Ch 34 Drugs Affecting The Immune Response

27 Questions | By Jmtruong1 | Last updated: Mar 21, 2022 | Total Attempts: 250

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Quiz for Ch 34 Drugs Affecting the Immune ResponseGSU Fall 2009

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1.

In addition to hairy cell leukemia, what other disorders may be treated with interferon alfa-2a (Roferon-A)?
- A.
  
  Kaposi scarcoma
- B.
  
  Breast cancer
- C.
  
  Lung cancer
- D.
  
  Hodgekin's disease
2.

What is NOT an appropriate route of administration of interferon alfa-2a?
- A.
  
  IV
- B.
  
  IM
- C.
  
  SC
- D.
  
  PO
3.

Which of the following are the most frequent adverse effects to interferon alfa-2a therapy?
- A.
  
  Confusion, depression, hypothyroidism
- B.
  
  Confusion, hypothyroidism, hypotension
- C.
  
  Confusion, hypotension, flu-like symptoms
- D.
  
  Confusion, lethargy, flu-like symptoms
4.

Patients receiving interferon-2a should have monthly lab testing including all of the following EXCEPT
- A.
  
  Complete blood count (CBC)
- B.
  
  White cell differential
- C.
  
  Liver and kidney function
- D.
  
  Urinalysis
5.

Before administering rituximab (Rituxan), the nurse should check the prescriber's orders for
- A.
  
  Premedications to reduce the severity of infusion reactions
- B.
  
  Postmedications in increase the efficacy of the drug
- C.
  
  Diabetic medication
- D.
  
  Frequency of vital signs
6.

To administer rituximab appropriately, the nurse should do all of the following EXCEPT
- A.
  
  Mix the drug with normal saline
- B.
  
  Hold administration of antihypersensitive medications for 12 h before rituximab administration
- C.
  
  Administer antihypersensitive medications immediately after the rituximab infusion is completed
- D.
  
  Stop the infusion if the patient experiences an adverse effect
7.

Cyclosporine works by suppressing
- A.
  
  T lymphocytes
- B.
  
  B lymphocytes
- C.
  
  Cell-mediated immune reactions
- D.
  
  Phagocytosis
8.

A common yet serious adverse effect to cyclosporine affects the _________ system
- A.
  
  Gastrointestinal
- B.
  
  Genitourinary
- C.
  
  Cardiovascular
- D.
  
  Renal
9.

Because a patient is taking interferon alfa-2a, the patient should be carefully assessed for
- A.
  
  Hypertension
- B.
  
  Hypoglycemia
- C.
  
  Depression
- D.
  
  Electrolyte imbalance
10.

During administration of aldesleukin the nurse should consistently monitor
- A.
  
  Blood pressure
- B.
  
  Level of consciousness
- C.
  
  Cardiac rhythm
- D.
  
  Heart rate
11.

Which of the following monoclonal antibodies targets the protein responsible for stimulating new blood vessel formation?
- A.
  
  Trastuzumab
- B.
  
  Cetuximab
- C.
  
  Bevacizumab
- D.
  
  Panitumumab
12.

Your 27 year old patient is being treated for hairy cell leukemia with interferon alfa-2a. This patient should be monitored for
- A.
  
  Hypothyroidism
- B.
  
  Diabetes insipidus
- C.
  
  Constipation
- D.
  
  GI bleeding
13.

Your patient is receiving interferon alfa-2a. As you prepare to give the patient diphenhydramine, the patient asks, "Why do I need that, and why do I get this medicine in the evening?" What is your best response?
- A.
  
  "This is the way your doctor ordered it"
- B.
  
  "It is given in the evening with something to help you sleep so you will not feel the minor discomforts that the drug can cause"
- C.
  
  "It is for the possible allergic response that you might have. I just haven't had the time to give it to you sooner"
- D.
  
  "It just came up from the pharmacy"
14.

Your 16 y o patient is receiving rituximab for the 1st time. After 1 h of the infusion, the patient reports fever, flushing, chills, and rigors. With your knowledge of the drug, you know
- A.
  
  This is an unexpected reaction and you need to stop the drug immediately
- B.
  
  This drug does not cause these symptoms, and the patient is just anxious
- C.
  
  These are the expected symptoms that occur with approx 80% of patients
- D.
  
  This is the beginning of a potentially life-threatening reaction
15.

