NURS165 exam 3 review

which statement indicates that the client understands immunosuppressant therapy following a solid organ transplant

"i know that I will need to stay on this medication for the rest of my life"

a middle aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patients drug regimen. what patient education should the nurse provide to this patient

"it's important that you let us know if you develop any significant swelling or puffiness"

a client has been exposed to staphylococcus aureus bacteria. place these steps in the clients immune response in the correct order

-antigens become present in the client -B cell reacts with the antigen -B cell transforms into a plasma cell -plasma cell produces immunoglobulins -an antigen antibody complex is formed -complement proteins are activated

what assessment data would confirm that a client is demonstrating the presence of effective major defense mechanisms

-intact skin and mucous membranes -redness and heat at the site of a cut - an elevated temperature -an elevated white blood cell count

the nurse is reviewing the clients medication history for evidence of NSAID use. what medications would the nurse identify as NSAIDs?

-naproxen -indomethacin -meloxicam -ibuprofen Acetaminophen is a nonsalicylate

the human body contains a variety of immunoglobulins. which of these immunoglobulins is found in sweat, tears, mucus, and bile?

IgA

during which phase of the cell cycle would a nurse expect a mitotic inhibitor to act

M

what is alemtuzumab

a antibody specific for lymphocyte receptor sites

the nurse is caring for diverse group of clients. which client is most likely to benefit from the administration of cyclosporine

a client with chronic renal failure who is recovering from a kidney transplant

what is methotrexate

a prototype antimetabolite

what is vincristine

a prototype mitotic inhibitor

a client is being treated for cancer and dronabinol has been added to the clients current medication regimen. what assessment finding would indicate a therapeutic effect of this medication

absence of nausea

what is omalizumab

an antibody to immunoglobulin E as important factor in allergic reactions

what is fluorouracil

an antimetabolite

while providing client teaching relative to inflammatory disorders, the nurse would explain the presence of inflammation as

an attempt by the body to remove the damaging agent and repair the damaged tissue

what route is alefacept administered

as an intravenous bolus or intramuscularly

a 49 year old client is diagnosed with ovarian cancer. what is a characterisitic of malignant cells that differentiates them from normal body cells

cancerous cells grow in an uncontrollable fashion

an oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribue to the success or failure of a patients chemotherapy. which cancerous cell is most susceptible to the effects of chemotherapeutic drugs

cells that have a rapid mitotic rate

a 42 year old client is experiencing chemotherapy induced thrombocytopenia. the nurse is providing information to the client regarding the medication oprelvekin. which information would the nurse include in the explanation

chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. oprelvekin is used to increase platelet production to decrease the risk

a patient is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. which nursing intervention is appropriate with each dose administration of omalizumab

have epinephrine available

a client is admitted to the emergency department with a suspected overdose of acetaminophen. what adverse effect is the most common in acute or chronic overdose of acetaminophen

hepatotoxicity

what conditions are salicylates effective in managing

pain, fever, inflammation

what is bleomycin used for

palliative treatment of squamous cell carcinomas ,testicular cancers, and lymphomas

the nurse reviews the plan of care for a patient receiving antineoplastic therapy. the nurse notes a nursing diagnosis of risk for infection. which adverse effect would the nurse expect the patient to exhibit

pancytopenia

IgE

present in small amounts and seems to be related to allergic responses and to the activation of mast cells

A client received an injection of doxorubicin and is now observing a reddish urine. the client reports blood in the urine to the nurse. how should she respond?

the reddish urine is an expected response to the drug

a client who is a young adult was immunized against pertussis as a child and has now been exposed to the causative bacteria, Bordatella pertussis. the clients exposure to this bacteria will cause

the release of IgG by memory B cells

what is daunorubicin used for

use as first line treatment for advanced HIV infection and associated kaposis sarcoma

for the first time, a 10 year old female has received an IM injeciton of Gardasil. what followup educaiton should the nurse provide

youll have to get another shot in around 2 months

a nurse is reviewing the medical record of a client who is prescribed NSAID therapy. which medication would be contraindicated with NSAID therapy

aspirin

which antineoplastic drugs are classified as antineoplastic antibiotics

bleomycin, dactinomycin, daunorubicin

a client is receiving oprelvekin. which would suggest that the client is experiencing a hypersensitivity reaction?

