Question 1

A 24-year-old client will be starting drug therapy with azathioprine (Imuran).Which of the following instructions related to reproduction would the nurse share with the client?

Accepted Answer

Azathioprine can cause birth defects and should not be used during pregnancy. Clients should use contraception during drug use and for 4 months after completion to avoid unplanned pregnancy. Barrier methods such as condoms may not be as effective as oral contraceptives, so the nurse may recommend oral contraception as a preferred method. Avoiding sexual activity altogether is not necessary unless the client chooses to do so, and explaining the risks to the partner is not the client's responsibility but rather the responsibility of the healthcare provider.

Question 2

Which nursing diagnosis would be appropriate for a client who is receiving immunosuppressive agents?

Accepted Answer

Immunosuppressive agents can pose a threat to the body's natural defense mechanisms, leaving the client vulnerable to infections, illnesses, and other biologic threats. Therefore, anxiety related to actual or perceived threat to biologic integrity is an appropriate nursing diagnosis for clients receiving these medications. Constipation related to adverse drug effects and imbalanced nutrition, greater than body requirements, are not directly related to the effects of immunosuppressive agents. Grieving related to permanent hair loss may be a concern for clients receiving chemotherapy, but it is not applicable to individuals receiving immunosuppressive agents.

Question 3

The nurse includes in client teaching related to cyclosporine (Sandimmune)therapy that the client should have dental checkups at what intervals to detect gingival hyperplasia?

Accepted Answer

Clients on cyclosporine (Sandimmune) therapy should have dental checkups every 3 months to detect gingival hyperplasia which is a possible side effect of the medication.

Question 4

The nurse would take which of the following actions to safely provide care to a client receiving immunosuppressant drugs?

Accepted Answer

Providing careful skin, mouth, and perianal care is crucial for clients on immunosuppressant drugs to prevent infections, as their immune systems are compromised.

Question 5

The nurse contacts the physician after noting that the leukocyte count in a client taking azathioprine (Imuran)has dropped below which of the following levels?

Accepted Answer

Azathioprine (Imuran) can cause bone marrow suppression, leading to leukopenia. A leukocyte count below 3000/mm^3 is considered critically low and warrants immediate contact with a physician due to the increased risk of infection.

Question 6

The nurse would assess for which of the following symptoms if a client is suspected of having an opportunistic infection?

Accepted Answer

Oral candidiasis is a common opportunistic infection seen in immunocompromised clients. Nausea and flushing face are not directly related to opportunistic infections, and seizures may be a symptom of a variety of conditions but not specific to opportunistic infections.

Question 7

After preparing a dose of basiliximab (Simulect)for a client at 08:00,the nurse determines that it needs to be administered by which of the following times?

Accepted Answer

Basiliximab (Simulect) is a medication used as an immunosuppressant to prevent organ rejection after transplantation. It is administered as an IV infusion over 20-30 minutes. The first dose is usually given within 2 hours before transplantation surgery, and the second dose is given 4 days after the surgery. Therefore, if the nurse prepared the dose of basiliximab at 08:00, it needs to be administered at 12:00, which is 4 hours after preparation. Choices A, B, and D are incorrect as they are not 4 hours after preparation.

Question 8

The nurse working on a transplant unit notes a drug order for basiliximab (Simulect)on a newly admitted client.The nurse expects to read in the medical record that the client underwent transplant of which organ?

Accepted Answer

Basiliximab (Simulect) is a monoclonal antibody that is used as an immunosuppressant to prevent rejection in organ transplantation. It is most commonly used in kidney transplant patients. Therefore, the nurse can expect that the client underwent kidney transplantation.

Question 9

The nurse would assess for which priority adverse effect in a client receiving daclizumab (Zenapax)?

Accepted Answer

Hypersensitivity is the priority adverse effect to assess for with daclizumab because it can lead to an anaphylactic reaction. Symptoms of hypersensitivity can include itching, hives, or respiratory distress. The other options listed are potential adverse effects but are not the priority to assess for.

Question 10

The nurse advises the client to avoid eating which of the following fruits while taking cyclosporine (Sandimmune)?

Accepted Answer

Grapefruit can interact with cyclosporine and increase its toxicity, leading to serious side effects. Therefore, it is important to avoid consuming grapefruit or drinking grapefruit juice while taking cyclosporine. The other fruits listed do not have a significant interaction with cyclosporine.

Question 11

The nurse understands that a client's immunocompromised state may be the result of which of the following?

Accepted Answer

The loss of mucocutaneous barriers can result in an immunocompromised state, making individuals more susceptible to infections.

Question 12

The nurse would administer the oral solution of cyclosporine (Neoral)by mixing it with which of the following beverages?

Accepted Answer

Mixing Neoral with orange juice can help mask the bitter taste of the medication and increase the drug's absorption. However, the patient should not use grapefruit juice as it can increase the drug's concentration in the bloodstream, leading to toxicity.

Question 13

The nurse has an order to begin drug therapy with cyclosporine for a client who has undergone transplant surgery.The nurse looks for a corresponding order for which of the following that is usually given with this drug?

