Ch 34 Drugs Affecting The Immune Response

27 Questions | Total Attempts: 250

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Drug Quizzes & Trivia

Quiz for Ch 34 Drugs Affecting the Immune ResponseGSU Fall 2009


Questions and Answers
  • 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

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