chest tightness

when describing alkylating agents, the nurse would explain that this medication is seen as the prototype

chlorambucil -prototype alkylating agent

what is idarubicin used for

combination therapy for treatment of acute myeloid leukemia in adults

IgG

contains antibodies made by the memory cells that circulate and enter the issue. Found mostly in the serum

what is the role of interferons in the normal function of the immune system

countering the replication and spread of viruses

the nurse is assessing a client for adverse effects related to methotrexate therapy. what diagnostic finding should the nurse prioritize

creatinine clearance

which would the nurse expect to administer orally

cyclosporine

IgM

first to be released, contains the antibodies produced at the first exposure to the antigen

the nurse is caring for a client with gout that is taking colchicine. in addition to the administration of this medication, what education can the nurse provide to help with the prevention of future episodes of gout

follow a low purine diet

a nurse is preparing to teach a client about the adverse effects of the prescribed NSAID therapy. which system would the nurse include as being involved

gastrointestinal

what route is abatacept administered

given intravenously

what drugs used to treat rheumatoid arthritis are contraindicated in a client who has a history of toxic levels of heavy metals

gold salts -can be quite toxic and are contraindicated in the presence of any known allergy to gold, severe diabetes, CHF, severe debilitation, renal or hepatic impairment, hypertension, blood dyscrasias, recent radiation treatment, history of toxic levels of heavy metals, and pregnancy or lactation

a nurse is conducting a medication reconciliation for an older adult client who has just relocated to the long term care facility. the nurse notes that the resident has been taking colchicine on a regular basis. which medication regimen should signal the nurse to the possibility of what diagnosis

gout

a client has been prescribed oral cyclosporine following a successful liver transplant. when providing education, the nurse should advise the client to avoid mixing the drug with what liquid

grapefruit juice

a 78 year old male client begins an immunosuppressant therapy for his rheumatoid arthritis. the nurse is concerned because this client is at greater risk for what complication, compared with younger adults using the same treatment modality?

infections

a client is lying on the back for more than 3 hours. the client develops a reddened area on the coccyx. what response is noted with the development of the reddened area

inflammation

the pathophysiology instructor is discussing phagocytosis. what types of responses would the instructor explain interact in complex ways and share a number of processes, including phagocytosis

inflammatory and immune

what best describes the action of NSAIDs

inhibit prostaglandin synthesis

a patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi sarcoma. As a result of this most recent diagnosis, the patients care team has opted to begin treatment with interferon alfa-2a. the nurse is aware that this drug will address the etiology of Kaposi sarcoma by

inhibiting tumor growth by enhancing inflammation

a group of students are reviewing information about immune modulators in preparation for a test. the students demonstrate understanding of the material when they identify what as an immune stimulant

interferon

which agent would be classified as an immune stimulant

interferon alfa-2b

a client comes to the clinic to learn about interferons. what would the nurse include in the lesson plan

interferons modulate the response of the immune system to viruses, bacteria, cancer, and other foreign substances

a male patient has been on long term bicalutamide therapy. in order to assess adverse effects of the drug therapy the nurse will closely monitor

liver function

a 30 yo man has spent 5 hours on a cross country flight seated next to a passenger who has been sneezing and coughing and the man has been inhaling viruses periodically. which situation would most likely result in the stimulation fo the mans T lymphocytes and adaptive immune system

recognition of a foreigh peptide bound to a self major histocompatibility compex (MHC)

an 11 year old client is having a cavity filled in the left mandibular first molar. the health care provider has prescribed aspirin for pain relief after the procedure. the nurse discovers upon assessment that the child is suffering from a flulike illness. the nurse contacts the healthcare provider about the prescribed medication for pain. what is the risk if aspirin is administered to this client

