pharm 15-18

The nurse is caring for a client whose rheumatoid arthritis has not responded well to conventional therapies. The client's health care provider has prescribed auranofin. What health education should the nurse provide?

" There is a possibility of significant and varied adverse effects"

The nurse is caring for a client who is immunocompromised and is explaining the function of cytotoxic T cells. What should the nurse explain to this client?

" these T cells can either destroy a foreign cell or mark it for aggressive destruction by another cell"

The nurse teaches a female client who is receiving immune modulating drugs about the need to use barrier contraceptives. The client says, "I hate using barrier contraceptives. Why can't I just take oral contraceptives?" What is the nurse's best response?

"Effects of oral contraceptives may be altered by liver changes or changes in the immune system"

A nurse is assessing a client who has been taking nonsteroidal antiinflammatory 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 for their diagnosis of rheumatoid arthritis?

"I asked my doctor to check for blood in my stool regularly"

The nurse is caring for a 30-year-old woman who presented to their gynecologist today to receive a human papillomavirus (HPV) vaccine (Gardasil), stating that they believe that they may have genital warts. What should the nurse teach this client?

"The drug is only effective if administered before exposure to human papillomavirus (HPV)."

A parent calls the clinic and tells the nurse that the their toddler has a temperature of 102°F (38.9°C). What should the nurse teach the parent about the child's fever?

"a fever is the body's way if fighting an infection and supporting the body's immune system"

A nurse asks a colleague who works in oncology why the body does not phagocytize a tumor. What would be the colleague's best response?

"sometimes tumor cells trick the T cells into allowing them to survive"

The nurse is caring for a client waiting for a heart transplant. The client's partner asks the nurse, "Why don't they just choose any heart until the right heart can be found?" What is the nurse's best response?

"the more closely the new heart matches the client's tissue, the less aggressive the immune reaction will be"

An older adult client has presented to the emergency department reporting frank blood in their stool over the past 24 hours. What assessment question should the nurse prioritize?

"what medications do you take for pain or inflammation?"

The nurse is teaching the client, who has been newly prescribed etanercept, how to administer the medication. What statement is accurate?

"you can rotate subcutaneous injection sites to avoid tissue damage"

The nurse is caring for a number of clients. Which client has lost a barrier defense, increasing the client's risk for infection?

24 year old diagnosed with a partial-thickness burn

A client is experiencing an allergy to a penicillin antibiotic. What immunoglobulin (Ig) will most directly relate to this immune response associated with mast cells?

IgE

A client has presented to the clinic for an allergy shot. The client asks the nurse what immunoglobulin (Ig) is located in the body's tissues and is thought to be responsible for allergic reactions. What is the nurse's appropriate response?

IgE is thought to be responsible for allergic reactions

A nurse received the seasonal influenza vaccine 10 weeks ago has now been exposed to that strain of the influenza virus. What immunoglobulin will hasten the nurse's immune response to this pathogen?

IgG

The nurse is explaining to a client how an antigen previously encountered elicits a much faster immune response because the body's immune cells "remember" previous encounters with the antigen. The nurse is describing the function of what cells?

B cells

While traveling, an older adult realize that the area they are visiting is currently experiencing an increased risk for a communicable disease? What resource should the individual use to best determine the most effective prophylactic treatment?

CDC

What client would be most likely to benefit from the administration of an antitoxin?

a client in distress who is showing signs and symptoms of botulism

What client is most likely benefiting from the effects of tumor necrosis factor (TNF) cytokines?

a client who has ductal carcinoma in situ (DCIS)

A parent has brought a 6-year-old child to the clinic. The child has a fever of 102.8°F (39.3°C) and is subsequently diagnosed with the flu. What medication best balances risks and benefits for treating this client's fever?

acetaminophen

A nurse has administered a prescribed dose of acetaminophen to a hospitalized client with a fever. This medication will reduce the client's temperature by what means?

acting directly on the hypothalamus to cause vasodilation and sweating

A healthy neonate will be discharged from the hospital 36 hours after birth. How should the nurse promote the neonate's immune function?

administer hepatitis B vaccination as prescribed

The nurse is caring for an adult client who has not responded to traditional antirheumatic drugs. The nurse should anticipate the administration of what interleukin receptor antagonist?

anakinra

A client is brought to the emergency department after being bitten by a snake. The nurse asks the client to carefully describe the snake that bit them. The nurse would ask this question for which reason?

antivenin is very specific with regard to the venoms it can treat

The nurse has a prescription to administer oprelvekin to a client for the first time. Before administering the drug, what assessment should the nurse perform?

assess for allergy to E.coli- produced products

How do immune suppressants work when ordered for a client who has had an organ transplant?

blocking normal effects of the immune system

The nurse is caring for a client who reports taking 800 mg of ibuprofen three times a day for relief of menstrual cramps. What laboratory results should the nurse prioritize when assessing this client?

complete blood count

A client is fighting an active infection, and antigen-antibody complexes are being created. How will these new complexes enhance the immune response?

