Immune drugs - MC

A patient who has chronic allergies takes loratadine [Claritin] and develops a severe reaction to bee stings. The patient asks the nurse why the antihistamine did not prevent the reaction. What will the nurse say? "H1 blockers do not prevent the release of histamine from mast cells and basophils." "Second-generation H1 blockers contain less active drug and do not work in severe reactions." "Severe allergic reactions occur through actions on muscarinic receptors." "Allergy symptoms that are severe are caused by mediators other than histamine."

"Allergy symptoms that are severe are caused by mediators other than histamine."

A patient asks the nurse to explain how antibodies protect the body against bacterial diseases. Which statement is an accurate response by the nurse? "Antibodies attach to the antigens (or large molecules) on the bacteria surface, creating a way for white blood cells to attach and destroy the bacteria." "Antibodies that destroy bacteria are part of the body's natural immunity. No prior exposure to the bacteria is needed for the body to respond." "Antibodies are large molecules present on the surface of bacteria. White blood cells are able to neutralize these antibodies and destroy the bacteria." "Most antibodies that protect against bacteria are called immunoglobulin A. These antibodies are found on the surface of mature B cells."

"Antibodies attach to the antigens (or large molecules) on the bacteria surface, creating a way for white blood cells to attach and destroy the bacteria."

A nurse is reviewing the immune system with a group of nursing students. One student asks about the difference between cell-mediated immunity antibody-mediated immunity. What should the nurse reply? "Antibody-mediated immunity uses cells produced by B lymphocytes in the immune response." "Antibody-mediated immunity requires cytolytic T cells that attack antigens directly." "Antibody-mediated immunity does not have a role in hypersensitivity reactions." "Antibody-mediated immunity does not involve helper T cells in the immune response."

"Antibody-mediated immunity uses cells produced by B lymphocytes in the immune response."

A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines? "Antihistamines block release of histamine from mast cells and basophils." "H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors." "First-generation antihistamines are more selective than second-generation antihistamines." "Antihistamines block H1 receptors to prevent actions of histamine at these sites."

"Antihistamines block H1 receptors to prevent actions of histamine at these sites."

A nurse is teaching a patient who is about to undergo allograft transplantation of the liver. Which statement by the patient indicates understanding of the post-transplant medications? "Immunosuppressants help reduce the risk of postoperative infection." "I will need to have periodic laboratory work to assess for toxicity." "I will need to take immunosuppressants until all signs of organ rejection are gone." "These drugs will prevent organ rejection."

"I will need to have periodic laboratory work to assess for toxicity."

Which statement by the patient taking fexofenadine would require further teaching? "This medication will help with my seasonal allergies." "I will take this medication in the morning with my juice and breakfast." "I know that I don't have to be as concerned about sleepiness with this medication as I used to be with other allergy medications." "I will take this medication as directed on the package, and as needed."

"I will take this medication in the morning with my juice and breakfast."

A patient currently taking sirolimus [Rapamune] tells the nurse that she is starting a very low-fat diet. Which statement by the nurse is the most appropriate? "Low-fat diets don't work. You should try a low-carb diet." "It is fine to be on a low-fat diet with your medication, as long as you take it with food." "If you change the fat content in your regular diet you should check with your prescriber." "Diet will not affect your medication, so you can do whatever diet you would like."

"If you change the fat content in your regular diet you should check with your prescriber."

The nurse will include which statements when teaching a patient about the use of acetaminophen [Tylenol]? (Select all that apply.) "Acetaminophen is a useful drug for the treatment of inflammation, such as a rheumatoid arthritis." "The most common side effect of treatment with the drug is kidney failure." "Notify your healthcare provider if you notice that your skin or eyes are turning yellow." Correct "Do not routinely use acetaminophen to prevent vaccine-associated fever and pain." Correct "Use of this drug can prevent heart attack and stroke."

"Notify your healthcare provider if you notice that your skin or eyes are turning yellow." Correct "Do not routinely use acetaminophen to prevent vaccine-associated fever and pain." Correct

A patient asks a nurse, "Why should I switch to fexofenadine [Allegra] for my allergies when I've taken diphenhydramine [Benadryl] for so long?" Which response should the nurse make? "The biggest benefit is that the cost is so much lower." "You'll have much less risk of cardiac problems." "There is not nearly as much drowsiness and sedation. "The dosing is more convenient, because you take it once a week."

"There is not nearly as much drowsiness and sedation.

Which instruction should be the priority for the nurse to teach a patient scheduled to start taking sirolimus [Rapamune]? "A lipid-lowering medication can be given to lower cholesterol levels." "There might be some joint pain, diarrhea, and rash with this medicine." "You'll need to notify your doctor if you experience any sore throat or fever." "Take this medication with food, but you'll need to avoid taking it with grapefruit juice."