reye syndrome

a client is receiving anakinra for treatment of rheumatoid arthritis. the client is scheduled to have arthroscopic evaluation of the right knee. what is the priority nursing diagnosis for this client after the procedure

risk for infection

a patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patients care plan accordingly. what nursing diagnosis is most appropriate in light of this addition to the patiens drug regimen

risk for infection related to bone marrow suppression

the pharmacology instructor is explaining interleukins to the class. what would the best definition of interleukins

they are chemicals used to communicate between leukocytes and are produced by T cells

a patient with acute lymphobastic leukemia is receiving imatinib on an inpatient basis. when planning the care of this patient, what assessment should be specified in the patients plan of nursing care

daily weights

an infant is being administered an immunization. which statement provides an accurate description of an immunization

it is the administration of an antigen for an antibody response

a nurse is preparing to administer imatinib to a client. the nurse expects to administer the drug by which route

oral

whcih autacoids facilitate platelet aggregation

thromboxanes

the nurse is describing the necessity of recover periods between treatment cycles to a client receiving chemotherapy. how should the nurse best explain the need?

time is needed to replace many of the healthy body cells killed by chemotherapy

What are antiandrogens used for in males

to treat prostate cancer.

a nurse on the oncology unit is caring for a client with an astrocytoma. the client has just been told the tumor is growing very fast. the client asks the nurse how these tumors grow. what would be the nurses best response

brain tumors infiltrate the surrounding tissue

a nurse is caring for a client with an allograft transplant. the health care provider orders a monoclonal antibody to prevent rejection of the transplant. what monoclonal antibody would the nurse expect to be ordered?

daclizumab -specific to interleukin-2 receptor sites on activated T lymphocytes; they react with those sites and block cellular response to allograft transplants

a 63 yo male patient has just begun treatment with IV paclitaxel. about 10 minutes into the infusion. the nurse bcomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing ...

dyspnea manifestations of a anaphylactoid rxn: dyspnea, hypotension, tachy, wheezing, CP

what is erlotinib

effective against specific to malignaant receptor sites

a male client is receiving paraenteral cytotoxic medicaitons in the home. adjunct therapy may include what substance

erythropoietin

a nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. what typically triggers protooncogenes to differentiate into oncogenes

exposure to carcinogens

which are common adverse reactions that is included in teaching a client about epoetin?

fatigue, nausea, headache

a group of students are reviewing class material about lymphoid tissue. the students demonstrate a need for additional teaching when they identify this as lymphoid tissue

histamine -histamine is a substance released when a cell membrane is injured and is not considered lymphoid tissue

a nurse is assessing a client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for many months. what statement by the client indicates to the nurse that the client has a good understanding of the use of this therapy

i asked my doctor to check for blood in my stool regularly

a clients chemotherapy regimen has been deemed successful but the client is experiencing debilitating n/v. these adverse effects should signal the nurse to the possibility of what nursing diagnosis

imbalanced nutrition: less than body requirements

a client is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. administration of filgrastim may aid in achieving what desired outcome

increased leukocytes

a patient is receiving carboplatin. the nurse would expect to administer this drug by which route?

intravenous adminitered IV on day 1 every 4 weeks

the client states that he knows many peopl who take acetaminophen, and asks the nurse what it is used for. what is the best response by the nurse

it is an aspirin substitute for pain and fever

a client is prescribed filgrastim. which is the nurses best explanation of how this drug works

it stimulates growth and production of WBCs to fight off infection

a client with mild low back pain has been advised to take acetaminophen. the nurse teaching the client about this medication would include that excessive intake of acetaminophen may result in which

liver damage

a nurse is caring for a patient who has just been diagnosed with adenocarcinoma of the pancreas. what antineoplstic does the nurse suspect the patient will receive

mitomycin

a male client is informed that the latest tests indicate that his cancer has spread to his liver. the client receives capecitabine as part of his treatment regimen. what would the nurse expect the health care provider to do

