NCLEX-RN Pharmacology Immune
System Exam
20 Original ATI & NGN Style Practice
Questions with Detailed Rationales
Nursing Study Guide
Question 1
Clinical Scenario
A 24-year-old woman with relapsing-remitting multiple sclerosis
(MS) is prescribed interferon beta-1a. During a follow-up visit,
she reports mild fatigue and muscle aches after injections.
Laboratory results show AST 32 U/L and ALT 35 U/L.
Question Stem
Which instruction should the nurse provide to minimize the
client's adverse effects?
A. Administer the medication in the morning on an empty
stomach.
B. Take acetaminophen before and after injections as
,prescribed.
C. Discontinue the medication if fatigue occurs.
D. Restrict fluid intake on injection days.
Correct Answer
Correct Answer: B. Take acetaminophen before and after
injections as prescribed.
Detailed Rationale
Interferon beta commonly causes flu-like symptoms including
fever, chills, fatigue, and myalgia. Administering acetaminophen
before and after injections can reduce discomfort and improve
adherence. The patient's liver enzymes are within acceptable
limits, making continued therapy appropriate.
Option A is incorrect because administration timing does not
significantly reduce flu-like symptoms. Option C is incorrect
because mild fatigue is expected and does not warrant
discontinuation without provider evaluation. Option D is
incorrect because hydration is encouraged to support overall
well-being.
Nurses should monitor liver function tests periodically because
interferons can cause hepatotoxicity. Clients should be
instructed to rotate injection sites and report depression,
suicidal thoughts, or severe fatigue.
Learning Objective
, After completing this question, the learner should be able to:
• Identify common adverse effects of interferon therapy.
• Implement nursing interventions to improve medication
adherence.
• Recognize appropriate patient education regarding MS
treatment.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 56-year-old man with rheumatoid arthritis is receiving
methotrexate therapy. His laboratory results reveal WBC
2,800/mm³, platelet count 95,000/mm³, and hemoglobin 10.8
g/dL.
Question Stem
Which action should the nurse take first?
A. Administer the scheduled methotrexate dose.
B. Encourage increased dietary protein intake.
C. Notify the provider of the laboratory results.
D. Administer folic acid and continue therapy.
System Exam
20 Original ATI & NGN Style Practice
Questions with Detailed Rationales
Nursing Study Guide
Question 1
Clinical Scenario
A 24-year-old woman with relapsing-remitting multiple sclerosis
(MS) is prescribed interferon beta-1a. During a follow-up visit,
she reports mild fatigue and muscle aches after injections.
Laboratory results show AST 32 U/L and ALT 35 U/L.
Question Stem
Which instruction should the nurse provide to minimize the
client's adverse effects?
A. Administer the medication in the morning on an empty
stomach.
B. Take acetaminophen before and after injections as
,prescribed.
C. Discontinue the medication if fatigue occurs.
D. Restrict fluid intake on injection days.
Correct Answer
Correct Answer: B. Take acetaminophen before and after
injections as prescribed.
Detailed Rationale
Interferon beta commonly causes flu-like symptoms including
fever, chills, fatigue, and myalgia. Administering acetaminophen
before and after injections can reduce discomfort and improve
adherence. The patient's liver enzymes are within acceptable
limits, making continued therapy appropriate.
Option A is incorrect because administration timing does not
significantly reduce flu-like symptoms. Option C is incorrect
because mild fatigue is expected and does not warrant
discontinuation without provider evaluation. Option D is
incorrect because hydration is encouraged to support overall
well-being.
Nurses should monitor liver function tests periodically because
interferons can cause hepatotoxicity. Clients should be
instructed to rotate injection sites and report depression,
suicidal thoughts, or severe fatigue.
Learning Objective
, After completing this question, the learner should be able to:
• Identify common adverse effects of interferon therapy.
• Implement nursing interventions to improve medication
adherence.
• Recognize appropriate patient education regarding MS
treatment.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 56-year-old man with rheumatoid arthritis is receiving
methotrexate therapy. His laboratory results reveal WBC
2,800/mm³, platelet count 95,000/mm³, and hemoglobin 10.8
g/dL.
Question Stem
Which action should the nurse take first?
A. Administer the scheduled methotrexate dose.
B. Encourage increased dietary protein intake.
C. Notify the provider of the laboratory results.
D. Administer folic acid and continue therapy.
