Pharm biologics quiz
A patient is to receive filgrastim (Neupogen) 5 mcg/kg/day. The patient weights 198 lbs. Calculate how many micro-grams of medication this patient will receive each day. a. 450 mcg b. 4.5 mcg c. 4500 mcg d. 45 mcg
A
A patient who has received chemotherapy has a steadily decreasing white blood cell count. The chemotherapy will end on Tuesday afternoon. The oncologist has mentioned that a colony-stimulating factor will be started soon. The nurse knows that the appropriate time to start this medication is when? a. Wednesday afternoon, 24 hours after the chemotherapy ends b. In 2 to 4 days, after the white blood cells have reached their nadir c. While the patient is still receiving chemotherapy d. Two hours after the chemotherapy ends
A
During a patient's therapy with interleukins, the nurse monitors the patient for capillary leak syndrome. Which assessment finding, if present, would indicate this problem? a. A sudden, 15 pound weight gain b. Bruising on the skin c. A dry cough d. Bradycardia
A
During a routine check-up, a 72-year-old patient is advised to receive an influenza vaccine injection. He questions this saying, "I had one last year. Why do I need another one?" What is the nurse's best response? A."Each year a new vaccine is developed based on the flu strains that are likely to be in circulation." B. "Taking the flu vaccine each year allows you to build your immunity to a higher level each time." C. "When you reach 65, you need boosters on an annual basis." D. "The effectiveness of the vaccine wears off after 6 months."
A
The nurse would anticipate administering which medication to a client demonstrating acute organ rejection? a. muromonab-CD3 (Orthoclone OKT3) b. azathioprine (Imuran) c. basiliximab (Simulect) d. sirolimus (Rapamune)
A
What are the functional cells of the humoral immune system that mature into immunoglobulins? a. B cells b. RBCs c. Granulocytes d. T cells
A
What is the general action of immunosuppressants? a. They inhibit T-lymphocytes b. They increase natural killer cellular activity c. They increase antibody response d. They reduce hepatic metabolism of steroids
A
What is the priority nursing assessment to monitor when administering vaccinations? a. anaphylaxis b. symptoms of infection c. pain at the injection site d. myalgias
A
Which client finding would the nurse hold the prescribed dose of filgrastim (Neupogen) for and notify the health care provider about? a. Absolute neurophil count (ANC) 12,000 celss/mm3 b. Blood pressure of 142/88 mm Hg c. Temperature of 99.5 F d. WBC cound of 4.5/mm3
A
A patient has started azathioprine (Imuran) therapy as part of renal transplant surgery. The nurse will monitor for which expected adverse effect of azathioprine therapy. Select all that apply. a. leukopenia b. fluid retention c. diarrhea d. thrombocytopenia e. Tremors f. hepatotoxicity
A, D, F
Before administration of an immunosuppressant drug, the nurse should perform which actions? Select all that apply. a. Assess level of consciousness b. Assess blood pressure and heart rate c. Check live enzyme tests d. Check BUN and creatinine levels e. Measure abdomnial girth
A,B,C,D
The nurse is reviewing the health history of a new patient who may need immunizations. Active immunizations are usually contraindicated in which patients? Select all that apply. a. Patients with a febrile illness b. Patients who are immunosuppressed c. Children younger than 1 year of age d. Elderly patients e. Those receiving cancer chemotherapy
A,B,E
When educating a patient about immunosuppressant therapy, what information would the nurse include in the teaching? Select all that apply. a. Never stop taking these medications without being instructed to do so by your health care provider. b. Over-the-counter medications are alright to take as needed. c. If you miss a dose of medication, take extra medicine to make up the missed dose. d. Take all medication exactly as prescribed. e. Medications must be taken at the correct time every time to avoid interactions.