"You'll need to notify your doctor if you experience any sore throat or fever."

After administering acetylcysteine [Mucomyst] to a patient who overdosed on acetaminophen [Tylenol], a nurse should recognize which outcome as an indicator of the therapeutic effects of acetylcysteine? Absence of jaundice Clear breath sounds Increased bowel sounds Palpable pedal pulses

Absence of jaundice

A nurse instructs the parent of a child with influenza that which medication or medications may be used safely to reduce fever? Ibuprofen [Advil] Naproxen [Aleve] Aspirin [Bayer] Acetaminophen [Tylenol] Indomethacin [Indocin]

Acetaminophen [Tylenol]

A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer? Aspirin [Bayer] Acetaminophen [Tylenol] Ibuprofen [Advil] Naproxen sodium [Aleve]

Acetaminophen [Tylenol]

What does the nurse identify as a possible adverse effect of long-term glucocorticoid therapy? (Select all that apply.) Adrenal insufficiency Osteoporosis Hypoglycemia Hyperkalemia Cataracts

Adrenal insufficiency Osteoporosis Cataracts

A nurse provides discharge instructions for a patient who is taking acetaminophen [Tylenol] after surgery. The nurse should instruct the patient to avoid which product while taking acetaminophen? Alcoholic drinks Leafy green foods Bananas Dairy products

Alcoholic drinks

A patient is receiving morphine sulfate and promethazine [Phenergan]. It is most important for the nurse to assess what? Heart rate Alertness Blood pressure Bowel sounds

Alertness

Before administering celecoxib [Celebrex], it is most important for the nurse to assess the patient for a history of what? Allergy to sulfonamides History of hepatitis C Hypothyroidism Diabetes mellitus

Allergy to sulfonamides

A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the patient? Antihistamines should not be taken during pregnancy but may be taken when breast-feeding. The margin of safety for antihistamines is clearly understood for pregnant patients. Antihistamines should be avoided unless absolutely necessary. Second-generation antihistamines are safer than first-generation antihistamines.

Antihistamines should be avoided unless absolutely necessary.

Which medication does the nurse identify as a monoclonal antibody used to inhibit allograft rejection in transplant recipients? Mycophenolate mofetil [CellCept] Basiliximab [Simulect] Tacrolimus [Prograf] Sirolimus [Rapamune]

Basiliximab [Simulect]

Which statements about the care of a patient with aspirin poisoning does the nurse identify as true? (Select all that apply.) Warming blankets are routinely used to raise the patient's temperature. Diuretics and fluid restrictions are needed to correct the fluid overload commonly seen with aspirin poisoning. Bicarbonate infusions are used to reverse acidosis and promote renal excretion of salicylates. Correct Activated charcoal is contraindicated in the treatment of aspirin poisoning. Hemodialysis or peritoneal dialysis can accelerate salicylate removal.

Bicarbonate infusions are used to reverse acidosis and promote renal excretion of salicylates. Correct Activated charcoal is contraindicated in the treatment of aspirin poisoning.

A patient is prescribed celecoxib [Celebrex] and warfarin [Coumadin]. The nurse should monitor the patient for what? Renal toxicity Bleeding Stroke symptoms Dysrhythmias

Bleeding

The nurse identifies which symptom as a result of activation of histamine1 (H1) by allergic reaction? Hypertension Bronchoconstriction Sweating Pupillary dilation

Bronchoconstriction

A nurse instructs a patient to discontinue the scheduled use of high-dose aspirin before undergoing which procedures? (Select all that apply.) Routine dental cleaning Removal of a skin mole Cataract surgery Cholecystectomy Hysterectomy

Cholecystectomy Hysterectomy

When assessing a patient for adverse effects of cyclosporine [Sandimmune], it is most important for the nurse to review which laboratory findings? (Select all that apply.) Creatinine level Hemoglobin level Platelet count Bilirubin level WBC count

Creatinine level Bilirubin level WBC count

The nurse knows that which immunosuppressants are among the most effective? Azathioprine [Imuran] and everolimus [Zortress] Methotrexate [Rheumatrex] and muromonab-CD3 [Orthoclone OKT3] Sirolimus [Rapamune] and methylprednisolone Cyclosporine [Sandimmune] and tacrolimus [Prograf]

Cyclosporine [Sandimmune] and tacrolimus [Prograf]

A patient is taking a first-generation H1 blocker for the treatment of allergic rhinitis. It is most important for the nurse to assess for which adverse effect? Skin flushing Wheezing Insomnia Dry mouth

Dry mouth

When administering prednisone to a patient, the nurse will do what? Administer the prednisone in the evening to coincide with the natural secretion pattern of the adrenal cortex. Instruct the patient to stop taking the prednisone immediately if diarrhea develops. Ensure that meals are at bedside so that administration with food reduces gastric irritation. Avoid intravenous delivery to prevent adverse effects.