Accepted Answer

Cyclosporine is an immunosuppressant drug used to prevent organ rejection in transplant patients. It is typically given in combination with corticosteroids to reduce the risk of rejection and decrease the incidence of adverse effects of cyclosporine. Antipyretics are used to reduce fever, antihistamines are used to treat allergic reactions, and cytoprotective agents are used to protect against cell damage, but none of these drugs are typically given with cyclosporine.

Question 14

The nurse would look to the results of which of the following laboratory studies when monitoring the nutritional status of a client receiving immunosuppressant drugs?

Accepted Answer

Monitoring serum protein and albumin levels can provide insight into a client's nutritional status. Immunosuppressant drugs can have side effects that affect nutrient absorption, putting the client at risk for malnutrition. Serum electrolytes, glucose, and hemoglobin A1c levels are important to monitor for other reasons but do not necessarily provide information about nutritional status. Serum creatinine and blood urea nitrogen levels are more indicative of kidney function.

Question 15

The nurse suspects that a client taking azathioprine (Imuran)who has not had an organ transplant will have which of the following health problems documented on the medical record?

Accepted Answer

Azathioprine (Imuran) is an immunosuppressant medication that is commonly used to treat autoimmune disorders such as rheumatoid arthritis. It is not typically used to treat Addison's disease, Kaposi's sarcoma, or systemic lupus erythematosus.

Question 16

A client who will be taking cyclosporine (Neoral)at home after transplant surgery indicates an understanding of self-administration by stating to do which of the following?

Accepted Answer

Cyclosporine (Neoral) is a medication that must be taken exactly as prescribed to prevent organ rejection after a transplant. Rinsing the cup with additional liquid and drinking it ensures that the entire dose is consumed, which is crucial for the effectiveness of the medication.

Question 17

Which of the following would not be included by the nurse when teaching a client about the adverse effects associated with the use of azathioprine (Imuran)?

Accepted Answer

Increased appetite is not an adverse effect commonly associated with the use of azathioprine (Imuran). Rather, it is more likely to cause gastrointestinal distress such as nausea and vomiting, as well as bone marrow suppression leading to megaloblastic anemia.

Question 18

The nurse would interpret that serum levels of cyclosporine could be low if the client starts to exhibit which of the following?

Accepted Answer

Cyclosporine is an immunosuppressant drug used to prevent organ rejection in transplant patients. If serum levels of cyclosporine are low, the patient's immune system may start to attack the transplanted organ, leading to signs of organ rejection.

Question 19

The nurse would include in client teaching that the most frequently reported adverse effect of cyclosporine is

Accepted Answer

Hirsutism (excessive hair growth) is the most frequently reported adverse effect of cyclosporine use. Other potential adverse effects may include hypertension, nephrotoxicity, neurotoxicity, and increased susceptibility to infections.

Question 20

The nurse explains to a client going home on immunosuppressant drug therapy that the client and anyone living in the household should not have which of the following vaccinations?

Accepted Answer

Oral polio is a live vaccine and should not be given to immunosuppressed clients or those living in the same household.

Quiz 63: Immunosuppressants and Immunomodulators

A 24-year-old client will be starting drug therapy with azathioprine (Imuran) .Which of the following instructions related to reproduction would the nurse share with the client?

Which nursing diagnosis would be appropriate for a client who is receiving immunosuppressive agents?

The nurse includes in client teaching related to cyclosporine (Sandimmune) therapy that the client should have dental checkups at what intervals to detect gingival hyperplasia?

The nurse would take which of the following actions to safely provide care to a client receiving immunosuppressant drugs?

The nurse contacts the physician after noting that the leukocyte count in a client taking azathioprine (Imuran) has dropped below which of the following levels?

The nurse would assess for which of the following symptoms if a client is suspected of having an opportunistic infection?

After preparing a dose of basiliximab (Simulect) for a client at 08:00,the nurse determines that it needs to be administered by which of the following times?

The nurse working on a transplant unit notes a drug order for basiliximab (Simulect) on a newly admitted client.The nurse expects to read in the medical record that the client underwent transplant of which organ?

The nurse would assess for which priority adverse effect in a client receiving daclizumab (Zenapax) ?

The nurse advises the client to avoid eating which of the following fruits while taking cyclosporine (Sandimmune) ?

The nurse understands that a client's immunocompromised state may be the result of which of the following?

The nurse would administer the oral solution of cyclosporine (Neoral) by mixing it with which of the following beverages?

The nurse has an order to begin drug therapy with cyclosporine for a client who has undergone transplant surgery.The nurse looks for a corresponding order for which of the following that is usually given with this drug?

The nurse would look to the results of which of the following laboratory studies when monitoring the nutritional status of a client receiving immunosuppressant drugs?

The nurse suspects that a client taking azathioprine (Imuran) who has not had an organ transplant will have which of the following health problems documented on the medical record?

A client who will be taking cyclosporine (Neoral) at home after transplant surgery indicates an understanding of self-administration by stating to do which of the following?

Which of the following would not be included by the nurse when teaching a client about the adverse effects associated with the use of azathioprine (Imuran) ?

The nurse would interpret that serum levels of cyclosporine could be low if the client starts to exhibit which of the following?

The nurse would include in client teaching that the most frequently reported adverse effect of cyclosporine is

The nurse explains to a client going home on immunosuppressant drug therapy that the client and anyone living in the household should not have which of the following vaccinations?