A,D,E
During therapy with hematopoietic drugs, the nurse will monitor the patient for which adverse effects? Select all that apply. a.edema b. black, tarry stools c. hypotension d. nausea and vomiting e. diarrhea f. headache
A,D,E,F
The Nurse should teach the client about what expected AE of filgrastim (Neupogen)? a. bone pain b. hypotension c. constipation d. insomnia
A. Bone pain
A 30-year-old woman is in the clinic for her yearly gynecologic exam and asks the nurse about the "new vaccine that prevents HPV." She wants to receive the papillomavirus vaccine (Gardasil). Which response by the nurse is most appropriate? a. "We will need to make sure you are not pregnant first." b. "For women, the recommended age for this vaccine is 13 to 26 years of age." c. "I will check with your health care provider and then get the first dose of vaccine ready." d. There will be a total of three injections."
B
A sanitation worker has experienced a needle stick by a contaminated needle that was placed in a trash can. The employee health nurse expects that which drug will be used to provide passive immunity to hepatitis B infection? a. haemophilus influenzae type B (Hib) b. hepatitis B immunoglobulin c. hepatitis B virus vaccine d. varicella virus vaccine
B
Administration of which substance provides passive immunity? a. antitoxins b. immunoglobulins c. toxoids d. vaccines
B
An allergy to which substance is a contraindication to the administration of an immunizing drug? a. corn b. egg c .wheat d. soy
B
During interleukin drug therapy, a patient is showing signs of severe fluid retention, with increasing dyspnea and severe peripheral edema. The next dose of the interleukin is due now. Which action will the nurse take next? a. Give the drug and notify the prescriber b. Hold the drug and notify the prescriber c. Give the drug along with acetaminophen and diphendhydramine (Benadryl) d. Monitor the patient for 2 hours and then give the drug if the patient's condition improves
B
Which condition is not an anticipated adverse effect of azathioprine (Imuran)? a. thrombocytopenia b. alopecia c. leukopenia d. hepatotoxicity
B
What is the mechanism of action of biologic response-modifying drugs? Select all that apply. a. Interruption of the cell lifecycle at the genetic level to interfere with growth of the cancer cell b. Enhancement or restoration of the host's immune system defenses against a tumor c. Adverse modification of a tumor's biology, making it harder for the tumor cells to survive and reproduce d. Regulation of gene expression that occurs during transcription e. Direct toxic effect on tumor cells, causing them to rupture
B,C,E
A 12-month-old infant has received an MMR II (measles, mumps, and rubella virus vaccine), and her mother calls the clinic that afternoon to ask about helping her fussy infant to "feel better". What will the nurse suggest? a. Bring the infant in to the emergency department for an immediate examination. b. Observe the site for further swelling and redness. c. Apply warm compresses to the injection site. d. Apply an ice pack to the injection site.
C
A health care worker will be receiving hepatitis B immunoglobulin (BayHep B), 0.06 mg/kg IM now and repeated in 30 days as part of hepatitis B prophylaxis after a needle stick accident. The patient weighs 264 pounds. Identify how many milligrams the patient will receive for each dose. a. 72 mg b. 0.72 mg c. 7.2 mg d. 720 mg
C
A patient asks about his cancer treatment with monoclonal antibodies. The nurse tell him that which is the major advantage of treating certain cancers with monoclonal antibodies? a. They are more effective against metastatic tumors. b. There are fewer incidences of opportunistic infections with monoclonal antibodies. c. Monoclonal antibodies target certain tumor cells and bypass normal cells. d. They will help the patient improve more quickly than will other antineoplastic drugs.