Ensure that meals are at bedside so that administration with food reduces gastric irritation.

A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer? Promethazine [Phenergan] Epinephrine Diphenhydramine [Benadryl] Hydroxyzine [Vistaril]

Epinephrine

A patient has chronic idiopathic urticaria. Which medication would be appropriate for the nurse to administer for this condition? Fexofenadine [Allegra] Loratadine [Claritin] Azelastine [Astelin] Diphenhydramine [Benadryl]

Fexofenadine [Allegra]

The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding does the nurse know is an adverse effect of ibuprofen [Advil] therapy? Hives Hematemesis Dysmenorrhea Jaundice

Hematemesis

A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication? Ibuprofen [Motrin] Zolpidem [Ambien] Loratadine [Claritin] Diphenhydramine [Benadryl]

Ibuprofen [Motrin] Ibuprofen [Motrin] can block the antiplatelet effects of aspirin; therefore, patients who take low-dose aspirin to protect against myocardial infarction and thrombosis should avoid taking ibuprofen [Motrin].

What does the nurse identify as possible complications of glucocorticoid therapy? (Select all that apply.) Impaired carbohydrate and glucose tolerance Increased production of glucocorticoids from the adrenals Predisposition to gastrointestinal ulceration Decrease in serum sodium and glucose levels Increase in plaque development in coronary arteries

Impaired carbohydrate and glucose tolerance Predisposition to gastrointestinal ulceration

The nurse knows that the production of memory T and B cells will do what? Slow the immune response. Provide the code for major histocompatibility complexes. Augment the release of specific cytokines. Increase the intensity of the immune response .

Increase the intensity of the immune response .

The nurse is developing a plan to minimize the risk of adrenal insufficiency for a patient who is receiving long-term glucocorticoid therapy. Which outcome should be included? Increases daily intake of sodium for vascular expansion Tapers blood pressure medications to avoid hypotension Obtains periodic ultrasound scans of adrenal glands Increases or supplements dosage of glucocorticoid at times of stress

Increases or supplements dosage of glucocorticoid at times of stress

A patient who takes cyclosporine [Sandimmune] is also receiving ketoconazole [Nizoral]. The nurse should expect which therapeutic outcome from the combined medications? Improved glomerular filtration rate Inhibition of cyclosporine metabolism Decreased risk of lymphoma occurrence Decreased risk of bacterial and viral infections

Inhibition of cyclosporine metabolism

A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen? It is selective for cyclooxygenase-2. It does not inhibit cyclooxygenase. It has minimal effects at peripheral sites. It is more similar to opioids than to nonsteroidal anti-inflammatory drugs (NSAIDs).

It has minimal effects at peripheral sites.

A nurse monitors a patient who takes azathioprine [Imuran] for which adverse effects? (Select all that apply.) Leukopenia Thrombocytopenia Alopecia Nephrotoxicity Red urine color

Leukopenia Thrombocytopenia Alopecia

A patient drinks five to six alcoholic beverages per day and takes acetaminophen [Tylenol] for pain relief. The nurse should caution the patient to do what? Limit intake of acetaminophen to less than 2000 mg/day Avoid taking acetaminophen for pain Take acetaminophen with food to reduce the risk of liver damage Avoid taking any pain reliever other than acetaminophen

Limit intake of acetaminophen to less than 2000 mg/day

The nurse is preparing to administer a medication for acute organ rejection. Which medication will the nurse prepare to administer? Methylprednisolone sodium [Solu-Medrol] Diphenhydramine [Benadryl] Acetaminophen [Tylenol] Meperidine [Demerol]

Methylprednisolone sodium [Solu-Medrol]

A woman who has arthritis is breast-feeding her infant and asks the nurse if it is safe to take NSAIDs while nursing. What will the nurse tell this patient? NSAIDs are safe to take while breast-feeding. NSAIDs are not safe, even in small amounts. She should take only COX-2 inhibitors while breast-feeding. She should request a prescription for narcotic analgesics.

NSAIDs are safe to take while breast-feeding.

A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important for the nurse to teach the patient to do what? Increase intake of dietary sodium. Take antibiotics to prevent infection. Never abruptly withdraw therapy. Have an eye examination every year.

Never abruptly withdraw therapy.

The nurse is screening a patient before administering a live virus vaccine. The patient is currently taking a glucocorticoid medication. Which action should the nurse take? Continue screening and give the vaccine if appropriate. Note the contraindication but give the vaccine anyway. Note the contraindication and clarify the order with the healthcare provider. Hold the vaccine and notify the deparment of health.

Note the contraindication and clarify the order with the healthcare provider.