create new receptor sites that activate complement proteins

Which consideration associated with the older adult client has priority when considering their care needs while on immune modulator therapy?

effects of normal aging

A parent brings the 18-month-old client into the clinic for a diphtheria, tetanus, and pertussis vaccine. The child has a runny nose, a fever of 102.4°F (39.1°C), and is coughing. What is the nurse's appropriate action?

hold the immunization until the child is free of allergic or coldlike symptoms

The nurse is caring for a client who is to receive interleukins. What change in the client's status would most clearly suggest successful therapy?

increased numbers of natural killer cells

Injury to a client's cell membrane has caused the local release of histamine. The nurse should anticipate what effect on the client?

increased pain

A client has just been told that their cancer has metastasized to the right kidney. An interferon (aldesleukin) has been prescribed to treat this metastasis. What potential benefit should the nurse describe to the client?

inhibition of tumor growth

A parent is discussing their concern about agreeing to vaccinate their newborn especially with the MMR vaccine with the nursery nurse. What information concerning the review of evidence by the American Academy of Pediatrics should guide the nurse's response?

it has been determined that the mmr vaccine is not responsible for autism

The nurse is educating a couple about the recommended immunization plan for their infant. What should the nurse teach these new parents?

keep a written record of the child's immunizations

The nurse is assessing a 10-year-old child who has been experiencing chronic headaches. The child's parent reports the administration of acetaminophen three to four times a day for the past several weeks. What assessment should the nurse prioritize?

liver enzymes

An employee of a long-term care facility has been administered the hepatitis B series prior to beginning employment. How should the employee's therapeutic response to the vaccination be best assessed?

measure the employee's serum antibody levels

The nurse is reviewing the results of the complete blood count of a client who is diagnosed with bacterial meningitis. What value should the nurse expect to see elevated?

neutrophil count

A nurse is providing client education to the parent of a child receiving their first immunization. The nurse should educate the parent that it is common for the child to exhibit what signs and symptoms afterward?

pain, redness, and swelling at the site of injection

A 2-year-old client is immunocompromised following treatment for leukemia, and the client's sibling has developed respiratory syncytial virus (RSV). What medication will best prevent RSV in the client?

palivizumab

The public health nurse is reviewing immunity with a group of school nurses prior to an immunization campaign. What should the public health nurse teach this group of school nurses?

passive immunity is limited, lasting only as long as the antibodies circulate

An older adult client who is receiving an immune suppressant has been admitted to the hospital unit. What action should the nurse prioritize?

protecting the client from infection

A client diagnosed with rheumatic disease is being prescribed salicylate therapy. The nurse should teach the client monitor for which adverse effects?

ringing in the ears

Which biological weapon is considered highly transmissible?

smallpox

A client on the transplant unit is taking cyclosporine after receiving a liver transplant 4 days earlier. A coworker of the client has come for a visit and is apologetic because of a cough and runny nose. What is the nurse's best action?

teach the visitor about the client's risk for infection and ask the visitor to return after becoming healthy

A client with severe rheumatoid arthritis has been prescribed etanercept. What health education should the nurse provide to this client?

technique for SQ self-injection

The clinic nurse is administering vaccines at well-baby checkups. Before administering a diphtheria, tetanus, and pertussis (DTP) vaccine, what assessment parameter should the nurse prioritize?

temperature

What is the primary difference between acute and chronic inflammation?

the chronic form can stimulate cellular damage

A 30-year-old female has been diagnosed with leukemia and will be using an immune modulator for treatment. What should the nurse teach the client about their drug therapy?

the client should use barrier contraceptives while taking the drug

A client has been diagnosed with an autoimmune disease that causes numerous distressing symptoms. What pathophysiologic process is causing this client's symptoms?

the clients body is producing antibodies against the clients own self-antigens

A nurse is discussing interferon alfa-2b with a client who has been prescribed the drug for a diagnosis of chronic hepatitis C. What health education should the nurse provide to the client?

the drug may cause flulike symptoms

A client's health care provider has concluded that the client is likely to benefit from treatment with a monoclonal antibody. The success or failure of treatment will primarily depend on what variable?

the match between target cell receptor sites and the monoclonal antibody

A client who has received a heart transplant has been given a prescription for medications that block T-cell activity. What is the rationale behind this order?

to prevent an inflammatory reaction against the transplanted heart

The client has arrived in the short stay unit for an infusion of iodine-131 tositumomab. Before beginning the infusion, the nurse assesses the client's vital signs and finds the client has a temperature of 101.5°F (38.6°C). What is the nurse's best action?

treat the fever as ordered before beginning the therapy

A parent has contacted the nurse and is concerned about media reports of a measles outbreak. The parent wants to confirm that their 9-month-old child has been immunized against measles. What is the best response by the nurse?

twelve months is the youngest age at which the child should be vaccinated

The nurse works with the client in a long-term care facility. What principle should guide the nurse's administration of influenza vaccinations?

unless contraindicated, residents should receive influenza vaccinations annually