monitor the client closely and repeat LFTs routinely

a client is administered cyclosporine to prevent rejection of a kidney transplant. which is a major adverse effect of cyclosporine

nephrotoxicity

a client has developed a wound infection and leukocytes are leaving the bloodstream to perform phagocytosis on pathogens. what white cells are most likely performing this function

neutrophils

a client presents to the ED with a swollen, reddened, painful leg wound has been diagnosed with MRSA cellulitis. the health care provider has ordered a CBC and white cell differential. which blood components would the provider most likely anticipate to be elevated

neutrophils

to help understand immunostimulant drug therapy, the client has come to the clinic for a class on thrombopoiesis. the nurse explains that the term means the formation of which types of blood cells

platelets

the nurse is providing care for a client whose current medications include tacrolimus. the nruse should anticipate that this client is likely to be taking what medication concurrently

prenisone

the nurse is caring for a child who will be receiving a renal transplant and who has been prescribed cyclosporine. when teaching the parents and child about this drug, the nurse should explain what primary rationale for administering this drug

prevention of organ rejection

when explaining the risks of pretransplant immunosuppression, the nurse demonstrates understanding of the process when making which statement

serious complications can occur if you are not monitored carefully while you are immunosuppressed

when preparing to administer ondansetron for a patients nausea and vomiting, the nurse understands that this agent blocks

serotonin

the nurse assists and educates clients on the difference between nonspecific and specific immunity. the body possesses several defense systems. which nonspecific defense mechanism provides a physical barrier and secretes enzymes that kill or reduce the virulence of bacteria

skin

the first physical line of defense is innate immunity is

skin and mucous membranes

a client is receiving an IV immune stimulant and develops a cardia arrhythmia. what is the nurses priority action?

stop the drug immediately

what route is glatiramer acetate administered

subcutaneously

a client became ill with an influenza virus several days ago. today the client describes being free of symptoms. what component of the immune system will be predominant today

suppressor T cells

a nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. what potential benefit of targeted therapies should the nurse highlight in this education session

targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected

the nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs for which client

the client diagnosed with peptic ulcers

a client is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. what effect will this regiment likely have on the cients hemostatic function

the clients platelet count will decline

a client is receiving immunosuppressant therapy. which adverse effects should the client be educated about regarding these effects

the importance of keeping the home clean

an older adult has been diagnosed with acute lymphoblastic leukemia and her care team has identified potential benefits of imatinib. which characteristics of this patients current health status may preclude the use of imatinib

the patient has chronic heart failure resulting in significant peripheral edema

a nurse is precepting a nursing student and together they are caring for a patient who is to receive interleukins. the student nurse asks what happens physiologically when a patient receives interleukins. what would be the nurses best response

the patient has increased in the number of natural killer cells

a student states "it seems like helper T cells do a lot more than just 'help' the cellular immunity process". which response about CD4+ helper T cells best conveys an aspect of their role in immunity

they do play a major role in stimulating and regulating the whole process -helper t cells are central to the regulation, proliferation and stimulation of the immune system

what potential benefit is unique to biologic agent therapies?

they may affect cancer cells while leaving normal body cells unaffected

the nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. how should the nurse best explain the need

time is needed to replace many of the healthy body cells killed by chemotherapy

what is chrysotherapy

treatment with gold salts -gold is taken up by macrophages which then inhibit phagocytosis. it is reserved for use in patients who are unresponsive to conventional therapy and can be very toxic

within an infected wound bed, many cell types are involved in protecting the host and eliminating the "foreign invaders" to promote wound healing. how does the identification of body tissues from foreign substances occur

via the immune system

which drug would be classified as a mitotic inhibitor

vincristine

a nurse is performing discharge teaching with a client who will soon return home. the client will continue taking imatinib for the foreseeable future, an the nurse is teaching the client about the safe administration of this drug. how should the nurse instruct the client to take imatinib

with food and a large glass of water