Which statement regarding antihistamine administration to older adults does the nurse identify as true? Antihistamines cause CNS excitation in older adults. Larger doses of antihistamines are needed for older adults. Antihistamines can be used to reduce intraocular pressure. Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.

Older men with benign prostatic hypertrophy can experience worse symptoms when taking antihistamines.

A patient is scheduled to start taking aspirin for the treatment of rheumatoid arthritis. The nurse anticipates that which medication most likely will be prescribed? Docusate sodium [Colace] Ascorbic acid (vitamin C) Pantoprazole [Protonix] Furosemide [Lasix]

Pantoprazole [Protonix]

A patient takes glucocorticoids and digoxin [Lanoxin]. It is most important for the nurse to monitor which electrolyte? Calcium Magnesium Sodium Potassium

Potassium

An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine [Phenergan]. What will the nurse do? Give the medication as ordered. Question the order. Monitor the child for bronchoconstriction. Request an order to give the drug orally.

Question the order.

A patient who has rheumatoid arthritis is scheduled to start taking celecoxib [Celebrex]. A nurse should recognize which factor from the patient's history as a contraindication to taking this medication? Hypothyroidism Recent heart bypass surgery Positive tuberculin skin test Allergy to penicillin

Recent heart bypass surgery

A nurse should recognize that a patient who takes an angiotensin-converting enzyme (ACE) inhibitor while also taking high-dose aspirin is at risk of developing what complication? Congestive heart failure Liver toxicity Incorrect Renal failure Hemorrhage

Renal failure

A patient has received a toxic dose of an antihistamine. It is most important for the nurse to assess the patient for what? Tinnitus Seizure activity Lethargy Visual disturbances

Seizure activity

A patient is prescribed sirolimus [Rapamune] and cyclosporine [Sandimmune] after renal transplantation. It is most important for the nurse to closely monitor which value? Serum creatinine Aspartate aminotransferase Serum potassium Partial thromboplastin time

Serum creatinine

A transplant recipient is receiving cyclosporine [Sandimmune]. Which response should a nurse expect if the medication is having the desired effect? Increased antibody response Increased natural killer (NK) cellular activity Suppression of T lymphocytes Suppression of hepatic metabolism of steroids

Suppression of T lymphocytes

The nurse should question an order for glucocorticoids in the treatment of a patient with what? Systemic fungal infection Diabetes mellitus Myasthenia gravis Glaucoma

Systemic fungal infection

A patient who takes over-the counter-diphenhydramine [Benadryl] for seasonal allergy symptoms complains of drowsiness. What should the nurse do? Instruct the patient to drink caffeinated beverages. Recommend taking the medication with meals. Ask the patient's health care provider to prescribe hydroxyzine [Vistaril]. Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.

Tell the patient to take cetirizine [Zyrtec] instead of diphenhydramine.

After receiving an allograft liver transplant, a patient is prescribed cyclosporine [Sandimmune] oral solution. What is the most critical component of patient teaching that the nurse should stress? The medication will help prevent transplant rejection. The oral solution can be mixed with orange juice. The medication will be taken every day for life. The medication causes reversible increase of hair growth.

The medication will be taken every day for life.

A patient with a chronic illness is on daily glucocorticoids. He is brought to the hospital following a severe motor vehicle accident. He is wearing a medical alert bracelet stating his home medications. Noting that the patient takes glucocorticoids daily, the nurse knows which of the following to be true? The patient will need lower doses of glucocorticoids following the trauma. The patient will have to stop all glucocorticoids immediately. The patient will need the same dose of glucocorticoids he used at home. The patient will need higher doses of glucocorticoids following a trauma.

The patient will need higher doses of glucocorticoids following a trauma.

Which of the following statements about promethazine are true? (Select all that apply.) The preferred route of parenteral dose is intramuscular. The medication should be administered through a large-bore IV. The medication should be given by IV push only. The medication should be given in a concentration of 25 mg/mL or less. This medication can cause severe tissue injury.

The preferred route of parenteral dose is intramuscular. The medication should be administered through a large-bore IV. The medication should be given in a concentration of 25 mg/mL or less.

Nonaspirin NSAIDs differ from aspirin in all but which way? They cause reversible inhibition of COX, so their effects decline as soon as their blood levels decline. They can suppress platelet aggregation, but they are not used to prevent MI and stroke. They increase the risk of MI and stroke and therefore should be used in the lowest effective dosage for the shortest possible time. They are safe to use in children with chickenpox or influenza.

They are safe to use in children with chickenpox or influenza.

A nursing student asks the nurse how antibodies like basiliximab provide immune suppression. The nurse responds by telling the student that antibodies: reduce proliferation of B cells. boost immune responses. block T-cell function. suppress interferon production

block T-cell function.