Which potential problem is of the most concern for a patient receiving immunosuppressant
drugs?
A. increased susceptibility to infections
B. orthostatic hypotension
C. neurotoxicity
D. confusion - Answers A. increased susceptibility to infections
*neurotoxicity and confusion may be a problem with some immunosuppressants but a
heightened susceptibility to opportunistic infections is a major risk factor for
immunosuppressed patients
A patient with active HIV has been taking zidovudine (Retrovir). Which potential adverse effect
may limit the length of time this medication can be taken?
A. bone marrow suppression
B. lactic acidosis
C. hepatomegaly
D. fatigue - Answers A. bone marrow suppression
*The major dose-limiting adverse effects of zidovudine is bone marrow suppression, and this is
often the reason a patient with an HIV infection must be switched to another anti-HIV
medication
The nurse working in an HIV testing and treatment clinic plans teaching about antiretroviral
therapy for which of the following clients?
A. a client who was infected with HIV 10 years ago and has a CD4+ T-cell count of 650/uL
B. a client with persistent generalized lymphadenopathy who was exposed to HIV 2 years
previously
C. a male health care worker who is HIV negative but has unprotected sex with a man
D. a client who tested positive for HIV 3 years ago and has developed tuberculosis - Answers D.
a client who tested positive for HIV 3 years ago and has developed tuberculosis
*antiretroviral therapy initiation is recommended for the following clients infected with HIV:
history of AIDS-defining illness (such as tuberculosis), CD4+ T-cell count <200 cells/uL or
between 200-350 cells/uL, pregnant women, persons with HIV-associated neuropathy, and
, persons come-infected with Hepatitis B
Before administering methotrexate to a patient, what is the most important for the nurse to
assess?
A. latent tuberculosis
B. allergy to eggs
C. congestive heart failure
D. hypothyroidism - Answers A. latent tuberculosis
* before administering a DMARD, it is important for the nurse to assess the patient for
contraindications to the use of DMARDs such as bacterial infection, active herpes, active or
latent tuberculosis, and acute or chronic hepatitis B or C.
A female patient has started azathioprine (Imuran) therapy in preparation for her kidney
transplant surgery. Which expected adverse effects of azathioprine should the nurse tell the
patient about?
A. leukopenia
B. fluid retention
C. diarrhea
D. tremors - Answers A. leukopenia
Which statement is true in regard to cyclosporine?
A. the use of styrofoam containers should be avoided
B. it should be mixed with water only
C. it can be given only intravenously
D. any left over solution should be refrigerated - Answers A. the use of styrofoam containers
should be avoided
*Styrofoam containers should be avoided because the drug has been found to adhere to the
inside of the container. Oral solutions may be mixed with chocolate milk, regular milk, or orange
juice and served at room temperature. After the solution is mixed, the patient must drink it
immediately. Oral solutions of cyclosporine should not be refrigerated. Cyclosporin can be given
orally and intravenously.
When providing patient education to biological response-modifying drugs, which is important
information to give to the patient?