C
A patient has an order for the monoclonal antibody adalimumab (Humira). The nurse notes that the patient does not have a history of cancer. What is another possible reason for administering this drug? a. Osteoporosis b. Severe anemia c. Rheumatoid arthritis d. Thrombocytopenia
C
A patient is in the urgent care center after experiencing a black widow spider bite. The nurse prepares to give which product to treat this injury? a. tetanus immune globulin b. live vaccine c. antivenins or antisera d. active immunizing drug
C
The nurse is reviewing principles of immunization. What type of immunization occurs when antibodies pass from mother to infant during breastfeeding or through the placenta during pregnancy? a. attenuating immunization b. artificial active immunization c. natural passive immunization d. artificial passive immunization
C
The nurse would teach a client prescribed cyclosporine (Sandimmune) to avoid which substance? a. sunscreen b. acetominophen c. grapefruit juice d. chocolate milk
C
When monitoring a patient who is on immunosuppressant therapy with azathioprine (Imuran), the nurse will monitor which laboratory values? a. RBC b. serum albumin levels c. WBC d. K+ level
C
When monitoring a patient's response to interferon therapy, the nurse notes that the major dose-limiting factor for interferon therapy is which condition? a. anxiety b. nausea and vomiting c. fatigue d. diarrhea
C
The nurse is reviewing the information about the herpes zoster vaccine (Zostavax) before administering the dose. Which statements about the vaccine are true? Select all that apply. a. The vaccine is given to children to prevent chickenpox b. It is used to prevent postherpetic neuralgia c. The vaccine is used to prevent reactivation of the zoster virus that causes shingles d. It is contraindicated in patients who have already had shingles e. The vaccine is recommended for patients 50 years of age and older f. It is a one-time vaccine
C,E,F
A 28-year-old patient is in the urgent care center after stepping on a rusty nail. The nurse evaluates the patient's immunity status and notes that the patient thinks she had her last tetanus booster about 10 years ago, just before starting college. Which immunization would be most appropriate at this time? a. Immunoglobulin intravenous b. DTaP (Daptacel) -- diphtheria, tetanus, and acellular pertussis c. No immunizatons are necessary at this time d. Tdap (Adacel) -- diptheria, tetanus, and acellular pertussis
D
A patient is prescribed monoclonal antibody therapy for the treatment of rheumatoid arthritis. What patient condition should alert the nurse to question the prescription for this class of drugs? a. Chronic obstructive pulmonary disease b. Hypertensive emergency c. Nephrotic syndrome d. Acquired immune deficiency syndrome (AIDS)
D
An animal control officer was bitten by a stray dog that showed signs of rabies. Which statement by the nurse is correct regarding the treatment for rabies prophylaxis? a. "You will need to receive 3 SQ injections over the next week." b. "You will receive treatment if you begin to show symptoms of rabies." c. "You will receive on oral dose of medicaiton today and one more in one week." D. "You will need to receive 5 IM injections over the next 28 days."
D
Cyclosporine is prescribed for a patient who had an organ transplant. The nurse will monitor the patient for which common adverse effect? a. fever and tremors b. agitation c. nausea and vomiting d. HTN
D
The nurse is preparing to administer an injection of monoclonal antibodies. Which additional drug will the nurse administer to minimize adverse reactions to the monoclonal antibodies? a.benzodiazepine b. opioid c. NSAID d. corticosteroid
D
Which statement MOST accurately describes the pharmcodynamics of vaccines? a. Vaccines work by suppressing the amino acid immunoglobulin sequence. b. Vaccines prevent the formation of antibodies against a specific antigen. c. Vaccines provide IgG antibodies to protect against infection. d. Vaccines work by stimulating the humoral immune system.
D
Which vaccination is marketed and recommended in the prevention of a virus that is known to cause cervical cancer? a. hepatitis B vaccine (Recombivax HB) b. pneumococcal vaccine (Prevnar 13) c. herpes zoster vaccine (Zostavax) d. papillomavirus vaccine (Gardasi
D
A patient will be on a tacrolimus (Prograf) infusion after receiving a liver transplant. The order reads, "Give 0.03 mg/kg/day as a continuous IV infusion." The patient weighs 159 pounds, and the medication injection solution is available in a 5-mg/ml strength. Identify how many milliliters will the nurse draw up for this infusion. a. 0.043 ml b. 43 ml c. 0.43 ml d. 4.3 ml
c