Your patient is receiving rituximab. The patient also has a history of hypertension. What special considerations should be made for this patient?
- A.
  
  None
- B.
  
  Administer any antihypertensive meds just before the rituximab
- C.
  
  Add a 2nd type of antihypertensive medication to the patient's regimen until the rituximab therapy is complete
- D.
  
  Do not administer the antihypertensive agent for 12 h before and 12-24 h after rituzimab administration
16.

Your patient is receiving abciximab after a PTCA procedure. The patient states, "My friend was taking rituximab for his cancer. They sure sound alike. Do I have a cancer they haven't told me about?" What is your best response?
- A.
  
  "You need to ask your doctor that question"
- B.
  
  "No, manufacturers just name the drugs any way they wish"
- C.
  
  "They are both from the same class of drugs, so the names sound alike, but the drugs are not used for the same purposes"
- D.
  
  "Ive never heard of that other drug"
17.

Your patient is receiving cyclosporine to prevent rejection of a heart transplant. Which of the following patient instructions is INCORRECT?
- A.
  
  "Used a glass container, not plastic, to prevent possible chemical interactions."
- B.
  
  "Mix the medication with grapefruit juice to disguise the taste"
- C.
  
  "Measure the oral solution with the dosing syringe provided, not a tablespoon"
- D.
  
  "You can mix this drug with chocolate milk"
18.

Your patient had a heart transplant 6 mo ago. The patient is prescribed cyclosporine and prednisone daily. The patient comes to the clinic today for the lab tests and states, "I had a heart transplant; why are you guys so interested in my kidneys?" What is your best response?
- A.
  
  "You know how doctors are-they want to check out everything"
- B.
  
  "Cyclosporine can cause damage to your kidneys"
- C.
  
  "Prednisone can stop your kidneys from working"
- D.
  
  "I'll check-perhaps someone made a mistake"
19.

Which nursing assessment should assume priority for the patient receiving rituximab? Assessment of the
- A.
  
  Respiratory system
- B.
  
  Gastrointestinal system
- C.
  
  Central nervous system
- D.
  
  Integumentary system
20.

The nurse should assess a patient who is receiving rituximab for symptoms of infusion reaction syndrome, which include
- A.
  
  Ventricular tachycardia, supraventricular tachycardia, angina, hypotension, and hypertension
- B.
  
  Profound bradychardia, pounding headache and hypotension
- C.
  
  Cellulitis at the insertion site and fever
- D.
  
  Increased respiratory rate, hypotension, and bradycardia
21.

A patient has been given instructions after administration of rituximab. Which of these responses, if made by the patient, would indicate that the patient correctly understood the instructions?
- A.
  
  "I will have a glass of wine before I go to bed tonight"
- B.
  
  "I will drink plenty of water"
- C.
  
  "I will refrain from eating dairy products for the next 24 h"
- D.
  
  "I will take my temperature every hour for the next 12 h"
22.

Your patient is to receive interferon alfa-2a to treat Kaposi sarcoma related to AIDS. Patient teaching should include
- A.
  
  How to give a SC injection
- B.
  
  How to avoid infections
- C.
  
  When to return for blood tests
- D.
  
  All of the above
- E.
  
  None of the above
23.

You are to adminster the first dose of rituximab to a patient who has had a liver transplant. To minimize adverse effects from the rituxmab, you should
- A.
  
  Administer antipyretics after the first dose, if needed
- B.
  
  Administer the drug by IV infusion using a pump
- C.
  
  Administer a high dose initally and then taper the dose
- D.
  
  Do all of the above
- E.
  
  Do none of the above
24.

Within 1 h of starting the rituximab infusion, the patient has a fever of 101.4 F, is flushed, and reports feeling cold. Your best initial response is to
- A.
  
  Provide warm blankets and ice chips
- B.
  
  Seek an order for acetaminophen
- C.
  
  Turn down the rate of rituximab infusion
- D.
  
  Turn off the rituximab infusion
25.

Cyclosporine, an immune modulator, has been prescribed for your patient after a bone marrow transplant. Which of these findings should concern you the most while this patient receives cyclosporine?
- A.
  
  Slightly elevated serum potassium
- B.
  
  Slightly low neutrophil count
- C.
  
  Significantly elevated blood urea nitrogen
- D.
  
  None of the above should cause concern, they are all normal findings