Kaposi's sarcoma.Which by the client would alert the nurse that additional assessment is necessary?
1)"I really feel sad;do I need to see a psychiatrist?"
2)"Is it safe to drink grapefruit juice with this medication?"
3)"Do I need to limit my fluids while on this medication?"
4)"Is it okay to use aspirin or ibuprofen products while on this medication?"

Question 18

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?
1)Administer only a pertussis-tetanus immunization.
2)Withhold this immunization and contact the physician.
3)Tell the mother to give the child acetaminophen (Tylenol)if another rash develops.
4)Administer diphenhydramine (Benadryl)prior to the diphtheria-pertussis-tetanus (DPT)immunization.

Question 19

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 (chicken pox).What does the best plan by the nurse include?
1)The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if he develops chicken pox.
2)The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.
3)The child should be brought to the clinic immediately to receive a vaccination for chicken pox.
4)The child should be kept away from other children to avoid further exposure to varicella.

Question 20

Immunosuppressants include
1)gamma globulin.
2)glucocorticoids.
3)antipsychotics.
4)antifungals.

Question 21

A new parent asks the nurse when her infant will receive the hepatitis A vaccine.How should the nurse reply? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"We will give the first dose before you take your baby home from the newborn nursery."
2)"It will be included in the series of immunizations given at 2 months,4 months,and 6 months."
3)"Your child will receive the first dose at 12 months."
4)"Not until school age."
5)"About 6 to 12 months after the initial vaccine,a booster will be given."

Question 22

The client had a liver transplant and asks the nurse if she really needs all of those medications.How should the nurse respond?" Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Yes,this is necessary for you to not reject the new liver,but in time you will be down to only one medication."
2)"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."
3)"You need these medications because it is important to dampen your immune response so you won't reject your new liver."
4)"New research indicates that immunosuppressant drugs are only needed for 6 months after transplant."
5)"This seems excessive to me,too,but your physician ordered all of them."

Question 23

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"You are correct that your baby will receive some passive immunity from you."
2)"That immunity is called adapted immunity and it only lasts for a few days."
3)"There are some diseases for which immunity is not passed from mother to child."
4)"Your baby will need the extra protection provided by standard immunizations."
5)"Vaccines are not indicated until you stop breastfeeding."

Question 24

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Breast cancer
2)Malignant melanoma
3)Kaposi's sarcoma
4)Bladder cancer
5)Cancer of the sinuses